Daily news articles of interest to health care consumers.

November 2013 Archives

Coping Tips for Winter Skin

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SATURDAY, Nov. 30, 2013 (HealthDay News) -- The cold, dry air of winter can deplete your skin of moisture and cause "winter itch."

But you can take steps to protect your skin and prevent that itchy feeling, according to Dr. Robyn Gmyrek, a dermatologist and director of the Skin and Laser Center at NewYork-Presbyterian/Columbia University Medical Center.

Moisturize daily with petrolatum- or cream-based moisturizers, Gmyrek said. Apply them directly to your wet skin after a bath or shower so that the moisturizer can help trap surface moisture. For sensitive skin, choose a moisturizer without fragrance or lanolin.

Clean your skin, but don't overdo. Too much cleansing depletes the skin's natural moisturizers, Gmyrek explained. Washing your face, hands, feet and between the folds of your skin once a day is enough. You can rinse your trunk, arms and legs daily, but you don't have to use soap or cleanser on these areas every day.

Limit your use of hot water and soap. If you do have winter itch, take short, lukewarm showers or baths with a cleanser that is non-irritating and non-detergent-based. Apply a thick cream or a petroleum-jelly-type moisturizer right away, and then gently pat skin dry, Gmyrek said.

Room humidifiers can help prevent indoor air from becoming too dry, she added. When you're outside, protect your skin from wind, extreme cold and sun. Don't use tanning beds or artificial sunlamps, which can damage your skin and increase your risk of skin cancer.

See a dermatologist if you have persistent dry skin, scaling, itching or skin growths that concern you. This applies throughout the year, not just during winter, Gmyrek said.

More information

The American Osteopathic College of Dermatology has more about dry skin.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

Tips for Being a Partner in Your Own Care

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FRIDAY, NOV. 29 (HealthDay News) -- Becoming a partner in your health care will help you get the most out of your primary care doctor visits, an expert says.

That's because "primary care is turning its efforts toward wellness and prevention initiatives to keep patients healthy as well as treating them once they get sick," Dr. Anthony Ardolino, executive dean of the Quinnipiac University School of Medicine in Hamden, Conn., said in a university news release.

"For this new approach to succeed, patients and physicians need to view their relationship as a partnership, and patients need to take a greater share of the responsibility for their health," he explained.

Communication and preparation are the key components of a productive doctor-patient relationship, Ardolino said.

Take time to prepare for your visit to the doctor, he advised. This includes having an up-to-date list of not only prescription medications, but also over-the-counter and herbal remedies. These products can interfere with prescription drugs and your doctor may decide to adjust a dose or give you a different prescription.

Prepare a list of questions. For example, you may want to inquire about screening for diabetes, high blood pressure, or colon, prostate, cervical or breast cancer. Ask your doctor if you should have flu, pneumococcal or hepatitis vaccinations, Ardolino suggested.

Provide your doctor with a family medical history, which is a major predictor of health. This includes a list of any conditions that run in your family, such as diabetes, high blood pressure, heart disease, depression, stroke and cancer.

It's also important to tell your doctor about any changes that you've experienced since your last visit. For example, unexplained weight loss or gain, increased difficultly climbing stairs or new sleeping problems. You also need to inform your doctor about any life-changing events -- such as job loss or divorce -- that may affect your health.

Time can be an issue for both you and your doctor. So it's a good idea to think about your top two or three main concerns or complaints before your visit. Doing so can lead to a more efficient and productive visit for both of you, Ardolino said.

Be honest and open about things that put your health at risk, such as diet, alcohol use, exercise and smoking. Many patients feel too guilty or embarrassed to admit they fall short in these areas, but doctors can help patients develop strategies to improve lifestyle habits.

More information

The U.S. National Library of Medicine offers advice about talking with your doctor.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 29, 2013 (HealthDay News) -- Heavy drinking by one partner in a marriage increases the risk of divorce, but that's not the case if both spouses are heavy drinkers, a new study finds.

Researchers followed nearly 650 couples for the first nine years of their marriage and found that the divorce rate was nearly 50 percent for couples where only one partner drank heavily. Heavy drinking was defined as having six or more drinks at one time or drinking to intoxication.

The divorce rate for couples where neither were heavy drinkers and for couples where both were heavy drinkers was 30 percent, according to the study, published in the December issue of Psychology of Addictive Behaviors.

"Our results indicate that it is the difference between the couple's drinking habits, rather than the drinking itself, that leads to marital dissatisfaction, separation and divorce," lead author Kenneth Leonard, director of the University at Buffalo Research Institute on Addictions, said in a university news release.

"This research provides solid evidence to bolster the commonplace notion that heavy drinking by one partner can lead to divorce. Although some people might think that's a likely outcome, there was surprisingly little data to back up that claim until now," he added.

The researchers were surprised that the divorce rate for two heavy drinkers was no higher than for two nondrinkers.

"Heavy drinking spouses may be more tolerant of negative experiences related to alcohol due to their own drinking habits," Leonard said.

But this does not mean that heavy drinking by both partners does not damage other areas of family life. "While two heavy drinkers may not divorce, they may create a particularly bad climate for their children," he noted.

Leonard concluded: "Ultimately, we hope our findings will be helpful to marriage therapists and mental health practitioners who can explore whether a difference in drinking habits is causing conflicts between couples seeking help."

More information

The U.S. National Institute on Alcohol Abuse and Alcoholism outlines the health effects of alcohol.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 29, 2013 (HealthDay News) -- American pedestrians and bicyclists are being killed by distracted drivers in increasing numbers, a new study finds.

Pedestrian deaths caused by distracted driving -- perhaps talking on cell phones, using a GPS or eating at the wheel -- jumped nearly 50 percent in a recent five-year period, reaching 500 in 2010.

The number of bicyclists killed by distracted drivers increased 30 percent, from 56 in 2005 to 73 in 2010, according to the study, which was published in the November-December issue of the journal Public Health Reports.

"We're constantly exposed to distracted drivers," study author Fernando Wilson, an associate professor at the University of Nebraska Medical Center, said in a university news release.

"I don't think there's a day that I don't see someone driving and using their cell phone. A lot of times they're texting," he said. "It's something that's pervasive in society. That's one of the reasons it's so difficult to deal with."

White males ages 25 to 64 accounted for two-thirds of the pedestrian victims and 83 percent of the cyclist victims, according to the study. About half of the pedestrian and cyclist deaths occurred during daytime hours. Many were killed in cities and outside of marked crosswalks.

This disturbing trend runs counter to the overall decline in motor-vehicle deaths in the nation.

"People have to be aware that this problem is not going away anytime soon," Wilson said. "When you're crossing the street or cycling, you need to be cognizant about this new threat to roadway safety."

A social stigma exists against drivers who don't use seat belts or car seats for their young children, Wilson said. "If you don't do these things, which now are the social norm, it's viewed negatively. The laws are stricter," he said. "With cell phones, we don't have that social stigma. Not to mention that distracted driving is more difficult to enforce than other driving-safety laws."

He said it's likely that cases of distracted driving are underreported because it's difficult for police to prove. This makes it difficult to implement effective policies to reduce the problem.

Data from the U.S. Fatality Analysis Reporting System was used for the study. Distracted driving was identified based on traffic-safety guidelines. This means police determined that a driver had been using a phone or other technological device, onboard navigation system, computer or two-way radio, or had been engaged in inattentive or careless activities.

More information

The U.S. National Highway Traffic Safety Administration has more about distracted driving.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 29 (HealthDay News) -- A new study suggests that thousands of men seek care in U.S. emergency rooms each year for the painful condition known as priapism -- an erection that lasts too long and threatens to permanently harm the penis.

The researchers estimated that it costs $124 million a year on average to treat priapism at hospitals.

"We're not talking about a massive problem, but it's more common than we thought," said study author Dr. Daniel Stein, chief resident with the urology department at the Northwestern University Feinberg School of Medicine.

It's not clear how many of an estimated 10,000 cases annually are due to a side effect of Viagra and similar impotence drugs, but urologists say they've seen very few men suffering from the infamous four-hour-plus erections that TV ads warn about. Sickle cell disease actually may be responsible for a much higher number of cases.

Stein said the researchers launched their study because there's little information about the number of cases of priapism, which has gotten more attention in recent years because of the warnings related to impotence drugs.

Priapism refers to an abnormal erection in which the blood that engorges the penis fails to drain out, Stein said. Blood stagnates in the penis, and tissue begins to die because it's not getting fresh oxygen.

"The mood is gone, but the reaction is still there," he said. "It's remarkably painful. All men coming in with priapism are unhappy about it."

In the new study, researchers examined a database of U.S. emergency room visits from 2006 to 2009. Based on their statistics, they estimated that ER doctors treat an average of 10,000 cases of priapism each year; it's not clear how many are men who needed to be treated more than once.

The average hospital cost to treat a patient was about $1,800 for patients treated in the ER and nearly $42,000 for those who had to be hospitalized.

Twenty-one percent of the patients also had sickle cell disease, in which red blood cells become deformed. The condition can cause the blood in the penis to thicken and not be able to drain, said Dr. Stephen Freedland, a urologist and associate professor of surgery and pathology at the Duke University School of Medicine.

Although his clinic may see a case of priapism an average of once per week, Freedland said he can't easily recall treating a case caused by an erectile dysfunction drug like Viagra.

Study author Stein said the drugs can sometimes cause erections that last too long by boosting the blood flow into the penis.

Another possible cause is an injection that some impotent men give themselves to have an erection, Freedland said.

Stein also said there's no apparent cause at all in some cases.

The good news: Priapism can be treated. The bad news: The treatments are anything but comfortable. A blood sample is taken from the penis to confirm that a patient is suffering from priapism, Stein said. The next step is typically to put a needle into the penis and try to flush out the stagnant blood.

If that doesn't work, physicians may try flushing out the blood again and perhaps move onto a procedure that cuts into the penis to release the blood, he said.

Freedland said another treatment is to give the patient oxygen and fresh blood cells to get things moving.

The study appeared in the October issue of The Journal of Sexual Medicine.

More information

The American Urological Association has more details on priapism.

Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- An antibiotic isn't appropriate for treating all infections, unless the illness is caused by bacteria.

If the illness is caused by a virus, on the other hand, an antibiotic won't do any good. In fact, using an antibiotic for anything other than a bacterial illness may do more harm than good.

The U.S. Centers for Disease Control and Prevention suggests how to ease discomfort when an antibiotic isn't what the doctor ordered:

  • Talk to your pharmacist or doctor about any over-the-counter medication that may ease symptoms.
  • Drink more fluids than usual.
  • Allow your body plenty of time to rest and recover.
  • Ease congestion by using a saline nasal spray or running a cool-mist humidifier.
  • If you have a sore throat, suck on ice chips, use a sore throat spray or suck on lozenges (adults only).

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

Health Tip: Practice Safe Snowboarding

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(HealthDay News) -- Snowboarding, like any snow sport, can be dangerous if you fail to take a few precautions.

The American Academy of Family Physicians suggests these safety tips for snowboarders:

  • Before you begin, make sure you're in good physical shape and that you take snowboarding lessons.
  • Make sure you use well-fitting equipment, including boots, snowboard and ski poles.
  • Wear protective gear, including wrist guards, a helmet, and arm and shin guards.
  • If you feel yourself starting to fall, keep fists closed, and try to roll into the fall.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, Nov. 28 (HealthDay News) -- If you are in the midst of planning the perfect wedding to the partner of your dreams and you suddenly get a bad feeling in your gut, new research on newlyweds suggests you would be wise to heed that instinct.

"The conscious attitude doesn't really predict what happens to the relationship over time," said study author Jim McNulty, a professor of psychology at Florida State University.

Rather, it was what McNulty called "semi-conscious" attitudes -- those gut feelings that many chose to ignore -- that determined how happy couples were years after they had exchanged their vows.

The finding is published in the Nov. 29 issue of the journal Science.

McNulty and his team followed 135 newlywed couples for four years. Every six months, the researchers measured the couples' conscious attitudes toward their relationship, asking them to evaluate their marriage by using adjectives such as "good," "satisfying," "bad" or "dissatisfied."

They also measured what psychologists call "automatic attitude." To do this, McNulty said, the men and women sat in front of a computer. On the screen flashed either a positive or a negative word, such as "awesome" or "awful." They hit one key to denote it was a positive word and another key for negative.

"Right before they saw the word, we would flash a picture of their partner for a third of a second," McNulty said. "When people see a picture of their partner, it activates that automatic attitude." Someone who's positive toward their partner, he said, will be quicker to hit the positive key and slower to hit the negative key.

The technique has been validated in previous research on prejudice and stereotyping, he noted.

"These automatic, gut-level, immediate reactions might be unrelated to what they consciously think when they evaluated their partners," McNulty said.

In following the couples, however, the semi-conscious attitudes predicted long-term happiness.

Overall, those who took longer to respond to positive words after seeing their partner's photo were less happy after four years than those who responded more quickly to positive words.

Why might that be? If the relationship has problems, the person is probably going to be less positive in their gut reactions, McNulty said. If their gut is warning them about problems, he said, it is important to address them before they affect the conscious attitude toward the relationship.

It's not as simple as having couples take a test before making a big commitment, McNulty said. He said the gut feelings tend to be telling on a group level, but not true in every case. "Some had a lukewarm automatic attitude, but remained happy," he said.

Currently, there's not a good diagnostic test that people can take to figure out their gut feelings toward their partner, he said.

"[However], people should try to trust their gut," McNulty said. "I'm not saying that if people have ambivalence, [they shouldn't] get married. At that point, it makes sense to talk to a therapist." The negative gut feelings may be pointing to problems that can be worked out, he said.

Danielle Adinolfi, a marriage and family therapist in Philadelphia, said this research backed up what therapists already knew. "Your gut feeling is a survival instinct -- it's something we are born with," she said. "If you are getting a gut feeling, that is to be trusted."

In her clinical experience, Adinolfi said, she has often had couples who split up tell her they somehow knew it wouldn't work out.

Gut feelings about a relationship need to be talked about immediately to try to solve the issues, she said. "Most people do realize they have them," she said. "But many people ignore them or make excuses for them."

A therapist who specializes in couples counseling could assess these gut feelings or unconscious attitudes about a relationship, she said.

More information

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

Copyright © 2013 HealthDay. All rights reserved.

Giving Thanks Could Be Good for You

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THURSDAY, Nov. 28, 2013 (HealthDay News) -- Thanksgiving may be an official day of gratitude, but research suggests that if you make time for "thank you" every day, you might enjoy life more.

Many people may think of gratitude as a "passive" gesture -- you wait for something good, then feel grateful, said David DeSteno, a professor of psychology at Northeastern University, in Boston. DeSteno studies the effects that thankfulness can have on people's behavior.

But a growing body of research is suggesting the opposite is true, according to DeSteno: By choosing to feel gratitude, people can make positive changes in their lives.

"Gratitude isn't passive reflection. It's active," DeSteno said. "And it's not about the past. It's there to help direct our behavior in the future."

In experiments where he and his colleagues set people up to feel grateful, they found that thankfulness appeared to spur participants to act in more cooperative, less selfish ways.

In one study, for example, people came to the lab to complete a computer task. At some point, certain participants' computers were rigged to "crash." Luckily, a kind stranger who had just completed the same task (and was actually part of the research team) offered help and got the computer running again.

Afterward, all of the study participants played a standard economic game where people have the opportunity to either act strictly in their own self-interest or in a more cooperative way.

In general, DeSteno's team found, the study participants who had gotten help from a stranger during that first test were more likely to be cooperative during the next test. (A survey all of the participants took confirmed that those who'd received help were, in fact, feeling more grateful than their counterparts who'd had smooth sailing.)

That's one of a number of studies, DeSteno said, that suggest that gratitude helps guide behavior. It can encourage you to get more exercise or feel less anxious, or to be more helpful to others (and not just that person you feel you "owe").

Some research has also found links between gratitude and better health, such as lower blood pressure and just feeling physically better. However, it's not clear whether gratitude directly affects physical well-being.

That's why researchers are also starting to look at whether gratitude changes measurable signs of health.

At the University of California, Los Angeles, Naomi Eisenberger and her colleagues have launched a study to see whether "practicing" gratitude affects people's blood levels of inflammation-related proteins. Chronic low-level inflammation is linked to a host of health conditions, from diabetes to heart disease. The researchers are also using brain scans to see what areas of the brain are active when people feel thankful.

"There's not much research on gratitude that has looked at biological markers [signs]," said Eisenberger, an associate professor of psychology. Typically, she added, studies have looked at people's subjective well-being -- which is important, but may also be swayed by any number of factors.

Eisenberger's team hopes to zero in a bit more on the effects of gratitude. For six weeks, some study participants will spend time writing about things for which they are grateful. The rest will write about positive subjects, but won't focus on gratitude.

The theory, according to Eisenberger, is that expressing gratitude will have a special effect on those inflammatory markers. One reason is that gratitude, based on studies like DeSteno's, seems to enhance people's ability to care for others.

And in animals, Eisenberger noted, caregiving is linked to lesser reactivity in the face of a threat -- maybe so mothers will feel less scared for themselves when a predator comes, and protect their babies instead.

Whatever the biological effects, plenty of research suggests that gratitude can change how you feel -- even about those people who've been in your life for years, according to Sara Algoe, an assistant professor of psychology at the University of North Carolina at Chapel Hill.

Her research has focused on the effects of gratitude in romantic relationships. In one study of 77 couples who'd been together for an average of four years, Algoe's team had each partner think of something the other had done for them recently -- no matter how small -- and then thank him or her.

Before that task, the couples completed a survey on their satisfaction with their relationship. Then they did it again six months later.

In general, the study saw a shift in people who felt their partner really meant that "thank you" -- thinking, for example, that "my partner saw the 'real' me." Those men and women typically felt more satisfied with their relationship six months later.

The findings, according to Algoe, highlight the importance of saying "thank you" even for those mundane things, from those people you see every day.

"Expressing gratitude well is a potent part of relationship satisfaction," Algoe said. "Sometimes we feel grateful, but we don't say it. This research suggests it's important to say it."

For people who are not prone to seeing the good in daily life, gratitude may take a little work, the experts say. But, Northeastern's DeSteno pointed out, that's also good news -- you don't have to be warm and fuzzy by nature.

"We encourage people just to take the time to pause and consider what you're grateful for," DeSteno said. You could write one thing down each day, he noted, or just hold it in your mind.

And if someone offers you help, try accepting it instead of shunning it. "See it as a gift," DeSteno said.

You can also try giving other people a break, and being thankful for the less-than-dramatic efforts they put forth, UNC's Algoe said. "Maybe lower your threshold for appreciating the things other people do," she suggested. "Just a little."

More information

The University of California, Berkeley has more on gratitude and other positive emotions.

Copyright © 2013 HealthDay. All rights reserved.

Safety Tips for Holiday Football Games

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THURSDAY, Nov. 28, 2013 (HealthDay News) -- Pick-up football games are a Thanksgiving tradition for many people, but they can lead to injuries if you're not careful, an expert says.

"Playing in a Turkey Bowl is a great way to get some exercise and burn off those pumpkin pie calories," Dr. Pietro Tonino, program director of sports medicine at the Loyola University School of Medicine, said in a university news release. "But make sure you play smart to stay safe."

Tonino, who also is a professor in Loyola's orthopedic surgery and rehabilitation department, offered the following tips to reduce the risk of injury:

  • Don't tackle. Play touch or flag football instead.
  • Warm up by jogging, running in place or doing jumping jacks for a few minutes before the game. Then slowly and gently stretch, holding each stretch for 30 seconds.
  • Don't wear cleats. There's a risk that they'll cause your foot to be stuck in one position while the rest of your body is moving in a different direction, resulting in an injury. Wear gym shoes instead.
  • Wear a mouth guard. They cost just a few dollars and can save hundreds of dollars in dental bills.
  • Wear loose-fitting clothes, such as sweats. This will make it easier for your body to move and reduce your injury risk.
  • Remember your age. If you're 40, don't try to play like you're still 20.
  • Don't drink alcohol before or during your Turkey Bowl.
  • If you get hurt, stay on the sidelines until symptoms go away completely. Before returning to the game, make sure you have no pain or swelling and have normal strength and a full range of motion.
  • When the game is over, remember to stretch. This will help reduce muscle soreness the next day.

More information

The U.S. Centers for Disease Control and Prevention has more holiday health and safety tips.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, Nov. 28, 2013 (HealthDay News) -- Flu shot, check. Hand soap, check. Window washer fluid, check.

Staying healthy and safe this holiday season requires adhering to a simple checklist, one expert says.

One way to avoid colds and flu is to wash your hands, said Dr. Sampson Davis, an emergency medicine doctor at St. Michael's Medical Center in Newark, N.J.

"Hand washing goes a tremendous way in preventing the spread of bacteria and viruses that live and thrive in the cold weather," Davis said in a news release. "I have escaped many sick days with a hand wash. It is the number one most important act to prevent contagious illnesses."

For those times when a sink isn't available, carry a small bottle of hand sanitizer, he suggests. "Also, if sick, make sure to sneeze and cough into your arm right by your elbow. This too will help prevent the spread of germs," he said. "And lastly, make sure to visit your physician, employment health center or local pharmacy for your yearly flu shot."

Eating is a big part of the holidays, but you need to keep it under control. Overindulging can lead to weight gain and other health problems. You also need to be careful about your alcohol consumption. One trick is to have a glass of water between drinks, Davis said.

It's important to maintain your exercise routine over the holidays. Gaining a few ounces a day can add up to too many extra pounds by the end of the winter.

If you're planning a car trip, monitor the weather and avoid snow storms. Make sure you gas tank is full, check your tires, and top off all your engine fluids, including the window washer fluid. Be sure to have a fully charged cell phone in case you have an unexpected car problem and need to call for assistance, Davis advised.

You also need to manage your stress.

"The holiday season, job deadlines and daily duties can overload the hard drive," Davis added. "Shop early, plan ahead and manage your calendar as well as your friends and family expectations. You may not be able to attend every holiday party and that is okay."

During the winter, some people suffer a mood problem called seasonal affective disorder (SAD). If you believe you have the condition, see your doctor. There are effective treatments available, Davis added.

More information

The U.S. Centers for Disease Control and Prevention has more holiday health and safety tips.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

Health Tip: Keep Diabetes in Check

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(HealthDay News) -- It can be difficult to eat healthy during the holidays, especially for diabetics.

The U.S. Centers for Disease Control and Prevention offers these suggestions for people with diabetes:

  • Eat a healthy snack before you attend a holiday gathering, or pack a healthy snack to eat there. You can also ask ahead of time which foods will be served, so you can better plan.
  • If there's a buffet, take small portions, then head to another room so you're not tempted to reload your plate.
  • Choose low-calorie or calorie-free drinks, from unsweetened tea to sparkling water. If you drink alcohol, drink a small amount with food.
  • Avoid foods such as glazed ham, turkey with gravy and side dishes laden with butter, cream or mayonnaise. Instead, opt for lighter dishes with a vegetable base and fewer fatty, sugary and salty ingredients.
  • For dessert, choose a food with a fruit base instead of desserts high in sugar, fat and cholesterol.
  • Focus on friends and family, not food.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

Health Tip: Avoid Holiday Weight Gain

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(HealthDay News) -- The edible temptations may be endless during the holiday season. Experts say you should focus on maintaining your current weight, forgetting the notion that the holidays are a good time to lose a few pounds.

The Cleveland Clinic offers these tips to help avoid holiday weight gain:

  • Get regular exercise every day. In fact, add some exercise to your daily routine to burn off any extra calories.
  • Eat at least seven servings of fruits and vegetables each day to help fill you up without overloading on calories.
  • Avoid temptations when possible; try to indulge in just one holiday treat per day.
  • Eat something healthy before you head to a party.
  • Make smart choices at the holiday buffet, and limit portion sizes.
  • Don't be afraid to turn down a treat. Make the holidays more about socializing than eating.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 27, 2013 (HealthDay News) -- An implanted heart pump for people with weakened hearts, called the HeartMate II, appears to be plagued by dangerous clotting problems, a new study finds.

These issues often require arduous device replacements or even heart transplants.

Almost 50 percent of patients who got a clot and did not undergo device replacement or a heart transplant died, the new report noted. And some patients needed the device replaced more than once.

Exactly why this problem is occurring isn't clear, but it is most likely a fault tied to mechanical changes made to the device itself, lead researcher Dr. Randall Starling, a professor of medicine and vice chairman of cardiovascular medicine at the Cleveland Clinic's Heart & Vascular Institute said.

"This is a question we are going to answer," he said. "We think that we saw a pattern when the change occurred. We think it's something about the device that has changed."

According to Starling's team, the problem started cropping up in March of 2011 and continues to occur. In their study, his team tracked patients at three hospitals that implant patients with the devices, and found that 66 of 837 patients developed the clotting problem.

According to Starling, California-based Thoratec Corporation, the maker of the device, started seeing the problem when they changed the bearings in the pump. However, Thoratec has not been able to pinpoint this as the cause, Starling said.

Another possible explanation is the speed at which the pump is run. If it is set too low, clots may develop from the heat of the pump as the blood flows slowly through it, Starling theorized.

Initially, patient behavior was thought to be playing a role, Starling said. That's because people who have the HeartMate II implanted must stick to a regimen of anti-clotting drugs such as warfarin or aspirin. However, Starling said that careful examination of Cleveland Clinic patients ruled out medication non-adherence as a contributing factor.

Starling has notified the U.S. Food and Drug Administration, which has been considering the problem. "They are aware that we plan to study this further," he said.

As for patients, they and their doctors should be aware of the clotting issues associated with the device, Starling said.

"Two years ago, when a patient had a HeartMate II and had persistent heart failure, clotting in the pump wasn't on my list as something that was going on," Starling explained. "Now when I see a patient with a device that doesn't appear to be doing the job it was intended to do, I have a heightened awareness that there could be pump[-related] clotting."

The report was published online Nov. 27 in the New England Journal of Medicine.

Patients who receive a HeartMate II are those whose hearts are too weak to pump blood effectively, but who are not candidates for a heart transplant because of age or other medical conditions, such as diabetes, kidney disease or cancer.

In addition, the device has been approved as a bridge to a transplant. So some patients waiting for a heart transplant get the device to keep them alive while they wait.

The HeartMate II is a ventricular assist device (VAD) that helps patients whose hearts are too weak to pump blood. The device does not replace the pumping action of the heart, but rather assists it.

The device is implanted in a patient's ventricle -- the lower chamber of the heart. A part of the device that includes the battery, the power supply and a controller to monitor the device remains outside the body.

The VAD runs on battery power or can be plugged into a wall socket.

According to Dr. Charles Klodell, an associate professor of surgery and director of the LVAD program at the University of Florida in Gainesville, the pump itself costs about $120,000 and there are hospital and other services that add another $100,000 to the cost.

The procedure is covered by most insurance, including Medicare, he said.

Klodell wasn't overly alarmed by the new findings. "These centers have had a little blip in their data," he said.

According to Klodell, a national registry for these implants, called INTERMACS, hasn't seen an increase in clotting with the device. In fact, they have seen a substantial decrease, he said.

"We have not experienced this in my center or in others whose data I am familiar with," Klodell said. "I think it is something we all need to pay attention to, and we need to keep an eye on the data, but this doesn't change my thought process on VADs or the HeartMate II," he said.

In addition, Klodell noted that without the device these patients' prognosis would be extremely "grim."

For the study, Starling's team collected data on 837 patients who received the device from 2004 through mid-2013.

They found 72 clots occurred in 66 patients. Beginning in March 2011, the number of patients experiencing clots three months after the device was implanted jumped from 2.2 percent to 8.4 percent by January of 2013.

Before March 2011, the average time clots appeared after implanting the device was 18.6 months. After that, clotting started appearing at 2.7 months after implantation, they noted.

Among patients who developed clots, 11 needed heart transplants, with one of these dying in the month after the transplant. Another 21 patients received new pumps.

Of those who did not receive a new pump or new heart, 48 percent died.

The device's maker defended its safety profile.

"The HeartMate II is the most widely used and studied device of its kind; it has been implanted in more than 16,000 patients worldwide and has demonstrated excellent clinical outcomes," according to a statement by Thoratec Corp.

"In fact, since the initial clinical trial, survival has improved, quality of life has remained consistently high, and complication rates in general have declined," the statement said.

There are a number of factors that could contribute to clotting, the company said, including underlying patient condition, ongoing patient and device management practices, pump implantation technique, and device-related factors.

"We have performed extensive analysis on HeartMate II and have not identified any change that would cause the increase observed in the INTERMACS registry," Thoratec said.

More information

For more information on ventricular assist devices, visit the U.S. National Heart, Lung, and Blood Institute.

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 27, 2013 (HealthDay News) -- Money can buy happiness, but only up to an amount of about $36,000, a new study suggests.

The study looked at gross domestic product (GDP) per person. Although GDP is not a measure of personal income, it is often considered an indicator of a country's standard of living.

As expected, the analysis of global data revealed that life satisfaction among people in poor countries rises as their nation's wealth increases and they are able to meet their basic needs.

However, the researchers were surprised to find that for people in wealthy countries, life satisfaction peaks when their nation achieves a GDP of about $36,000 per person. Beyond that amount, there is a slight dip in life satisfaction.

This dip may occur because having more money creates higher ambitions, leading to disappointment when those goals are not fulfilled, according to the study published online Nov. 27 in the journal PLoS One.

"There is a sense of keeping up with the Joneses as people see wealth and opportunity all around them and aspire to having more," explained study co-leader Eugenio Proto, an economist at the University of Warwick in the United Kingdom.

"But this aspiration gap -- the difference between actual income and the income we would like -- eats away at life satisfaction levels. In other words, what we aspire to becomes a moving target and one which moves away faster in the richest countries, causing the dip in happiness we see in our analysis," Proto said in a university news release.

Compared to people in countries with a GDP of around $18,000 per person, people in countries with a GDP of below $6,700 per person were 12 percent less likely to report the highest level of life satisfaction, the researchers found.

But once countries cross the threshold of around $20,400 GDP per person, the boost in happiness created by greater wealth is less apparent. Between $20,400 GDP and $54,000 GDP (the highest per-person level), there is only about a 2 percent difference in the likelihood of claiming to have the highest level of life satisfaction, the study findings indicate.

More information

Mental Health America offers tips on how to live your life well.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 27, 2013 (HealthDay News) -- The federal health agency responsible for HealthCare.gov on Wednesday announced that small businesses cannot use the website to enroll their workers in health plans until November 2014.

The delay affects small businesses in the 36 states where the federal government operates health exchanges.

It is the latest in a string of delays for the Small Business Health Options Program (SHOP), initially set to take effect in October.

The latest setback for HealthCare.gov, the gateway for millions of Americans to access health insurance coverage, comes as a technical team works through the Thanksgiving holiday to meet a Nov. 30 deadline for improving the beleaguered website.

Julie Bataille, a spokeswoman for the Centers for Medicare and Medicaid Services, said the SHOP delay comes as the information technology team to works to improve website capacity and functionality for individual consumers to buy health insurance coverage.

"It was important for us to prioritize the functionality that would enable consumers individually to shop and enroll online in coverage," Bataille said.

Today, the website can comfortably handle some 25,000 simultaneous users, according to the Centers for Medicare and Medicaid Services. But the worry is that as the open-enrollment deadline approaches, the site will experience periods of high volume. CMS intends to double site capacity -- to 50,000 users -- by Saturday.

The administration remains "on track" to have the site working smoothly for most users by the end of November, she said.

The federal government's rollout of HealthCare.gov on Oct. 1 was intended to make it easy for individuals and families to compare health plan options and shop for coverage, and help small businesses make health insurance available to their workers. But the rocky launch forced President Barack Obama and his administration to delay certain provisions of the health reform law known as the Affordable Care Act, including online shopping for small businesses.

Bataille said, however, that small businesses may still enroll directly in a health plan through an insurer, agent or broker, and can get certified for a tax credit after they enroll.

"Although online enrollment will only be available in November 2014, we expect that making direct enrollment, tax-credit applications and comparison shopping easier will help to ensure that small businesses can take full advantage of the marketplace and tax credits worth up to 50 percent of employer-paid premiums," she said.

"This new delay announcement is a disappointment but not a surprise," Kevin Kuhlman, manager of legislative affairs at the National Federation of Independent Businesses, said in a prepared statement.

"Small businesses continue to be low on the priority list during the Obamacare implementation process," he said. "It probably matters little to people in Washington that the failure to get the small business exchanges online adds yet another onerous paperwork requirement for job creators."

More information

The Henry J. Kaiser Family Foundation has tools and information to help consumers understand the Affordable Care Act.

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 27, 2013 (HealthDay News) -- Doctors in the United States overuse Pap tests for cervical cancer screening in some groups of women, according to a new study.

Researchers found that women who have had their sex organs removed and others considered too old to worry about cervical cancer are among those getting tested.

"Almost two-thirds of women who have had hysterectomies reported having recent Pap tests," study co-author Deanna Kepka, an assistant professor in the College of Nursing at the University of Utah, said in a university news release.

"Half of women over 65 who have no cervical cancer history also reported a recent Pap test," said Kepka, who also is an investigator at the Huntsman Cancer Institute in Salt Lake City. "This represents 14 million women in the United States receiving an unnecessary procedure."

A Pap test involves scraping cells from the surface of the cervix and examining them for abnormalities under a microscope.

Because older women have a very small risk of developing slow-growing cervical cancer, Pap tests do not benefit women over age 65 who have no history of cervical cancer or pre-cancerous conditions, Kepka said.

She also said women who have had hysterectomies do not benefit from a Pap test because nearly all of them no longer have a cervix, which is the specific target of this type of screening.

For their study, Kepka and her colleagues examined data from the 2010 National Health Interview Survey. Their findings were published online Nov. 25 in the journal JAMA Internal Medicine.

"We knew there would be overuse of Pap tests, because the few studies of cervical cancer screening showed overuse 10 years ago," Kepka said. "But we were shocked to see so little change over the past 10 years."

"We're hoping to see better use of the tests over the next decade as changes in the health care infrastructure take place," she said. Electronic medical records, physician reminder systems and new strategies to improve the quality of care may promote guideline-consistent practices among clinicians, she said.

More information

The U.S. National Cancer Institute has more about cervical cancer screening.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 27, 2013 (HealthDay News) -- Breathing treatments that provide low levels of oxygen may help people with certain types of spinal cord injuries walk longer distances at faster speeds, new Canadian research indicates.

After the low-oxygen treatment, people with less severe spinal cord injuries were able to walk approximately 33 feet about four seconds faster than those on a placebo treatment. They also were able to increase the distance they could walk in six minutes by about 328 feet.

"The rehabilitation world after a spinal cord injury can be frustrating and limited," said study author Randy Trumbower, an assistant professor in the division of physical therapy at the Emory University School of Medicine in Atlanta. "After the first year, it's a lifelong journey to overcome their diagnosis. Someone may be able to cross the street right now, but can they do it in enough time? Or someone might be able to get to the grocery store, but do they have the endurance to shop?"

"We wanted to find a treatment that could provide incremental changes for those with incomplete spinal cord injuries to allow them to do these things," Trumbower said.

Results of the study were published online Nov. 27 in the journal Neurology.

Almost two-thirds of spinal cord injuries are what is known as incomplete, according to background information in the study. This means some nerve connections are still intact. They may not function as they used to, but they are not completely severed.

Because some connections remain, someone with an incomplete spinal injury may still be able to walk, but not in the same way they could before the injury. People with incomplete injuries often have to rely on canes, braces and wheelchairs to get around.

Previous research in animals has shown that brief exposure to low levels of oxygen can help the animals walk better, Trumbower said. The oxygen treatment causes a number of changes, such as a release of serotonin, a brain chemical that helps transmit messages from one nerve cell to another.

Low oxygen levels also cause the release of a growth factor that's known to help repair nerves and improve their plasticity, said Dr. Michael Fehlings, the co-author of an editorial accompanying the study.

The current study was designed to see if brief periods of low oxygen could induce these types of reactions in humans.

Nineteen people with incomplete spinal cord injuries participated in the study. Everyone could walk at least one step without assistance from another person.

The volunteers were placed into one of two groups. One group would receive the intermittent low-oxygen treatment and the other would receive a sham treatment. Two weeks later, the groups switched treatments.

People who got the oxygen treatment improved their walking speed by 3.8 seconds over 33 feet compared to those given the placebo treatment. They also were able to walk about 328 feet farther in a period of six minutes than those who were treated with the sham treatment.

"[Low-oxygen treatment] may be strengthening the connections or improving how the connections behave," Trumbower said. "The effect of coupling hypoxia with traditional healing techniques was greater than each of its individual parts. Combining the therapies seems to amplify the effects of a single intervention."

"[This was] a small but well-designed [study] that showed people with a relatively mild form of spinal cord injury can have some recovery with [low-oxygen treatment]," said Fehlings, a professor of neurosurgery at the University of Toronto. "But there's still a lot of work to be done. How long will these effects last? Will the treatment need to be constantly administered? Would that cause toxicity?"

Fehlings said this study also doesn't address whether people with more severe injuries could benefit from this type of therapy.

More information

Learn more about spinal cord injuries from the U.S. National Library of Medicine.

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 27, 2013 (HealthDay News) -- Young people are increasingly more likely than adults to be diagnosed with a mental health disorder, according to a large new study.

Researchers analyzed data from nearly 450,000 patient visits to U.S. doctors' offices between 1995 and 2010 for the study, which was published online Nov. 27 in the journal JAMA Psychiatry.

Between the periods from 1995 to 1998 and 2007 to 2010, visits that led to diagnoses of mental-health problems increased faster for patients younger than 21 than for adults. Visits to psychiatrists also rose faster for youths than for adults, according to a journal news release.

Increases in the number of prescriptions of medications to manage mental health disorders were similar for youths and adults.

"Over the last several years, there has been an expansion in mental health care to children and adolescents in office-based medical practice," said Dr. Mark Olfson, of the College of Physicians and Surgeons at Columbia University, and colleagues.

The researchers said this growth, which occurred along with a rise in prescriptions for psychiatric drugs, gives health care providers new opportunities to help children and teens in distress from common psychiatric disorders.

"Yet it also poses risks related to adverse medication effects, delivery of non-evidence-based care and poorly coordinated services," the researchers said.

More information

The National Alliance on Mental Illness has more about mental illness.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 27, 2013 (HealthDay News) -- The number of gay and bisexual men in the United States who said they had unprotected anal sex at least once in the past year jumped from 48 percent in 2005 to 57 percent in 2011, a new study finds.

The researchers, from the U.S. Centers for Disease Control and Prevention, said this increase is cause for concern due to the high risk of being infected with HIV while having unprotected anal sex.

HIV is the virus that causes AIDS. Gay and bisexual men account for almost two-thirds of new infections, as well as half of all people in the United States who are currently living with HIV, the CDC said. There's also been a steady rise in new infections in recent years, concentrated mainly among young men.

"We remain concerned about potentially increasing levels of sexual risk," CDC director Dr. Tom Frieden said in an agency news release. The new analysis tracked 2011 data from 20 major cities across the United States.

One expert said that everyone, including gay and bisexual men, must remain vigilant against the threat of HIV.

"The nightmare epidemic of AIDS in this country is a fading memory, but HIV infection is a serious health issue with profound impacts on well-being, personal and societal costs," said Dr. Bruce Hirch, an attending physician in the division of infectious diseases at North Shore University Hospital in Manhasset, N.Y. "The miracle of long life and improved health [that has come] with treatment for HIV should not lull us into taking health for granted."

There was some good news from the report, however: Once men knew their HIV-positive status, their rate of engaging in risky sex was much lower.

For example, one out of every three HIV-positive gay and bisexual men who did not know they were infected had recent unprotected anal sex with a partner who they believed was HIV-negative or whose HIV status they did not know, the CDC found.

On the other hand, HIV-positive gay and bisexual men who knew they were infected were 60 percent less likely to have unprotected sex with HIV-negative partners or those with unknown HIV status.

"These findings are a stark reminder that we cannot afford to undervalue HIV testing," said Dr. Jonathan Mermin, director of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the CDC. "Getting an HIV test at least once a year is essential for gay and bisexual men. Only when a man knows his status can he make the best prevention choices for himself and his partners."

More frequent testing for HIV may be best in terms of prevention. For example, the study found that 7 percent of men who said they had tested negative for HIV between 7 and 12 months ago were found to be positive by the time of the study, compared to only 4 percent of those who said they had tested negative within the past 3 months.

Still, the researchers stressed that far too many gay and bisexual men are unaware of their HIV status. In 2011, one-third of gay and bisexual men said they had not been tested for HIV within the past 12 months, as recommended by the CDC.

There is also a widening array of HIV prevention options out there, the agency said. These include consistent and correct condom use and cutting down on the number of sexual partners and engaging in safe sex.

In addition, people who find they are infected with HIV should begin therapy early, to cut down the odds that they will transmit the virus to a partner, the CDC said. And for people who are at high risk of exposure to the virus, taking daily medication ("pre-exposure prophylaxis," or PrEP) can cut down their risk of acquiring HIV.

The study is published in the Nov. 27 issue of the CDC journal Morbidity and Mortality Weekly Report.

More information

The U.S. National Institute of Allergy and Infectious Diseases has more about HIV/AIDS.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 27, 2013 (HealthDay News) -- Tongue piercings may be stylish in some circles, but they also are central to the latest innovation in wheelchair mobility for folks paralyzed from the neck down.

Researchers have developed a new navigation system for powered wheelchairs in which patients use a magnetic tongue piercing to steer their chair about, according to new research published Nov. 27 in Science Translational Medicine.

The "Tongue Drive System" uses sensors located near a person's cheeks to track the movement of the magnetic tongue piercing. Signals from the sensors are picked up by a smartphone, which then relays them to the powered wheelchair.

Essentially, the patient's tongue becomes the joystick through which they steer their wheelchair.

"There is absolutely no difference between the tongue piercing you need for this device and the one you get at your local tattoo parlor," said study co-author Maysam Ghovanloo, an associate professor in the School of Electrical and Computer Engineering at the Georgia Institute of Technology. "The only difference is we've replaced the jewelry with a small magnet."

In clinical trials, paralyzed people were able to use the Tongue Drive to steer their wheelchairs much more quickly and just as accurately as those using the most popular current technology, in which a person steers by sipping or puffing into a straw.

On average, 11 quadriplegics testing the Tongue Drive steered their chairs three times faster than they did when they used the sip-and-puff system, even though more than half had been using sip-and-puff every day for years, researchers reported.

"It actually does quite well," said Jason DiSanto, 39, a quadriplegic electrical engineer who participated in the clinical trial. "The big advantage is it's more intuitive. I felt when I was learning to drive with the sip and puff, learning the different commands was cumbersome in the beginning. With the tongue drive system, that guesswork wasn't there anymore."

For example, roll your tongue to the left or right and the wheelchair turns in that direction, as opposed to taking a soft sip for a left turn or a soft puff for a right turn, he said.

The device could replace the sip-and-puff devices now being used by 10,000 to 15,000 quadriplegics in the United States, said Paul Tobin, president and CEO of the United Spinal Association, an advocacy group for people with spinal cord injuries.

"I think it's an incredible opportunity to provide a higher level of independence," Tobin said. "The device is much more versatile and sensitive, so it provides much greater levels of accuracy for driving a power chair."

It also could prove helpful to the one in 50 Americans who are afflicted with paralysis in their upper or lower extremities due to a wide variety of reasons, study co-author Ghovanloo said. Causes include stroke, multiple sclerosis, cerebral palsy, polio and traumatic brain injury.

"As long as the patient can move his or her tongue reliably and consistently, they should be able to use this technology," Ghovanloo said. "The tongue is directly connected to the brain, so even people with severe spinal cord injuries are able to move their tongues."

The Tongue Drive is probably a couple of years away from receiving U.S. Food and Drug Administration approval and going out onto the market, Ghovanloo said. When it does, the navigation system likely will cost between $6,000 and $7,000.

The drive now in clinical testing uses cheek sensors attached to a headset placed on the outside of the person's head. However, researchers already are working on the next-generation model -- one that will fit the sensors inside the mouth.

"We have shrunk the technology so the whole thing fits inside the mouth," Ghovanloo said. "It's completely hidden from sight, and because it's inside the mouth, it's much better protected in the outdoor environment."

Researchers also believe that the tongue drive could be used to operate a computer or any wireless device, since the tongue motions mapped by the drive could be adapted to command any piece of hardware.

The best part may be that the piercing never needs to be replaced. "It never runs out of juice because it is a passive device," Ghovanloo said. "It's just a simple magnet."

But in the end, a person does have to get a tongue piercing, which can be painful and troublesome.

"That was a new experience, but it went quite well," DiSanto said of his piercing. "The recovery time went quite well. A couple of weeks of swelling and a little slurred speech."

More information

For more about spinal cord injuries, visit the U.S. National Library of Medicine.

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 27, 2013 (HealthDay News) -- Scientists have identified a giant meat-eating dinosaur that roamed the Earth about 100 million years ago and was likely dominant over early tyrannosaurs.

The remains of the creature were found in the Cedar Mountain Formation in Utah. It is the first of its kind discovered in North America, the researchers said in a news release from the Field Museum of Natural History in Chicago.

"This dinosaur was a colossal predator second only to the great T. rex and perhaps Acrocanthosaurus in the North American fossil record," said study lead author Lindsay Zanno, director of paleontology at the North Carolina Museum of Natural Sciences and North Carolina State University.

The dinosaur -- named Siats meekerorum -- was more than 30 feet long and weighed more than four tons. Zanno initially discovered it in 2008 and its remains were retrieved during an excavation that lasted two summers.

The newly identified meat-eater was not a close relative of T. rex, but belongs to the family of predatory dinosaurs known as carcharodontosaurs. A famous member of that family is the Giganotosaurus, which was first discovered in Argentina.

Siats belongs to a branch of that family that was previously unknown in North America, according to the study, which was published in the Nov. 22 issue of the journal Nature Communications.

"We were thrilled to discover the first dinosaur of its kind in North America and add to mounting evidence that dinosaurs were widely dispersed across the globe 100 million years ago," study co-author Peter Makovicky, curator of dinosaurs at the Field Museum, said in the news release.

Siats appears in the middle of a 30-million-year gap in the fossil record of large predatory dinosaurs in North America. During that time, the top predator role changed from carcharodontosaurs in the Early Cretaceous period to tyrannosaurs in the Late Cretaceous period.

Teeth of tyrannosaurs from the Utah site indicate that the tyrannosaurs that were around at the same time as Siats were much smaller and did not compete for the top predator role.

"The huge size difference certainly suggests that tyrannosaurs were held in check by carcharodontosaurs, and only evolved into enormous apex predators after the carcharodontosaurs disappeared," Makovicky said.

"Finding Siats in the 30-million-year predator gap tells us carcharodontosaurs reigned supreme in North America for much longer than anyone had expected," Zanno said in the news release.

More information

The Smithsonian National Museum of Natural History has more about dinosaurs.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 27, 2013 (HealthDay News) -- Researchers have identified a genetic mutation that increases the risk of Parkinson's disease linked to pesticides.

The gene mutation causes nerve cells that produce a substance called "dopamine" to lose their protection from pesticide damage. The body uses dopamine to send messages to the part of the brain that controls movement and coordination.

Parkinson's disease -- which causes movement problems such as stiffness, tremors and slurred speech -- occurs when nerve cells in the brain don't produce enough dopamine.

The study is the first "to show that a genetic mutation combined with exposure to pesticides creates a 'double-hit' scenario," by disabling specific pathways, which then leads to nerve-cell death, study senior author Dr. Stuart Lipton, professor and director of Sanford-Burnham Medical Research Institute's Center for Neuroscience, Aging, and Stem Cell Research, said in an institute news release.

Prior to this research, the suspected link between pesticides and Parkinson's disease was based mainly on animal research and studies that found an increased risk of Parkinson's disease among farmers, rural populations and others exposed to agricultural chemicals.

The study was published online Nov. 27 in the journal Cell.

While these findings clearly show the relationship between a gene mutation, the environment, and the damage done to dopamine-producing nerve cells, other mutations and pathways could be important influences as well, the researchers noted.

The investigators plan further research to learn more about how genes and environmental factors interact to contribute to Parkinson's and other neurodegenerative diseases such as Alzheimer's and amyotrophic lateral sclerosis (Lou Gehrig's disease).

"In the future, we anticipate using the knowledge of mutations that predispose an individual to these diseases in order to predict who should avoid a particular environmental exposure. Moreover, we will be able to screen for patients who may benefit from a specific therapy that can prevent, treat or possibly cure these diseases," Lipton said.

More information

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

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 27, 2013 (HealthDay News) -- Hoping to counter all those Thanksgiving calories with extra exercise?

A recent study suggests the strategy may not keep off holiday pounds.

Researchers followed 48 men and 100 women for the six weeks between the Thanksgiving and New Year's celebrations. They ranged between 18 and 65 years of age.

Half reported being serious, regular exercisers. On average, they said, they worked up a sweat almost five hours each week, nearly double the amount of moderate physical activity recommended by the American Heart Association. The other half copped to being couch potatoes.

Researchers weighed and measured each person to calculate their body mass index (BMI) before and after the holidays. They also gauged their percentage of body fat and took their blood pressure.

From mid-November to early January, people in the study gained an average of one-and-a-half pounds. Men gained slightly more, around two pounds each, while women gained a little less, about a pound apiece.

A pound or two may not sound so bad, but studies have found that on average, people gain about two pounds each year. It's called weight creep. And studies have found that once most people put it on, they never take it off.

After 10 years of small annual increases, that's an additional 20 pounds of fat. That means holiday weight gain could be a more important factor in the obesity epidemic than many people realize, said researcher Jamie Cooper, an assistant professor of nutritional sciences at Texas Tech University in Lubbock, Texas.

People who were obese at the start of the study had the biggest increases in weight. They also had significant rise in their percentage of body fat. In fact, starting weight was the best predictor of how much weight and body fat a person might gain.

Exercise had no significant impact on holiday weight gain. Researchers aren't entirely sure why.

On the one hand, Cooper said it could be that the study didn't have enough participants to detect small differences in weight change between exercisers and non-exercisers.

But she said the results could also mean that people were just eating far more calories than they could burn off, even with all that physical activity.

"If you think about going for a run, if you run for 30 minutes and you run three miles during that time, you burn about 300 calories. Well, one piece of pumpkin pie without anything on it is about 300 calories," Cooper said. "So, it's really easy to eat all those calories that you burn during exercise and then some."

Exercise also boosts appetite, which can lead to even more overeating.

Cooper said that means there really is no substitute for moderation during the holidays, a time when foods are much more likely to be loaded with fat and sugar and hidden calories.

Despite the disappointing results, one expert said the study shouldn't be an excuse for people to abandon their workout routines over the next few weeks.

"Exercise has numerous benefits beyond just regulation of weight," said Joy Dubost, a nutritionist and spokesperson for the Academy of Nutrition and Dietetics.

The study found that exercisers may have maintained an advantage over non-exercisers: Their blood pressure tended to stay lower through the holiday hustle.

Dubost thinks that the problem with the holidays isn't just a big meal here or there, it's a mindset of indulgence that people tend to adopt between now and the end of the year.

"Typically what happens on Thanksgiving Day doesn't necessarily just stay for that day. It tends to trickle into an eating pattern that can stay with you through the holiday season," Dubost said.

"Then you step on the scale and it's gotten away from you," she added.

The study was published recently in the European Journal of Clinical Nutrition.

More information

For more on weight management, head to the U.S. Department of Health and Human Services.

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 27, 2013 (HealthDay News) -- A brain region that is involved in decision-making has been pinpointed by researchers.

Their experiments with rats led them to the lateral habenula, which is one of the smallest parts of the brain and is known to be linked to depression and avoidance behaviors.

"These findings clarify the brain processes involved in the important decisions that we make on a daily basis, from choosing between job offers to deciding which house or car to buy," Stan Floresco, a professor in the department of psychology at the University of British Columbia, said in a university news release.

"It also suggests that the scientific community has misunderstood the true functioning of this mysterious, but important, region of the brain," added Floresco, who is also with the university's Brain Research Center.

The researchers trained lab rats to choose between receiving one food pellet on a regular basis or four food pellets less often. The rats tended to choose the four pellets when they didn't have to wait too long to receive them, but chose the single pellet if it took too long to receive the four pellets.

When the researchers turned off the rats' lateral habenula, the animals chose either food option at random. This showed they no longer had the ability to choose the best option, according to the study published Nov. 24 in the journal Nature Neuroscience.

The study authors suggested that their findings may prove important for treating people with depression.

"Deep brain stimulation -- which is thought to inactivate the lateral habenula -- has been reported to improve depressive symptoms in humans," Floresco said. "But our findings suggest these improvements may not be because patients feel happier. They may simply no longer care as much about what is making them feel depressed," he explained.

He also said that a better understanding of decision-making processes is crucial because impairments in these processes are associated with many mental health disorders, including depression, schizophrenia and substance abuse.

Experts note that results obtained in animal studies are not always replicated in humans.

More information

The American Academy of Family Physicians has more about depression.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 27, 2013 (HealthDay News) -- Seniors with higher levels of PCBs in their bodies have poorer mental abilities than those with lower levels of the toxic chemicals, a new study finds.

PCBs -- polychlorinated biphenyls -- are chemicals that were used as coolants, insulating materials and lubricants in electric equipment. Although they were banned in the United States in 1979, PCBs are still found in the blood of many older people.

The study included more than 700 American seniors whose blood was analyzed to determine their levels of PCBs. The participants also underwent memory and physical-skills tests.

There was a significant association between higher PCB levels and poorer mental performance among people aged 70 to 84. This association also was seen to a lesser extent in people aged 60 to 69.

Women in the older age group had the largest decline in mental skills in relation to PCB levels in their body, according to the study published online Nov. 25 in the journal Environmental Health Perspectives.

"While most studies have looked at the impact of PCBs on infant development, our research shows that this toxin might affect us throughout our lives," study author Maryse Bouchard, of the University of Montreal, said in a university news release.

"Aging persons could be at particular risk because of higher cumulative exposure built up across a lifetime; susceptibility due to underlying medical conditions, such as vascular disorders; and diminished cognitive reserve capacity," Bouchard said.

The findings suggest that PCBs, even at levels generally considered to pose low or no risk, may contribute to mental deficits, she said.

More information

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

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

Health Highlights: Nov. 27, 2013

By on

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

Princeton Students Can Get Meningitis Vaccine Starting Dec. 9

A meningitis B vaccine will be offered at Princeton University beginning in early December, the school said Tuesday.

On Friday, the university announced the eighth reported case of meningitis B this year.

The vaccine will be available to certain groups of people recommended by the Centers for Disease Control and Prevention. These include all undergraduate students, graduate students living in dorms or the Graduate College and annexes, and other people in the university community who have certain medical conditions, according to CNN.

The first dose of the vaccine will be available at the university's Frist Campus Center from Dec. 9 to 12, and the second dose will be available in February. For maximum protection, people must receive two doses. The cost of the vaccine will be covered by Princeton.

Previously, university spokesman Martin Mbugua said the vaccine would be recommended for about 5,000 undergraduates and 550 graduate students in dorms, CNN reported.

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U.S. Government Moves to Keep Ban on Payments for Bone Marrow Donors

The U.S. government is taking steps to maintain a ban on paying bone marrow donors.

The move comes in response to a 2011 9th U.S. Circuit Court of Appeals ruling that some marrow donors could be compensated if they donated marrow-producing cells through a newer blood-filtering instead of the older method of extracting marrow cells from inside the bone, the Associated Press reported.

In its ruling, the court noted that it's legal to pay donors of blood plasma, which is collected using a method that's similar to the newer one used to gather bone marrow-producing cells.

The federal government's proposal on banning payment for all types of bone marrow donations is open for public comment through Monday.

"It is not a matter of how you obtain it," Shelley Grant of the Health Resources and Services Administration's transplant division, told the AP. "Whether we obtain them through the marrow or the circulatory system, it is those stem cells that provide a potential cure."

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Gynecologists Can Treat Men: Board

Gynecologists can treat men for sexually transmitted infections and screen men for anal cancer, the American Board of Obstetrics and Gynecology said Tuesday.

The statement reverses restrictions announced in September that said gynecologists could lose their board certification if they treated men. While exceptions were made to allow certain procedures, screening men at high risk for anal cancer was not permitted, The New York Times reported.

The board explained that it wanted to protect the profession as a female specialty and limit the non-gynecological work performed by its members.

But after pressure from anal cancer experts and patient advocates, the board reconsidered and realized that gynecologists have a long tradition of treating sexually transmitted infections in both women and men, according to Dr. Kenneth Noller, the board's director of evaluation.

Anal cancer is usually caused by the human papillomavirus (HPV), which is sexually transmitted, The Times reported.

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Obamacare Contraception Fight Goes to Supreme Court

The U.S. Supreme Court agreed Tuesday to review provisions in the Affordable Care Act that require companies of a certain size to offer employees insurance coverage for birth control and other reproductive health services without a co-pay.

The court will examine whether non-profit organizations and private companies can snub the requirement by claiming it violates their religious beliefs. Oral arguments will likely be heard in March and a ruling issued by late June, CNN reported.

Nearly 100 lawsuits have been filed in federal court challenging the contraception coverage provision. Three federal appeals courts have struck down the birth control rule, while two others have upheld it.

Companies that refuse to provide the coverage could be fined up to $1.3 million a day, CNN reported.

The Supreme Court's decision to hear the case is an "important fight for Americans' religious liberty," according to Kyle Duncan, general counsel of the Becket Fund for Religious Liberty and lead lawyer for Hobby Lobby, one of the companies challenging the birth control provision.

The owners of Hobby Lobby say there is a clash between their Christian beliefs and the fact that some of the drugs that would be provided under the rule prevent human embryos from being implanted in the womb, which they equate to abortion. They do not object to providing other forms of contraception, such as condoms and diaphragms, for their employees, CNN reported.

Federal government officials say their are rules that exempt certain nonprofit groups and religiously-affiliated organizations from the contraceptives coverage requirement. In such cases, women would receive coverage from another company at no cost.

Supporters of the law note it does not require individual company owners to personally provide coverage they might find objectionable, but instead puts that responsibility on the corporate entity, CNN reported.

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 27, 2013 (HealthDay News) -- Women with a family history of breast cancer often want to get tested for the BRCA1 and BRCA2 genetic mutations linked to the disease.

But a new study suggests that even if a woman tests negative for the BRCA2 gene, she could still be at increased risk for breast cancer.

"With the recent revelation that Angelina Jolie tested positive for the BRCA gene, many patients have been asking questions regarding genetic testing," said Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City. "The general public wants to know what a positive or negative test really means."

Until now, it's been thought that women in families with BRCA mutations who themselves test negative for the gene would have the same risk for breast cancer as women in the general population.

But that may not always be true, according the study, which was published Nov. 27 in the journal Cancer Epidemiology, Biomarkers & Prevention.

The researchers analyzed data from more than 800 families in England with BRCA mutations. They found that 49 women in those families who tested negative for the family-specific BRCA mutation later went on to develop breast cancer.

Dr. Gareth Evans is an honorary professor of medical genetics and cancer epidemiology at the University of Manchester, in England. "We found that women who test negative for family-specific BRCA2 mutations [still] have more than four times the risk for developing breast cancer than the general population," Evans said in a journal news release.

"We also found that any increased risk for breast cancer is largely limited to BRCA2 families with strong family history and other genetic factors," he said. "It is likely that these women inherit genetic factors other than BRCA-related genes that increase their breast cancer risk."

Evans said about 77 genetic mutations are currently known to be linked with breast cancer risk. Researchers need to identify additional mutations in order to understand why some BRCA-negative women from families with BRCA mutations still have a higher risk for breast cancer, he said.

Bernik said genetic tests may not tell the whole story when it comes to cancer risk.

"Although the risk of getting cancer is not as high [for women who test negative for BRCA2] as that of a gene carrier, it appears to be elevated," she said. "The numbers in this study were not large enough to prove this definitively, but certainly it raises the issue that more attention needs to be given to every family member in genetically susceptible lineages."

Dr. Elisa Port, chief of breast surgery at the Dubin Breast Center, part of the Mount Sinai Health System in New York City, said getting reliable results from a gene test is key to good care.

"Providing patients with accurate information on their risk for developing breast cancer in the future is critical for decision making regarding different options and interventions," Port said. These measures include preventive mastectomy, the option Jolie chose, or taking the anti-breast cancer drug tamoxifen.

The new study suggests that women "who test BRCA-negative are not completely off the hook regarding a higher risk of developing breast cancer," said Port, who is also an associate professor of surgery at the Icahn School of Medicine at Mount Sinai. "More information like this will hopefully help us refine our treatment and recommendations for the individual patient."

More information

The U.S. National Cancer Institute has more about BRCA mutations and cancer risk.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 27, 2013 (HealthDay News) -- A big part of having a happy and healthy Thanksgiving is making sure you correctly thaw, clean, cook and store the turkey, an expert says.

Turkey and other poultry are home to illness-causing bacteria such as salmonella and E. coli, but you can prevent the growth and spread of such bacteria by following some simple steps, said Donna Duberg, an assistant professor of clinical laboratory science and germ expert at Saint Louis University.

Before you begin preparing your turkey, clean the kitchen counter and sink with either a solution of one-part vinegar and nine-parts water or hot, soapy water.

"Make sure you clean everything from the counter to the utensils and the cutting boards, so that bacteria from your kitchen do not transfer to the turkey," Duberg said in a university news release.

Thaw a frozen turkey evenly by refrigerating it for five to six days, putting it in cold water, or microwaving it. For every pound, let the turkey sit in cold water (less than 40 degrees Fahrenheit) for 30 minutes and change the water frequently. As the turkey sits in the water, the bird will thaw more evenly and at a temperature which slows the growth of bacteria.

"If you decide to thaw the turkey in a microwave, make sure you cook it immediately as some parts of the turkey may have heated unevenly and can start growing bacteria," Duberg noted.

"Forty to 140 degrees Fahrenheit is the danger zone -- that's when the turkey is most prone to growing bacteria. It is essential that the turkey thaw and be kept cold until cooking (less than 40 degrees)," she explained.

Before cooking, make sure the turkey is completely thawed. If you're cooking it without stuffing, check the temperature of the innermost part of the thigh, breast and wing with a food thermometer and make sure all are 165 degrees Fahrenheit.

"If you plan to put the stuffing inside the turkey, make sure the temperature of the center of the stuffing is 165 degrees Fahrenheit," Duberg recommended.

Do not leave cooked turkey out for more than two hours.

"When the turkey is left out, any bacteria present will start growing. Children and the elderly with a weaker immune system could easily get sick," she warned.

More information

The U.S. Centers for Disease Control and Prevention has more about the safe preparation of your holiday meal.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 27 (HealthDay News) -- Parents who set firm rules about behaviors like TV viewing, dinner time and physical activity tend to have children of healthier weights, a new Australian study finds.

"Children of parents who set consistent rules have a slightly lower body-mass index [BMI]; they're thinner," said study author Pauline Jansen.

Both mothers and fathers who enforced clear guidelines had a similar effect on their children's weight -- regardless of their own weight -- found Jansen, an honorary off-campus fellow at the Murdoch Children's Research Institute in Melbourne.

The study involved more than 4,000 children and their parents who participated in a long-term study of Australian children.

Starting in 2004 when the children were 4 or 5 years old, parents reported their offspring's height and weight and described their parenting styles four different times every two years.

Jansen found an association between consistent parenting and healthy weights in children, not a cause-and-effect.

And while the effects were not great, they were only slightly less than the effects of other factors often cited as contributing to a child's healthy weight, such as breast-feeding, said Jansen, now a researcher at Erasmus Medical Center in the Netherlands.

This suggests programs aimed at helping get children to a healthy weight should include talk about parenting styles, she said.

Childhood obesity is a troubling public health problem. In the United States, 17 percent of children aged 2 to 19 are obese, according to the U.S. Centers for Disease Control and Prevention, raising the risk of high blood pressure, high cholesterol, joint problems, diabetes and other conditions.

The new study is published online Nov. 25 and in the December print issue of the journal Pediatrics

What exactly is parental consistency? For the study, Jansen said, ''the parenting consistency we assessed did not refer to lifestyle habits, but was more global. It reflects the degree to which parents set and ensure compliance with age-appropriate instructions, rules and expectations. We showed that this global consistency benefits child BMI."

BMI is a measurement of body fat that takes height and weight into account.

Why would parenting style affect children's weight? Jansen didn't look at that specifically. However, she speculated that those who are consistent in parenting ''may be more likely to set clear expectations around healthy behaviors -- for example rules regarding television viewing, screen time and physical activity, bedtime routines and the timing and type of foods consumed."

One expert said the finding is a good starting point.

The study ''is a good first start to see the influence that both parents have" in affecting a child's weight, said Dr. Gloria Riefkohl, a pediatrician at Miami Children's Hospital. In future research, she said, "we need to take a look at the influence of expanded families," she said, such as the effect of grandparents. Researchers should also look at nontraditional families.

Parents can help encourage healthy weights in their children in a number of ways, she said. "Choose family goals, such as exercising every day and eating fruits and vegetables," she said. "Keep track of who meets their goals, and praise those who do. And when the whole family achieves the goals, do something fun together -- going to the zoo, park or aquarium, and so on."

Parents should also focus on establishing healthy eating habits early, Riefkohl said: "What we eat is a learned process."

More information

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

Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- With candles, dry trees and wreaths scattered throughout the home, the holidays pose an increased risk of fire.

The U.S. Consumer Product Safety Commission offers this advice for a safer holiday season:

  • Make sure children can't reach candles, matches or lighters.
  • Don't smoke near any flammable decorations, don't burn evergreen branches in the fireplace and don't light candles near evergreen trees.
  • Practice an emergency fire plan for your home, making sure every member of the family knows the plan.
  • Avoid loosely-fitting clothing (especially sleeves) around candles, fireplaces and other fire sources.
  • Watch for any potential fire hazards, and move to reduce risk.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- Having a learning disability is challenging for a child, and parents must do their best to help boost self-esteem.

The National Center for Learning Disabilities mentions these suggestions:

  • Look at the world as your child would, and be sympathetic to his or her struggles.
  • Communicate respectfully, taking time to answer questions and listen.
  • Plan for one-on-one time, so your child doesn't have to fight for your attention.
  • Love and appreciate your child for who he or she is.
  • Don't blow mistakes out of proportion, but use them as learning opportunities. Let your child make decisions.
  • Highlight your child's strengths, and encourage positive relationships and social interactions.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 26 (HealthDay News) -- The high salt content of fizzy medications like Alka-Seltzer could pose a threat to people with heart disease, according to a new study.

The researchers want consumers to be aware of how much salt certain over-the-counter drugs contain. In some cases, the salt content of a day's worth of tablets exceeds American Heart Association guidelines for daily salt intake -- and that's without taking a single bite of food.

"There is a significant risk in taking these effervescent, dispersible and soluble medications over the long term," said lead researcher Dr. Jacob George, a senior clinical lecturer and honorary consultant in clinical pharmacology at the University of Dundee, in Scotland.

Excessive salt intake is linked to high blood pressure, stroke and kidney disease. George said people with heart conditions or those who are at risk for cardiovascular disease should stay away from these fizzy medications.

Drug labels also should be required to include salt content just as food labels do, George said.

Fizzy medications are more common in the United Kingdom than in the United States. In Britain, many pain, headache and cold tablets come in this form, as do indigestion treatments and vitamin supplements, George said.

It's the salt in these medications reacting with water that adds the fizz to the drugs.

Alka-Seltzer, an over-the-counter heartburn drug, is the most well-known medication in this category in the United States, said Ola Oyetayo, a pharmacist at Scott & White Memorial Hospital in Temple, Texas.

One Alka-Seltzer tablet contains 445 milligrams of salt, according to Bayer, the drug's maker. By taking the maximum recommended dose -- two tablets four times a day -- you'll consume 3,560 mg. That's more than double the American Heart Association's recommendation to limit salt intake to 1,500 milligrams of salt a day.

According to the AHA, if Americans limited salt intake to the recommended level, the nation would see a nearly 26 percent decrease in high blood pressure and savings of more than $26 billion in health care costs in just one year.

A high-salt diet may be the reason one in three Americans develop high blood pressure, according to the AHA.

Calls made to Bayer for comment on the study were not returned.

For the study, George's team collected data on more than 1.2 million British patients. During an average of seven years of follow-up, more than 61,000 heart attacks, strokes or deaths occurred from heart disease among these patients.

The researchers found that patients taking at least two of these medications during the study period were at a 16 percent increased risk of a heart attack, stroke or death from heart disease compared with patients taking the salt-free versions of those same medications.

These findings remained unchanged even after taking into account factors such as weight, smoking, alcohol, history of chronic illnesses and use of some other medications, the researchers said.

More information

For more information on salt, visit the American Heart Association.

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 26, 2013 (HealthDay News) -- The worldwide death toll from the 2009 swine flu pandemic was about 11 times higher than previously estimated, according to a new study.

More than 60 researchers in 26 countries concluded that the outbreak of the H1N1 virus caused up to 203,000 deaths worldwide. The findings were published online Nov. 26 in the journal PLoS Medicine.

The World Health Organization had said there were about 18,500 laboratory-confirmed deaths. That was widely regarded as a low number, however, because it was based only on people with confirmed cases of H1N1.

"This study confirms that the H1N1 virus killed many more people globally than originally believed," study lead author Lone Simonsen, a research professor in the department of global health at the George Washington University School of Public Health and Health Services, said in a university news release.

"We also found that the mortality burden of this pandemic fell most heavily on younger people and those living in certain parts of the Americas," she said.

The WHO's lower number of confirmed deaths led some to say the public health response to the outbreak was excessive. But these new findings -- based on an analysis of data from the WHO and from 21 countries accounting for about 35 percent of the world's population -- suggest that the virus was extremely dangerous.

People younger than 65 accounted for 62 percent to 85 percent of patients who died in the 2009 pandemic. This high death toll among younger people is in contrast to seasonal flu, which poses the greatest threat to seniors.

The researchers also found that certain countries had much higher death rates than others. For example, Argentina, Brazil and Mexico had the highest death rates, while the toll was much lower in Australia, New Zealand and most parts of Europe.

Learning more about these types of outbreaks is important in order to plan and prepare for the next pandemic, Simonsen said.

More information

The U.S. Department of Health and Human Services has more about H1N1 swine flu.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 26, 2013 (HealthDay News) -- Toxic or dangerous toys can still be found on store shelves despite tough new federal regulations, according to a report released Tuesday.

Researchers found toys for sale that contained toxic levels of lead, cadmium, antimony and phthalates, said this year's "Trouble in Toyland" report from the U.S. Public Interest Research Group (PIRG).

One vinyl toy, the Marvel Super Hero Squad Soft Shield, contained 29 times the legal limit of lead.

"That toy is recommended for ages 2 and up," said Andrew Fish, a program associate with the Massachusetts Public Interest Research Group. "It really shouldn't be recommended for anyone at that level."

A Lamaze-brand infant play mat contained high levels of antimony, a toxic metal that has been classified as a cancer-causing agent. A Ninja Turtles Pencil Case contained high levels of phthalates and cadmium. Phthalates are chemicals suspected to cause developmental health effects. Cadmium is a toxic metal that can cause learning disabilities and kidney problems.

U.S. PIRG researchers also found the following:

  • Toys that still pose a choking hazard, despite a ban on small parts in toys for children under 3 years old
  • Toys that are potentially harmful to children's hearing
  • Toys containing small powerful magnets that can be dangerous if swallowed

Magnets are a particular concern. If a child swallows more than one, the magnets can stick together inside their bodies and cause internal damage.

"Magnet toys are much stronger than they have been in the past, and therefore pose a greater health risk, especially to young children because they routinely put toys in their mouths," Fish said.

A 2-year-old child suffered intestinal tears in January after swallowing 62 rare earth magnets, the report found. Between 2009 and 2011 there were 1,700 emergency room visits following the ingestion of magnets. More than 70 percent of those cases involved children between ages 4 and 12.

The U.S. PIRG report also raised concerns regarding excessively loud toys that could harm a child's hearing.

The group tested toys based on standards that consider anything above 85 decibels dangerous to human ears, and sounds above 65 decibels dangerous for toys meant to be held close to the ear. Prolonged exposure can lead to gradual hearing loss.

"One in five children will have some form of hearing loss by the time they reach age 12," Fish said.

Researchers found three toys on store shelves that exceed these loudness limits. These were the LeapFrog Chat & Count Smart Phone, the LeapFrog Lil'Phone Pal and the Fisher Price Laugh & Learn Remote.

Toys that pose a choking hazard also continued to crop up on store shelves, the report said. U.S. PIRG researchers found a number of toys containing parts that would fit through the "choke tube" that the U.S. Consumer Product Safety Commission (CPSC) provides to parents to assess choking hazards.

Fish said parents should be on their guard regardless of where they purchase toys. "We found hazardous toys from dollar stores and from nationwide chains. The problems are really across the board," he noted.

"Parents should remember that our report only includes examples of potentially hazardous toys, and is not intended to be a comprehensive list," Fish said. "They should always examine toys carefully for potential hazards before purchasing, and they should always read labels, warnings and age recommendations."

Consumer groups also called on the CPSC to continue vigorous enforcement of safety laws governing children's toys.

"Parents and all consumers should have more confidence in the products they may own or consider purchasing but should also continue to do the right research to select the safest and most appropriate gifts for the children on their gift lists," Rachel Weintraub, legislative director and senior counsel at Consumer Federation of America, said in a U.S. PIRG statement.

"Manufacturers should ensure they comply with the law," Weintraub said. "Continued CPSC enforcement and adequate funding is necessary to further protect our nation's children."

More information

Visit the U.S. Public Interest Research Group to view the complete Trouble in Toyland 2013 report.

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 26, 2013 (HealthDay News) -- New research from Africa suggests that basic multivitamin and selenium supplements might greatly lower the risk that untreated people with the AIDS virus will get sicker over a two-year period.

It's not clear how patients who take the vitamins and mineral might fare over longer periods. And the impact of the study in the United States will be limited because many Americans diagnosed with HIV, the virus that causes AIDS, immediately begin treatment with powerful medications known as anti-retroviral drugs. Those in the African study hadn't yet begun taking drugs to keep the virus at bay.

Still, "it is incredibly useful to find new strategies to delay the progression of HIV disease," said Dr. Jared Baeten, an associate professor of global health at the University of Washington in Seattle who's familiar with the findings. "Not every HIV-infected person is immediately willing, or able, to initiate anti-retroviral therapy. Inexpensive, proven treatments ahead of starting anti-retroviral therapy can fill an important role."

At issue: Do HIV-infected people benefit from nutritional supplements? Previous research has suggested that even well-fed people infected with HIV may not properly process nutrients in food, said study author Marianna Baum, a professor of dietetics and nutrition at Florida International University's Stempel School of Public Health.

The researchers wondered whether the immune system would get a boost if patients who hadn't yet begun anti-retroviral treatment took nutritional supplements. No study had looked at this before, Baum noted.

For the study, published in the Nov. 27 issue of the Journal of the American Medical Association, the researchers divided nearly 900 HIV-infected patients in the African country of Botswana into several groups. Some took a placebo, a sugar pill with no active ingredients. Others took a multivitamin including B, C and E vitamins. Another group took the multivitamin along with supplements of the mineral selenium, and still others took only selenium.

None of the treatments had a noticeable effect except the combination of multivitamin and selenium. After adjusting their statistics so they wouldn't be thrown off by various factors, the researchers reported that those who took the combination were about half as likely to show signs over two years that their infection had progressed toward AIDS as those who took the placebo.

Overall, the risk that the disease would progress over the two years of the study was fairly low: 32 of the 217 who took the placebo suffered progression of the disease, she said, compared to 17 of the 220 who took the vitamin/mineral combination.

Baum didn't have information about the costs of the supplements, but she said they are low. In the United States, supplements that contain many vitamins and minerals can cost just pennies a day.

The supplements appeared to have no side effects, said Baum, who recommends that people newly diagnosed with HIV begin taking multivitamins. They seem to boost the immune system, she said. The selenium supplements, in particular, may provide enough of the mineral that the virus isn't able to hog it, she said.

Baeten cautioned that not just any multivitamin will do. "The results of this study appear to illustrate that it is not just any supplement," he said.

"Only the combination of vitamins plus selenium was effective," Baeten said. "For U.S. patients, this latter point is relevant, as there's a huge variety of supplements available. I would suggest talking with a doctor before taking any supplements."

He added that the study doesn't detract from the crucial importance of anti-retroviral drug treatment.

Researchers next want to see if the supplements help patients already taking anti-retroviral medications, study author Baum said.

More information

For more about HIV and AIDS, see the U.S. National Library of Medicine.

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 26, 2013 (HealthDay News) -- Thalidomide, a drug made infamous after it caused devastating birth defects in the 1950s, may help treat children with Crohn's disease who haven't responded to other medications, new research suggests.

After eight weeks of treatment, more than 46 percent of children taking thalidomide had reached remission, compared to about 11 percent of those given an inactive placebo. And remission lasted longer for the children on thalidomide -- an average of 181 weeks compared to just 6.3 weeks for those who took the placebo.

The Italian researchers published their results in the Nov. 27 issue of the Journal of the American Medical Association. Funding for the study was provided by the Italian Medicines Agency, while the drug's manufacturer, Celgene, provided the drug for the study.

Crohn's disease is an inflammatory bowel disease. It's estimated that about 500,000 people in the United States have Crohn's disease, and for about one-quarter of those patients, symptoms started in childhood, according to background information in the study. Pediatric cases of Crohn's disease tend to be more severe, and nearly one in five children with the disease will require surgery within five years of when the disease starts, the study noted.

Thalidomide was first used in the late 1950s as a treatment for insomnia, anxiety and morning sickness, according to the March of Dimes. It was approved for use in Europe, Japan, Canada and Australia, but never in the United States. By the early 1960s, it was apparent that the drug caused significant birth defects, including severely malformed or missing arms and legs. The medication was quickly withdrawn from the market.

It remained off the market for a significant time until researchers realized that the drug had other uses, particularly for dampening an overactive immune system. And if care was taken to ensure that no one who might be pregnant or become pregnant took the drug, its other side effects were less serious, according to the March of Dimes.

The U.S. Food and Drug Administration approved the use of thalidomide to treat a complication of leprosy, and the drug was approved in 2006 to treat multiple myeloma, a cancer of the bone marrow.

Thalidomide is currently being studied as a treatment for a number of inflammatory diseases, but in all cases where the drug is used, any woman of reproductive age must be counseled on the potential for serious birth defects should she become pregnant while on thalidomide. The March of Dimes reports that even one dose of thalidomide can cause birth defects. Males taking the drug should use condoms because thalidomide can also affect the sperm quality.

The current study looked at what effect, if any, thalidomide could have on Crohn's disease in children and adolescents. A total of 54 children with moderate to severe Crohn's disease were included in the study. All of the children had received other treatments for Crohn's that had failed to control their disease.

Twenty-eight children received thalidomide and 26 were given a placebo for eight weeks. Those who hadn't shown improvement while on placebo for eight weeks were switched to thalidomide for an additional eight weeks. Any of the children who responded to thalidomide therapy remained on it for at least 52 weeks, according to the study.

Children or teens taking thalidomide were more likely to achieve a remission of their disease, and the remission was likely to last far longer than a remission achieved while on placebo, the study found.

Side effects were infrequent. The most severe frequent side effect was a condition that causes strange sensations in the arms or legs. When someone stops taking thalidomide, the condition goes away. Thalidomide also can have a strong sedative effect, which can have less of an impact if given at night.

"As it turns out, the mechanism of thalidomide is very effective for exactly the targets we're trying to treat in Crohn's, and it might be helpful for sparing kids from high steroid use," said Dr. Jonathan Ramprasad, a pediatric gastroenterologist at McLane Children's Scott &White Hospital in Temple, Texas.

"But, it won't be a wonder drug. This wouldn't be a first-line treatment, or a treatment on its own. It would be used as an [additional] therapy," noted Ramprasad, who was not involved with the study. "The research is still early, and we need to see longer term follow-up."

Another expert, Dr. Michael Pettei, chief of pediatric gastroenterology at Cohen Children's Medical Center of New York in New Hyde Park, N.Y., agreed.

"While it's good to have another agent, more studies need to be done on this," he said.

"There are a large number of agents currently available for the treatment of pediatric Crohn's disease, and all have different benefits and side effect profiles. If additional studies confirm these findings, thalidomide might be an additional choice," Pettei added.

Both experts said that because the drug has been around for so long, treatment with thalidomide would likely be very affordable.

Children and teens could probably continue using the drug into adulthood, although when they reached reproductive age, they would need to be counseled on the very serious risks of birth defects should a pregnancy occur. And, counseling and the use of birth control methods are currently required for a prescription for thalidomide.

More information

Learn more about the treatment of Crohn's disease in children from the Crohn's and Colitis Foundation of America.

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 26, 2013 (HealthDay News) -- Cipro and other drugs in the same class of antibiotics don't appear to raise the risk of an eye problem called retinal detachment, according to a new study that contradicts previous research.

Retinal detachment -- separation of the retina from its connection to the back of the eye -- can cause vision loss. A group of researchers recently concluded that use of antibiotics called fluoroquinolones was associated with a significantly increased risk of retinal detachment. This new study challenges that finding.

The latest investigation involved an analysis of data from millions of people in Denmark. Of nearly 600 people diagnosed with retinal detachment, 72 had used fluoroquinolones. Most had taken Cipro (ciprofloxacin), while others had used ofloxacin (Floxin, Ocuflox), fleroxacin (Quinodis and Megalocin) or moxifloxacin (Moxeza, Avelox, Vigamox).

People who used fluoroquinolones did not have an increased risk of retinal detachment compared to those who didn't use the antibiotics, Dr. Bjorn Pasternak, of the Statens Serum Institute in Copenhagen, and colleagues said in the Nov. 27 issue of the Journal of the American Medical Association.

In the worst-case scenario, the use of fluoroquinolones would account for no more than 11 additional cases of retinal detachment per 1 million cases of treatment with fluoroquinolones, they said.

"For the physician caring for a [patient who needs] fluoroquinolone therapy, retinal detachment should not cross the physician's mind," Dr. Allan Brett, of the University of South Carolina School of Medicine, wrote in an accompanying journal editorial.

"But the next time an outpatient with no good [reason for taking] a quinolone asks for one ... the physician might mention a remote possibility of retinal detachment among the many reasons for declining the request," Brett said.

More information

The U.S. National Eye Institute has more about retinal detachment.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 26, 2013 (HealthDay News) -- Teens who are in committed relationships and have good communication with their partner are among those most likely to get tested for HIV, a new study finds.

Researchers surveyed 980 sexually active teens aged 14 to 17 in the Bronx, where there is a high rate of AIDS. They found that 44 percent of the teens had been tested for HIV, the virus that causes AIDS.

Further analysis showed that 60 percent of those who have good HIV-related communication with their partner had been tested. The same was true for 54 percent of those in committed relationships, and 48 percent of those who had good communication and were comfortable discussing sex with their partners.

Overall, teens who had high HIV/AIDS-related communication with their parnters were 3.7 times more likely to have been tested for HIV than those with low levels of partner communication, according to the findings in the November issue of the journal AIDS Patient Care and STDs.

Teens who had more knowledge about HIV and engaged in risky sexual activity were not more likely than other teens to get tested for HIV, the investigators found. This group included teens who knew more about HIV and understood how the virus is transmitted, as well as protection and treatment methods.

"Despite efforts to educate about the risks of HIV and AIDS in schools, it is clear that more is needed to prompt adolescents to speak up and take the next step of getting tested," study author Dr. Hina Talib, an adolescent medicine physician at the Children's Hospital at Montefiore Medical Center, said in a college news release.

"Early identification of HIV in adolescents is associated with earlier treatment and better health outcomes, so it is especially important that these sexually active high school-aged adolescents be tested," noted Talib, who is also an assistant professor of pediatrics at Albert Einstein College of Medicine in New York City.

"These findings highlight opportunities for health care providers to include a discussion of the partner's testing status when counseling adolescents about HIV testing," Talib said. Programs to encourage HIV testing in the teens who need it most should be designed to include partner communication methods, she suggested in the news release.

More information

The U.S. National Institute of Allergy and Infectious Diseases has more about HIV/AIDS.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

Age-Related Eye Differences May Cause Falls

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TUESDAY, Nov. 26, 2013 (HealthDay News) -- Older adults are far more likely than young people to have vision differences between their eyes. This could increase their risk for falls if they don't get the correct vision prescription for each eye, researchers say.

The new study followed nearly 120 seniors, average age 67, for 12 years. The researchers looked at the participants' development of anisometropia, defined as a significant difference in prescription between the two eyes in one of four areas.

By the end of the study, the number of participants needing a different prescription for each eye doubled to 32 percent, according to the findings in the journal Optometry and Vision Science.

Most cases were related to differing degrees of farsightedness between the eyes, while others were caused by unequal blurring of the lens of the eye. The researchers also found that differences between the eyes could begin at any age, and that the difference actually decreased in a few patients.

Previous studies have shown that only 2 percent to 4 percent of children have anisometropia, the study authors noted in a journal news release.

"Whatever the cause of the increase in anisometropia with aging, the fact that significant anisometropia is at least 10 times more common in those over 75 years of age than in children needs to be clearly emphasized to clinicians," wrote study leader Gunilla Haegerstrom-Portnoy of the University of California, Berkeley, and colleagues.

They said their findings highlight the importance of appropriate vision correction in both eyes for older adults.

Uncorrected anisometropia is likely to lead to vision disturbances that may contribute to falls in the elderly, the researchers noted.

Journal editor-in-chief Anthony Adams agreed.

"For older people a lack of correction of this prescription difference between the eyes may contribute to the increased frequency of falls that, in turn, can have a severe impact on health and even life expectancy," he said in the news release.

More information

The U.S. National Eye Institute has more about aging and eyes.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 26, 2013 (HealthDay News) -- If remorse over sex strikes a man or a women, he'll likely regret a lost opportunity while she'll fret over a one-night stand, a new study shows.

The researchers say the findings make evolutionary sense.

"For men throughout evolutionary history, every missed opportunity to have sex with a new partner is potentially a missed [reproductive] opportunity -- a costly loss from an evolutionary perspective," study leader Martie Haselton explained in a University of Texas at Austin news release.

"But for women, reproduction required much more investment in each offspring, including nine months of pregnancy and potentially two additional years of breast-feeding," said Haselton, who is a social psychology professor at the University of California, Los Angeles. "The consequences of casual sex were so much higher for women than for men, and this is likely to have shaped emotional reactions to sexual liaisons even today."

In the study, Haselton's team surveyed nearly 25,000 heterosexual, bisexual, gay and lesbian Americans, and found that the top three most common sexual regrets for men were: being too shy to make a move on a prospective sexual partner (27 percent); not being more sexually adventurous when young (23 percent); and not being more sexually adventurous during their single days (19 percent).

For women, the top three regrets were: losing their virginity to the wrong partner (24 percent); cheating on a present or past partner (23 percent); and moving too fast sexually (20 percent).

More women than men (17 percent vs. 10 percent) listed having sex with a "physically unattractive partner" as a top regret, according to the study published in the Archives of Sexual Behavior.

Rates of engaging in casual sex were similar overall among participants (56 percent), but women in all groups (heterosexual, bisexual and lesbian) had more frequent and intense regrets about it.

Haselton said that differences in men's and women's reaction to sex seem to endure over millennia, even though the context in which people have sex may have changed.

"For example, we have reliable methods of contraception," she said. "But that doesn't seem to have erased the sex differences in women's and men's responses, which might have a deep evolutionary history."

More information

The U.S. Centers for Disease Control and Prevention offers information about sexual health.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 26, 2013 (HealthDay News) -- A potentially deadly form of meningitis has now been reported at three U.S. colleges, and experts say that while it's not time to panic, students need to be aware of the possible symptoms and seek treatment for them right away.

This outbreak is concerning because most of the cases have been confirmed as a subtype of bacterial meningitis called group B. And the current meningitis vaccine used in the United States does not protect against group B.

Meningitis is an inflammation of the membranes that surround the brain and spinal cord, and it's most often caused by a virus.

Bacterial meningitis is rare in the United States, but when it strikes, it's usually severe. About 10 to 15 percent of Americans who fall ill with the infection die, and up to 19 percent of survivors suffer nervous-system damage or lose a limb, according to the U.S. Centers for Disease Control and Prevention.

Cases have fallen in recent years, thanks to vaccination. Last year, the CDC says, there were about 500 infections, of which 160 were group B.

But as of Friday, eight cases of group B meningitis had been reported at Princeton University in New Jersey, where an outbreak began last March.

Last week, the University of California, Santa Barbara said three students had fallen ill with confirmed cases of group B. Another New Jersey college -- Monmouth University in West Long Branch -- said an employee had been hospitalized with meningitis.

It was not yet known whether the Monmouth case was group B or not.

No one is sure why most of the outbreak cases have been B strain, said Dr. William Schaffner, an infectious disease expert at Vanderbilt University School of Medicine in Nashville, Tenn.

In the United States, group B meningitis mainly strikes infants, not college-age adults -- who most often contract other bacterial types. "This is very unusual," Schaffner said. "We're all kind of scratching our heads at this point."

What is clear, he said, is that young people should still get the standard U.S. vaccine that protects against four other types of bacterial meningitis (known as A, C, Y and W). Besides meningitis, those bacteria can also cause serious bloodstream infections.

Ideally, children should get the vaccine when they are 11 or 12 years old, then have a booster shot at age 16. "But it's never too late to get it," Schaffner stressed.

Just as important, he said, is awareness of the initial symptoms of bacterial meningitis. Those include sudden fever, headache, neck stiffness, vomiting and sensitivity to light.

Schaffner said Vanderbilt has sent information to students urging them to get quick medical attention if they develop those symptoms. "Get to the student health center," Schaffner said. "Don't try to tough it out."

One advocate who's had personal experience with meningitis agreed.

"It is really important for everyone to be aware of the symptoms," said Lynn Bozof, of the National Meningitis Association, an advocacy group founded by parents of children killed or disabled by meningitis.

A vaccine -- called Bexsero -- does protect against group B meningitis, but it is not yet licensed in the United States.

Bexsero is licensed in Europe and Australia, however, and Princeton announced last week that it is importing the vaccine -- with approval from the CDC and U.S. Food and Drug Administration. It will be offered to students and certain employees who may be at increased risk.

In general, college students living in dorms are at risk of meningitis because they are in close contact. But the CDC and other experts have stressed that bacterial meningitis is not passed casually, like the common cold. People have to come in contact with someone else's respiratory secretions -- through kissing, or sharing food, drinks and utensils.

Bozof said it's not time for "panic." Still, she added, "if I were a student at Princeton, I would take this opportunity to get the [Bexsero] vaccine. I'd be the first in line."

For now, the vaccine is only an option for certain at-risk groups at Princeton, the CDC says. On Monday, the agency also said that Princeton students should feel free to stick to their Thanksgiving travel plans.

Why isn't the Bexsero vaccine available in the United States? Schaffner said vaccines against group B meningitis have been particularly difficult to develop, partly because of the wide variety of strains within the group. Bexsero only arrived on the market in Europe and Australia within the past year.

Novartis, which makes the vaccine, completed some studies in the United States, but has since decided to push another vaccine -- one that fights all five bacterial meningitis strains -- into late-stage development, the CDC says.

Whatever happens with that vaccine, Bozof said the current outbreak is a "wake-up call." Some college students, she noted, might pass on any meningitis vaccination because they are young and healthy, and feel that's enough.

"My son was a young, healthy 20-year-old," Bozof said. "And he died of meningitis."

More information

The U.S. Centers for Disease Control and Prevention has more on group B meningitis.

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 26, 2013 (HealthDay News) -- A new study suggests that the replication of HIV may slow or stop altogether in patients who are on long-term treatment, although remnants can still lurk in the body.

And the researchers now suspect that the virus is especially weak in those people who started treatment immediately after becoming infected.

The study is very small, involving just eight patients. However, the findings add more evidence to the debate over how soon patients should begin drug treatment after they're diagnosed as being infected with HIV. One of the study authors is ready to say that treatment must begin immediately.

"Patients should be started on therapy as soon as they are diagnosed to prevent the virus from hiding in large numbers of cells," said the researcher, Sarah Palmer, deputy director of the Center for Virus Research at Westmead Millennium Institute for Medical Research, in Australia. "Diagnosing HIV infection early and initiating therapy immediately is crucial for limiting the number of cells containing HIV."

While doctors can use drugs to kill the AIDS virus in the body, it's impossible to eliminate it completely. That means there's no cure for HIV infection or AIDS, the potentially deadly condition that the virus causes.

But what does the virus do when a patient is on medication -- does it keep replicating [making copies of itself] or does it hide? The authors of the new study sought to find an answer by analyzing immune-system cells taken from eight HIV-infected patients. All had been taking anti-HIV drug treatment for years.

This combined drug treatment is known as antiretroviral therapy (ART).

The researchers analyzed the cells and found that drug treatment appeared to stop the virus from replicating -- an important finding that suggests a possible weakness. However, HIV didn't vanish but instead hid in certain types of immune-system cells known as "resting memory T cells." These cells "remember" how to fight a particular body invader, such as a germ or virus and sit around waiting for it to return.

"These cells can remain dormant for many years even though they are carrying HIV," Palmer said. "When these cells start to replicate or are stimulated to replicate as part of our normal immune response, they also produce HIV, keeping the virus viable. Essentially, these cells are a ticking time bomb in patients, and once they are ignited they explosively produce HIV."

This finding confirms previous research showing that the lurking virus is "very stable for years," said David Schaffer, director of the Berkeley Stem Cell Center at the University of California, Berkeley. "It means that treatments must be developed to directly eliminate this long-lived pool, which is challenging," said Schaffer, who is familiar with the study's findings.

However, there's some good news. The numbers of these cells were smaller in patients who had started treatment soon after being diagnosed instead of waiting until they began to show symptoms.

"Diagnosing HIV infection early and initiating therapy immediately is crucial for limiting the number of cells containing HIV," Palmer said. "The scientific community must develop better strategies to flush HIV from its hiding place in patients without causing new infections."

Schaffer agreed. A treatment can't just halt the virus from growing in the body and wait for the infected cells -- the "latent pool" -- to die out, he said. "Finding a cure for HIV means that therapies must be developed to directly eliminate the latent pool of virus."

The study will appear online in this week's issue of the Proceedings of the National Academy of Sciences.

More information

For more about HIV/AIDS, try the U.S. National Library of Medicine.

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, NOV. 26, 2013 (HealthDay News) -- Thanksgiving is a time of travel, but one expert warns that sleep deprivation and darkness can cause drivers to become sleepy even though they believe they're alert.

"When you are sleep-deprived for more than 24 hours, you need stronger sensory stimulation to maintain alertness," Dr. Xue Ming, a sleep medicine specialist at Rutgers New Jersey Medical School, said in a Rutgers news release.

Sensory input such as light, noise and touch keeps people alert, Ming said. "But when there's little stimulation, the brain will drift into a full sleep state or a micro sleep, which can last from a fraction of a second to up to 30 seconds," she said. "In this state, the person feels like he is awake -- he might even still have his eyes open -- but he is actually asleep."

Drivers are most vulnerable to drowsiness from 2 a.m. to 4 a.m. and 1 p.m. to 3 p.m., when there is a dip in their circadian rhythm, which regulates periods of sleepiness and wakefulness. The circadian rhythm also causes people to feel drowsy in fading daylight -- something to remember with the change in daylight savings time this weekend.

"If a person had a big meal at lunch or did not sleep well the night before, this decline is more prominent," said Ming, who noted that shift workers are particularly at risk for drowsy driving when they leave work in the early morning hours.

Ming said there are ways for drivers to boost their alertness for limited periods of time, including a 20-minute nap; two cups of coffee or a similar caffeinated beverage; brightening the dashboard; and buying a visor light box that simulates morning light and placing it on the passenger side of the vehicle.

"But if you are feeling really tired, the best thing to do is park your car and call a cab," Ming said.

Drowsy driving is a major problem in the United States. A 2011 National Sleep Foundation survey found that 60 percent of adults said they had driven at least once while drowsy, and 37 percent admitted to falling asleep at the wheel in the past year. One in six fatal traffic crashes is caused by drowsy driving, according to the American Automobile Association.

More information

The U.S. National Sleep Foundation has more about drowsy driving.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

Health Highlights: Nov. 26, 2013

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

Obamacare Contraception Fight Goes to Supreme Court

The U.S. Supreme Court agreed Tuesday to review provisions in the Affordable Care Act that require companies of a certain size to offer employees insurance coverage for birth control and other reproductive health services without a co-pay.

The court will examine whether non-profit organizations and private companies can snub the requirement by claiming it violates their religious beliefs. Oral arguments will likely be heard in March and a ruling issued by late June, CNN reported.

Nearly 100 lawsuits have been filed in federal court challenging the contraception coverage provision. Three federal appeals courts have struck down the birth control rule, while two others have upheld it.

Companies that refuse to provide the coverage could be fined up to $1.3 million a day, CNN reported.

The Supreme Court's decision to hear the case is an "important fight for Americans' religious liberty," according to Kyle Duncan, general counsel of the Becket Fund for Religious Liberty and lead lawyer for Hobby Lobby, one of the companies challenging the birth control provision.

The owners of Hobby Lobby say there is a clash between their Christian beliefs and the fact that some of the drugs that would be provided under the rule prevent human embryos from being implanted in the womb, which they equate to abortion. They do not object to providing other forms of contraception, such as condoms and diaphragms, for their employees, CNN reported.

Federal government officials say their are rules that exempt certain nonprofit groups and religiously-affiliated organizations from the contraceptives coverage requirement. In such cases, women would receive coverage from another company at no cost.

Supporters of the law note it does not require individual company owners to personally provide coverage they might find objectionable, but instead puts that responsibility on the corporate entity, CNN reported.

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Whooping Cough Shot May Halt Illness But Not Transmission, Animal Study Suggests

Baboons that were recently vaccinated against whooping cough don't get sick but still carry the infection in their throats and can spread the disease to unvaccinated baboons, according to a new study.

Researchers say the finding may help explain the recent dramatic rise in cases of whooping cough across the United States, which reached a 50-year high in 2012, The New York Times reported.

The study was published Monday in the journal Proceedings of the National Academy of Sciences.

"When you're newly vaccinated you are an asymptomatic carrier, which is good for you, but not for the population," said study leader author Dr. Tod Merkel, a researcher in the Office of Vaccines Research and Review in the Food and Drug Administration, The Times reported.

The study finding was surprising and could be important as scientists try to improve whooping cough vaccines for people, experts say.

Current whooping cough vaccines were introduced in the 1990s after an older version was found to cause side effects. However, the new vaccines begin to lose effectiveness after about five years, The Times reported.

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European Morning-After Pill Ineffective in Heavier Women

The label on a "morning-after" emergency contraceptive sold in Europe will be changed to alert consumers that it is not effective in women who weigh more than 176 pounds.

The new warning on the label of Norlevo will also caution that the pill starts to lose its effectiveness in women heavier than 165 pounds, and is not recommended for anyone over this weight, CBS News reported.

"When we became aware that there appeared to be an impact on efficacy (linked to weight), we felt it was our ethical duty as a drug manufacturer to report it and be transparent," Erin Gainer, CEO of HRA Pharma, the French manufacturer of Norlevo, told the New York Daily News.

Norlevo is identical in formula to the over-the-counter Plan B One-Step emergency contraceptive sold in the United States. The U.S. maker of Plan B One-Step, Teva Pharmaceutical Industries, declined to comment on the issue when asked about it by the Daily News and Mother Jones, CBS News reported.

Copyright © 2013 HealthDay. All rights reserved.

Want to Stay Young? Start Moving

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TUESDAY, Nov. 26, 2013 (HealthDay News) -- A new study finds that exercise among older adults helps ward off depression, dementia and other health problems, such as heart disease, cancer and diabetes.

Exercise increased the odds of healthy aging as much as sevenfold, the researchers found. And apparently it's never too late to start: Even adults who don't begin exercising until they're older could increase their odds of healthy aging threefold, the researchers said.

"In a growing elderly population, it is important to encourage healthy aging. Physical activity is effective in maintaining health in old age," said lead researcher Mark Hamer, from the department of epidemiology and public health at University College London, in England.

"Encouraging physical activity in older adults is of benefit, and small changes are also linked to healthier aging," he said.

The report was published online Nov. 25 in the British Journal of Sports Medicine.

Samantha Heller, a senior clinical nutritionist and exercise physiologist at NYU Langone Medical Center in New York City, said it's well known that physical activity and exercise are good for you. "Regular exercise staves off chronic diseases like cancer, heart disease, diabetes and depression," she said.

"What this study emphasizes is that the 'I'm too old' excuse doesn't fly, because it is never too late to get your fanny off the couch and out the door for some exercise," she said.

The benefits of exercise include better circulation and improved bone, muscle, cardiovascular and organ health. Even the brain benefits from regular exercise, which increases communication between neurons and slows the brain tissue loss associated with aging and mental decline, Heller said.

"The question we face now is, How do we motivate and support people of all ages to get moving and keep moving? There is an undeniable resistance among non-exercisers to the notion of motion," Heller said. "On an individual level, we can gently insist that family and friends join us in regular walks, a dance or yoga class, a game of tag, or an exercise DVD."

Partnering with someone is a real motivator, Heller said. "Give a session with a qualified personal trainer as a holiday gift; explore fitness-class offerings at the local YMCA or community or senior centers; or sign up for a charity walk, run or swim."

For the study, Hamer and his colleagues collected data on nearly 3,500 people with an average age of 64 who took part in the English Longitudinal Study of Aging.

As part of the study, the participants reported their level of physical activity every two years between 2002-'03 and 2010-'11.

The researchers categorized the participants by how much exercise they did each week. There were those who were inactive, those who did moderate exercise and those who exercised vigorously.

In addition, the researchers kept track of serious health problems, such as heart disease, stroke, diabetes, emphysema and Alzheimer's disease. They also monitored the participants' mental health and physical.

Over eight years, almost one in 10 participants became active and 70 percent remained active. The others stayed inactive or became inactive.

By the end of the study, almost 40 percent of the participants developed a chronic medical condition, nearly 20 percent were depressed, 20 percent were mentally impaired and one-third had a disability.

One in five, however, was considered by the researchers to be a "healthy ager." There was a direct association between healthy aging and exercise, the researchers said, although they did not prove a cause-and-effect link.

People who partook in moderate or vigorous physical activity at least once a week were three to four times more likely to be healthy agers, compared with those who remained inactive, the researchers found.

Moreover, people who were active at the start of the study were seven times more likely to be healthy agers than people who were inactive and remained so, the researchers found.

More information

For more on the benefits of exercise, visit the U.S. Centers for Disease Control and Prevention.

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 26, 2013 (HealthDay News) -- Allergies and hay fever may increase the number and severity of migraine headaches, according to a new study.

Researchers analyzed data from nearly 6,000 migraine sufferers who filled out a questionnaire in 2008 as part of the American Migraine Prevalence and Prevention Study. Two-thirds of the respondents said they had nasal or seasonal allergies, or hay fever.

Based on the findings, the study authors concluded that those with allergies and hay fever were 33 percent more likely to have more frequent migraines than those without these conditions. The report was published online Nov. 25 in the journal Cephalalgia.

The study is one of the first to link the frequency of migraines to irritation and inflammation of the nasal mucus membrane caused by allergic and non-allergic triggers, according to lead author Dr. Vincent Martin. He is a professor of medicine at the University of Cincinnati and co-director of the university's Headache and Facial Pain Program.

"We are not sure whether the [allergies and hay fever] causes the increased frequency of headaches or whether the migraine attacks themselves produce symptoms of [allergies and hay fever] in these patients," Martin said in a university news release. "What we can say is if you have these symptoms, you are more likely to have more frequent and disabling headaches."

The findings could prove important in treating migraines, according to study principal investigator Dr. Richard Lipton, co-director of the Headache Center at Montefiore Medical Center in New York City.

"The nose has largely been ignored as an important site involved in the initiation and [worsening] of migraine headache," he said in the news release. If allergies and hay fever worsen migraine symptoms, as the study findings suggest, treating these nasal conditions may help relieve headache in people with both disorders, noted Lipton. He is also a professor of neurology at the Albert Einstein College of Medicine at Yeshiva University.

About 12 percent of people in the United States have migraines, which are three times more common among women than men. Allergies and hay fever affect between one-quarter to one-half of the U.S. population. Symptoms include a stuffy and runny nose, postnasal drip and itchy nose.

More information

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

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 26, 2013 (HealthDay News) -- Premature infants with no obvious problems in the structure of their brains may still have subtle chemical differences compared with full-term babies, a new study finds.

Researchers said it's not clear if these microscopic differences are actually signs of trouble. But they hope that a deeper understanding of preemies' brain development will eventually be useful in improving their outlook.

"Many premature infants are healthy, but they are at increased risk of problems," said lead researcher Stefan Bluml, of Children's Hospital Los Angeles. Those problems can include learning disabilities, behavioral issues -- such as attention-deficit/hyperactivity disorder -- and autism.

To gain more insight into preemie brain development, Bluml's team used magnetic resonance spectroscopy (MRS) to image infants' brains on the microscopic level.

All 81 babies in the study -- 30 preterm and 51 full-term -- had normal brain structure, based on standard MRI scans. But when the researchers used MRS, they saw "biochemical" differences between the premature and full-term infants.

In general, the preemies showed an "early start" in the brain's white matter development, which put it out of sync with the maturation of the brain's gray matter. Gray matter can be seen as the brain's information-processing centers, while white matter is like the wiring connecting those centers.

Bluml described it as a "false start" in preemies' white matter development, and the trigger appears to take place after birth. It's not clear what that trigger is, but one possibility, according to Bluml, is oxygen.

The fetal brain, he explained, is designed to develop in a low-oxygen environment. At birth, babies are thrust into a much more oxygen-rich world, and preemies' brains might not be quite ready for that.

Still, it's not clear if the brain differences Bluml's team found are "bad." "These might be necessary compensatory mechanisms," Bluml said. "At present, it's not clear. We're just saying there are differences."

The findings are scheduled for presentation Sunday at the Radiological Society of North America annual meeting, in Chicago. Research presented at meetings should be viewed as preliminary until published in a peer-reviewed medical journal.

One expert agreed that the significance is unknown. But it would be interesting to follow these infants over time, to see if the chemical differences are associated with any learning or behavior issues later, said Dr. Madhavi Koneru, a neonatologist who treats newborns at McLane Children's Hospital at Scott & White in Temple, Texas.

"What does this mean down the road? That's what we want to know," Koneru said.

In recent years, medical advances have allowed more and more of the tiniest preemies to survive. But, Koneru said, "surviving is not enough. We want them to thrive."

She said she thinks that brain-imaging research like this will one day aid in improving preemies' outcomes.

For now, Bluml said, they are just trying to map the course that preemies' brain maturation typically takes. "Our goal is to establish certain landmarks of brain development," he said.

Eventually, he added, MRS scans could potentially be used to evaluate whether a therapy for preterm babies is actually having an effect on brain development.

More information

The March of Dimes has more on preterm birth.

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 26, 2013 (HealthDay News) -- As young children sleep, the connections between the right and left sides of their brains strengthen, according to a small new study.

Researchers measured the brain activity of eight children while they slept at ages 2, 3 and 5 years. They found that connections in the brain generally became stronger during sleep as the children aged.

The strength of the connections between the left and right sides of the brain increase as much as 20 percent over a night's sleep, according to the study, which was published online Nov. 12 in the journal Brain Sciences.

"There are strong indications that sleep and brain maturation are closely related, but at this time, it is not known how sleep leads to changes in brain structure," study leader Salome Kurth, a postdoctoral researcher at the University of Colorado, Boulder, said in a university news release.

How sleep disruption during childhood may affect brain development and behavior will be examined in future studies.

"I believe inadequate sleep in childhood may affect the maturation of the brain related to the emergence of developmental or mood disorders," Kurth said.

It was already known that the brain changes drastically during early childhood. New connections are formed, others disappear and a fatty layer called "myelin" forms around nerve fibers in the brain. The growth of myelin strengthens the connections by speeding up the transfer of information, according to background information included in the news release.

Maturation of nerve fibers improves children's skills in areas such as language, attention and impulse control. But it hasn't been clear what role sleep plays in the development of such brain connections.

More information

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

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

Health Tip: Soothing Baby's Eczema

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(HealthDay News) -- Eczema can cause red, itchy, dry patches on baby's skin, particularly in the folds of the legs and arms.

The American Academy of Pediatrics suggests how to help treat baby's eczema:

  • Talk to your pediatrician about which over-the-counter lotions or creams are best for your child's eczema.
  • If your baby's eczema is mild, the pediatrician may not recommend any treatment
  • To keep eczema at bay, bathe baby with a very gentle cleanser, and use a gentle detergent to clean baby's clothes.
  • Dress baby in soft clothing, avoiding wool and similar scratchy fabrics.
  • Avoid frequent baths, limiting to no more than three times per week.
  • Talk to the doctor about whether baby should avoid any foods.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

Health Tip: Limiting Kids' TV Time

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(HealthDay News) -- If you decide your children are spending too much time in front of the television, the University of Michigan Health System offers this advice for limiting kids' TV time:

  • Set rules about when TV is not allowed, such as during meals or homework.
  • Restrict TV to no more than two hours per day.
  • Don't allow your child to watch TV until homework and chores are finished. If your child is doing poorly in school, consider abolishing TV altogether.
  • Focus on conversation instead of television, and spend more time reading together.
  • Encourage physical activity and hobbies.
  • Don't use TV as a reward, punishment or babysitter.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 25, 2013 (HealthDay News) -- The U.S. Food and Drug Administration announced Monday that it is lifting the tough safety restrictions it imposed on the diabetes drug Avandia two years ago because of reported links to heart problems.

The agency's decision was expected, and follows up on a June vote by an expert advisory panel to rescind the restrictions, based on new data that suggested the medication may not be as harmful as once thought.

Avandia had been taken off drug store shelves in 2011, and its use restricted to patients who first signed a waiver saying they understood the possible risks. Only specially registered pharmacies could dispense Avandia.

But an independent review by Duke University researchers, based on Avandia's original clinical trial, concluded that patients had no elevated risk of heart attack or death compared with those taking standard diabetes drugs.

"Our actions today reflect the most current scientific knowledge about the risks and benefits of this drug," Dr. Janet Woodcock, director of the FDA's Center for Drug Evaluation and Research, said in a statement. "Given these new results, our level of concern is considerably reduced. Thus, we are requiring the removal of certain prescribing restrictions."

Dr. Steven Nissen, head of cardiology at Cleveland Clinic, first sounded the alarm about Avandia in 2007 with an analysis of 42 studies that showed that the medication caused a 43 percent increased risk of heart attack.

Following his study, an FDA analysis of more than 50 studies concluded that Avandia was linked to an increased risk of heart problems, and the agency decided to pull the drug from pharmacy shelves.

However, the FDA also asked drug maker GlaxoSmithKline to review key aspects of Avandia's clinical trial related to heart safety. This was the review that led to Monday's decision.

Nissen condemned the FDA's latest action.

"This decision is not in the public interest," Nissen said. "It's really more about the FDA than it is about the drug. It does not make any good regulatory sense, and in fact it's rather bizarre."

Not everyone agreed with him, however.

Dr. Yehuda Handelsman, an endocrinologist in Tarzana, Calif. and incoming president of the American College of Endocrinology, applauded the FDA for "doing what's right by standing up for the science."

"I thought it was about time. Many of us never thought the information brought against the drug was very scientifically solid or correct," Handelsman said of today's announcement.

For his part, Dr. Bob Eckel, a past president of the American Heart Association, greeted the news with more of a shrug.

"I think they've made the appropriate decision based on the updated evidence," Eckel said. "It's consistent with the latest evidence."

Both Nissen and Eckel agreed that widespread use of Avandia is not likely to resume, regardless of the FDA's change of heart, because too many concerns have been raised regarding the drug's safety.

"The good news is physicians are not going to start using this drug again. It's basically an obsolete drug, so this will have no practical implications," Nissen said. "Who's going to use it? What patient is going to take it and what doctor is going to prescribe it, given everything we know?"

Another expert concurred. "The decision by the FDA is irrelevant in clinical practice," said Dr. Ronald Tamler, clinical director of the Mount Sinai Diabetes Center at The Mount Sinai Hospital in New York City. "Patients have been reading about increased risk of cardiovascular events with Avandia since 2007 and will not abandon their concerns overnight, despite the FDA decision. Moreover, a medication with similar properties, pioglitazone [Actos], is available as a generic drug at a much lower cost."

But Handelsman said Avandia -- or its generic form -- might still have a bright future.

It's entirely possible that Avandia could come back in generic form, and that diabetes doctors might start prescribing it again as a viable option to other medications. "For us, it's not a problem to use," he said.

In its heyday, Avandia was a blockbuster diabetes drug for maker GlaxoSmithKline, with about $3.2 billion in sales posted in 2006.

Under the FDA's decision, the drug's information will be changed to reflect that Avandia may be used along with diet and exercise to improve control of blood sugar in type 2 diabetes patients. Patients will be able to receive the medication through regular and mail-order pharmacies.

More information

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

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 25 (HealthDay News) -- Despite recent outbreaks of bacterial meningitis at Princeton University and the University of California, Santa Barbara, U.S. health officials said Monday that students are safe to travel home for the Thanksgiving break.

At Princeton, there have been seven confirmed cases and one additional case now under study. At UCSB, three cases have been confirmed so far, according to experts at the U.S. Centers for Disease Control and Prevention.

"There have been no fatalities from these outbreaks, but there have been some very serious cases," CDC medical officer Dr. Amanda Cohn said during an afternoon press conference.

Despite the outbreaks, Cohn said, there is no need for students from these schools or their families to change Thanksgiving plans.

"CDC does not recommend curtailing social interactions or canceling travel plans as a preventative measure," she said. "Instead, we want to remind students from these universities to remain vigilant and watch for symptoms, seek treatment. Also [health care] providers should be aware of the situation."

Both outbreaks of meningococcal disease involve the so-called B strain, for which there is no approved vaccine licensed in the United States. A new vaccine against the B strain of the disease is licensed in Europe and Australia, Cohn said, and the CDC and the U.S. Food and Drug Administration have agreed to allow its use in Princeton to prevent further spread of the outbreak.

Final steps to permit its use in the United States are ongoing, and it's hoped that vaccinations can begin after Thanksgiving, Cohn said. The company that makes the vaccine hasn't sought its approval in the United States, and is instead looking to have a vaccine approved that covers all strains of meningococcal disease -- including the B strain.

Cohn stressed that meningitis isn't a particularly easy disease for people to catch. That's because meningitis bacteria are hard to spread and don't survive long outside the body. "They are spread through the exchange of respiratory secretions," Cohn said. "So, they spread through close contact, such as household contact or 'French' kissing."

The bacteria cannot be spread by simply being in the same room with someone who is infected or handling items they have touched, Cohn added. People who may have been exposed to someone with meningitis are typically given antibiotics to prevent the possibility of developing the disease.

Right now, many American adolescents get shots against the C, Y, A and W strains of the disease. Cohn said that vaccine coverage for these strains is currently very high at both of the affected universities.

Overall, fewer than 1,000 cases of meningitis are seen each year in the United States, she said. "In 2012, about 500 cases were reported," Cohn said. "We do see a couple of outbreaks each year." Most outbreaks occur in schools or organizations.

Since the 1990s, cases have been dropping because of the increased vaccination rate, Cohn said. In those years, there were typically 3,000 cases a year.

Bacterial meningitis can be deadly. About 10 percent to 15 percent of people who get sick die, and about 15 percent of survivors have long-term disabilities. These include the loss of arms or legs, deafness, nervous system problems or brain damage, Cohn said.

Immediate treatment is essential to prevent these consequences, but it is often difficult to diagnose meningitis, because the early symptoms are so similar to flu, she said.

Signs and symptoms of meningitis include high fever, headache and stiff neck.

"When we say headache, it's among the worst headache that somebody has had in their life. And with a stiff neck, they really can't move their neck. For example, they can't touch their chin to their chest," Cohn explained. Other symptoms include nausea and vomiting, sensitivity to light, exhaustion, confusion and sometimes a rash, she said.

More information

For more on bacterial meningitis, visit the U.S. Centers for Disease Control and Prevention.

Copyright © 2013 HealthDay. All rights reserved.

How the 'Love Hormone' Works Its Magic

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MONDAY, Nov. 25, 2013 (HealthDay News) -- Scientists, and women everywhere, have long wondered exactly what keeps a man from straying with a stranger.

From a biological perspective, at least, cheating is easy to understand. The more sexual partners a man has, the more likely he'll be to pass on his genetic material.

So why do so many men settle down, get married and stick around to raise their kids?

Researchers think they may have found a clue in oxytocin, a hormone released during sex and other intimate gestures like hugging or holding hands that's been proven to strengthen social bonds in other mammals.

They found that the hormone appears to boost men's attraction to their mate -- even when presented with pictures of other women.

The findings are published in this week's issue of the Proceedings of the National Academy of Sciences.

In the study, 20 men who were in committed relationships for 28 months, on average, took whiffs of either oxytocin nasal spray or an inactive placebo spray.

For the first test, the men looked at pictures of their partner, a woman they'd never met, or a house. The photos of the women were carefully matched so one wasn't more attractive than the other.

In the second experiment, they looked at pictures of their partners or of women they knew but weren't related to, perhaps someone they saw at work every day.

Then the men rated the attraction they felt to the various faces. Men consistently rated their partners as being more attractive and arousing than the other women and, in most cases, a whiff of oxytocin boosted that effect compared to the placebo.

But what really fascinated the researchers was what happened inside the men's brains.

Under the influence of oxytocin, two areas of the brain responsible for feelings of reward and pleasure lit up when men saw their partner's faces. But the sight of other women had the opposite effect, suppressing feelings of pleasure.

"Oxytocin triggers the reward system to activate on the partner's face, the presence of the partner," said study author Dr. Rene Hurlemann, a professor of psychiatry at the University of Bonn, in Germany.

"Sexual monogamy is actually quite costly for males, so there must be some form of mechanism binding males and females together, at least for some time," Hurlemann said. "There must be some benefit, and reward is actually the strongest motivation underlying human behavior."

An expert who was not involved in the study said the results suggest that couples who keep a high level of intimacy in their relationships can maintain stronger bonds.

"When you're first becoming intimate, you're releasing lots of dopamine and oxytocin. That's creating that link between the neural systems that are processing your facial cues, your voice and the reward system" of a partner's brain, said Larry Young, a professor of psychiatry at Emory University in Atlanta. He studies the role of oxytocin in social bonding.

As time goes on, and couples become less intimate, Young noted that linkage can decay. But activities that release oxytocin, such as really looking into another person's eyes, holding hands, kissing and having sex may help restore the connection.

"To me, it suggests that it may be a way to help prevent the decay that can occur that leads couples to separate," he said.

Hurlemann agreed: "I think this is the only reason that we do hug and touch each other all the time. I think this is the mechanism that keeps oxytocin levels high in relationships."

More information

Head to the U.S. Centers for Disease Control and Prevention for more on sexual health.

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 25, 2013 (HealthDay News) -- Children of mothers who take a widely used class of antidepressants during pregnancy are not at increased risk for autism, a large new study finds.

Autism, a neurodevelopmental disorder that affects communication and social skills, is estimated to affect about one in 88 children in the United States.

Previous research has suggested that women who take antidepressants during pregnancy are up to five times more likely to have children with autism.

This study focused on antidepressants called selective serotonin reuptake inhibitors (SSRIs), such as Prozac (fluoxetine) and Paxil (paroxetine). Researchers followed more than 600,000 Danish children born between 1996 and 2006.

Initial results showed an almost 2 percent risk of having a child with autism for pregnant women who took SSRIs during their pregnancy, compared with 1.5 percent for those who did not.

However, after analyzing mental health diagnoses among the children's siblings and parents, the researchers concluded that the risk of autism associated with SSRIs was minimal. The finding was published recently in the journal Clinical Epidemiology.

"More and more women are given antidepressant medication while they are pregnant. And an increasing number of children are diagnosed with autism. This has given rise to concern over a possible connection," study author Jakob Christensen, a researcher at Aarhus University and staff specialist at Aarhus University Hospital, said in a university news release.

However, he said, "In contrast to other, smaller studies, our survey cannot demonstrate that the risk of having a child with autism is increased by taking antidepressant medication during pregnancy."

The researchers noted that there may be other risks associated with taking antidepressants during pregnancy, and women should talk to their doctor if they are taking any type of medication and are thinking about becoming pregnant.

More information

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

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 25, 2013 (HealthDay News) -- When it comes to being vaccinated and protected against the human papillomavirus (HPV), too many U.S. adolescents are missing out, a new review finds.

Cost and parental concerns about the link to sexual activity may be why relatively low numbers of girls and boys are getting the HPV vaccine as recommended.

Educating doctors and parents about the benefits of the vaccine and debunking some of the myths that surround it may help improve these rates and protect more adolescents, experts said.

Two available HPV vaccines -- Cervarix and Gardasil -- protect against the strains of genital warts responsible for 70 percent of all cases of cervical cancer. The U.S. Centers for Disease Control and Prevention currently recommends routine HPV vaccination for girls aged 11 to 12.

They also recommend Gardasil for males starting at age 11 to protect against genital warts, as well as oral, penis and rectal cancers.

But "parents have a number of concerns including the mindset that 'my child isn't sexually active yet,' and many may hope that they will remain inactive for years to come," said study author Dawn Holman.

However, "vaccinating young is when the shot is most effective and a great way to protect your child's health, even if they wait to get married to become sexually active," said Holman, a behavioral scientist at the CDC's Division of Cancer Prevention and Control.

Holman and colleagues reviewed 55 studies on the HPV vaccine published from 2009 through 2012 to see why the rates remain low in comparison to other recommended vaccines. Their findings appear online in the Nov. 25 issue of JAMA Pediatrics.

Cost was cited as a major barrier by many parents. The American Cancer Society reports that the vaccine can cost about $130 per dose, and a series of three shots is required. Current changes in health care may help remove the cost barrier for some people, Holman said, and financial assistance programs are available to help pay for the shots.

Beside identifying barriers, the new study also highlighted ways to improve rates of HPV vaccine acceptance.

"Parents report that a recommendation from their health care provider is the key factor in their decision," Holman said, yet the study found that many didn't get this recommendation from their doctor.

Dr. Greg Yapalater, a pediatrician in New York City, routinely counsels adolescents and their parents about the HPV shot. "People shy away from anything that has to do with sex, and this shot has to do with the sex talk," he noted.

When talking to families, Yapalater discusses puberty and sexually transmitted diseases and how not to get them. "This opens up the chapter in terms of condoms and vaccinations," he said. "I spend time discussing this with the entire family as ultimately the parents are the ones who will say yes or no to the vaccine."

Many parents fear that vaccinating against HPV will encourage their children to be promiscuous, but this is not the case, he said. "Educating families can help debunk any of these myths or concerns associated with the vaccine. This is an amazing vaccine because it prevents cancer."

Dr. Mark Wakabayashi, co-director of the gynecological cancers program and chief of gynecologic oncology at City of Hope Cancer Center in Duarte, Calif., treats people who have some of the cancers this shot may help prevent. So he finds less resistance among his patients.

Wakabayashi said that because the HPV vaccine targets a sexually transmitted infection, stigma often plays a role in people's decision for or against it. ""If this was like the chickenpox vaccine, there would be a higher rate of acceptance," he said.

More education is needed to increase acceptance of this vaccine, and this starts by educating the doctors who are tasked with providing it, he said.

Dr. Jennifer Wu, an ob/gyn at Lenox Hill Hospital in New York City, said that cost is the primary barrier among her patients when it comes to the HPV shot. Still, parents' fears about their children becoming sexually active can also be an obstacle.

"Some parents want to wait until their child is older, but the goal is to complete the series of vaccinations before the child becomes sexually active," Wu said. "You are protecting the general population, too. That is why we want boys and girls to get the shot."

More information

The U.S. Centers for Disease Control and Prevention has more about HPV vaccination.

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 25, 2013 (HealthDay News) -- Chest pain is not a symptom that doctors can use to accurately diagnose a woman suffering a major heart attack, according to new research.

A survey of about 800 women and 1,700 men found that women tend to suffer the same types of chest pain as men during a heart attack, Swiss researchers from the University Hospital Basel said.

However, most of the chest pain symptoms reported by women could not be used to tell a heart attack from some other cause of severe chest pain.

Doctors said the study, which was published Nov. 25 in the journal JAMA Internal Medicine, provides further evidence that emergency-room doctors should use concrete heart tests to diagnose a heart attack.

These tests include the electrocardiogram (EKG), which checks the heart's electrical activity, and the cardiac troponin test, which is a blood test that checks for proteins called troponins that are released when the heart muscle is damaged.

"Doctors must be much more aggressive in trying to diagnose heart disease through EKG and troponins, because without those objective data it's very hard to tell it's a woman's heart," said Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York City. "The symptoms aren't going to tell us. We have to use the diagnostic tools we have."

Some physicians, however, expressed concern that these findings, while important to doctors, would prompt some women to ignore chest pain that otherwise would have sent them to the hospital for testing.

"We use symptoms to try to drive people to the hospital, but we would never diagnose a heart attack by symptoms alone," said Dr. Nieca Goldberg, a cardiologist and medical director of the Joan H. Tisch Center for Women's Health at NYU Langone Medical Center in New York City. "If you are experiencing chest pain, the most important thing is you get to the hospital as soon as possible. If any of the symptoms of heart attack come on all of a sudden, don't just ignore it."

About nine out of 10 people suffering a heart attack complain of chest pain or discomfort, the researchers said. But there are many other medical problems that can also cause chest pain, in addition to heart attacks.

Women also are more likely to experience other common signs of heart attacks. These include shortness of breath, nausea, vomiting, and pain in the back, neck or jaw.

The Swiss study involved nearly 2,500 people suffering from severe chest pain who went to one of nine different emergency rooms.

Of those people with chest pain, only 18 percent of women and 22 percent of men were actually suffering a heart attack, the researchers found.

Looking at the women, the researchers assessed the ability of 34 different chest-pain characteristics to accurately determine whether the patient was having a heart attack. These included things like the location of the pain, where the pain radiated from, what the pain felt like, and whether movement, breathing or other factors aggravated the pain.

Although some differences emerged, they were too small to support their use in the early diagnosis of heart attack in women, the researchers said.

"None of the chest pain characteristics were helpful in differentiating [heart attack] from other causes of chest pain," Steinbaum said. "If a woman had chest pain, it was very difficult to determine if that chest pain was her heart."

More information

For more information on women's heart attack symptoms, visit the American Heart Association.

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 25 (HealthDay News) -- Low levels of the hormone estrogen are not to blame for mood swings and poor memory after menopause, a new study suggests.

Based on this finding, the researchers believe there's no reason to use hormone replacement therapy to boost mental well-being after periods stop.

"These study findings provide further evidence that a woman's decision about hormone therapy use during early postmenopause should be made independently of considerations about thinking abilities," said lead researcher Dr. Victor Henderson, a professor of neurology and neurological science at Stanford University in California.

However, while estrogen wasn't tied to any mental benefits, the study found that another hormone -- progesterone -- might affect thinking ability in younger women.

But this could be a chance finding and merits further investigation, according to the report, published online Nov. 25 in the Proceedings of the National Academy of Sciences.

The sex hormones estrogen and progesterone typically decline in a woman's 30s and 40s, eventually resulting in menopause and an end to fertility. The average age of menopause is about 50.

The benefits and harms of hormone replacement therapy have been the subject of much debate. Previous studies have linked use of synthetic hormones after menopause with increased risk for heart disease, stroke, blood clots and breast cancer.

Dr. Jennifer Wu, an obstetrician/gynecologist at Lenox Hill Hospital in New York City, said that after menopause "a lot of women think that lack of estrogen will lead to mental decline, and that's just not the case."

Doctors don't usually start with hormone replacement therapy as the first line of treatment for postmenopausal symptoms because of the associated risks, she said.

"Trying to maintain mental abilities is not a reason to take on all the risks of hormone replacement therapy," she said. And other medications are available for treating hot flashes -- episodes of intense body heat related to menopause.

Some scientists theorized that estrogen's effect on thinking might depend on how soon after menopause hormone levels were boosted. This led the researchers of this study to divide the participants into two groups -- women within six years of menopause and those more than 10 years beyond menopause.

Henderson said length of time in estrogen decline appeared to make no difference. "We found that the relation between blood levels of estrogen and memory or planning skills is the same in younger postmenopausal women as in older postmenopausal women," he said. "Essentially, for estrogen there is no association at either age."

Although these findings don't absolutely rule out estrogen as relevant to thinking and memory, since there is no direct way of measuring estrogen in the brain, they suggest that boosting estrogen levels -- even in younger postmenopausal women -- may not affect mental skills one way or the other, he said.

Dr. Marc Gordon, chief of neurology at Zucker Hillside Hospital in Glen Oaks, N.Y., agreed that this finding doesn't "support the hypothesis that younger postmenopausal women would be more responsive to the beneficial effects of estrogen on their mental abilities."

He also said the correlation between higher progesterone levels and better memory and thinking skills in younger women needs to be replicated. "It is not yet clear what the effect of this sex hormone on the brain may be," he added.

The study relied on data on more than 600 postmenopausal women, aged 41 to 84. None of them was using hormone replacement therapy.

Researchers administered a series of tests to gauge the women's memory and overall thinking skills. They also assessed them for depression, and measured levels of the hormones estradiol, estrone, progesterone and testosterone.

More information

For more information on hormone replacement therapy, visit the U.S. National Library of Medicine.

Copyright © 2013 HealthDay. All rights reserved.

Olysio Approved as Hepatitis C Treatment

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MONDAY, Nov. 25, 2013 (HealthDay News) -- Olysio (simeprevir) has been approved by the U.S. Food and Drug Administration to treat chronic hepatitis C infection in adults.

The hepatitis C virus causes inflammation of the liver, which can inhibit the organ's function and ultimately lead to deadly liver failure. Most people have no symptoms until the virus causes liver damage, the agency said in a news release. Complications of the disease, which affects some 3.2 million Americans, could include a yellowing of the eyes and skin known as jaundice, abdominal fluid accumulation or liver cancer.

The new drug was approved to be used with two other antiviral medications to treat people who have cirrhosis but whose liver is still functioning, people who haven't been treated for hepatitis C previously, or for people who haven't responded to other therapies, the FDA said. The new drug should only be used in combination with peginterferon-alfa and ribavirin, and should not be administered by itself, the agency warned.

Olysio, combined with the other two drugs, was evaluated in clinical studies involving more than 2,000 people. Common side effects included rash, itching and nausea. Noting the potential for serious reactions involving light exposure, users are advised to avoid the sun and to use sunscreen and other protective measures during treatment, the FDA said.

Olysio is marketed by Raritan, N.J.-based Janssen Pharmaceuticals.

More information

The U.S. Centers for Disease Control and Prevention has more about hepatitis C.

-- Scott Roberts

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 25, 2013 (HealthDay News) -- DNA can be used to predict taller-than-average height, a new study finds.

This could prove useful in criminal investigations and in estimating if a child will be abnormally tall as an adult, the researchers said.

Their study of nearly 800 extremely tall adults and more than 9,000 normal-height people focused on 180 DNA variants previously linked to normal height differences. Forty percent of the DNA variants showed a significant effect on height in tall people.

The findings appeared Nov. 20 in the journal Human Genetics.

The study wasn't as accurate as past research that used DNA to predict eye color, hair color and age, study leader Professor Manfred Kayser said in a journal news release.

"[Still], I expect that upcoming new knowledge on height genetics will further increase the accuracy in predicting tall stature, and eventually the full range of body height, from DNA," said Kayser, a member of the department of forensic molecular biology at Erasmus University Medical Center, in the Netherlands.

That could help police when they're trying to identify suspects in crimes.

"In forensics, DNA-based prediction of appearance traits such as height, eye color, hair color and age, is useful to find unknown perpetrators whose conventional DNA profiles are not known to the investigating authorities and who thus escape current DNA identification," Kayser said.

There are also medical benefits for children with certain growth issues, said study co-author Professor Stenvert Drop, of the Erasmus University Medical Center's department of pediatrics.

"DNA-based prediction of extreme body height is relevant in pediatrics to estimate the expected body height of a child in adulthood, which can assist in considering growth-limiting treatment," Drop said in the news release.

More information

The U.S. Centers for Disease Control and Prevention website includes children's growth charts.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 25, 2013 (HealthDay News) -- When it comes to making friends in high school, the classes a student chooses seems to set the course, a new study finds.

Researchers analyzed data from about 3,000 students at 78 U.S. high schools and found that teens were more likely to make friends in small classes. These classes were often non-mandatory courses known as "electives," which distinguished these students from a school's general population.

For example, the study authors explained, friendships were more likely to develop in Latin and woodshop classes than in a large physical education class that all students were required to take.

Students who take the same set of courses tend to get to know each other very well and may focus less on social status, such as whether a person is considered "cool" or not. These students are also less likely to judge classmates on traits such as race and gender, the researchers pointed out.

The investigators also found that girls were more likely to take demanding math classes if other girls in their shared set of courses took advanced math, according to the study published recently in the American Journal of Sociology.

Interestingly, the pattern of influence that courses had on friendships was distinctive to each high school. For example, friendships may form among students taking woodshop, Spanish and European history at one school, while in another it may be among students taking agricultural business management, advanced accounting and calculus.

"People generally want to think that kids are choosing their friends from the well-known categories like jocks and nerds -- that it's like 'The Breakfast Club' and the same at every school," study author Kenneth Frank, a professor in Michigan State University's College of Education, said in a university news release.

"But our argument is that the opportunities an adolescent has to choose friends are guided by the courses the adolescent takes and the other students who take the courses with them. Moreover, the pattern of opportunities differs from school to school," he noted.

The findings have implications for school administrators. Schools should offer classes with a thought to bringing high- and low-achieving students together. Otherwise, there is the risk of driving them apart socially and academically, Frank said.

More information

The American Academy of Pediatrics has more about children and friends.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

H5N1 Bird Flu Vaccine Approved

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MONDAY, Nov. 25, 2013 (HealthDay News) -- A new vaccine has been approved by the U.S. Food and Drug Administration to prevent the so-called "bird flu" virus in adults at greater-than-average risk of exposure, the FDA said.

While most strains of bird flu don't infect people, the H5N1 virus has caused "serious illness and death in people outside of the U.S., mostly among people who have been in close contact with infected and ill poultry," the agency said in a news release announcing the approval.

The shot, called the Influenza A (H5N1) Virus Monovalent Vaccine, has been developed "in the event that the H5N1 avian influenza virus develops the capability to spread efficiently from human to human, resulting in the rapid spread of the disease across the globe," the FDA added.

The vaccine, produced by a Canadian subsidiary of GlaxoSmithKline, is not intended for commercial distribution, the FDA said. It's designed to be administered in two doses given three weeks apart.

In clinical testing involving some 3,400 adults, the most common side effects included injection-site pain and swelling, muscle aches, headache and fatigue.

More information

To learn more about bird flu, visit flu.gov.

-- Scott Roberts

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 25, 2013 (HealthDay News) -- The U.S. Food and Drug Administration has approved a new drug for chronic hepatitis C infection that some experts hope will cut down on side effects from current therapies.

Hepatitis C infection triggers an inflammation of the liver that can lead to reduced liver function, liver failure and even death over time. According to the U.S. Centers for Disease Control and Prevention, 3.2 million Americans -- many of them in the "baby boomer" generation -- are infected with the hepatitis C virus.

The new drug, called Olysio (simeprevir), is approved as part of a combination antiviral drug regimen to treat certain classes of adult patients with hepatitis C. These include people who have cirrhosis or other liver disease but whose liver is still functioning, people who haven't been previously treated for their hepatitis infection, or those whose infection has not improved after prior treatment.

The approval of Olysio is promising, one expert said, because it might someday free some patients from having to rely on interferon, which can have difficult side effects.

"The approval of Olysio is the first step toward once daily interferon-free treatment of hepatitis C," said Dr. Douglas Dieterich, director of outpatient hepatology at the Icahn School of Medicine at Mount Sinai in New York City.

The FDA's approval was based on the results of six clinical trials that evaluated Olysio in combination with peginterferon-alfa and ribavirin, two other drugs commonly used to treat hepatitis C virus infection.

The three-drug combination was effective in 80 percent of patients who had never been treated for hepatitis C, the study found, compared to 50 percent effectiveness in patients who got an inactive placebo plus peginterferon-alfa and ribavirin.

The three-drug combination was also 79 percent effective in patients who had received prior treatment but had relapsed, compared to 37 percent effectiveness in people who got only the two older drugs, the FDA said.

Olysio is from the protease inhibitor class of drugs, and it works by blocking a key protein the virus needs to reproduce. It's the third such drug approved by the FDA to treat chronic hepatitis C infection. The other two drugs are Victrelis (boceprevir) and Incivek (telaprevir), both approved in 2011.

Another expert was optimistic about the treatment.

Olysio "is an important new addition to the hepatitis C virus treatment regimens, offering improved efficacy, easier administration with once-a-day dosing and an improved side effect profile," said Dr. David Bernstein, chief of the division of hepatology at North Shore University Hospital in Manhasset, N.Y.

The clinical trials for Olysio also found that patients with a specific strain of the hepatitis C virus commonly found in the United States were less likely to respond to treatment with the drug. The drug's label therefore tells doctors to screen patients for the presence of this strain before beginning treatment with Olysio and to consider other treatments for patients with this strain.

Common side effects among patients who took the three-drug combo included sensitivity to light, itching and nausea. Some patients had severe light sensitivity that required hospitalization. Patients will be advised to limit their sun exposure and to use sun protective measures when taking Olysio with peginterferon-alfa and ribavirin, the FDA said.

Dieterich believes that patients now have more options than ever before in treating hepatitis C infection.

The approval of Olysio "represents the first once-daily protease inhibitor, which when used with interferon and ribavirin, has about an 80 percent success rate in curing hepatitis C in 24 weeks," he said. "This could be the beginning of the end for hepatitis C, if everyone that has it gets tested and treated, as the CDC recommends for baby boomers."

Olysio is marketed by Janssen Pharmaceuticals.

More information

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

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 25, 2013 (HealthDay News) -- A procedure used to treat bleeding stomach ulcers could stand as a potential weapon in the battle of the bulge, a small preliminary study suggests.

The procedure is called gastric artery embolization. It involves using a catheter to introduce some "obstructive agent" -- like tiny beads or gel foam -- into an artery supplying the stomach.

In the new study, researchers reviewed the records of 14 patients who underwent embolization of the left gastric artery to treat stomach bleeding. Over the next three months, those patients lost 8 percent of their body weight, on average.

That compared with a 1 percent weight loss among 18 patients who were treated for the same problem, but had a different artery embolized.

That difference is "intriguing," the researchers said, because the left gastric artery supplies the area of the stomach that churns out the appetite-boosting hormone ghrelin.

It's possible that the reduced blood flow to that stomach region curbed patients' ghrelin production, according to lead researcher Dr. Rahmi Oklu, an assistant professor of radiology at Harvard Medical School, in Boston.

However, no one is saying embolization is the new route to a trimmer physique.

"This is just an observation that deserves more study," Oklu said. "Our point is just to say, let's look at this. It still needs to be rigorously investigated."

The findings will be presented at the annual meeting of the Radiological Society of North America, being held next week in Chicago. In general, studies presented at meetings are considered preliminary until they are published in a peer-reviewed journal.

Since the results were based on patient records, Oklu's team does not actually know if embolization lowered people's ghrelin levels.

But animal studies suggest that could be the case, according to Dr. Mitchell Roslin, chief of bariatric (weight-loss) and metabolic surgery at Lenox Hill Hospital, in New York City.

"There is some science behind this," said Roslin, who was not involved in the study.

Still, he doubted that embolization will help obese people see lasting weight loss. Ghrelin is only one of the hormones involved in appetite and metabolism. When one hormone's activity is altered, the body generally finds a way to compensate.

"With weight loss, you have to look at the long term," Roslin said. "My guess is, the response with [embolization] will be fleeting."

Gastric embolization is a minimally invasive procedure, and Oklu said it's a generally safe, same-day procedure. But it is normally used to treat bleeding -- no one knows how it would work out as an obesity treatment.

Researchers have, however, already taken a first, small step. Earlier this year, investigators reported on the first five patients to have gastric artery embolization specifically to manage obesity.

In that study, reported at an American College of Cardiology meeting, patients lost an average of 45 pounds in six months, and there were no complications. However, patients' ghrelin levels, which had dropped in the first few months after the procedure, were on the rise again by the sixth month.

And that is what you'd expect when tinkering with the hormone, according to Lenox Hill's Roslin. "I really can't imagine this will hold up in the long term," he said.

But study author Oklu said that even if ghrelin levels don't stay down, the procedure might give some people the weight loss jump-start they need.

And, he said, it might be appealing to patients who want an alternative to the extensive surgeries that, right now, stand as the only option for substantial, long-term weight loss.

More information

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

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 25, 2013 (HealthDay News) -- Politeness and consideration for fellow diners could play a role in holiday weight gain, a new study suggests.

When people are picking snacks and other foods for themselves and someone else, their choices are different when the other person is average-sized than when the person is overweight, the researchers found.

In an experiment, participants chose a snack of either wheat crackers or chocolate chip cookies for themselves and a woman they had just met. In some cases, the woman was her normal weight (wearing a size zero or two). At other times she wore a body suit that appeared to increase her weight by nearly 65 pounds (making her closer to a size 16).

Nearly 60 percent of the participants chose the same snack for themselves and the woman when she appeared overweight. But, this occurred just about 30 percent of the time when the woman was her normal size.

"What the results show is that people pick the same snack to avoid offending someone they perceive as overweight," study co-leader Gavan Fitzsimons, a marketing professor at the Duke University School of Business, said in a university news release.

"This means that people might pick unhealthier options for themselves and others during the holidays if they think not doing so could hurt someone's feelings," he said.

In additional experiments, participants told the researchers they thought it would be offensive to give an overweight person healthy food and then take unhealthy food for themselves, said study co-leader Peggy Liu, a marketing doctoral student. Similarly, the participants said it would be offensive to give an overweight person unhealthy food and then take healthy food for themselves.

"This suggests that if you are heading back to the buffet to cut a piece of pumpkin pie for your overweight uncle, you might also cut a larger piece than normal for yourself so you don't hurt his feelings," Liu said in the news release.

The study appears in the November issue of the journal Organizational Behavior and Human Decision Processes.

More information

The U.S. Centers for Disease Control and Prevention outlines how to prevent weight gain.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 25, 2013 (HealthDay News) -- Having youngsters use smaller bowls may be one way to help reduce childhood obesity, a new study suggests.

In their first experiment, researchers gave 8- or 16-ounce bowls to 69 preschoolers. Adults then served the children cereal and milk in increments until the children said they'd had enough. Children with the larger bowls asked for 87 percent more cereal and milk.

How much kids weighed or whether they were boys or girls did not affect how much food they requested.

A second experiment included 18 elementary school students who were given smaller or larger bowls. Secret scales were embedded within the tables to weigh each child's serving and to determine how much the children ate. Those with larger bowls asked for 69 percent more cereal and milk, and ate 52 percent more than those with smaller bowls.

"Bigger bowls cause kids to request nearly twice as much food, leading to increased intake as well as higher food waste," study author Brian Ven Ittersum, a professor of behavioral economics at Cornell University, said in a university news release.

"Based on these findings, using smaller dishware for children may be a simple solution for caregivers who are concerned about their kids' caloric intake," he said.

The study was published online Nov. 18 in the Journal of Pediatrics.

More information

The U.S. Office of Disease Prevention and Health Promotion explains how to keep children at a healthy weight.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

Health Highlights: Nov. 25, 2013

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

FDA Tells Gene Testing Company to Halt Marketing

A company that offers genetic testing directly to consumers has been told to stop marketing its main DNA service until it receives approval from the U.S. Food and Drug Administration.

An FDA warning letter sent to Califoria-based 23andMe says the company has failed to provide adequate evidence that its Personal Genome Service provides accurate results. The letter was issued Friday and posted on the FDA's website Monday, The New York Times reported.

The letter says the agency considers the service to be a medical device that requires approval.

"FDA is concerned about the public health consequences of inaccurate results from the PGS device," the letter states. "The main purpose of compliance with FDA's regulatory requirements is to ensure the tests work."

23andMe's service has been used by about half a million people. It claims to tell consumers whether they might be at increased or decreased risk for various diseases, among other things, The Times reported.

-----

Ultrasound Scan for Liver Tumors Cuts Kids' Exposure to Radiation: Study

Using an new ultrasound technique to look for dangerous tumors in children's livers could reduce their exposure to radiation, according to U.K. researchers.

A CT scan can tell the difference between benign growths and malignant tumors in a child's liver, but the test results in radiation exposure.

"We are trying to stop children having unnecessary radiation as the long-term effects show a substantial increase in cancer," Professor Paul Sidhu, a consultant radiologist at King's College Hospital in London, told BBC News.

He and his colleagues are testing a new method of ultrasound that has been used for a decade in adults but not in children. A harmless chemical that's injected into the body forms temporary microscopic bubbles in the bloodstream and acts as a contrast agent for the ultrasound.

"It makes the arteries light up and then the veins and the whole liver. It looks like a field of gold," Sidhu said. If the liver tumor is benign, it lights up like the rest of the liver, but a cancerous tumor will rapidly get rid of the contrast agent, BBC News reported.

The researchers tested the new method on 44 children with chronic liver problems and found that it provided accurate diagnoses. However, further studies involving thousands of patients are needed to confirm the study findings, which were published in the European Journal of Ultrasound.

FDA Approves Bird Flu Vaccine

On Friday, the U.S. Food and Drug Administration approved a vaccine to prevent H5N1 influenza, known as avian or bird flu. The vaccine will not be commercially available but will be added to the nation's anti-flu stockpile. It's specifically meant for use in people aged 18 and older at increased risk for H5N1 virus exposure.

Bird flu is typically spread among poultry infected by certain influenza A viruses. Outside the United States, however, there have been cases when people in close contact with infected poultry have died or become severely ill. About 60 percent of infected people die, according to the World Health Organization. Because wild birds continue to be infected, the potential for a human pandemic exists, according to an FDA news release.

"This vaccine could be used in the event that the H5N1 avian influenza virus develops the capability to spread efficiently from human to human, resulting in the rapid spread of disease across the globe," Dr. Karen Midthun, director of the FDA's Center for Biologics Evaluation and Research, said in the news release.

The new vaccine is called Influenza A (H5N1) Virus Monovalent Vaccine, Adjuvanted. It contains an oil-in-water emulsion -- the adjuvant. Adjuvants enhance or direct the immune response of the person receiving the vaccination. The vaccine is made by ID Biomedical Corporation of Quebec (a division of GlaxoSmithKline Biologicals). It will be included in the Strategic National Stockpile to be distributed by U.S. public health officials if needed.

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 25, 2013 (HealthDay News) -- Kids near death because of severe flu infection have a better chance of survival if they are given antiviral medications early in their treatment, researchers say.

Children treated with antiviral drugs called neuraminidase inhibitors (NAIs) within the first 48 hours of serious flu symptoms developing are significantly more likely to survive, according to a study published online Nov. 25 in the journal Pediatrics.

"The benefit was more apparent for the most severely ill children, who required a ventilator to help with breathing," said co-author Dr. Janice Louie, chief of the influenza and respiratory diseases section at the California Department of Public Health's Center for Infectious Diseases.

In children rendered critically ill by the flu, treatment with NAIs reduced their risk of dying by 64 percent, the study found.

Researchers found that in recent years, however, fewer than two-thirds of severely ill children received NAIs while hospitalized for the flu.

Dr. Octavio Ramilo, a professor of pediatrics at Ohio State University, said a flu-stricken child who is sick enough to go to the hospital needs to receive antiviral therapies immediately.

"The minute you come to the hospital, we [should] start you on antiviral therapy," said Ramilo, who also is chief of infectious diseases at Nationwide Children's Hospital in Columbus, Ohio.

Doctors usually advise children with the flu to rest, drink lots of liquids and, if needed, use over-the-counter drugs to ease symptoms such as fever or congestion. But some people develop serious complications such as pneumonia that require hospitalization.

The study focused on nearly 800 patients younger than 18 who were treated in intensive-care units for the flu between April 2009 and September 2012.

Only 3.5 percent of kids who received NAI treatment during the first 48 hours ended up dying, the researchers found. By comparison, 9 percent of kids died who received NAIs between day eight and day 14 of their illness, and 26 percent died who received the medication after day 14.

Overall, 6 percent of kids treated with NAIs died from the flu, while 8 percent of kids died who didn't receive the medication.

Despite these numbers, hospitals appear reluctant to use NAIs when treating kids sick enough from the flu to require hospitalization.

About 90 percent of kids in the ICU with the flu received NAIs during the 2009 H1N1 flu pandemic, the researchers found. Only 63 percent of kids, however, received NAIs in the years following the pandemic.

"I'm not at all sure why that percentage was so low," said Dr. Rich Whitley, professor of pediatric infectious diseases at the University of Alabama at Birmingham. "There's no good reason for that."

Cost shouldn't be a factor, Louie said. "The cost of oseltamivir, the most commonly prescribed NAI, is approximately $7 per pill," she said. "The usual treatment course is one pill twice a day for five days, for a total $70."

The drug's side effects also should not be an issue. The main side effects are nausea and vomiting, which are much more common in children but occur in less than 10 percent of patients.

The explanation might be that smaller hospitals that treat fewer cases of the flu do not have the same level of experience and sense of urgency as hospitals that regularly deal with flu outbreaks, Ramilo said.

"If you work in a big teaching hospital, then you see these cases more often," he said. "The [doctors] think about it right away."

Some doctors also may not suspect flu when they start treating a very sick child. "Many clinicians may not initially consider influenza as a possible cause of respiratory illness or pneumonia, especially when it occurs outside of the peak of the influenza season," Louie said.

Another problem could be that intravenous forms of the antiviral medications currently are not available, Ramilo said. Kids have to take them by mouth, and very sick kids often are administered the medication via a tube snaked through their nose and down their throat.

Although this study lends hope for treating critically ill children, Ramilo and Whitley said flu shots remain the first and best line of defense against the flu.

"Children need to be immunized just like adults need to be immunized," Whitley said. "It's still the best approach we have to prevent influenza."

More information

For more on children and the flu, visit the U.S. Centers for Disease Control and Prevention.

Copyright © 2013 HealthDay. All rights reserved.

Health Tip: Keep Pests Away

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(HealthDay News) -- Keeping your home clean and tidy can help keep pests away without the use of pesticides.

The Wisconsin Department of Health Services offers these suggestions:

  • Wash dishes shortly after you finish eating, and wipe down counter tops.
  • Empty indoor trash cans daily, storing trash in secure cans outdoors.
  • Store sugar, cereals, cookies and crackers in containers with sealed lids.
  • Promptly repair any plumbing leaks.
  • Caulk windows, replace broken siding, install screens on vents and windows, and make sure doors fit well.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

Health Tip: Stuff Your Turkey Safely

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(HealthDay News) -- Make sure everyone has a good time during and after your Thanksgiving meal by taking steps to prepare all that food properly.

The University of Illinois Extension offers these holiday suggestions:

  • Stuff the turkey just before you plan to start cooking it.
  • Mix the ingredients, wash the cavity of the turkey, and lightly stuff inside.
  • Chop and prepare dry ingredients ahead of time, but add any moist ingredients just before cooking the turkey.
  • Prepare about 1/2 cup of stuffing per pound of turkey. Since stuffing will expand as it cooks, don't overstuff. Cook any extras in a separate pan.
  • Make sure stuffing is cooked to an internal temperature of 165 degrees Fahrenheit. Stuffing often contains eggs and other ingredients that can be harmful if undercooked.
  • Before you carve the turkey, remove the stuffing.
  • Make sure leftovers are refrigerated within two hours of serving, are reheated to 165 degrees Fahrenheit and are eaten within two days.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

SUNDAY, Nov. 24, 2013 (HealthDay News) -- The holidays can be a difficult time when a loved one has Alzheimer's disease, but there are ways to keep the season happy and memorable, an expert says.

"Making some minor adjustments to your family traditions, caregivers and their loved ones are still able to make the most of their holiday," Rebecca Axline, a supervisory clinical social worker at Houston Methodist Hospital's Nantz National Alzheimer Center, said in a hospital news release.

She offered the following suggestions:

  • Keep your family member as involved as possible. For example, open cards together, discuss gift selections or give them simple baking tasks. Try to focus on the moment rather than results.
  • Be consistent with medications and doctors' recommendations. Maintaining the structure of medications, treatments and day programs will be better for both you and your loved one.
  • Make sure living spaces are safe. For example, lighted candles may be hazardous and large blinking lights can cause disorientation.
  • Minimize overstimulation and your own anxiety, as this can transfer to your loved one. Keep activities simple, and alert your guests ahead of time about what's needed. Reduce the number of visitors, simplify plans and allow a few days before and after an event to be quiet and relaxing.
  • Look after yourself. Make a list of the usual things you do during the holidays and decide which ones you want to keep and which ones you can skip. Let others help you and be clear about what you need them to do. Include time away for yourself and things that help you restore your energy.

More information

The Alzheimer's Association has more about holidays and Alzheimer's families.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

SATURDAY, Nov. 23, 2013 (HealthDay News) -- Traveling long distances in cars and planes over the holidays could put you at risk for deep vein thrombosis -- potentially deadly blood clots in the deep veins of the lower legs and thighs, an expert says.

Sitting for long periods of time in cramped spaces can limit circulation in the legs, resulting in the formation of a blood clot. The clot can travel through the blood stream and lodge in the lungs, brain, heart and other areas. This can lead to severe damage to organs and possibly death.

However, it's easy to prevent deep vein thrombosis.

"If you plan to travel overseas or cross country, make sure you get up and walk around at least every two hours, and try not to sleep more than four hours at a time," Dr. Alan Lumsden, chief of cardiovascular surgery at Houston Methodist Hospital's heart and vascular center, said in a hospital news release.

"Drink plenty of water or juices, wear loose-fitting clothing, eat light meals and limit alcohol consumption," he added.

Elderly people and those with circulation problems should wear compression stockings that help prevent clots from forming in the deep veins, Lumsden suggested.

If you can't get up and move around every couple of hours, you can do the following exercises while sitting down:

  • Extend both legs and move both feet back and forth in a circular motion.
  • Move the knee up to the chest and hold the stretch for at least 15 seconds.
  • Put both feet on the floor and point them upward. Also, put both feet flat and lift both heels as high as possible.

If you are pregnant or have a history of heart disease, cancer or blood clots, you should always consult with your doctor before going on a long trip, Lumsden advised.

About 2 million Americans develop deep vein thrombosis every year, and nearly 200,000 die. "It's a very serious condition that can simply be avoided by getting up and moving around," Lumsden said.

"Symptoms include pain and tenderness, swelling, redness and increased warmth in one leg," Lumsden said. "In some cases, a physician might suggest that a patient go on blood thinners or simply take an aspirin before and during a long trip to avoid [deep vein thrombosis]."

More information

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

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

SATURDAY, Nov. 23, 2013 (HealthDay News) -- Nail-gun injuries are on the rise, and young, male construction workers are at greatest risk, according to a new study from Australia.

Researchers looked at 87 cases of nail-gun injuries that occurred in Australia between January 2007 and July 2012. Of those injuries, nearly 96 percent happened at work.

Fifty-eight percent of the patients required surgery, 32 percent were treated solely in the emergency room and 10 percent were transferred to a private facility. Among the patients who underwent surgery, 14 percent had tendon, joint or neurovascular damage, and 20 percent had foreign material in the wound.

Nail-gun injuries result in a significant loss of productivity, as well as having a significant financial cost, according to the authors of the study, which was published online Nov. 8 in the journal Emergency Medicine Australasia.

An analysis of data from the state of Queensland showed that there were 81 workers' compensation claims for nail-gun injuries on average each year during the past five years. Each case led to an average of 15 days off work, according to a journal news release.

Nail-gun injuries can cause immediate damage to soft tissues, tendons and bones, and can result in infections and septic arthritis, the researchers said. The non-dominant hand often is involved in such injuries.

"While nail-gun injuries involving the skull, chest and abdomen have been reported, the vast majority of injuries occur to the upper and lower limbs," wrote Dr. James Ling and colleagues from Princess Alexandra Hospital in Brisbane.

More information

The U.S. Occupational Safety and Health Administration offers nail-gun safety tips.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 22, 2013 (HealthDay News) -- Giving steroid injections to pregnant women before premature birth may increase the child's risk of developing attention-deficit/hyperactivity disorder and other behavioral and emotional disorders, a small study suggests.

Pregnant women who are expected to give birth prematurely often receive glucocorticoids, which mimic the natural hormone cortisol. This treatment is important to help a premature baby's lungs mature, the researchers explained.

However, their findings suggest that steroid injections may also increase a child's risk of developing ADHD and other mental health problems.

Children with ADHD have trouble paying attention and following through on tasks. They may also talk excessively and behave impulsively.

The study included 37 children whose mothers were given synthetic glucocorticoids before they gave birth and 185 children who were born at the same gestational age but were not exposed to glucocorticoids.

At ages 8 and 16, the children who were exposed to glucocorticoids before birth had poorer scores on general mental health and were more likely to have symptoms of ADHD, compared to the other children.

The findings were confirmed in a comparison group of more than 6,000 children, according to the study, published Nov. 22 in the journal PLoS One.

"There are a lot of studies that have found links between stress in pregnancy and effects on children's mental health, especially ADHD, and this might be related to cortisol," study senior author Alina Rodriguez, a visiting professor at the School of Public Health at Imperial College London in England, said in a college news release.

"Synthetic glucocorticoids mimic the biological reaction when the mother is stressed, so we wanted to see if babies who were exposed to this treatment are affected similarly in terms of mental health outcomes," she explained.

Although the findings suggest that the use of glucocorticoids may pose long-term risks to children's mental health, they don't prove a cause-and-effect relationship. The number of children in the study who were exposed to glucocorticoids was relatively small, and more studies are needed to confirm the findings, Rodriguez noted.

"We would like to reassure parents that in light of all available evidence to date, the benefits of steroid treatment on immediate infant health and survival are well-established and outweigh any possible risk of long-term behavioral/emotional difficulties," she said. Parents who are concerned that their child might have behavioral or emotional difficulties should contact their child's doctor, she added.

More information

The U.S. National Institute of Child Health and Human Development has more about preterm labor and birth.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 22, 2013 (HealthDay News) -- U.S. Food and Drug Administration approval for the anti-cancer drug Nexavar (sorafenib) has been expanded to include late-stage differentiated thyroid cancer, the most common type of thyroid cancer.

In a Friday news release about the approval, the agency said thyroid cancer will be diagnosed in an estimated 60,220 Americans this year, and an estimated 1,850 will die from the disease.

Nexavar is designed to inhibit proteins that prompt cancer cells to divide and grow. The new approval is meant for people with differentiated thyroid cancer that no longer responds to radioactive iodine treatment.

The drug was approved for this new use based on clinical studies involving 417 people whose thyroid cancer did not respond to treatment. The drug increased the time recipients lived without cancer progression by about 41 percent compared to those who took a placebo, the FDA said.

The most common side effects of Nexavar included diarrhea, fatigue, infection, hair loss, skin reactions, weight loss, loss of appetite, abdominal pain and high blood pressure. The agency also warned that increased production of thyroid stimulating hormone -- a potential promoter of thyroid cancer -- was possible among the drug's users.

Nexavar was FDA-approved to treat advanced kidney cancer in 2005, followed by approval to treat advanced liver cancer in 2007, the agency said.

The drug is marketed by Bayer HealthCare Pharmaceuticals, based in Wayne, N.J.

More information

Medline Plus has more about thyroid cancer.

-- Scott Roberts

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 22, 2013 (HealthDay News) -- Consumers who want to enroll in a health insurance plan through HealthCare.gov will get a few extra days to sign up for coverage that will take effect on Jan. 1.

The deadline for buying insurance through the federal health insurance exchange will be pushed from Dec. 15 to Dec. 23, a spokeswoman for the Centers for Medicare and Medicaid Services (CMS) said during a Friday news conference.

People who sign up by Dec. 23 and pay their first month's premium by Dec. 31 will have coverage effective Jan. 1.

"This extension will allow consumers more time to review plan options, to talk to their families, providers or enrollment assisters and to enroll in a plan," said Julie Bataille, director of the Office of Communications at CMS.

"We understand that technical challenges have made comparing plans more difficult in these first months, and we want to give consumers as much time as possible," she said.

Also Friday, published reports said President Barack Obama plans to delay the second-year start of enrollment for Affordable Care Act health plans. Doing so would let insurers adjust to the demands of the health-reform law and possibly avert premium increases before the 2014 congressional elections.

The second-year enrollment period, previously set to start Oct. 15, 2014, will now start Nov. 15, said an anonymous U.S. Department of Health and Human Services official who spoke with Bloomberg News.

The Oct. 1, 2013, launch of the federal and state health insurance exchanges was intended to be a major milestone in the Affordable Care Act's implementation, offering millions of Americans a venue to compare health plans and enroll in coverage, often with the help of federal subsidies. But with the federally run HealthCare.gov website experiencing troubles from the start, many people have been thwarted from signing up for coverage.

Further complicating matters, millions of Americans with health coverage have been told by their insurers that their plans are being cancelled because they don't meet minimum coverage standards set by the Affordable Care Act. Some of those minimum standards include maternal health care, mental health care and pediatric dental and vision care, according to Pew Charitable Trusts.

HealthCare.gov is being used by consumers in 36 states. The remaining states and the District of Columbia are running their own insurance enrollment sites.

The exchanges are designed to serve as the gateway for enrolling some 30 million uninsured Americans in health insurance coverage under the Affordable Care Act, President Obama's chief domestic policy achievement.

Under the law, most Americans must have health insurance coverage by 2014 or pay federal tax penalties. It is also designed to protect all Americans from abusive health insurance practices, like being dropped from coverage due to pre-existing health conditions.

During Friday's news conference, Jeffrey Zients, an advisor to the team of consultants working to fix the HealthCare.gov website, said the team was "on track" to have the site working smoothly for the vast majority of users by the end of November.

By then, he said, the website will be able to accommodate 50,000 simultaneous users -- the number that the federal government had originally intended to log on at one time.

In addition, the team is working to double the site's overall capacity, Zients said.

"This means the system will be able to accommodate more than 800,000 visits a day from consumers who are seeking information, filling out applications, shopping and enrolling," he said.

Anticipating peak periods when the number of users exceeds that level of capacity, the team is building what Zients called a "customer-friendly cueing system" to send consumers an e-mail message notifying them of better times to come back to the site.

Last week, the Obama administration reported that a disappointing number of people had enrolled for health insurance coverage through the new federal and state insurance exchanges.

Just over 106,000 Americans had enrolled in health plans through the new marketplaces from Oct. 1 through Nov. 2, U.S. Health and Human Services Secretary Kathleen Sebelius said. Another 975,000 people had applied for coverage and received a determination of eligibility for coverage "and are currently still shopping for a plan," she said.

More information

Learn how to get insurance coverage through the new health exchanges.

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 22, 2013 (HealthDay News) -- One in every 10 U.S. children has been diagnosed with attention-deficit/hyperactivity disorder (ADHD), but the steady rise in cases has started to slow, a new government survey shows.

The 2011 poll of more than 95,000 parents showed that about 11 percent -- or about 6.4 million -- of children aged 4 to 17 had been diagnosed with ADHD. That's up from a 2007 survey that found that 9.5 percent of youngsters in that age group had an ADHD diagnoses.

Nearly one in every five high-school age boys, and about one in every 11 high school age girls, was reported by their parents as being diagnosed with having ADHD, the U.S. Centers for Disease Control and Prevention report found.

Numbers also varied widely between states, as well, with 15 percent of children in Arkansas and Kentucky reporting a history of ADHD treatment, compared to just 4 percent of those in Nevada.

The number of children placed on ADHD medications -- which include stimulants such as Ritalin or Concerta -- also rose by about 1 million between 2003-04 and 2011-12, the CDC said. That means that more than 3.5 million youngsters between the ages of 4 and 17 are now taking an ADHD drug.

The survey was published Nov. 22 in the Journal of the American Academy of Child and Adolescent Psychiatry.

According to the survey, half of children with ADHD are diagnosed with the disorder by the age of 6.

"This finding suggests that there are a large number of young children who could benefit from the early initiation of behavioral therapy, which is recommended as the first-line treatment for preschool children with ADHD," study author and CDC researcher Susanna Visser said in a journal news release.

Not every child with ADHD is getting proper treatment, the study found. According to the survey, 18 percent of kids with ADHD had not received either psychiatric counseling or drug therapy during 2011-2012.

"This finding raises concerns about whether these children and their families are receiving needed services," Dr. Michael Lu, senior administrator at the U.S. Health Resources and Service Administration (HRSA), said in the journal news release.

There was some good news from the survey, however. The CDC noted that ADHD diagnoses among American children were rising at a rate of about 6 percent a year in the mid-2000s, but that rate slowed to 4 percent a year from 2007 to 2011.

Visser told the Associated Press that this slower rate of diagnoses might reflect that doctors are closer to identifying most of the youngsters with the disorder.

ADHD makes it difficult for kids to pay attention and control impulsive behaviors. Treatments can include drugs, behavioral therapy or both.

More information

Find out more about ADHD at the U.S. National Institute of Mental Health.

-- E.J. Mundell

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 22, 2013 (HealthDay News) -- Older women who drink lots of soda and other sugary beverages may be at higher risk for endometrial cancer, a new study suggests.

Endometrial cancer involves tumors in the lining of the uterus, and typically affects women in their 60s or 70s, according to the U.S. National Cancer Institute (NCI).

In the new NCI-funded study, researchers looked at data from more than 23,000 postmenopausal women in Iowa who were followed from 1986 to 2010.

They found that those who drank the largest amounts of sugar-sweetened beverages had a 78 percent higher risk for a tumor known as estrogen-dependent type I endometrial cancer.

The more sugar-sweetened beverages a woman drank, the greater her risk, according to the study published online Nov. 22 in the journal Cancer Epidemiology, Biomarkers & Prevention.

There was no link between endometrial cancers and consumption of sugar-free soft drinks, sweets/baked goods and starch.

In a journal news release, study author Maki Inoue-Choi said she wasn't surprised that increased intake of sugary drinks was tied to this estrogen-linked cancer.

"Other studies have shown increasing consumption of sugar-sweetened beverages has paralleled the increase in obesity," explained Inoue-Choi, who was a research associate at the University of Minnesota School of Public Health when the study was conducted. "Obese women tend to have higher levels of estrogens and insulin than women of normal weight, [and] increased levels of estrogens and insulin are established risk factors for endometrial cancer."

Inoue-Choi is currently a postdoctoral fellow at the NCI and the U.S. National Institute on Minority Health and Health Disparities.

A group representing the beverage industry took issue with the findings.

In a statement from the American Beverage Association, Dr. Richard Adamson, former director of the NCI's Division of Cancer Etiology and now a consultant to the group, said that, "this study does not show that sugar-sweetened beverage consumption causes endometrial cancer."

Adamson said that, "in fact, its findings conflict with the results of several other published studies that showed no association between consumption of sugar and risk for endometrial cancer."

He also stressed that the study only showed an association between sweetened beverage intake and endometrial cancer risk, and it could not show cause-and-effect. And he noted that people in the upper one-fifth of sweetened beverage intake had levels ranging from 1.7 to 60.5 servings per week.

That is "the difference between 1 can and more than three 12-packs a week [in 8-ounce servings]," Adamson said. " This is a very broad range."

For her part, Inoue-Choi said that since these are the first findings of their kind, they do need to be reproduced in other studies.

But, she added, "research has documented the contribution of sugar-sweetened beverages to the obesity epidemic. Too much added sugar can boost a person's overall calorie intake and may increase the risk of health conditions such as obesity, diabetes, heart disease and cancer."

More information

The American Cancer Society has more about endometrial cancer.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 22, 2013 (HealthDay News) -- A mechanical device that delivers chest compressions during CPR does not improve short-term survival of cardiac arrest patients, compared to traditional hand compressions, a new study shows.

"Many factors affect the chances of survival after cardiac arrest, including early recognition of arrest, effective CPR and defibrillation, and post-resuscitation care. One important link is the delivery of high-quality chest compressions to achieve restoration of spontaneous circulation," wrote authors of the study published Nov. 17 in the Journal of the American Medical Association.

"The effectiveness of manual chest compressions depends on the endurance and skills of rescuers, and manual compressions provide only approximately 30 percent of normal cardiac output," Dr. Sten Rubertsson, of Uppsala University in Sweden and colleagues explained in the study.

Manual CPR involves prolonged "hands-off" time and its quality drops most when the patient is being transported, the authors report. To improve CPR, mechanical chest-compression devices have been developed.

However, the use of such devices in patients who suffer out-of-hospital cardiac arrests had not been tested in large clinical trials, the researchers noted.

This study included nearly 2,600 people who suffered out-of-hospital cardiac arrest in Sweden, Britain and the Netherlands between January 2008 and February 2013. Ambulance crews gave half of the patients CPR with a mechanical chest compression device and the other patients received CPR with hand compressions.

The mechanical device used an integrated suction cup designed to deliver compressions according to CPR guidelines.

The four-hour survival rates was 23.6 percent for patients who received mechanical CPR and 23.7 percent for those who received manual CPR. Among patients who were still alive after six months, 99 percent of those who received mechanical CPR and 94 percent of those who received manual CPR had good neurological outcomes, according to a journal new release.

The type of CPR given didn't appear to make a difference.

"In patients with out-of-hospital cardiac arrest, mechanical chest compressions in combination with defibrillation during ongoing compressions provided no improved four-hour survival vs. manual CPR according to guidelines. There was a good neurological outcome in the vast majority of survivors in both groups, and neurological outcomes improved over time," the researchers wrote.

More information

The American Academy of Family Physicians has more about CPR.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 22, 2013 (HealthDay News) -- The tiniest premature infants often cling to life for weeks in intensive-care units while their parents worry about what physical and mental health problems their babies might face as they grow up.

But researchers say they now have some reassuring news to report: Although those who start life as "extreme preemies" do face more health, social and economic difficulties during childhood or young adulthood, most of them are satisfied with their lives as adults.

"This self-assessment might be the most important fact overall," said study author Dr. Brian Darlow, a professor of pediatric research at the University of Otago, Christchurch, in New Zealand.

Darlow and his team have been keeping tabs on 230 young adults who were born at very low birth weights, around 3 pounds or less. The young adults, who were born in 1986, sat down with researchers to answer questions about their lives, social circumstances and health.

The researchers also asked the same questions of 69 people who were the same age, but were born at normal weights.

Their findings are published in the December print issue of the journal Pediatrics.

As a group, the preemies hadn't gone as far in school as their normal-weight peers. They were about half as likely to have received a college degree. They also were more likely to say they didn't have friends or significant others, or to be sexually active. And they reported having more health problems and hospitalizations.

But the study authors said many of those statistical differences were driven by the 10 percent of very low birth weight babies who had more severe mental and physical disabilities at ages 7 and 8. By and large, the kids who were doing well in grade school continued to function well as adults.

There were no differences in rates of drug use, criminal activity, or mental or behavioral problems. Those who were small at birth were significantly less likely to report using illegal drugs.

Perhaps most important of all, they scored the same on measures of self-esteem and life satisfaction as those who were normal weight at birth.

Darlow said the study participants, who are now aged 26 and 27, are undergoing another battery of psychological testing and will soon repeat the same questionnaire. It's his belief that they probably won't see any difference in measures of friendships or social functioning this time around.

"My guess is that the social isolation will be much less and probably no longer present at all, so in that area maybe they have just taken a little longer to catch up," he said.

Another expert said the findings should comfort parents of very low birth weight babies.

"The fact that the long-term data looks this good is very heartening," said Dr. Jill Rabin, chief of ambulatory care, obstetrics and gynecology at Long Island Jewish Medical Center in New Hyde Park, N.Y. "I think parents can take heart and have hope."

"You can really make up what the child didn't get in the beginning from being very low birth weight or premature," Rabin said. "Eventually they do catch up, and are able to be fully functioning adults."

More information

For more on low birth weight and prematurity, visit the March of Dimes.

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 22, 2013 (HealthDay News) -- Simple compression bandages are as effective as complicated massage treatments in treating the swollen arms of breast cancer patients, according to a new study.

This swelling of the arms -- called lymphedema -- is a complication of breast cancer treatment that can last a long time. It affects between 6 percent and 30 percent of patients, and can cause discomfort, reduced arm function, infection and emotional distress.

The six-week study included about 100 Canadian breast cancer patients with arm swelling.

The patients were divided into two groups. One group wore elastic compression sleeves and gloves for 12 hours a day. The other group received an hour of lymphatic drainage massage from trained therapists each weekday for four weeks, along with exercise and skin care.

The women in the massage group also wore compression bandages on their arms and hands the rest of the day and night. After the month of massage treatment, they wore elastic compression sleeves and gloves during the day, the same as the other group.

Regular assessments of the women's arm size and function, as well as quality of life, showed no significant difference in the effectiveness of the two treatment methods, according to the researchers from McMaster University in Hamilton, Canada.

The study was published in a recent issue of the Journal of Clinical Oncology.

"In the future, patients who receive or can only afford elastic sleeves and gloves should be comforted knowing that their care has not been compromised," lead author Dr. Ian Dayes, an associate professor of oncology, said in a university news release.

More information

The American Cancer Society has more about lymphedema after breast cancer treatment.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 22, 2013 (HealthDay News) -- Nursing home residents whose beds have newer high-density foam mattresses may not have to be turned every two hours to prevent bedsores, according to a new study.

The two-hour standard, which has been used for more than 50 years, was necessary because older mattresses that had spring coils and were covered in thick plastic put more pressure on residents' bodies than the newer high-density foam mattresses, the researchers explained.

Their study included 960 nursing home residents in 29 facilities in the United States and Canada who had a moderate to high risk of developing bedsores (also called pressure sores) and had high-density foam mattresses on their beds. The participants were randomly assigned to be turned at intervals of two, three or four hours.

After three weeks, none of the residents had developed serious bedsores, according to the U.S. National Institutes of Health-funded study recently published in the Journal of the American Geriatrics Society.

"We are very interested in preventing pressure ulcers. It's a serious health problem. Also, we're interested in improving care for nursing home residents. Turning residents every two hours throughout the night awakens them, and many people can't go back to sleep, therefore decreasing their quality of life," study leader Nancy Bergstrom, associate dean at the University of Texas Health Science Center at Houston School of Nursing, said in a center news release.

The study findings show "that turning residents every two hours may no longer be necessary when high-density mattresses are in place and nursing time can be used to attend to other resident needs, such as feeding, assisted mobility and ultimately develop a stronger relationship with their residents," study co-leader Susan Horn, of the Institute for Clinical Outcomes Research, said in the news release.

More information

The American Academy of Family Physicians has more about bedsores.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 22, 2013 (HealthDay News) -- A recent program encouraged healthy eating by offering extra spending power to poor people who get government assistance to buy food. The only catch: They had to purchase healthier types of food at farmers' markets.

It's not clear if the thousands of San Diego-area participants in the federally funded program actually became healthier because they bought foods like produce, meat and bread.

But in the big picture, the program "increased access to healthy foods," said San Diego County public health officer Dr. Wilma Wooten, co-author of a new report on the findings. "And it helps the market vendors and the growers."

Wooten said local public health officials launched the program with money from two federal grants -- one from an anti-obesity fund in the Obama administration stimulus package and the other from an Affordable Care Act fund designed to fight chronic disease.

The study appeared in the Nov. 14 issue of Preventing Chronic Disease, published by the U.S. Centers for Disease Control and Prevention.

Obesity is common in the United States among people of all income levels, but the poor appear to be at special risk. A study published a year ago found that 5-year-old kids who live in the poorest neighborhoods were 28 percent more likely to be obese -- a step above just being overweight -- compared to children from the wealthiest areas.

Research also suggests that the poor often live in "food deserts" where healthier food like produce is hard to find and expensive compared to fast food.

The new project, called the Farmers Market Fresh Fund Incentive Program, ran from mid-2010 through 2011. It allowed people who get public food assistance like food stamps to buy tokens to use for healthier foods -- including produce, meat, bread and eggs -- at local farmers' markets. They'd get tokens worth the purchased amount plus a matching amount at no extra cost up to $10 a month.

In other words, participants would get $20 worth of tokens for healthier foods per month if they purchased $10 worth.

Nearly 7,300 people enrolled in the program, far more than the 3,000 that officials had expected, Wooten said. Most (82 percent) had never been to a farmer's market before.

Among the people who enrolled, 252 took part in surveys while using the program and a year later. The percentage of those who said their diet was "healthy" or "very healthy" rose from 4 percent to 63 percent. In addition, 93 percent said the program was "important" or "very important" in their choices to shop at a farmers' market.

The cost to manage the program wasn't available, but the extra food itself cost about $330,000, an average of $93 per participant.

The study doesn't examine why the participants took part in the program. Nor does it look at whether it would be cheaper to allow the participants to buy healthier foods at supermarkets and membership superstores instead of only farmers' markets. Wooten, however, said the program is specifically designed to boost farmers' markets.

Diane Whitmore Schanzenbach, chair of the program on child, adolescent and family studies at Northwestern University's Institute for Policy Research, said it's difficult to gauge the impact of the project. She noted that many participants didn't take the follow-up surveys, and those who did may have "found the subsidy to be most valuable."

A similar federal program showed excellent results by matching 30 cents on the dollar for food stamp recipients and allowing them to spend money on produce at grocery stores, she said. "When we subsidize healthy food, low-income families purchase and eat more healthy food. It's really Economics 101."

And, she said, "it makes sense to subsidize these goods where ever people shop, be that farmers' markets, corner stores, Costco, you name it."

In the San Diego area, federal funding through the county has ended, study co-author Wooten said. But an advocacy group for refugees, whose numbers are high in poor San Diego-area neighborhoods, is continuing to support the program, she said. However, federal funding for food stamps recently dipped.

"Our hope is that Congress in the future will recognize the importance of this project and create a national program that supports this kind of effort," Wooten said.

More information

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

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 22, 2013 (HealthDay News) -- Black Americans with advanced colorectal cancer are less likely than white patients to see cancer specialists or to receive cancer treatments, according to a new study.

This may be a major reason blacks with advanced colorectal cancer -- cancer of the colon and rectum -- have a 15 percent higher death rate than whites, according to researchers from the University of California, San Diego.

The risk of death, however, was the same for patients who received the same cancer treatments, such as chemotherapy and surgery, regardless of their race, the researchers said.

The researchers analyzed data from more than 11,000 patients over age 66 who had metastatic colorectal cancer, which is cancer that has spread to other areas of the body. Blacks were 10 percent less likely than whites to have primary tumor surgery, 17 percent less likely to receive chemotherapy and 30 percent less likely to receive radiation therapy.

Chemotherapy was associated with a 66 percent lower risk of death, according to the study, which was published online Nov. 14 in the Journal of the National Cancer Institute.

Among patients who received chemotherapy, whites were more likely than blacks to receive more than one chemotherapy agent. Blacks typically began chemotherapy four days later after diagnosis than whites.

The researchers also found that almost half of the survival disparity between black and white patients was because of treatment differences. After accounting for these differences, the racial disparity in survival disappeared.

Possible reasons for the racial disparities noted in this study include conscious or unconscious biases from health care providers, patient mistrust and health literacy, the researchers said. Breakdowns in communication between patients and their doctors, barriers to health care access and differences in how the disease affects people of different races could also explain the disparities, they said.

"Further studies may answer the important question of why there are racial disparities in consults with cancer specialists and treatment among this population," Dr. James Murphy, chief of the radiation oncology gastrointestinal tumor service at the University of California, San Diego, Moores Cancer Center, said in a university news release. "The answers may lead to areas we can improve upon to close these gaps."

"I suspect that this pattern of disparity could be present in other underserved minority groups as well," he said.

More information

The American Cancer Society has more about colorectal cancer.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 22, 2013 (HealthDay News) -- People with autism are more likely to have a condition called synesthesia -- a "mixing of the senses" -- a small new study finds.

For example, people may see colors when they hear sounds, or notice different tastes when they hear musical notes.

Researchers tested 164 adults with autism and 97 adults without the disorder. They found that nearly 19 percent of those with autism had synesthesia, compared with about 7 percent of those without autism.

Among the 31 people with autism who also had synesthesia, 21 said that sound caused them to see colors. Meanwhile, 18 saw black and white letters as colored, and 18 said that tastes, pain or smells caused them to see colors, according to the study published Nov. 20 in the journal Molecular Autism.

"I have studied both autism and synesthesia for over 25 years and I had assumed that one had nothing to do with the other," study leader Professor Simon Baron-Cohen, of the Autism Research Center at Cambridge University, in England, said in a university news release.

Now, he said, the new findings "will refocus research to examine common factors that drive brain development in these traditionally very separate conditions."

Autism, a neurodevelopment disorder that affects communication and social skills, is estimated to affect about one in 88 children in the United States.

"This has major implications for educators and clinicians designing autism-friendly learning environments," study co-author Donielle Johnson, who carried out the study as part of her master's degree in Cambridge, said in the news release.

More information

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

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

Health Highlights: Nov. 22, 2013

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

Hugh Jackman Treated for Skin Cancer

Actor Hugh Jackman said Friday that he has been treated for skin cancer on his nose and urged others to use sun protection and get checked for the disease.

In a note posted on Instagram, the 45-year-old "Wolverine" star revealed that he was diagnosed with a common form of skin cancer called basal cell carcinoma, which is rarely fatal. He also included a selfie of his bandaged nose, but did not say when his treatment took place, the Associated Press reported.

"Deb said to get the mark on my nose checked. Boy, was she right!" Jackman wrote, referring to his wife, Deborra-Lee Furness.

He added: "Please don't be foolish like me. Get yourself checked. And USE sunscreen!!!" the AP reported.

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Deaths Lead to Recall of Baby Monitors

About 600,000 baby monitors are being recalled after two babies strangled to death on the device's cord, the U.S. Consumer Product Safety Commission says.

The recall covers Angelcare Movement and Sound Monitors with Sensor Pads that were made between 1999 and 2013. The cord, which is attached to the monitor's sensor pad is placed under the crib mattress, poses a strangulation risk if the child pulls the cord into the crib and it becomes wrapped around the neck.

Two infant deaths linked to the monitors have been reported to the CPSC: a 13-month-old girl who died in San Diego in 2011 and an 8-month-old boy who died in Salem, Ore. in 2004. In both cases, the infants pulled the sensor pad cord into the crib.

Quebec-based Angelcare Monitors Inc. is providing consumers with a repair kit that includes rigid protective covers through which the sensor pad cords can be threaded, a new electric cord warning label about the strangulation risk, and revised instructions, CPSC said.

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NFL Team Owner Funds Brain Injury Research

The owner of the NFL's Seattle Seahawks announced Thursday that he'll fund a two-year, $2.4 million study into whether repeated blows to the head can lead to brain diseases later in life.

The donation from Paul Allen -- a co-founder of Microsoft -- will be used by researchers at the Allen Institute for Brain Science and the University of Washington to examine donated brains for links between head injuries and later problems such as dementia and Parkinson's disease, the Associated Press reported.

The brains will come from the Group Health brain bank, which has more than 500 brains that were donated during the past 25 years by older Seattle adults.

Concussion-related brain damage among football players is a major issue. About 19,000 retired NFL players became eligible for money and medical testing under a recent $765 million deal reached with the NFL to settle concussion lawsuits. The Seattle study has no financial connection with that settlement, the AP reported.

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 22, 2013 (HealthDay News) -- Alan Hilfer remembers precisely where he was when he heard the news 50 years ago today.

Hilfer was 15, and his high school German-language teacher was sobbing in the hallway. He and his friends asked the teacher what was wrong, and she said, "The president's been shot and I think he's dead."

Alarmed and confused, the boy had no idea what that meant for the country or for his future, remembers Hilfer, now director of psychology at Maimonides Medical Center in New York City.

Most Baby Boomers tell a similar story with the same clarity half a century later, a collective memory that psychologists see as the hallmark of a generation transformed forever in one stunning minute.

All across the country on Nov. 22, 1963, America's children were in school when the news of President John F. Kennedy's assassination in Dallas was announced. For many of them, the first sign of something wrong was seeing their teachers cry. And when they were sent home early, there was respected CBS newscaster Walter Cronkite struggling to keep his composure in front of the TV cameras.

"The authorities being shocked is pretty scary for kids," said Ronald Eyerman, a sociology professor at Yale University and the author of a book on the cultural sociology of political assassinations.

"It scared us," agreed Hilfer. "It made us feel that all of our goals and dreams, which Kennedy amplified, could be destroyed in a heartbeat. It made us all aware of the vulnerability of life."

The images -- from the sniper shots to the very public shooting of assassin Lee Harvey Oswald to JFK's funeral cortege and even his small son's final salute -- made an indelible impression on an entire generation that remained glued to the TV as the events unfolded.

Most Baby Boomers who were children when the charismatic 43-year-old president was shot say the assassination affected their lives in at least some way. Others say it had a profound impact.

For some, Kennedy's killing created a sense of fear and vulnerability in their lives, much like 9/11 did for another generation of children four decades later, Hilfer said. Others say the assassination inspired them to join the Peace Corps. Or go into public service, medicine, nursing, social work, law or teaching.

But all shared one common reaction: their sense of innocence about the world had been shattered, Hilfer added.

Unlike random acts of violence, people instinctively know that an assassination is an act against an entire community or nation, Eyerman said. "It's a crime against everyone," he added.

Historians are quick to point out that the period of time before Kennedy's assassination wasn't as peaceful and idyllic as some may nostalgically recall. Baby Boomers typically remember something about the Cuban missile crisis in 1962 and the Cold War. And they haven't forgotten "drop drills" and air-raid siren tests done to prepare the nation in case of a nuclear attack from what was then the Soviet Union.

But somehow those events didn't feel so personal, Hilfer said.

Watching a young president in the prime of life being cut down in the back of an open convertible really hit home, Hilfer said.

Ironically, an assassination can create a "community of feeling," a sense of unity that comes from the shared horror and sadness that follows, Eyerman said.

But after that single moment in Dallas, a cascade of events soon followed that roiled America: more assassinations, divisions over the Vietnam war, urban riots, and social strife -- events that pitted young against old, right against left.

"It's very similar to what happened in 9/11," said Sarah Feuerbacher, clinic director at the Center for Family Counseling at Southern Methodist University, in Plano, Texas. "In the days afterwards, everyone came together.

"But afterwards, the fallout occurs," she added, dissolving the sense of common ground and shared experience.

Feuerbacher said most Baby Boomers don't realize that they probably suffered some level of post-traumatic stress disorder (PTSD) after witnessing JFK slumping in the convertible and Jackie Kennedy scrambling over the trunk.

Viewing even just one traumatic event like the assassination can produce all the symptoms of PTSD, Feuerbacher said.

"The fact that he was not only killed, but it was caught on live camera, individualized the trauma so that it was like watching a family member die, an entirely new playing field for the world," she noted. "Boomers all had a bit of PTSD. If you had not experienced the assassination, your life would have been different. You wouldn't have felt that vulnerability at such a young age."

Feuerbacher warned that just seeing a 50th anniversary special or news report about the assassination can be harmful to the elementary-school children of today. Fifty-year-old TV footage can seem violent, and young children may not realize that what they're watching happened half a century ago.

"Watching it on television is different from going to a museum. To actually see it occurring on television is a very real experience for a young child," she said.

For Baby Boomers with teenage children or grandchildren, Feuerbacher suggested telling the teens: "I remember right where I was when we heard Kennedy had been shot."

Share the experience firsthand, she added: "It's a teachable moment to help make real something they're only reading about in a textbook."

More information

To learn more about coping with a traumatic event, visit the U.S. Centers for Disease Control and Prevention.

Copyright © 2013 HealthDay. All rights reserved.

How to Slash Heart Risks Tied to Obesity

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FRIDAY, Nov. 22, 2013 (HealthDay News) -- Obese or overweight people who lower their blood pressure, cholesterol and blood sugar levels could cut their risk of heart disease and stroke by more than half, a new study indicates.

Researchers analyzed 97 studies that included a total of more than 1.8 million people worldwide. They found that high blood pressure, cholesterol and blood sugar levels explain up to half of overweight and obese people's increased risk of heart disease. And those same factors account for three-quarters of their increased risk of stroke.

High blood pressure posed the greatest threat, accounting for 31 percent of the increased risk of heart disease and 65 percent of the increased risk of stroke, according to the study, published online Nov. 22 in The Lancet.

"Our results show that the harmful effects of overweight and obesity on heart disease and stroke partly occur by increasing blood pressure, serum cholesterol and blood [sugar]," senior study author Goodarz Danaei, an assistant professor of global health at Harvard School of Public Health in Boston, said in a school news release. Therefore, controlling these risk factors -- for example, through better diagnosis and treatment of high blood pressure -- can prevent some of the harmful effects of overweight and obesity, he added.

Obesity has nearly doubled worldwide since 1980. More than 1.4 billion adults aged 20 and older are overweight or obese. Health problems associated with overweight and obesity include heart disease and stroke -- the leading causes of death worldwide -- diabetes, and several types of cancer.

Moreover, about 3.4 million people worldwide die each year because of overweight and obesity, according to the researchers.

Study co-author Majid Ezzati, a professor of global environmental health at Imperial College London, said controlling blood pressure, cholesterol and diabetes will be "an essential but partial and temporary response" to the obesity epidemic.

"As we use these effective tools, we need to find creative approaches that can curb and reverse the global obesity epidemic," Ezzati said in the news release.

More information

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

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 22, 2013 (HealthDay News) -- Certain lifestyle factors may improve women's chances of having a healthy pregnancy, according to a new study.

The researchers analyzed data from more than 5,600 women in England, Ireland, Australia and New Zealand to pinpoint lifestyle factors at 15 to 20 weeks of gestation that were associated with complication-free pregnancies.

Helpful lifestyle factors included eating fruit, having a healthy weight, having lower blood pressure, having a job, and stopping drug and alcohol abuse, according to the study, which was published Nov. 21 on the bmj.com website.

The findings suggest that encouraging women to make healthy choices before and during pregnancy "may increase the likelihood of normal pregnancy outcomes," said Lucy Chappell, of the Women's Health Academic Center of King's College London, and colleagues.

Of the women in the study, 61 percent had an uncomplicated pregnancy. Fewer women in England and Ireland (58 percent) had an uncomplicated pregnancy than those in Australia and New Zealand (63 percent).

The most common pregnancy-related problems were babies who were too small for their gestational age (11 percent), high blood pressure (8 percent), preterm birth (4 percent) and a dangerous spike in blood pressure called preeclampsia (5 percent).

Among the potentially dangerous lifestyle factors that women can change (modifiable factors) were being overweight, having high blood pressure and the misuse of drugs, including binge drinking, the researchers said.

On the other hand, modifiable lifestyle factors that reduced the risk of problems were high levels of fruit consumption in the month before pregnancy and working at 15 weeks into pregnancy.

Lifestyle factors beyond women's control that increased the risk of problems during pregnancy were poverty, having high blood pressure before pregnancy while taking birth control pills, a family history of high blood pressure during pregnancy and bleeding during pregnancy.

Although the study identified risk factors associated with pregnancy complications, it did not prove cause-and-effect relationships.

More information

The U.S. Office of Disease Prevention and Health Promotion outlines how to have a healthy pregnancy.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- Eating a bad Thanksgiving bird can ruin your holiday in a hurry.

The U.S. Food Safety and Inspection Service suggests how to ensure that your turkey is properly cooked and prepared:

  • Take in account factors that influence how long your turkey will take to cook, from its size to its storage temperature.
  • Completely thaw the turkey before cooking.
  • Roast it at 325 degrees Fahrenheit or higher.
  • Use a roasting pan of 2 inches to 2.5 inches deep.
  • If you stuff the turkey, make sure stuffing is loosely packed inside.
  • Check the temperature of both the stuffing and the turkey with a food thermometer; temperature should be at least 165 degrees Fahrenheit.
  • Make sure the turkey cooks long enough, and allow 20 minutes before carving.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

Health Tip: Stay Fit in Your 30s

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(HealthDay News) -- You're in your 30s, but you're not too young to start protecting yourself from heart attack and stroke.

The Academy of Nutrition and Dietetics says staying fit in your 30s can help:

  • Lower high blood pressure and high cholesterol.
  • Lower your risk of type 2 diabetes.
  • Boost bone health.
  • Maintain ideal weight.
  • Alleviate stress.
  • Lower your risk of dying at an early age.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, Nov. 21, 2013 (HealthDay News) -- Less than half of American teens with mental health disorders receive treatment, and those who do get help rarely see a mental health specialist, a new study indicates.

The findings underscore the need for better mental health services for teens, said study author E. Jane Costello, associate director of the Duke Center for Child and Family Policy in Durham, N.C.

"It's still the case in this country that people don't take psychiatric conditions as seriously as they should," Costello said in a Duke news release. This remains so, despite a wave of mass shootings in which mental illness may have played a role, she and her colleagues noted.

The analysis of data from more than 10,000 teens aged 13 to 17 across the United States also showed that treatment rates varied greatly for different types of mental health problems.

For example, teens with attention-deficit/hyperactivity disorder, conduct disorder or oppositional defiant disorder received mental health care more than 70 percent of the time, while those with phobias or anxiety disorders were least likely to be treated.

The researchers also found that blacks were much less likely than whites to be treated for mental disorders, according to the study, published online Nov. 15 in the journal Psychiatric Services.

In many cases, teens received treatment from pediatricians, school counselors or probation officers, rather than mental health specialists. This is because there are not enough qualified child mental health professionals to handle the demand, said Costello, who is also a professor of psychology and epidemiology at Duke University.

"We need to train more child psychiatrists in this country," Costello said in a university news release. "And those individuals need to be used strategically, as consultants to the school counselors and others who do the lion's share of the work."

As many as one in five children living in the United States experiences a mental health disorder in any one year, according to a U.S. Centers for Disease Control and Prevention report.

More information

The American Psychiatric Association has more about teen mental health.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

Start at the Healthier End of the Buffet

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THURSDAY, Nov. 21, 2013 (HealthDay News) -- Putting healthier foods at the start of a buffet table can help diners pass up more fattening fare, according to a new study.

Researchers found that when healthy foods are seen first, people are more likely to select them and less likely to crave higher-calorie foods that may be farther down the buffet line.

"Each food taken may partly determine what other foods a person selects," the researchers said. "In this way, the first food a person selects triggers what they take next."

For the study, published recently in the journal PLoS One, the researchers provided two breakfast buffets to 124 people. In the first buffet, the participants encountered healthy foods, such as fruit, low-fat yogurt and low-fat granola, first. In the second buffet, high-calorie foods, such as cheesy eggs, fried potatoes and bacon, were at the start of the line.

The study revealed that when healthy foods were offered first, 86 percent of the diners selected fruit. But when more fattening foods were seen first, only 54 percent took the fruit. Similarly, when high-calorie foods were at the front of the buffet line, 75 percent of the participants chose cheesy eggs, compared to 29 percent of those on the healthy buffet line.

"The first three food items a person encountered in the buffet comprised 66 percent of their total plate, regardless of whether the items were high- or low-calorie foods," behavioral economist Brian Wansink, of Cornell University, said in a university news release.

The order of foods in a buffet played a role in what the participants chose to add to their plate, said the researchers, who dubbed this a "trigger effect."

"There's an easy take-away for us: Always start at the healthier end of the buffet," Wansink said. "Two-thirds of your plate will be the good stuff."

More information

The U.S. Centers for Disease Control and Prevention provides more information on healthy eating.

-- Mary Elizabeth Dallas

Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, Nov. 21 (HealthDay News) -- Despite progress in some areas, health disparities remain for many Americans, health officials reported Thursday.

These inequalities are related to income, education, sex, race, ethnicity, employment and sexual orientation, and they all affect Americans' health and well-being, according to the U.S. Centers for Disease Control and Prevention.

"The purpose of the report is to highlight disparities in health that still exist in the country," said Dr. Chesley Richards, director of the CDC's Office of Public Health Scientific Services, which produced the report.

"If you look at health in the country over the last 50 years, there has been a dramatic improvement in health," he said. "We have seen an increase in life expectancy in the last 20 or 30 years."

Across the 29 categories in the report there has been improvement, but many disparities persist, Richards said.

"For example, we have seen a decrease in tobacco use, but it's not even. In people who have lower educational status, the disparity has actually widened -- not improved," he said.

"Although we have seen pretty dramatic improvement in health for the population overall, you really have to look at particular groups to see that there are still tremendous disparities in health outcomes," Richards said.

The report is published in a Nov. 22 supplement to Morbidity and Mortality Weekly Report, a CDC publication.

The report covers a variety of areas, including disparities in deaths and illness, use of health care, lifestyle risk factors, environmental hazards and social aspects of health.

Key findings include the following:

  • A dramatic drop occurred in the rate of teen births -- by 18 percent from 2007 to 2010, with significant decreases seen among whites, blacks and Hispanics. There was substantial variation across states, from no significant change to a 30 percent reduction in Arizona.
  • Hispanics, low wage earners, those with only a high school education, men and those born outside the United States are those most likely to take high-risk jobs -- jobs where workers are likely to be injured or sickened.
  • Binge drinking is more common among people aged 18 to 34, men, whites and people with higher household incomes.
  • Despite a 58 percent drop in new cases of tuberculosis between 1992 and 2010, the disease remains disproportionately high among racial and ethnic minorities and those born outside the United States.
  • Diabetes rates are higher among Hispanics and blacks than among Asians and whites. Higher rates are also seen among people without a college degree and who have lower household incomes.
  • The infant death rate for blacks is more than double the rate for whites. The highest rates are in the South and Midwest.
  • Men are nearly four times more likely to commit suicide than women, regardless of age, race or ethnicity. The highest rates for both men and women are among American Indians/Alaska Natives and whites.
  • Cardiovascular disease is the leading cause of death in the United States, with blacks at least 50 percent more likely to die of heart disease or stroke prematurely than whites.

The report also covers 10 new areas involving health disparity. These are: access to healthy foods, activity limitations due to chronic diseases, asthma attacks, fatal and nonfatal work-related injuries and illnesses, health-related quality of life, gum disease in adults, living close to major highways, tuberculosis and unemployment.

It also highlights the need to collect more consistent health data that have been lacking in surveys, such as disability and sexual orientation, the authors noted.

"This report is a timely reminder that the United States has vast resources that are very unevenly distributed," said Dr. David Katz, director of the Yale University Prevention Research Center.

"We have huge disparities in health, because we have huge disparities in everything from income to education," he said.

Katz said that health care reform must extend beyond the doctor's office and hospital.

"We will best eliminate health disparities not by improving disease care, but by improving equity," he said.

More information

To find out more about health disparities, visit the U.S. National Library of Medicine.

Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, Nov. 21, 2013 (HealthDay News) -- Two research teams say they have pinpointed how changes in genes linked to autism act together to disrupt normal brain development.

Their studies, published Nov. 21 in the journal Cell, represent a leap forward in understanding the complex condition, said an expert who was not involved with the research.

"This gives us a moment in time when genetic risk for autism actually gets put into motion," said Robert Ring, a neuroscientist and chief science officer for the nonprofit advocacy group Autism Speaks. "This is very important."

That two research groups looking at different sets of genes came to the same conclusion "gives a lot of validity to the finding," Ring said.

Autism -- which impairs the ability to communicate, regulate behavior and relate to others -- is thought to affect about 1 in 88 children in the United States.

The mutations appear to come into play in mid-pregnancy. They interrupt the formation of specific cells that connect brain layers in a region that controls movement, sensory perception, conscious thought and language.

The changes appear to cause a sort of faulty wiring of the brain before birth, the researchers said.

They also said their findings might explain why early intervention programs, which enroll kids as young as 1 year old, help children with autism. Since their brains are still developing, they might be capable of correcting or compensating for some of these bad connections.

For both studies, researchers took advantage of BrainSpan atlas, an ambitious public project to catalog the gene makeup of the brain at many different ages. The brains used in the project are from 57 healthy, deceased males and females. Their ages ranged from six weeks after conception to 82 years old.

The work is groundbreaking, said one expert.

"This is something we couldn't have done two years ago because we didn't have this dataset," said Jeremy Willsey, a graduate student in genetics at Yale University.

Willsey led one of the studies, in which researchers focused on rare "lightning strike" mutations that caused a loss of function in nine genes. These mutations are changes to DNA that occur randomly, and aren't passed from parent to child. But previous studies have shown that individuals with autism often share these same random mutations.

Focusing on the actions of these nine genes, the researchers checked the BrainSpan atlas to see if any were working together at the same time. They found that those genes and others associated with autism worked together at only three distinct places and periods in development. Those corresponded to the deeper layers of the front of the brain between 10 and 24 weeks after conception.

The gene mutations seem to interfere with the development of nerve cells that connect different brain regions.

"We know there's a disruption in the cells' development, but we don't know much more than that," Willsey said. "That's sort of the next step that our lab is addressing. That's what's going to help you progress toward treatment."

For the other study, researchers at the University of California, Los Angeles, took a different approach.

Using the BrainSpan data, they first looked at gene expression in normal brains from eight weeks after conception through 12 months of age. They then mapped hundreds of genes shared by individuals with autism and determined when and where those genes were active in the developing brain. Strikingly, although there were many autism risk genes, they all acted together at just a few points in brain development.

The researchers also compared the activity of autism risk genes to the genes involved in intellectual disability, or low I.Q. Although the conditions share many of the same risk genes, the study found that they were active in different ways at different times, adding more proof that the two conditions are distinct.

Their findings also pointed to a disruption in the brain's wiring, probably because of an error in the development of the brain-connecting nerve cells.

The researchers stressed, however, that the findings probably don't explain all cases of autism.

"These gene mutations definitely contribute to autism in some people," said Neelroop Parikshak, a graduate student at the University of California, Los Angeles, who led the second study. "[But] we don't know how much in a given individual."

Willsey agreed. He said that for the first time, however, these studies show the genetics of autism in action, something that should speed the path to better treatments.

"We feel this is a turning point," he said. "We're taking these genes and being able to tie them to a specific time point and a specific region in the brain, which really allows us to take the next step and follow this up in more detail. It's very exciting."

More information

For more information on autism, head to the U.S. National Institute of Neurological Disorders and Stroke.

Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, Nov. 21, 2013 (HealthDay News) -- Researchers warn that patients who see perfectly well in their eye doctor's office often end up seeing considerably less well in the comfort of their own home.

The principal culprit: poor home lighting.

"The results from our study suggest that older adults are not seeing as well in their homes compared to their vision when tested in the clinic," said study author Dr. Anjali Bhorade, an associate professor of ophthalmology at the Washington University School of Medicine, in St. Louis.

"For example, a patient may see 20/20 in the clinic. However, [they can] have 20/40 or worse vision in their home," she said. "This decreased vision in the home can negatively affect their function in their home, and thus their quality of life."

"We found that poor lighting in the home was the most significant factor contributing to decreased vision," Bhorade said. "More than 85 percent of older adults had lighting in their homes below that of the recommended level. Our results suggest that simply ... increasing lighting may improve the vision of older adults in their homes."

Bhorade and her colleagues discussed their findings in the Nov. 21 online issue of the journal JAMA Ophthalmology.

The researchers focused on 175 eye patients between the ages of 55 and 90.

Most of the patients had been diagnosed with glaucoma before attending a regularly scheduled appointment with their ophthalmologist at some point between 2005 and 2009. The remainder had no eye health issues.

All of the patients had their vision tested both in their doctor's office and at home. Both exams were scheduled within a one-month span, and took place during the daytime. Home exams included testing that assessed near-vision abilities, such as paying bills or reading.

Digital light meters also were used to determine lighting levels in both settings.

Vision test results were significantly better in the doctor's office than in a home setting, regardless of whether a patient had glaucoma.

For example, nearly 30 percent of glaucoma patients were able to read two or more lines more easily on an eye chart when tested in the doctor's office than when at home. Among those with more severe glaucoma, nearly four in 10 read three or more lines better when tested in the office than when tested at home.

The same dynamic was observed with near vision, the researchers said. More than one-fifth of patients experienced better results at the doctor's office when trying to read two or more lines of text.

Bhorade and her associates determined that lighting was the key factor behind the difference. Home lighting was three to four times less bright than in a clinical setting, on average.

"Not all older adults, however, may benefit from increased lighting," Bhorade said. "Therefore, to optimize lighting conditions in the home, we recommend an individualized in-home assessment by an occupational therapist, or a referral to a low-vision rehabilitation specialist."

Dr. Alfred Sommer, a professor of ophthalmology at the Bloomberg School of Public Health at Johns Hopkins University, said the study highlights the broader issue of understanding the real-world limitations of people with vision issues.

"This is a real issue," he said. "The ophthalmologist's office is not the world we live in. It's a very artificial situation, in which vision is tested in a very dark room but with very high contrast letters. And even that's only looking at one measure of vision, without regard to other possible [eye] issues."

"It's no surprise that when people are in their home setting, under ambient conditions, everything is a little bit grayer and not so intense," Sommer said. "The question is whether that difference has a functional impact. Can people easily navigate through their world and function in society?"

"This is a whole new science that is now coming into play -- the effort to develop ways to test for real-life conditions so we can improve vision in a way that's really meaningful to patients," Sommer said.

More information

For more on eye exams, visit the U.S. National Eye Institute.

Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, Nov. 21 (HealthDay News) -- One in six teens has some degree of preventable hearing loss, but few parents warn their kids to turn down their iPods or avoid other sources of excessive noise, new research finds.

"High-frequency hearing loss, which is typically noise related, has increased among U.S. adolescents," said study researcher Dr. Deepa Sekhar, assistant professor of pediatrics at Penn State College of Medicine.

Yet Sekhar's poll of about 700 parents found that the overwhelming majority -- more than 96 percent -- believed their teen was not at risk or only slightly at risk of developing hearing problems from too much noise. More than two-thirds said they hadn't talked to their teen about noise hazards because of that perceived low threat.

Personal music devices and concerts are a common cause of noise overdose, as is lawn-mowing, especially when listening to music at the same time, she said. Shop class and sporting events also can be extremely noisy, she said.

High-frequency hearing loss doesn't happen overnight. It creeps up gradually, limiting the ability to hear high-frequency common sounds in speech, such as the letters s, h and f. Over time, this can hurt school performance, personal life and, later, workplace success.

Whereas 13 percent of teens exhibited high-frequency hearing loss in the early 1990s, that figure had passed 16 percent by 2006, according to background information Sekhar provided.

The study, which involved parents with teens aged 13 to 17 years old, was published online Nov. 21 in the journal JAMA Otolaryngology -- Head and Neck Surgery. It was funded by a grant from the Children's Miracle Network, a nonprofit organization that draws attention to children's health issues.

Sekhar said she doesn't expect music-loving teens to give up this cherished pastime. Instead, she wants to raise awareness among parents that hearing protection is essential.

Keeping the volume of personal listening devices at reasonable levels is one way to safeguard hearing, she said.

"It's difficult to give an exact volume level because it is both the volume and the length of the exposure that impact hearing in the long run," Sekhar said. She suggested investing in volume-limiting headphones and volume controls on portable listening devices.

Parents also can suggest that their children wear ear plugs when they know noise will be excessive, such as at concerts, in shop class and when mowing the lawn, she said.

They should also discourage using two sources of loud noise simultaneously -- for example, listening to music while mowing the lawn or snow-blowing, she said.

Hearing specialist Robert Frisina, director of the Global Center for Hearing and Speech Research at the University of South Florida, in Tampa, offered some advice for parents. "For personal listening devices, activate the volume limit that most devices have to prevent noise damage but are not usually activated by teenagers," he said.

When teens are going to be engaging in activities that involve loud noise, advise them to wear hearing protection, he added. The pliable ear plugs available at drug stores are one option.

Sounds above 85 decibels can cause permanent hearing loss, according to the American Speech-Language-Hearing Association. Some MP3 players can reach 110 decibels, while lawn mowers can hit 106.

In her study, Sekhar found that better-educated parents and parents of younger teens were more likely than others to encourage safe-listening practices.

More information

To learn more about hearing loss, visit the American Speech-Language-Hearing Association.

Copyright © 2013 HealthDay. All rights reserved.

Texting Your Way to Weight Loss

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THURSDAY, Nov. 21, 2013 (HealthDay News) -- If you like texting and are trying to lose weight, a new study found that using texting to track diet and exercise habits may help you shed pounds.

Previous research has shown that keeping food and exercise diaries improves the likelihood of success when trying to shed excess weight. Using a computer or pen and paper to record information, however, can be a burden and cause some people to give up.

Duke University researchers said using text messages to stay on top of eating and exercise habits can save time and increase the chances that people will stick with their weight-loss regimen.

The study included 26 obese women with an average age of 38. The women used daily texting as part of their weight-loss program. The text messages focused on tracking personalized goals, such as avoiding sugary drinks or walking 10,000 steps a day. Messages also provided brief feedback and tips.

Every morning, the women received a text from an automated system that said, "Please text yesterday's # of steps you walked, # of sugary drinks and if you ate fast food." Based on the women's responses to the text message, the system sent another text with personalized feedback and a tip.

After six months, the women who used daily texting lost an average of nearly 3 pounds, while another group of women who used traditional methods to keep food and exercise diaries gained an average of 2.5 pounds, according to the study, which was published online Nov. 18 in the Journal of Medical Internet Research.

"Text messaging has become ubiquitous and may be an effective method to simplify tracking of diet and exercise behaviors," study author Dori Steinberg, a postdoctoral obesity researcher in the Duke Obesity Prevention Program, said in a university news release.

Steinberg said text messaging offers several advantages compared to other self-monitoring methods. Unlike Web-based diet and exercise diaries, data in a text message can be entered quickly on nearly all cellphone platforms. This provides more portability, nearly real-time tracking and more accessibility for receiving tailored feedback.

And because of the limited number of words used in text messages, it saves time and is not as mentally demanding, Steinberg said.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases outlines how to choose a safe and successful weight-loss program.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, Nov. 21, 2013 (HealthDay News) -- Doctors are being warned that two drugs used in cardiac nuclear stress tests can cause heart attacks and death in patients, the U.S. Food and Drug Administration says.

These rare but serious events have led the agency to approve changes to the labels of Lexiscan (regadenoson) and Adenoscan (adenosine) and to update recommendations for their use.

Cardiac nuclear stress tests can diagnose heart problems that other stress tests or an examination at rest might not detect. The drugs are approved for use during cardiac nuclear stress tests in patients who cannot exercise. The drugs dilate the arteries of the heart and increase blood flow to help reveal blockages or obstructions in the heart's arteries, the FDA explained.

Lexiscan and Adenoscan cause blood to flow to the healthier, unobstructed arteries, which can reduce blood flow in an obstructed artery. But in some cases, this reduced blood flow can lead to a heart attack, the FDA said.

The "Warnings & Precautions" section of the drugs' labels previously included information about the possible risk of heart attack and death with use of these drugs.

"However, recent reports of serious adverse events in the FDA Adverse Event Reporting System database and the medical literature prompted us to approve changes to the drug labels to include updated recommendations for use," the FDA said in a news release.

The new recommendations advise doctors to screen all nuclear stress-test candidates for their suitability to receive Lexiscan or Adenoscan. Doctors should not use "these drugs in patients with signs or symptoms of unstable angina or cardiovascular instability, as these patients may be at greater risk for serious cardiovascular adverse reactions," according to the FDA.

Also, cardiac resuscitation equipment and trained staff should be available before patients are given Lexiscan or Adenoscan, the agency said.

Currently, it's not known if there is a difference in risk of heart attack or death between Lexiscan and Adenoscan, the FDA said.

More information

The U.S. National Library of Medicine has more about cardiac nuclear stress test.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, Nov. 21, 2013 (HealthDay News) -- Women who go to bed and wake up at regular times tend to maintain a healthy weight, a new study suggests.

Research has shown that not sleeping enough can have an effect on weight, but this new study from Brigham Young University finds that consistency in sleeping times can influence body fat.

"The message of this study seems fairly straightforward: Sleeping well consistently is associated with lower body fat in young women," said Dr. David Katz, director of the Yale University Prevention Research Center. Katz was not involved with the study.

The study also suggested that better sleep -- characterized by its efficiency, consistency and duration -- is associated with more routine physical activity, he said.

"Some of the advantage in body composition from better sleep appears to be the effect of sleep itself, while some may be a product of more activity, " Katz said. "It may also be that exercise facilitates better sleep, or vice versa."

Katz cautioned, however, that this study did not prove a cause-and-effect relationship between sleep and weight.

The report was published online in the November issue of the American Journal of Health Promotion.

For the study, a team lead by exercise science expert Bruce Bailey collected data on 330 college women. Over a weeklong period, those who slept and woke at consistent times maintained a healthier weight.

Those who went to bed and woke up at or around the same time each day had lower body fat. Those who slept between eight and eight and a half hours had the lowest body fat, the researchers found.

Those whose sleep patterns varied more than 90 minutes had higher body fat than those whose sleep patterns varied less than 60 minutes, the researchers found.

Getting too little or too much sleep also had an effect on body fat. Sleeping less than six and a half or more than eight and a half hours a night was associated with higher body fat.

Moreover, quality of sleep was important, with those who had better sleep quality having lower body fat, the researchers found.

Sleep quality is a measure of how much time spent in bed is spent sleeping. Bailey said staying up late or sleeping in may be doing more harm than good.

"We have these internal clocks, and throwing them off and not allowing them to get into a pattern does have an impact on the [physical and chemical functioning of our bodies]," Bailey said in a statement.

Consistent sleep patterns are good sleep hygiene, he said. When sleep is changed, it can change physical-activity patterns and affect some hormones involved with metabolism and contribute to excess body fat, Bailey said.

To improve sleep quality, Bailey recommends exercising, using beds only for sleeping, and keeping the bedroom cool, quiet and dark.

Katz said more research is needed since the findings are specific to young women. "But there is no apparent reason why they would not pertain equally to men," he said.

"For now, it is reasonable to reaffirm that sleep matters to weight control and health," Katz said.

More information

Visit the National Sleep Foundation for tips on how to improve your sleep habits.

Copyright © 2013 HealthDay. All rights reserved.

Laser Toys Can Damage Eyes: Report

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THURSDAY, Nov. 21, 2013 (HealthDay News) -- Popular laser toys can cause serious and potentially permanent eye damage, a new report warns.

The high-powered blue laser gadgets, sold over the Internet, are increasingly sought after by male teens and young adults, according to the researchers.

The study authors report on 14 cases of laser-caused eye damage treated at Saudi Arabia's King Khaled Eye Specialist Hospital between 2012 and 2013. The injuries were caused by high-power blue laser gadgets and included four cases of perforations of the retina, the part of the eye responsible for detailed central vision.

"We fear our experience may mark the beginning of an alarming trend and may portend a growing number of young people suffering serious eye damage as these high-power lasers become more ubiquitous," Dr. J. Fernando Arevalo, chief of the hospital's retina division and professor of ophthalmology at the Johns Hopkins Wilmer Eye Institute, said in a Hopkins news release.

The toys resemble light sabers from "Star Wars" and are most often used for play, but also to light cigarettes and set plastic or paper on fire from a distance.

The patients were males aged 11 to 30, and all of them suffered sudden vision loss in one eye. Ten required surgery or other treatment. While most of the injuries were reversed with treatment, two patients suffered permanent damage to the retina.

All patients recovered some or most of their vision over the course of a few weeks or months, according to the study, published online Nov. 4 in the journal Ophthalmology.

All of the patients sought treatment immediately, which may explain their successful recovery, the researchers noted.

Sixteen more patients have been seen and treated at the hospital for laser-caused injuries since the study was written, the researchers said.

More information

The U.S. Consumer Product Safety Commission has more about toy safety.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, Nov. 21, 2013 (HealthDay News) -- Mercury levels in American women of childbearing age have dropped about one-third over a decade, a new federal study shows.

It's likely the trend can be attributed to women making more informed choices about what types of seafood are safer to eat, health officials said.

An analysis of national data found that blood mercury levels among women in this age group dropped 34 percent between 1999 and 2010, according to the U.S. Environmental Protection Agency.

The EPA also found that the percentage of women of childbearing age with blood mercury levels above the "level of concern" fell 65 percent during the study period.

Even so, there was little change in the amount of fish eaten by women between 1999 and 2010. The decrease in mercury levels suggests that women may have started eating types of fish with lower mercury levels, the EPA said in an agency news release.

The agency noted that fish and shellfish are an important part of a healthy diet. These foods are a source of high-quality protein, many vitamins and minerals, omega-3 fatty acids, and are mostly low in saturated fat. A well-balanced diet that includes a variety of fish and shellfish can be good for heart health and children's growth and development.

However, nearly all fish and shellfish contain traces of mercury. For most people, the risk from mercury by eating fish and shellfish is low, the agency noted. But some fish and shellfish contain higher amounts of mercury that may harm an unborn baby or a young child's developing nervous system. The risks depend on the amount of fish and shellfish eaten and the levels of mercury in the fish.

Women who may become pregnant, pregnant women, nursing mother, and young children should avoid some types of fish, but continue to eat fish and shellfish that are low in mercury, the EPA and U.S. Food and Drug Administration recommended.

The agencies offered the following advice:

  • Do not eat shark, swordfish, king mackerel or tilefish -- they have high levels of mercury.
  • Eat up to 12 ounces (two average meals) weekly of a variety of fish and shellfish that are low in mercury. Five of the most commonly eaten are shrimp, canned light tuna, salmon, pollock and catfish.
  • Albacore ("white") tuna has more mercury than canned light tuna. So, when choosing two meals of fish and shellfish, you may eat up to 6 ounces (one average meal) of albacore tuna per week.
  • Check local advisories about the safety of fish caught in local lakes, rivers and coastal areas. If no advice is available, eat up to 6 ounces (one average meal) per week of fish caught from local waters. Don't consume any other fish during that week.
  • Follow these recommendations for young children, but serve smaller portions.

More information

The U.S. Environmental Protection Agency has more about mercury in seafood.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, Nov. 21, 2013 (HealthDay News) -- Researchers report that they have identified a gene that is tied to severe obesity.

They say their findings could lead to new treatments for obesity.

The team studied an Israeli Arab family whose members were severely obese. They found that the family members had a mutation in a gene that produces a protein called CEP19.

When the researchers deleted this gene in mice, the rodents became obese and developed diabetes. They also had increased appetites and burned less energy.

Scientists note, however, that research done in animals often fails to produce similar results in humans.

The study was published online Nov. 21 in the American Journal of Human Genetics.

"Starting with gene discovery in a single family with morbid obesity, these studies led to the identification of a gene that seems to be fundamental to regulating nutritional status [body weight]," study co-senior author Dr. John Martignetti, of the Icahn School of Medicine at Mount Sinai, in New York City, said in a journal news release.

"This gene is shown to be present not only in humans and mice, but also in the simplest known single-cell animal," he said. "Nature considers this gene so important that it has preserved its structure for more than 700 million years."

The specific role of the CEP19 protein in maintaining a balance between leanness and obesity remains unknown. Further research is needed to determine how the protein affects appetite control, the amount of calories the body burns and insulin sensitivity, the study authors said.

Previous research has indicated that genes play a role in 40 percent to 90 percent of cases of obesity, according to the news release.

More information

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

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

What Not to Do for Migraines

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THURSDAY, Nov. 21, 2013 (HealthDay News) -- Prescription pain medications should not be the first treatment for migraines. And doctors shouldn't routinely order brain scans for patients with these debilitating headaches, according to new guidelines.

Taking a stand on common but often unnecessary or potentially risky tests and treatments for migraine, the American Headache Society published new recommendations in the November-December issue of the journal Headache.

"Our aim is to encourage doctors and patients to think carefully about medical care that can be harmful or unnecessary," said Dr. Elizabeth Loder, president of the American Headache Society. "We didn't approach this with cost uppermost in mind. The goal is to help address the problems of low-value care."

Opioid painkillers, such as OxyContin and Vicodin, and the barbiturate butalbital pose serious long-term risks, the society said.

"The effectiveness of opioids is not the question," explained Loder, chief of the division of headache and pain in the neurology department at Brigham and Women's Hospital in Boston. "The problem is that even if they are effective in a single attack, for many people migraine is a chronic disorder that they will have for many decades."

The risk of dependency associated with these drugs is evidenced by the growing epidemic of prescription painkiller abuse in the United States. Nearly three out of four prescription drug overdoses are caused by opioid painkillers, according to the U.S. Centers for Disease Control and Prevention.

"This ends up being a second problem patients have," Loder noted.

Using too much of these pain medications can also lead to a condition called medication overuse headache, said another expert.

"There is a lot of research that opioids actually increase the sensitivity to pain in the head," said Dr. Rebecca Erwin Wells, assistant professor of neurology at Wake Forest Baptist Medical Center in Winston-Salem, N.C. Medication overuse headaches are difficult to treat, Wells added.

In addition, the guidelines indicate that brain scan studies should not be performed on patients with stable headaches that meet criteria for migraine. And CT scans should not be used in a non-emergency situation as a diagnostic tool for headache patients when MRI is available.

"MRI can diagnose more conditions that may cause headache that CT scans can miss," Loder explained.

Also, unlike CT scans, MRIs use powerful magnets and do not expose patients to radiation. "MRI is better value and safer," Loder concluded.

The headache specialists also said that surgery targeting migraine trigger points is still experimental and not recommended outside of a clinical trial.

"We lack sufficient evidence to say the benefits of surgery outweigh the potential harms or that it is even helpful," Loder cautioned. Before new drugs can be approved for use, they must go through rigorous testing that meets a certain standard, she noted, "and the standard for surgical interventions that are irreversible should not be lower."

Finally, prolonged or frequent use of over-the-counter pain medications for headache is also unwise, the guidelines state. People shouldn't take these drugs more than twice a week, noted Wells.

Loder agreed. "It's not good for the kidneys, liver or stomach to be taking these medications on a daily basis," Loder said. "There are a lot of strategies that can work that are better than just grabbing handfuls of Motrin."

So what does work for most migraine sufferers? Triptans are a family of drugs used to stop migraines once they start, Loder said. And preventive therapies such as biofeedback can be used on a regular basis by people who experience frequent migraines, she added. Biofeedback is a technique that people can learn to use to help change how their body responds to physical symptoms.

Getting enough sleep and not skipping meals can also help keep migraine pain at bay, she suggested.

Migraine treatment and perceptions of the condition itself have changed dramatically over the years. Scientists now believe migraine has a genetic link and that the disorder involves brain chemistry and nerve pathways.

"We understand a lot more about different kinds of headache and have specific treatments that work," Loder said.

It's estimated that 12 percent of Americans get migraine headaches, three times as many women as men.

More information

The U.S. National Institute of Neurological Disorders and Stroke provides more information on migraine.

Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, Nov. 21, 2013 (HealthDay News) -- Too much time spent playing sports can be as bad as too little time for teens, a new study finds.

Swiss researchers found the greatest benefit seemed to be associated with 14 hours of sports a week. That's higher than European, American and World Health Organization (WHO) recommendations of at least seven hours of physical activity a week for adolescents.

Researchers Arnaud Merglen, at the University of Lausanne, and colleagues reported their findings online Nov. 20 in the Archives of Disease in Childhood.

They asked more than 1,200 participants aged 16 to 20 in Switzerland about their levels of sports participation. In addition, they assessed the participants' physical and mental well-being using a WHO scale of zero to 25. Scoring below 13 indicated poor well-being.

Participants were evenly split between males and females and their average age was just under 18. About 9 percent were overweight or obese. The average well-being score for all the teens was 17.

Weekly sports participation of zero to 3.5 hours was considered low and seen in 35 percent of teens. Between 3.6 and 10.5 hours was considered average and seen in 41.5 percent of participants. High levels of 10.6 to 17.5 hours were reported by 18.5 percent of participants, and very high levels of more than 17.5 hours were reported by 5 percent of tens.

Teens in the low and very high groups were more than twice as likely as those in the average group to score below 13 on the well-being scale, according to a journal news release.

Peak scores of well-being were seen among teens who did about 14 hours of sports a week. However, the protective effect was reversed after more than 17.5 hours of sports a week.

Regular exercise is known to provide mental and physical benefits by reducing stress and anxiety, and by boosting self-esteem and brain power, the researchers said.

Although doubling the recommended weekly time spent playing sports to 14 hours seems to be good for the mental and physical health of teens, going beyond this seems to be harmful, the researchers concluded.

More information

The American Council on Exercise has more on teen fitness.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, Nov. 21, 2013 (HealthDay News) -- Recessions can have long-lasting effects, and they may not be just financial.

A new study has found that people affected by an economic downturn in middle age may be at risk for mental decline later in life.

Researchers examined data from 12,000 people aged 50 and older in 11 European countries.

Men aged 50 to 74 who lived through four or more recessions by the time they were in their mid- to late-40s had lower scores on mental abilities such as memory, speech and math than those who did not experience a recession, the investigators found.

Their findings were published online Nov. 20 in the Journal of Epidemiology and Community Health.

The impact of recessions on women appeared to occur at an earlier age, according to a journal news release.

Job loss and having to take part-time work or lower-paying, lower-status jobs may explain the toll that recessions can take on people's mental abilities, suggested researcher Anja Leist, at the University of Luxembourg, and colleagues.

Previous research has suggested that good working conditions may help people build up a mental "reserve," which in turn affects mental performance at a later age.

Although the study found an association between economic recessions in mid-life and later declines in thinking skills, it did not prove a cause-and-effect relationship.

More information

The U.S. Substance Abuse and Mental Health Services Administration offers tips for getting through tough economic times.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

Health Highlights: Nov. 21, 2013

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

J&J Announces $2.5B Settlement for Hip Implant Lawsuits

Johnson & Johnson says it will pay $2.5 billion to settle lawsuits over faulty hip replacements, making it one of the largest settlements paid out in the medical device industry.

The agreement presented in U.S. District Court in Toledo, Ohio, resolves about 8,000 cases involving patients who had to have the metal ball-and-socket hip implant -- called the ASR Hip System -- removed or replaced, the Associated Press reported.

The metal implant was pulled from the market in 2010 after data showed that it failed sooner than older types of plastic or ceramic hip implants.

The settlement announced late Tuesday provides about $250,000 per patient and covers those whose implants were removed or replaced before Aug. 31, 2013. Most of the patients are expected to receive their payments in 2014, the AP reported.

J&J's lawyers have denied that the company acted improperly.

The deal does not cover all lawsuits related to the hip implant, J&J's DePuy unit said in a statement. "DePuy will continue to defend against remaining claims and believes its actions related to the ASR Hip System have been appropriate and responsible," the company said.

The ASR Hip System was sold for eight years and used in about 35,000 patients in the United States and more than 90,000 worldwide. Production of the hip implant was halted in 2009 and it was recalled in 2010, the AP reported.

Internal J&J documents suggest that company officials knew about problems with the device at last as far back as 2008. And a 2011 company review of a patient registry said that more than one-third of the hip implants were expected to fail within five years of implantation, the AP reported.

Replacement hips are generally supposed to last at least 10 to 20 years, according to the news service.

-----

Obese Pilots, Air Traffic Controllers Must Be Checked for Sleep Disorder: FAA

Obese pilots and air traffic controllers in the United States will soon have to undergo screening to determine if their excess weight is causing them to lose sleep and therefore affecting their work performance, the Federal Aviation Administration says.

Agency officials explained that overweight people are at increased risk for obstructive sleep apnea (OSA), a disorder that impairs sleep and can cause drowsiness when people are awake, FoxNews.com reported.

"Airman applicants with a BMI (body mass index) of 40 or more will have to be evaluated by a physician who is a board certified sleep specialist," FAA's air surgeon, Fred Tilton, wrote in a recent FAA medical bulletin. "Anyone who is diagnosed with OSA will have to be treated before they can be medically certificated."

Body mass index is a measurement of body fat based on height and weight. People with a BMI of 40 and higher are considered extremely obese.

The memo also says that the FAA plans to expand the screening program to include those with a BMI of 30, FoxNews.com reported. People with a BMI of 30 are considered moderately obese.

Copyright © 2013 HealthDay. All rights reserved.

Health Tip: Is Your Child Overloaded?

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(HealthDay News) -- Everyone is under some stress. But too much stress can impair your child's well-being and emotional health.

The American Academy of Pediatrics mentions these warning signs that your child is under too much stress:

  • If there are physical pains, such as stomach aches or headaches.
  • If the child appears agitated, restless and tired.
  • If the child seems depressed, but is unwilling to talk about his or her feelings.
  • If the child behaves irritably or negatively, or lacks excitement about daily activities.
  • If the child chooses to stay home, rather than participate in activities once enjoyed.
  • If the child's grades decline.
  • If the child shows behavioral changes, such as lying or stealing, becoming forgetful, refusing your requests or depending on you more than usual.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- A sore throat can be triggered by allergies or by something more serious, such as a bacterial or viral infection.

So how do you know when a sore throat is more serious? The U.S. Centers for Disease Control and Prevention mentions these warning signs:

  • If the sore throat persists longer than a week.
  • If there are problems swallowing or breathing.
  • If there's excessive drooling among younger children.
  • If there's a temperature higher than 100.4 degrees Fahrenheit.
  • If there are patches of pus on the back of the throat.
  • If a skin rash develops.
  • If there is blood in the phlegm or saliva.
  • If there are symptoms of dehydration, including fatigue, dry mouth, infrequent urination or no tears.
  • If there has been exposure to someone with strep throat.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

Joblessness May Age You, Study Suggests

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WEDNESDAY, Nov. 20, 2013 (HealthDay News) -- Men who are unemployed for an extended time may age more quickly, a new study suggests.

That aging is evident in their DNA, the British researchers reported. More specifically, it is found in the length of the gene tips or caps, referred to as "telomeres." The shortening of telomeres has long been seen as an indicator of aging.

"Shorter telomeres are linked to a higher risk of age-related conditions, such as heart disease and type 2 diabetes," said study author Jessica Buxton, a research associate in the department of medicine at Imperial College London. "It seems that long-term unemployment is the latest example of a stressful life experience that may trigger permanent changes to the cell's DNA.

"It's important to note that other studies have shown too much work can be as harmful as too little," she said. "Work-related exhaustion and the holding of multiple jobs have also been linked to shorter telomeres."

The report was published Nov. 20 in the online journal PLoS One.

Constant stress over a long time changes the hormones in one's body, said Curtis Reisinger, a clinical psychologist at Zucker Hillside Hospital in Glen Oaks, N.Y. This may be what is causing these changes in telomere length.

"You see the same thing with depression and high stress levels," he said. "The consequence is that you wind up looking and feeling older."

Reisinger said seeing a mental-health professional can help relieve stress. But having a positive attitude also is important.

"This is not the end of the world," he said. "You have to stay focused and have faith that if you keep at it and have a positive outlook, chances are you will be more likely to get a job than if you're down in the dumps and pessimistic."

For the study, Buxton and her colleagues examined DNA from more than 5,600 men and women born in Finland in 1966.

Specifically, they looked at telomere length in DNA samples collected in 1997, when the participants were 31 years old.

The researchers found that men who were unemployed for more than two out of the previous three years were more than twice as likely to have short telomeres compared with men who were employed.

To be sure their findings resulted from unemployment alone, the researchers accounted for other social, biological and behavioral factors that could cause shortened telomeres.

"It's interesting that unemployment itself appears to have a negative effect on health, even after accounting for the potential effects of smoking, physical-activity levels, weight, illness, education and marital status," Buxton said.

Buxton's team found this effect among men and not women, which might be because there were fewer unemployed women in the study, she said.

Although the study found an association between unemployment and faster aging, it did not prove a cause-and-effect link.

More information

Visit the U.S. National Library of Medicine for more on stress.

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 20, 2013 (HealthDay News) -- Black adults typically have low levels of vitamin D in their blood, but they are on par with whites when it comes to the "active" form of vitamin D used by the body's cells, a new study finds.

Experts said the findings go a long way toward explaining a paradox: Blacks usually have fairly low vitamin D levels, but have greater bone mass than whites. Vitamin D is needed to maintain strong bones.

What's more, the results suggest that doctors may be overdiagnosing vitamin D deficiency in black patients, said lead researcher Dr. Ravi Thadhani, chief of nephrology at Massachusetts General Hospital, in Boston.

"We're suggesting that the definition of vitamin D deficiency needs to be rethought," said Thadhani, whose report appears in the Nov. 21 issue of the New England Journal of Medicine.

Right now, doctors use a blood test that measures a person's total 25-hydroxyvitamin D level. And if you consider just that total level, Thadhani said, up to 90 percent of black Americans would be labeled vitamin D deficient.

Among the nearly 1,200 black adults in his study, the average total vitamin D level was just shy of 16 nanograms per milliliter (ng/mL), versus almost 26 ng/mL among 900 white adults.

In general, levels below 20 ng/mL are considered a vitamin D deficiency.

But then Thadhani's team looked at study participants' levels of vitamin D-binding protein, which basically locks up the vitamin, away from body cells' use. It turned out that blacks also had lower levels of vitamin D-binding protein. So on balance, black and white adults had similar levels of "bioavailable" vitamin D -- the kind that their bodies can actually use.

And just like in past studies, black adults typically had greater bone mass and higher calcium levels than their white counterparts.

Why the discrepancy? Thadhani said that gene variations appeared to explain most of the difference in people's levels of the vitamin D-binding protein. Most blacks adults carried a gene variant linked to lower levels of the protein, while fewer than half of whites did.

"This highlights the role of genetics in determining our vitamin D status," Thadhani said. "Treating different populations as one big whole doesn't necessarily serve people well."

He said his team is not suggesting that doctors treat low vitamin D levels based on race. But, he added, "we shouldn't treat just based on total (vitamin D) levels alone."

Instead, Thadhani said, doctors could look at whether a black patient with low vitamin D has any other indicators of a problem -- such as low calcium levels or a very high level of parathyroid hormone.

Right now, there is no commercially available test that specifically gauges bioavailable vitamin D levels. Thadhani said he thinks it would be helpful to get such a test on the market.

But an expert not involved in the study said that while the results are "very interesting to scientists," it's not clear how they should be used in medical practice.

"We've known for a long time that blacks have lower levels of total vitamin D, but don't seem to show the consequences," said Dr. Michael Holick, a vitamin D researcher at Boston University Medical Center who wrote an editorial published with the study.

"This study may give us an explanation," Holick said.

But he added that as far as testing for and treating vitamin D deficiency, "it's not clear yet what it all means."

Holick noted that low levels of total vitamin D have been linked to health problems other than brittle bones. And, he said, some of those conditions, including diabetes and heart disease, are more common in blacks -- though it's not known whether vitamin D has anything to do with that.

Still, Holick said more research is needed before anyone diagnosed with vitamin D deficiency should stop taking supplements. "We can't make any definite comment yet on what people should do with this," he said.

In general, experts recommend that most adults get 600 international units (IU) of vitamin D per day. Meanwhile, those older than 70 should aim for 800 IU. The body makes vitamin D when the skin is exposed to the sun. The process is less efficient in darker-skinned people, which is why blacks typically have low total levels of vitamin D.

Fatty fish such as mackerel and salmon are the main sources of natural vitamin D. But certain foods -- including milk, orange juice and breakfast cereals -- are fortified with the vitamin.

More information

The U.S. National Institutes of Health has more on vitamin D and health.

Copyright © 2013 HealthDay. All rights reserved.

Eat Nuts, Live Longer?

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WEDNESDAY, Nov. 20, 2013 (HealthDay News) -- If you like nuts -- and it doesn't seem to matter what kind is your personal favorite -- you might be cutting your risk of early death by eating a handful of them every day.

New research found that people who ate a 1-ounce serving of nuts each day showed a 20 percent reduced risk of dying from any cause over three decades, compared to those who didn't eat the tasty snacks.

"We looked at nut consumption in approximately 119,000 Americans over the past 30 years," said study senior author Dr. Charles Fuchs, director of the Gastrointestinal Cancer Center at the Dana-Farber Cancer Institute in Boston. "People who were regular nut consumers had a significant reduction in [death from all causes]."

"This is an observational study, so it's not absolute in terms of proof," Fuchs said. "But prior studies suggest health benefits like a lower risk of heart disease and type 2 diabetes, and lower cholesterol, among other health outcomes."

The study was funded by the U.S. National Institutes of Health and the International Tree Nut Council Nutrition Research and Education Foundation, a nonprofit institute that represents nine different nut industries.

The findings were published in the Nov. 21 issue of the New England Journal of Medicine.

Nuts are nutrient-dense foods, according to background information included in the study. They contain unsaturated fatty acids, fiber, vitamins, minerals and antioxidants. Previous research has linked nut consumption to a lower risk of heart disease, as well as improvements in risk factors for heart disease such as high cholesterol, according to the study.

The researchers looked at how nut consumption might affect all causes of death, as well as whether nuts were linked to death risk from specific conditions, such as heart disease.

The study included more than 76,000 women from the Nurses' Health Study and more than 42,000 men from the Health Professionals Follow-Up Study. Anyone with a history of heart disease, stroke or cancer was excluded from the study.

Nut consumption was verified at the start of the study, and then every two to four years during the study. During about 30 years of follow-up, more than 16,000 women and more than 11,000 men died.

When the researchers compared people who ate nuts to people who never ate nuts, they found a 7 percent reduced risk of dying from any cause during the 30-year study. People who consumed more nuts had an even lower risk of dying. Those who had nuts once a week had an 11 percent lower risk of death, while people who had two to four servings of nuts a week saw their risk drop by 13 percent. Those who consumed the most nuts -- at least seven 1-ounce servings weekly -- reduced their overall death risk by 20 percent, according to the study.

Eating more nuts also was linked to a lower risk of death due to cancer, heart disease and respiratory disease.

The study uncovered an association between eating nuts and living longer, but it didn't prove cause-and-effect.

Fuchs said a 1-ounce serving was equal to about 16 to 24 almonds, 16 to 18 cashews or 30 to 35 peanuts.

People who ate nuts tended to be healthier overall, according to the study. They were leaner, had lower rates of obesity, had lower cholesterol, had less high blood sugar, had smaller waist circumferences, ate more fruits and vegetables, and exercised more than people who ate fewer or no nuts.

Fuchs and his team controlled the data to account for these factors.

One expert said what people who are eating nuts aren't eating instead is also important.

"This study adds to the research that nuts are part of an overall healthful diet, especially if people are choosing to have nuts instead of chips or candy," said Alice Bender, associate director for nutrition programs with the American Institute for Cancer Research.

"Nuts provide quality protein, fiber, good fats [and] B vitamins," she said. "Nuts are a whole package of health, and they've shown some cancer-protective qualities."

"But nuts aren't a magic bullet," she said. "They're just one part of all the wonderful foods we have. It's important to eat foods that are minimally processed."

"The best thing to do is to substitute nuts for other foods that may be crunchy or sweet," Bender said. "Replace some of those foods that don't contribute much to our diets with nuts. You'll be replacing empty calories with a whole food."

More information

Learn more about the benefits of nuts from the American Academy of Nutrition and Dietetics.

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 20 (HealthDay News) -- Feel like you're losing your hearing? It's important to see a doctor before you start looking for a hearing aid or amplifier, the U.S. Food and Drug Administration says.

"The problem might be as simple as a wax impaction blocking the ear canal, which is easily treated, or at the other end of the spectrum, it could be something as serious as a tumor pressing on the hearing nerve," Dr. Eric Mann, clinical deputy director of the FDA's division of ophthalmic, and ear, nose and throat devices, said in an agency news release.

Many cases of hearing loss are related to aging and exposure to loud noises, and a hearing aid might be the solution. While a prescription is not required for most kinds of hearing aids, it's wise to see a health care professional to rule out other medical causes of hearing loss, and to ensure that hearing aids are properly fitted and come with follow-up care.

Your primary care doctor may refer you to an ear, nose and throat specialist -- an otolaryngologist -- for evaluation and diagnosis of hearing loss, the FDA said. It also noted that two types of hearing health professionals are authorized to measure hearing loss and dispense hearing aids:

  • Audiologists, who must have at least a master's degree and specialized training in hearing loss.
  • Hearing aid dispensers, who are licensed by states under varied requirements.

Consumers shouldn't deal with businesses that say there is no need for a medical exam before buying a hearing aid.

If you're shopping for a hearing aid, the FDA says you should:

  • Find a licensed hearing aid professional who offers products from several manufacturers.
  • Ask whether there is a trial period. Most states require 30-60 day trial periods. Find out what exactly is refundable if you return the hearing aid during the trial period.
  • Examine the details of the warranty, including whether you'll get a free loaner if your device needs serving and repair.
  • Check whether the price quoted includes testing and follow-up services.

More information

The U.S. National Institute on Deafness and Other Communication Disorders has more about hearing aids.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 20 (HealthDay News) -- Women with post-traumatic stress disorder are more likely to be overweight or obese than women without the condition, a new study suggests.

According to the researchers, one in nine women will have post-traumatic stress disorder (PTSD) at some point in her life. That's twice as often as men. Women are more likely to experience traumatic events, such as rape, which carry a high risk for PTSD, the study authors said.

"PTSD is not just about mental health, but also has physical health consequences," said lead researcher Karestan Koenen, an associate professor of epidemiology at Columbia University's Mailman School of Public Health, in New York City.

Women with PTSD gain weight faster than women who do not have the condition, Koenen said. "This, in turn, has consequences for the risk of heart disease and all the adverse outcomes associated with obesity," she said.

How PTSD is linked to weight gain isn't known, Koenen said, but it may be caused by the high levels of hormones released because of stress.

These hormones are involved in a range of body processes, including metabolism, she said.

"In addition, women with PTSD may change behaviors that lead to obesity," Koenen said. "There is evidence that people under stress crave high-calorie processed foods, so it could be diet." These women also are less likely to exercise, she said.

Koenen said the same problem may exist in men suffering from PTSD, but this hasn't been well studied.

The new report was published Nov. 20 in the online edition of the journal JAMA Psychiatry.

For their research, Koenen and her colleagues collected data on more than 50,000 women who took part in the Nurses' Health Study II between 1989 and 2009. Their ages ranged from 22 to 44 at the study's start.

The women were asked about the worst trauma they experienced and if they had symptoms of PTSD. Symptoms included re-experiencing the traumatic event, feeling threatened, avoiding social situations and feeling emotionally numb. PTSD was defined as having four or more symptoms over a month or more.

The researchers found that women originally of normal weight who developed PTSD had a 36 percent higher risk of becoming overweight or obese, compared to women who, despite experiencing trauma, didn't develop PTSD.

This finding held even after taking into account other factors, such as depression, that have also been considered major factors in weight gain, the researchers said.

In women who had PTSD before the study period began, weight increased more rapidly than it did among women without PTSD.

Although the study found an association between women having PTSD and a higher risk for obesity, it did not establish a cause-and-effect.

"This important study highlights, once again, the significant impact that psychological disorders can have on physical health," said Simon Rego, director of psychology training at the Montefiore Medical Center and Albert Einstein College of Medicine, in New York City. He was not involved with the research.

Rego said trauma and obesity are both common in today's society. They can cause distress, difficulty in functioning and disability, he said, and all these conditions are hard to treat. That's why it's important for doctors to understand the impact of PTSD symptoms -- not only on mental health, but also on physical health.

Treating PTSD might also help in reversing weight gain, he said. "Doctors ... should be encouraged to screen for PTSD, especially in populations at high risk for trauma but also in patients presenting with obesity," he said.

If PTSD symptoms are found, the patient should be referred to a clinical psychologist or other mental-health professional with expertise in treating PTSD, Rego said.

More information

To learn more about post-traumatic stress disorder, visit the U.S. National Institute of Mental Health.

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 20, 2013 (HealthDay News) -- Months after concussion symptoms such as dizziness, headaches and memory loss fade, the brain continues to show signs of injury, a new study suggests.

Comparing 50 concussion patients with the same number of healthy people, researchers found that the brains of those suffering concussions showed abnormalities four months later. This happened despite the fact that their symptoms had already eased to some degree.

The findings may sway conventional thinking about when it's safe to resume physical activities that could produce another concussion, the study authors said.

"This is a very different population than professional athletes going out and having concussions on a fairly [frequent] basis, as well as jostling their brain around their skull on a regular basis in practice," said study author Andrew Mayer, an associate professor of translational neuroscience at the Mind Research Network in Albuquerque, N.M. It's hard to predict an outcome based on these findings, he said, "but just because you feel you're healed doesn't mean you are."

The study, which was funded by the U.S. National Institutes of Health, is published in the Nov. 20 online edition of the journal Neurology.

Considered a mild traumatic brain injury that occurs from a sudden blow to the head or body, a concussion has symptoms that range from headache and blurry vision to difficulties in sleeping or thinking clearly. Most occur without losing consciousness, according to the U.S. Centers for Disease Control and Prevention.

Mayer and his team matched 50 patients with mild concussions to 50 healthy people of similar age and education levels. They tested all participants in memory and thinking skills, as well as other symptoms such as anxiety and depression.

Special brain scans using technology that is not available in standard brain scans were also given. All tests and scans were repeated two weeks after the concussion, and again four months later.

While concussion symptoms were reduced by up to 27 percent four months after injury, brain scans of those with concussions showed abnormalities in the frontal cortex area of both sides of the brain. These abnormalities may have resulted from changes in location of fluid around brain cells or changes in the shape of certain brain cells in response to damage, Mayer explained.

The findings, he noted, suggest that the recommendation that athletes suffering concussions should refrain from play for one to two weeks may not be sufficient.

"In one or two weeks, most people typically report feeling better," he said. "But when we start talking about it in an analogy of a burn or knee injury, it becomes a little more clear when the doctor says we need to wait a bit longer [to return to prior activities]. It makes sense that the brain would be similar to those tissue types," added Mayer.

Kenneth Podell, co-director of the Houston Methodist Concussion Center, said the study strengthens the understanding that physical changes within the brain after concussion are separate from mental symptoms. But Podell, who was not involved in the research, added that the study couldn't offer implications for potential long-term concussion effects such as depression or dementia.

"Everyone seen at four months should be followed in another four, six or eight months and then re-scanned," he said. "One of the biggest problems we have looking at concussions is we try to predict long-term effects from short-term findings. This injury is very difficult to commit the type of resources needed to do that kind of very expensive and time-consuming study."

More information

The U.S. National Library of Medicine has more on concussions.

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 20, 2013 (HealthDay News) -- Poor circulation in the legs, a condition called peripheral artery disease (PAD), affects many Americans and can become so serious it leads to amputation.

But a new study finds wide hospital-to-hospital variance in spending on PAD, with no significant difference in amputation rates.

"Medicare spending on patients with severe PAD varies more than twofold across the United States," wrote a team led by Dr. Philip Goodney of the Dartmouth-Hitchcock Medical Center.

In background information in the study, the researchers noted that in recent years, care aimed at preventing amputation has become increasingly costly due to the rising use of less-invasive "revascularizations" -- treatments used to improve blood flow. According to Goodney's team, hospitals in regions that spent the most on PAD patients often ordered these lower-limb treatments in the year prior to an amputation.

The researchers analyzed data from more than 18,400 Medicare patients who underwent major PAD-related amputations between 2003 and 2010. The average cost of inpatient care in the year before amputation was $22,405 per patient. This included the costs related to amputation.

However, there was wide variation in regional costs, ranging from $11,077 in Bismarck, N.D., to $42,613 in Salinas, Calif., according to the study published online Nov. 20 in the journal JAMA Surgery.

The study "offers little evidence to suggest that more expensive vascular care offers a marginal advantage over less expensive vascular interventions," Goodney's team concluded.

Two other heart experts stressed that the care of patients with PAD -- who often have other illnesses such as diabetes or heart failure -- is complex, and the new study might not tell the full story.

"This study should not suggest that leg revascularizations are useless," said Dr. Jeffrey Berger, a cardiologist at NYU Langone Medical Center in New York City. "A leg revascularization could have other beneficial outcomes that this study did not investigate, such as improvement in quality of life, or [it could] affect the type of amputation that might be required," he said.

Dr. Maja Zaric is an interventional cardiologist at Lenox Hill Hospital in New York City. She said that better and more rigorous trials are needed to investigate the issue. The current study "looks only into the Medicare population and analyzes only inpatient cost, which underestimates real and overall costs," Zaric said.

She also believes that people in the more "expensive" group may have been sicker, with more co-existing illnesses. These illnesses, such as heart failure, kidney failure and heart disease, "do affect PAD course and progression, as well as the treatment success," Zaric noted.

Finally, she added, treating patients at specialized vascular centers "that involve easy access to diagnosis, treatment and wound care [might be the place] where both procedural success and cost effectiveness will come together."

More information

The American Heart Association has more about peripheral artery disease.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 20, 2013 (HealthDay News) -- Older men with higher or lower testosterone levels are more likely to die early than those with mid-range levels of the male sex hormone, a new study suggests.

It was already known that low testosterone levels were associated with health problems, but this study suggests that high levels of the hormone are also a problem.

Researchers measured the testosterone levels of nearly 3,700 Australian men, aged 70 to 89, between 2001 and 2004. They then checked to see how many were still alive in December 2010. Those with the lowest testosterone levels had the highest death rate, followed by those with the highest levels.

Men with mid-range levels of testosterone had the highest survival rate, according to the study, which was published recently in the Journal of Clinical Endocrinology & Metabolism.

"When the body metabolizes testosterone, it produces dihydrotestosterone (DHT), which is tied to a lower risk of dying from ischemic heart disease," study author Bu Beng Yeap, of the University of Western Australia, said in a journal news release. In ischemic heart disease, there is reduced blood supply to the heart.

"Having the right amount of testosterone and higher levels of DHT might indicate that these men are in better health overall, or it could help them maintain good health as they grow older," he said.

Although the study found an association between high or low testosterone levels and increased death rates in men, it did not establish a cause-and-effect relationship.

"Sex hormones are an important predictor of mortality in older men, but we haven't determined if treatments to change testosterone and DHT levels can alter these outcomes," Yeap said.

He said additional research could help find ways to use this information to improve older men's health.

More information

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

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 20, 2013 (HealthDay News) -- Even seemingly healthy obese people are at increased risk for diabetes and heart disease, a new study suggests.

Researchers analyzed data from more than 6,500 participants in a San Antonio-based heart study who were followed for between six and 10 years. They were checked for high blood pressure, elevated triglycerides (a type of blood fat) and blood sugar levels, insulin resistance and low levels of "good" HDL cholesterol.

People with none or only one of these conditions were classified as "metabolically healthy," whether they were normal weight or overweight.

However, the researchers found that obese people who were considered metabolically healthy still had an increased risk for diabetes and heart disease, according to the study in the Journal of Clinical Endocrinology & Metabolism.

"Unfortunately, our findings suggest metabolically healthy obesity is not a benign condition," study corresponding author Dr. Carlos Lorenzo, of the University of Texas Health Science Center at San Antonio, said in a journal news release. "Regardless of their current metabolic health, people who are obese face an increased risk of developing cardiovascular disease and diabetes in the future."

Although the study tied so-called healthy obesity to a higher risk of developing diabetes or heart disease, it did not prove a cause-and-effect relationship.

The researchers also found that normal-weight people with multiple metabolic conditions also had an increased risk of diabetes and heart disease.

The findings show "the importance of continuing to monitor for diabetes and cardiovascular disease in both people with metabolically healthy obesity and those who have metabolic abnormalities despite being a normal weight," Lorenzo said.

"If physicians and patients are too complacent about assessing risk, we can miss important opportunities to prevent the development of chronic and even deadly conditions," he explained.

More information

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

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 20, 2013 (HealthDay News) -- Coffee seems to offer a mysterious benefit to heart health -- one that doctors have been at pains to explain.

Now, a small, new study from Japan suggests that the caffeine in a cup of coffee might help your small blood vessels work better, which could ease strain on the heart.

A cup of caffeinated coffee caused a 30 percent increase in blood flow through the small vessels of people's fingertips, compared with a cup of decaf, according to the research, which is scheduled for presentation Wednesday at the American Heart Association's annual meeting in Dallas.

These microvessels regulate the ease with which blood flows through the circulatory system and the body's tissues, said lead researcher Dr. Masato Tsutsui, a cardiologist and professor in the pharmacology department at the University of the Ryukyus, in Okinawa.

Previous studies have shown an association between coffee drinking and lower risk of heart attack, heart disease and stroke, said Dr. Gordon Tomaselli, chief of cardiology at the Johns Hopkins University School of Medicine. Researchers found that high doses of caffeine may improve the function of larger arteries.

But scientists have not been able to figure out why this is, given that coffee also can increase blood pressure. High blood pressure can damage arteries.

"This is an intriguing observation that may help us understand why consumption of coffee may be beneficial," said Tomaselli, former president of the American Heart Association.

The study involved 27 healthy adults, aged 22 to 30, who did not regularly drink coffee. They were asked to drink a 5-ounce cup of either caffeinated or decaffeinated coffee. Researchers then measured their finger blood flow using a noninvasive laser technique for gauging blood circulation.

Two days later, the experiment was repeated with the other type of coffee. Neither the researchers nor the participants knew when they were drinking caffeinated coffee.

The researchers found that blood flow in the small blood vessels improved by nearly one-third among the people who drank caffeinated coffee. The effect continued in those people over a 75-minute period.

Heart rate levels remained the same between the two groups, although caffeinated coffee slightly raised blood pressure.

The improved blood flow is likely because of improved function of the inner lining of the blood vessels, Tsutsui said. Researchers have linked the function of the lining of blood vessels -- also known as endothelial function -- to future heart attacks, heart disease and strokes.

By opening blood vessels and reducing harmful inflammation, caffeine may create favorable conditions for good heart health, he said.

But how much coffee is too much? Tsutsui pointed to a landmark U.S. National Institutes of Health study that showed that, overall, drinking six or more cups of coffee a day reduced men's risk of early death by 10 percent and women's risk by 15 percent.

That study, published last year in the New England Journal of Medicine, found that risk of heart disease and stroke either remained low or went even lower as people drank more coffee during the day.

The new study was co-sponsored by the All Japan Coffee Association, which might raise some healthy skepticism were it not for the large body of evidence that already shows coffee's heart health benefits, Tomaselli said.

That said, the study's small sample size does not conclusively explain why coffee is so good for the heart. "I don't think this answers any questions for us," Tomaselli said.

Data and conclusions presented at meetings typically are considered preliminary until published in a peer-reviewed medical journal.

More information

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

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 20, 2013 (HealthDay News) -- Seniors who quit smoking cut their risk of death by heart disease much more quickly than previously thought, particularly if they were light-to-moderate smokers, a new study says.

Past estimates held that it takes smokers about 15 years after they quit to lower their risk of heart attack, heart failure or stroke to that enjoyed by people who never smoked, said lead author Dr. Ali Ahmed, senior study researcher. Ahmed is a professor of cardiovascular disease at the University of Alabama at Birmingham's School of Medicine.

But a new examination of 853 former smokers aged 65 and older found that many with a light-to-moderate smoking history can cut their risk in eight years or less, Ahmed said.

"Even though they quit only eight years ago, because they smoked less they were able to become like never-smokers in half the time," Ahmed said, citing findings he is scheduled to present Wednesday at the American Heart Association's annual meeting in Dallas.

Ahmed and his colleagues analyzed 13 years of medical information compiled by the U.S. National Heart, Lung, and Blood Institute to compare 853 people who had quit smoking 15 or fewer years ago with about 2,500 people who had never smoked. Half the smokers surveyed quit eight or fewer years before.

The researchers defined light smokers as people who had smoked less than 32 "pack years." This adds up to 3.2 packs a day for 10 years, or less than one pack a day for 30 years. About 37 percent of the former smokers fell into this category.

American Heart Association past president Dr. Gordon Tomaselli said that's a pretty generous definition of light smoking. "A pack a day for 32 years, that's not light," he said.

Light-to-moderate smokers who more recently quit had just a 14 percent chance of dying from heart disease, heart attack or stroke, compared with a 22 percent chance for former heavy smokers. People who never smoked had a 17 percent chance of death due to heart health problems.

These were somewhat surprising results, given the age of the patients and their smoking history, Tomaselli said. "The benefit was in a group we weren't sure would benefit as much as people who had smoked less or were younger," he said.

However, both light and heavy smokers continued to have a higher risk of death from other causes, including cancer and emphysema, Ahmed said.

Light smokers had a 29 percent chance of dying from a cause not related to their heart health, while heavy smokers had a 33 percent chance. Nonsmokers had a 22 percent chance, the investigators found.

"Yes, you get cardiovascular benefit [from quitting], but another part of your overall risk remains high even if you smoke at so-called light levels," Ahmed said.

Overall risk of death was 39 percent for nonsmokers, 43 percent for former light smokers and 55 percent for former heavy smokers in the study.

Ahmed and Tomaselli said smokers should heavily weigh the heart benefits of quitting. Heart disease is the number-one cause of death in the United States, taking nearly 600,000 lives a year, according to the U.S. Centers for Disease Control and Prevention.

"Cardiovascular disease is the biggest killer, and you can reduce that risk by smoking less and quitting early," Ahmed said. "Smoking is the single most preventable risk for heart disease."

Tomaselli said this study gives doctors a leg up when seniors argue that they've been smoking for too long and it's too late for them to quit.

"You can say to them with confidence that if you quit now, you can realize some benefits for cardiovascular health," Tomaselli said. "It's a reason even in older patients for doctors to be aggressive in recommending smoking cessation."

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

To find out more about smoking cessation, visit the U.S. Centers for Disease Control and Prevention.

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 20, 2013 (HealthDay News) -- Neurons in the area of the brain responsible for face recognition respond differently in people with autism than in those without the disorder, a new, small study finds.

Autism is a complex disorder of brain development that affects social interactions, communication skills and behaviors.

For this study, published in the Nov. 20 issue of the journal Neuron, brain scientists collaborated to decipher why people with autism focus more on someone's mouth and less on the eyes to collect and process information.

The researchers examined the firing of individual nerve cells in the brains of two patients with a high-functioning form of autism and in people without autism as they looked at pictures of entire faces or parts of faces. Each face showed either fear or happiness, and the participants were asked to decide which emotion was being expressed.

The results showed that a specific type of neuron in the brain's amygdala performed differently in the autism patients than in those without the disorder.

In the amygdala -- which is important for emotional memory -- certain neurons fire when a person looks at a whole face, while other neurons are activated when a person looks at parts of faces or certain facial features such as an eye or mouth.

In the two patients with autism, "whole-face" neurons responded appropriately, but the "face-part" neurons were much more active when the patients were shown the mouth region compared to when they were shown the eyes, the researchers found.

"Many studies have found that people who have autism fail to focus on the eye region of others to gather social cues and process information about emotions," study first author Ueli Rutishauser, director of human neurophysiology research at Cedars-Sinai Medical Center, said in a center news release.

"The amygdala -- which is critical for face recognition and processing of emotions -- is thought to be one of the principal areas where dysfunction occurs, but this is the first time single neurons in the structure have been recorded and analyzed in patients with autism," Rutishauser said.

The study offers new insights into mechanisms underlying the symptoms of autism and opens the door for further studies, said senior author Ralph Adolphs, a professor of psychology and neuroscience at Caltech, the California Institute of technology, in Pasadena.

"Are there genetic mutations that lead to changes in this one population of neurons? Do the cell abnormalities originate in the amygdala or are they the result of processing abnormalities elsewhere in the brain?" Adolphs said.

Many questions remain unanswered, "but this study points us in a specific direction that we believe will help understand autism," he said in the news release.

More information

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

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 20, 2013 (HealthDay News) -- A new therapy may help lower tough-to-treat high blood pressure in people with chronic kidney disease, a new study finds.

"Blood pressure that is difficult to control, even on multiple medications, in patients with chronic kidney disease is a significant issue," explained an expert who was not connected to the new study, Dr. Adam Auerbach.

"Poorly controlled blood pressure can lead to worsening kidney function, heart disease and stroke," said Auerbach, who is a cardiologist at North Shore University Hospital in Manhasset, and Long Island Jewish Medical Center in New Hyde Park, N.Y.

The new technique is called renal (kidney) denervation, and involves the interruption of a key nerve in the kidney. It is a minimally invasive, catheter-based procedure that uses radio waves to heat and remove tissue.

The study included 15 people averaging 66 years of age. All had chronic kidney disease along with high blood pressure that had proven resistant to standard drugs, even though the patients were taking at least three medications to lower their blood pressure.

All of the patients underwent renal denervation and were followed for one year. During that time, the patients were treated with an average of five different medications for high blood pressure.

The patients' blood pressure decreased significantly during the follow-up and their kidney function remained stable and did not further deteriorate, the researchers noted.

The small pilot study suggests that "treatment with renal denervation decreases blood pressure, and most important, slows or even halts the decline of [kidney] function in treatment-resistant patients with chronic kidney disease," study lead author Dr. Roland Schmieder said in a news release from the American Heart Association.

Auerbach cautioned that renal denervation "is in addition to taking medications, it does not replace them." He added that "this is a promising procedure, but the number of patients in this study was small and further investigation is needed."

Another expert was similarly cautious.

While the finding could be of "great clinical significance" to patients, "it remains to be seen if this stoppage of renal function decline by renal denervation therapy translates into lives saved or [heart attacks] prevented," said Dr. Sripal Bangalore, assistant professor in the department of medicine at NYU Langone Medical Center in New York City.

"Nevertheless, if these results are replicated in other large trials this could potentially be a game-changer for patients with kidney disease and resistant hypertension [high blood pressure]," Bangalore said.

The study is scheduled for presentation Nov. 20 at the annual meeting of the American Heart Association in Dallas. Findings presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

More information

The American Academy of Family Physicians has more about high blood pressure.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

Health Highlights: Nov. 20, 2013

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

J&J Announces $2.5B Settlement for Hip Implant Lawsuits

Johnson & Johnson says it will pay $2.5 billion to settle lawsuits over faulty hip replacements, making it one of the largest settlements paid out in the medical device industry.

The agreement presented in U.S. District Court in Toledo, Ohio, resolves about 8,000 cases involving patients who had to have the metal ball-and-socket hip implant -- called the ASR Hip System -- removed or replaced, the Associated Press reported.

The metal implant was pulled from the market in 2010 after data showed that it failed sooner than older types of plastic or ceramic hip implants.

The settlement announced late Tuesday provides about $250,000 per patient and covers those whose implants were removed or replaced before Aug. 31, 2013. Most of the patients are expected to receive their payments in 2014, the AP reported.

J&J's lawyers have denied that the company acted improperly.

The deal does not cover all lawsuits related to the hip implant, J&J's DePuy unit said in a statement. "DePuy will continue to defend against remaining claims and believes its actions related to the ASR Hip System have been appropriate and responsible," the company said.

The ASR Hip System was sold for eight years and used in about 35,000 patients in the United States and more than 90,000 worldwide. Production of the hip implant was halted in 2009 and it was recalled in 2010, the AP reported.

Internal J&J documents suggest that company officials knew about problems with the device at last as far back as 2008. And a 2011 company review of a patient registry said that more than one-third of the hip implants were expected to fail within five years of implantation, the AP reported.

Replacement hips are generally supposed to last at least 10 to 20 years, according to the news service.

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Obese Pilots, Air Traffic Controllers Must be Checked for Sleep Disorder: FAA

Obese pilots and air traffic controllers in the United States will soon have to undergo screening to determine if their excess weight is causing them to lose sleep and therefore affecting their work performance, the Federal Aviation Administration says.

Agency officials explained that overweight people are at increased risk for obstructive sleep apnea (OSA), a disorder that impairs sleep and can cause drowsiness when people are awake, FoxNews.com reported.

"Airman applicants with a BMI (body mass index) of 40 or more will have to be evaluated by a physician who is a board certified sleep specialist," FAA's air surgeon, Fred Tilton, wrote in a recent FAA medical bulletin. "Anyone who is diagnosed with OSA will have to be treated before they can be medically certificated."

Body mass index is a measurement of body fat based on height and weight. People with a BMI of 40 and higher are considered extremely obese.

The memo also says that the FAA plans to expand the screening program to include those with a BMI of 30, FoxNews.com reported. People with a BMI of 30 are considered moderately obese.

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Supreme Court Won't Intervene in Texas Abortion Law Fight

A strict new abortion law in Texas will remain in place at least for now after the U.S. Supreme Court said Tuesday that it will not intervene in an ongoing legal fight over the issue.

At least one-third of Texas' abortion clinics have been closed since October when a three-judge panel of the 5th Circuit Court of Appeals ruled in favor of the law requiring doctors who perform abortions to have admitting privileges at a nearby hospital, the Associated Press reported.

The 5th Circuit panel's ruling overturned U.S. District Judge Lee Yeakel's decision to block the provision. Yeakel said it served no medical purpose and created an illegal barrier for women seeking an abortion.

No more than 20 clinics in the state could meet the new standard. All of those clinics are in metropolitan areas. There are none in the Rio Grande Valley along the border with Mexico. As a result of the new law, some women must travel hundreds of miles to get an abortion, the AP reported.

Planned Parenthood is challenging the new law, saying that it unconstitutionally restricts women's rights.

Tuesday's Supreme Court decision isn't the final word on the issue, but it means that the law will remain in effect while Planned Parenthood's lawsuit against it continues. The case is scheduled to be heard in January by the 5th Circuit Court of Appeals, the AP reported.

Texas is the second-most populous state in the United States, and an average of 80,000 abortions are performed in the state each year, the news service said.

"This law is blocking women in Texas from getting a safe and legal medical procedure that has been their constitutionally protected right for 40 years. This is outrageous and unacceptable -- and also demonstrates why we need stronger federal protections for women's health. Your rights and your ability to make your own medical decisions should not depend on your ZIP code," said Cecile Richards, president of Planned Parenthood Federation of America, the AP reported.

Broad abortion limits have been approved in several conservative states in recent months, but the ones in Texas are especially controversial because of the large number of clinics affected and the distance some women must travel to get an abortion.

The other states with laws on admitting privileges are Tennessee and Utah. Courts have temporarily suspended similar laws in Alabama, Kansas, Mississippi, North Dakota and Wisconsin, the AP reported.

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Princeton Students 'Highly Unlikely' to Spread Meningitis During Holiday Travel: Officials

It's "highly unlikely" that a meningitis outbreak at Princeton University will spread when students travel over the holidays, but students should get vaccinated as soon as possible, health officials say.

Another person on campus was diagnosed with the rare strain of meningitis last week. It's the seventh case since the strain first appeared at Princeton in March. Six students and one campus visitor have been infected, but no cases outside of campus have been reported, according to USA Today.

On Monday, university officials said the school would offer a new vaccine not yet approved for use in the United States.

The vaccine, called Bexsero, is currently approved for use in Australia and Europe. It is the only vaccine that specifically protects against meningococcal disease caused by serogroup B, the rare strain that's affecting people at Princeton, USA Today reported.

It is "highly unlikely" that Princeton students would spread the disease during holiday travel, because it "requires prolonged, close contact in order to spread from person to person," according to Sharon Hoskins, a senior press officer at the Centers for Disease Control and Prevention.

Princeton students don't need to cancel or alter their holiday plans, but the families of the seven people who have already contracted the disease should consider taking preventative antibiotics, she told USA Today.

 

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Heart Drug Maker Accused of Withholding Negative Study Data

A drug company withheld clinical trial data showing that a medicine meant to lower the risk of heart attack actually increased the risk, according to cardiologists.

They said that for more than a year, Anthera Pharmaceuticals ignored a requirement to provide academic investigators with data from the Phase 3 study of a drug called varespladib.

"Despite a contract that required transfer to the academic authors, the company stonewalled every attempt to acquire the data," Dr. Steven Nissen, a cardiologist at the Cleveland Clinic, said in an email to The New York Times.

He was the senior author of a report on the study data that was published online Monday in the Journal of the American Medical Association and released at the annual meeting of the American Heart Association.

In presenting the results at the meeting, study lead investigator Dr. Stephen Nicholls chastised the drug company.

"We think that when you enter into a clinical trial, and we enter into contracts with our patients, there's an obligation that we are going to do the right thing," said Nicholls, a cardiologist at the South Australian Health and Medical Research Institute in Adelaide, The Times reported.

The study looked at whether the drug could reduce the risk of heart attack, stroke, chest pain requiring hospitalization, and death in more than 5,100 patients with acute coronary syndrome. The results showed that patients who took the drug actually had a higher risk of heart attack and other cardiovascular problems than those who took a placebo.

The study was halted early by the safety monitoring committee in March 2012.

The accusations of withholding study data were denied by Anthera's chief medical officer, Dr. Colin Hislop. He said it simply took time to gather and organize the data. "I don't think the timeline was particularly protracted, nor were we being difficult," Hislop told The Times.

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 20, 2013 (HealthDay News) -- Nearly two-thirds of women who had a cesarean delivery for their first child were successful when they attempted a natural birth for their second baby, British researchers found.

The study, published Nov. 20 in BJOG: An International Journal of Obstetrics and Gynaecology, used data on almost 144,000 British women who had their first baby by C-section between 2004 and 2011. The researchers found that 52 percent of them attempted a vaginal birth for their second baby.

"This study shows encouraging results with the majority of women who attempted a natural delivery after a primary C-section being successful," journal deputy editor John Thorp said in a journal news release.

Of the women who attempted a vaginal birth for their second baby, 63 percent had a successful delivery. Black women had a lower success rate than white women (50 percent vs. 66 percent), and women older than 34 had a lower success rate than those aged 24 and younger (59 percent vs. 69 percent).

Women aged 24 and younger were more likely to attempt natural delivery for their second child than women older than 34, the study found. And Asian women and black women were more likely than white women to attempt natural delivery for their second child.

The reason for a C-section in the first birth strongly determined the likelihood of a successful vaginal delivery for the second birth. Women with a history of failed induced labor were almost twice as likely to be unsuccessful when attempting a vaginal birth after previously having a C-section.

The researchers also found that the rates of attempted and successful vaginal birth after an earlier C-section varied between hospitals for reasons that could not be explained.

Study leader Hannah Knight said an informed discussion about whether or not to attempt a vaginal delivery after a cesarean section requires an assessment of the risk of emergency cesarean.

"This paper provides valuable information both for women and the obstetricians and midwives caring for them," Knight, of the Royal College of Obstetricians and Gynecologists, said in the news release.

The majority of women with an uncomplicated first C-section are candidates for a vaginal delivery the next time around, "but our data found that only half of those women chose this option," she noted.

More information

The American Academy of Pediatrics has more about cesarean delivery.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 20, 2013 (HealthDay News) -- In advance of Thursday's Great American Smokeout, an expert offers some tips on how to quit smoking.

Being mentally ready to quit smoking is the most important indicator for success, said Robert DiGregorio, senior director of pharmacy services at the Brooklyn Hospital Center and an expert in smoking cessation.

For some people, graphic antismoking ads are a motivator. Others may decide to quit due to education and awareness about the effects of secondhand smoke on children. Still others quit because of the high cost of smoking.

Regardless of their reasons, many people find it difficult to quit. It can take an average of four tries over one to two years to kick the habit, DiGregorio said. There are a variety of questionnaires available online or from doctors that can help smokers determine if they're ready to quit.

The simplest indicator is to ask yourself if you are thinking about quitting in the next 30 days. If you are, then you are ready to quit and should seek help from a health professional to develop a specific plan, DiGregorio said in a hospital center news release.

He said the 30-day question is important for two reasons. First, it has been shown to be an effective predictor of readiness. Second, certain treatments take up to 14 days to be effective.

Many products are designed to help people quit smoking, including nicotine patches and the medications Chantix (varenicline) and Zyban (bupropion). Short-acting aids include nicotine gum, inhalers, nasal spray and lozenges.

Chantix and Zyban are effective, but have drawbacks, according to the news release. Chantix carries a warning about psychiatric side effects, and Zyban has been linked to seizures and mood disorders in some patients.

As for electronic cigarettes, the jury is still out on whether they are a safe and effective way to help people quit smoking, DiGregorio said.

If you are trying to quit smoking and have cravings, DiGregorio recommended using the five Ds: Delay until the urge passes, usually three to five minutes; distract yourself; drink an ice-cold glass of water; deep breaths to relax; and discuss your feelings with someone.

DiGregorio said successful quitters have a support network or coaches to help them get through the most difficult challenges and reward themselves for success.

More information

The American Cancer Society offers a guide to quitting smoking.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

Health Tip: Track Your Child's Sleep

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(HealthDay News) -- If your child struggles to fall asleep, keeping a sleep diary can help figure out why.

The University of Michigan Health System suggests what to include in a sleep diary:

  • The time your child woke in the morning.
  • The time your child napped during the day, and how long the nap lasted.
  • The time your child went to bed, and if possible, the time he or she fell asleep.
  • Any problems your child had in falling asleep, any remedies and whether those remedies proved effective.
  • The time, if any, your child awoke during the night, and how long your child stayed awake.
  • How you handled your child's night waking, and whether it was effective.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

Health Tip: Battling Bruxism

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(HealthDay News) -- Bruxism, the clenching or grinding of teeth, commonly occurs while you sleep. It can cause headaches, jaw pain and tooth damage.

The National Sleep Foundation suggests how to cope with bruxism:

  • Bruxism may be a sign of stress. To help alleviate stress, develop a soothing bedtime routine.
  • Create a cool, dark and comfortable sleep environment, and don't let work into the bedroom.
  • Sleep on your side or stomach, not on your back.
  • Get regular exercise, and make sure you get enough sleep.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 19, 2013 (HealthDay News) -- CPR training rates are lower in poor, rural U.S. communities, according to a new study.

The finding is troubling because timely bystander CPR -- cardiopulmonary resuscitation -- can boost the odds of survival for those who experience cardiac arrest outside of the hospital.

The researchers also found that fewer people are trained in CPR in the South, Midwest and West. The study authors suggest this could help explain why bystander CPR is used less frequently in these areas.

Using data from the American Heart Association, the American Red Cross and the Health & Safety Institute, the investigators examined CPR training rates among roughly 13 million people living in more than 3,100 U.S. counties.

The study, published online on Nov. 18 in JAMA Internal Medicine, showed that counties with the lowest rates of CPR training -- less than 1.3 percent of the population -- were also more likely to have a greater proportion of rural areas, black and Hispanic residents, and a lower average household income.

These areas also had fewer doctors and, on average, older residents, according to a journal news release.

The researchers, led by Dr. Monique Anderson, of the Duke Clinical Research Institute, in Durham, N.C., noted that counties in the Northeast had higher rates of CPR training.

"With regard to rural areas, more studies are needed on interventions that target the entire chain of survival," the study authors concluded.

More information

The American Heart Association has more about bystander CPR.

-- Mary Elizabeth Dallas

Copyright © 2013 HealthDay. All rights reserved.

Men's Bigger Builds Need Bigger Noses

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TUESDAY, Nov. 19, 2013 (HealthDay News) -- Beak, snout, schnozz: However you refer to them, men's noses are typically bigger than women's. Now, new research may help explain why.

Men's noses are an average of 10 percent bigger than women's noses due to differences in their physical builds and energy demands, researchers report.

The investigators tracked the nose size and growth of 38 people of European descent from the age of 3 until they were in their mid-20s. In general, boys and girls had the same nose size from birth until puberty began. After that, males had bigger noses than females.

Males tend to have more lean muscle mass, which requires more oxygen for muscle tissue growth and maintenance. Having a large nose means that more oxygen can be inhaled and transported in the blood to nourish the muscle, according to the University of Iowa researchers.

"This relationship has been discussed in the literature, but this is the first study to examine how the size of the nose relates to body size in males and females in a longitudinal study [where a group of people is followed over a long period of time]," study author Nathan Holton, an assistant professor in the College of Dentistry, said in a university news release.

The findings, published recently in the American Journal of Physical Anthropology, likely apply to most racial/ethnic groups, the researchers added.

The study also helps explain why modern humans have smaller noses than their ancestors did. Ancient humans had more muscle mass and required large noses to bring oxygen to that extra muscle tissue, Holton explained. He also noted that the rib cages and lungs of modern humans are smaller, which reinforces the idea that modern humans don't require as much oxygen as ancient humans did.

More information

The American Academy of Otolaryngology -- Head and Neck Surgery has more about your nose.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 19, 2013 (HealthDay News) -- Genetic testing could help better guide doctors' use of warfarin, new research suggests. The blood-thinning medication is widely used to prevent stroke and heart attack in people with irregular heartbeats.

Warfarin is a popular medication, but a tricky one to use, the researchers said. Patients who receive too strong a dose can suffer from unusual and excessive bleeding, potentially coughing up or vomiting blood, according to the American Heart Association (AHA).

But doctors who used genetic testing to guide patients' warfarin doses were better able to quickly reach and consistently remain within the drug's therapeutic "sweet spot," according to the study. It was published in the Nov. 19 online edition of the New England Journal of Medicine and presented Tuesday at the AHA's annual meeting in Dallas.

"[Blood-thinning] therapy is difficult and it's associated with a lot of potentially harmful side effects," said Barbara Howard, a senior scientist at MedStar Health Research Institute in Hyattsville, Md. "It is important to get the dose right, and here is a potential area where genetic testing could play a valuable role." Howard, who is also a professor at Georgetown University Hospital, was not involved with the new research.

The study involved about 450 patients, approximately half of whom were randomly assigned to receive a genetic test that would guide their warfarin dose, said the study's lead author, Munir Pirmohamed, chairman of pharmacogenetics at the University of Liverpool, in England.

"Warfarin is 60 years old," Pirmohamed said. "Dwight D. Eisenhower was one of the first people to get this medication." Despite the drug's age, however, dosing guidelines haven't changed much, he said.

About three-quarters of the patients in the study suffered from atrial fibrillation, a heart rhythm disorder that increases a person's risk of heart attack and stroke by allowing blood to pool in one of the heart's chambers. The rest of the participants had deep vein thrombosis, a condition in which blood clots in veins put patients at risk for heart attack and stroke.

Doctors used two specific genes associated with the blood-clotting process to help determine the amount of medication a person would receive, Pirmohamed said.

Patients with a genetically guided warfarin dose remained within the therapeutic sweet spot for 67 percent of their three-month-long treatment, compared with 60 percent for people taking warfarin without the genetic guidance.

Patients with genetic dosing reached that sweet spot about 28 percent more quickly, Pirmohamed said. They also were able to begin a stable long-term dose about 25 percent more quickly. In addition, they required 9 percent fewer dose adjustments.

The researchers used a limited genetic test that costs about $67.

A U.S. expert said genetic testing is likely to become much more useful in determining drug dosage in the future, given that the costs of such tests are falling.

A test that can reveal a person's entire genetic code currently costs about $1,000 -- down from $80,000 a few years ago, said Dr. Joseph Loscalzo, chairman of the department of medicine and physician-in-chief at Brigham and Women's Hospital in Boston. Loscalzo, who also is editor-in-chief of the journal Circulation, said he expects that one day such a test could cost as little as $100.

MedStar's Howard said a person would only need one genetic test to help guide their therapy. After all, genetics do not change.

The picture regarding these tests remains hazy, however. A related study, led by Dr. Stephen Kimmel, of the University of Pennsylvania Perelman School of Medicine, was presented Tuesday at the AHA meeting. The study of nearly 1,000 patients found no significant difference between those whose warfarin dose was based on genetic testing and those with doses set using current guidelines.

In that study, both groups of patients were in the therapeutic sweet spot about 45 percent of the time.

The difference between the two studies might be the other factors beyond genetics that can determine warfarin dosing, said Dr. Patrick Ellinor, a cardiologist at the Massachusetts General Hospital Heart Center.

Those factors can include the age, weight and race of the patient, as well as whether they smoke or have other health risks. "That's just as helpful as the genetic information, and we should be using it," said Ellinor, who also is an associate professor at Harvard Medical School.

Another study suggested a potential substitute for warfarin. The study found that the medication edoxaban does just as good a job preventing stroke and heart attack but with significantly lower risk of bleeding.

The edoxaban study involved more than 21,000 atrial fibrillation patients at nearly 1,400 hospitals in 46 countries.

Edoxaban performed just as well as warfarin in preventing strokes, according to the study, which was published recently in the New England Journal of Medicine and presented at the AHA meeting.

But major bleeding was 20 percent lower among patients taking a high dose of edoxaban and 53 percent lower among those taking a low dose, compared to patients taking similar doses of warfarin.

Compared to warfarin, the high dose of edoxaban was associated with a 14 percent reduction in death by heart attack or stroke, while the low dose was associated with a 15 percent reduction.

"We know this drug is safer than warfarin, particularly at a low dose," said the study's lead author, Dr. Robert Giugliano, a researcher and physician at Brigham and Women's Hospital.

More information

For more information on warfarin, visit the American Heart Association.

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 19, 2013 (HealthDay News) -- Some Americans hardest-hit by the recent recession may have turned to alcohol to deal with their problems, a new study suggests.

The study, of almost 5,400 U.S. adults, found that those who lost a job or a home during the 2008-2009 recession had higher rates of problem drinking -- such as getting drunk or getting into accidents. The problem was mainly seen among people in their 30s and 40s, and men were more affected than women.

The findings do not prove that the recession is to blame for people's alcohol problems, according to lead researcher Nina Mulia, a scientist with the Alcohol Research Group in Emeryville, Calif.

"The most obvious alternative explanation would be that pre-existing drinking problems led people to lose their job and housing," Mulia said.

On the other hand, she added, "we also know that people drink to relax or to cope with stress and tension. And so it wouldn't be surprising if people who are dealing with severe stress -- who were actually affected by job or housing loss -- would turn to alcohol."

Whatever the reasons, Mulia said the findings suggest that during economic hard times, doctors should pay special attention to screening patients for alcohol problems.

The results, published online Nov. 19 in the journal Alcoholism: Clinical & Experimental Research, are based on a government health survey done in 2009-2010. Of almost 5,400 adults, close to 18 percent said they'd lost a job or housing due to the recession.

Overall, those people were around three times more likely to report symptoms of alcohol dependence, or admit to at least two "negative drinking consequences" -- for example, getting into fights or accidents, being arrested or suffering health problems.

When the researchers dug deeper, they found that men were particularly likely to report those issues. They were also more likely to get drunk at least once a month, versus men who were unaffected by the recession.

The findings also varied by age. People in their 30s or 40s who'd lost a job or home reported more drunkenness, alcohol dependence and other problems. In contrast, both younger and older adults showed relatively few effects; older adults who'd lost retirement savings drank more often than their peers, but did not report more consequences.

"We know that during the recession, many young folks were moving back in with their parents," Mulia noted. So that support might have helped those in that age group.

In contrast, she said, middle-aged adults typically have their own families to support, and generally bigger expenses. And for men that age, job loss may be especially stressful.

Even in two-earner homes, Mulia said, men are often the "primary breadwinner," and feel a heavy burden from not being able to fill that role.

Still, even though there's a logic to the findings, they run counter to the "prevailing wisdom," according to Laura Schmidt, a professor of health policy at the University of California, San Francisco School of Medicine.

In general, low-income adults smoke and drink less than higher-income people, and studies have found that during economic hard times, smoking rates go down -- possibly because people have less to spend on cigarettes.

But this study makes one thing clear, according to Schmidt: The relationship between a bad economy and drinking is "really complicated."

Not only are different people affected differently, Schmidt said, but there may also have been something unique about this most recent recession.

"It wasn't just your own job; you were seeing the people around you losing theirs, too," Schmidt said. "And we had a slow recovery."

This study did not measure people's stress levels, she noted, but it's possible that this latest downturn hit some Americans particularly hard. The types of hardships linked to drinking problems -- job loss and housing loss -- are especially stressful, Schmidt noted.

Schmidt agreed that the findings underscore the importance of screening for and treating alcohol problems, especially when the economy is bad. Primary care doctors can screen patients with just a few simple questions, Schmidt said. And for people who have milder drinking problems, counseling from their own doctor may be enough.

"Even a 10-minute conversation with your doctor can help someone who is not severely dependent," Schmidt said.

More information

The U.S. National Institute on Alcohol Abuse and Alcoholism has more on problem drinking.

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 19, 2013 (HealthDay News) -- A daily dose of aspirin has become a common treatment for people at high risk for heart attacks or strokes, because it thins the blood and prevents clots from forming.

But does it matter when during the day you take the drug?

A new Dutch study suggests that people who take aspirin at bedtime might get more protection against heart attacks or strokes.

The research involved nearly 300 heart attack survivors who were taking aspirin to ward off a second heart attack. During two separate three-month periods, half the patients took 100 milligrams of aspirin after they woke up in the morning while the other half took the same dose at bedtime.

The researchers wanted to see if taking aspirin at night could better thin a person's blood and potentially lower their heart attack risk, said study author Dr. Tobias Bonten, who serves in the department of clinical epidemiology at Leiden University Medical Center in the Netherlands.

"Since the 1980s, it's been known that cardiovascular events happen more often in the morning," Bonten said. Morning hours are a peak period of activity for platelets, blood cells that aid in clotting, he said. Doctors suspect that might have a hand in the increased risk of heart attacks and strokes in the morning.

Aspirin reduces the activity of platelets, and thus reduces the chance that those platelets will clot in the bloodstream and cause a heart attack or stroke, according to the findings. The study is scheduled for presentation Tuesday at the American Heart Association's annual meeting in Dallas.

Research presented at meetings should be viewed as preliminary until published in a peer-reviewed medical journal.

The timing of taking aspirin, however, has not drawn much scholarly attention, said Dr. Gregg Fonarow, a spokesman for the American Heart Association.

"There really have not been studies looking at the timing of aspirin," said Fonarow, a professor of cardiology at the University of California, Los Angeles. "You would imagine that timing of the dose, morning or evening, wouldn't matter very much."

That's because aspirin has a long-lasting effect on platelets, helping thin the blood for days after it is taken, he said.

"That's why, prior to surgery, patients are told to hold off on aspirin for five to seven days, and why it continues to thin your blood even when you miss a dose," Fonarow said.

But the Dutch researchers found that taking aspirin at bedtime reduced platelet activity more than taking it in the morning, apparently because it headed off the body's normal morning surge in platelet activity.

The team also found that people who took aspirin at bedtime did not suffer any more stomach upset or other side effects than people who took it in the morning, Bonten said.

The researchers also had hoped that taking aspirin at bedtime would lower a person's blood pressure, something that had been observed in an earlier Spanish study. They found no difference, however, between the blood pressures of waking and bedtime aspirin users.

You don't necessarily have to start taking your aspirin at night right away, however. Fonarow said the study involved too few people and did not attempt to determine whether taking a bedtime dose will provide better protection against heart attacks or strokes.

"The key question is whether this is enough of a difference that it would translate to improved clinical outcomes," he said.

Until larger follow-up studies take place, Fonarow said, people prescribed aspirin for heart problems should continue to take it whenever in the day they like.

Another study presented at the American Heart Association meeting found that sedentary seniors can use exercise to slow the progression of heart disease.

Researchers looked at a protein called Troponin T to track the rate of heart injuries in more than 300 people aged 70 and over.

Doctors found that people who had been assigned to a year of supervised physical activity had three times less increase in their Troponin T levels than people who had not regularly exercised.

"Our findings suggest biochemical evidence to support the old adage, 'You're never too old to start a physical-activity program to improve cardiac health,'" study author Dr. Christopher DeFilippi, an associate professor of medicine at the University of Maryland School of Medicine, said in a statement.

More information

For more information on aspirin and heart disease, visit the American Heart Association.

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY Nov. 19, 2013 (HealthDay News) -- If your face turns red after a few drinks, it could be a sign of added risk for alcohol-linked high blood pressure, new research suggests.

It was already known that excessive drinking is a risk factor for high blood pressure, say researchers reporting online Nov. 18 in the journal Alcoholism: Clinical & Experimental Research. Experts have also known that facial flushing after drinking is tied to higher sensitivity or even intolerance to alcohol.

In the new study, the South Korean research team examined the medical records of more than 1,700 men and divided them into three groups: non-drinkers, people whose faces flushed after drinking and drinkers who didn't have the flushed-face reaction.

"Flushers" were more apt to have drinking-related high blood pressure than non-flushers, the research found, and the risk of high blood pressure was much higher among flushers who had more than four drinks per week.

"Facial flushing after drinking is always considered as a symptom of high alcohol sensitivity or even intolerance to alcohol, unless a patient is taking special medicine," study author Jong Sung Kim, head of the department of family medicine at Chungnam National University School of Medicine in South Korea, said in a journal news release.

"The facial flushing response to drinking usually occurs in a person who cannot genetically break down acetaldehyde, the first metabolite of alcohol," Kim explained.

According to the authors, facial flushing after drinking could serve as a signal for a greater risk of alcohol-linked high blood pressure.

Based on the new data, doctors should "consider evaluating their patients' flushing response to alcohol, as well as drinking amount, in daily routine care," Kim said.

More information

The U.S. National Institute on Alcohol Abuse and Alcoholism has more about alcohol and your health.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 19, 2013 (HealthDay News) -- Younger Hispanic, black and white women are more likely to die in the hospital after a heart attack than white men are, a new study finds.

Researchers examined data from about 207,000 American adults hospitalized for heart attack -- including more than 6,500 Hispanic and black women younger than 65 -- and found significant racial, gender and age disparities.

Younger Hispanic, black and white women were 1.5, 1.4 and 1.2 times, respectively, more likely to die in a hospital than white men, the investigators found.

The study also found that Hispanic and black women were significantly younger than white women when they were hospitalized after a heart attack. Younger Hispanic women had a higher rate of diabetes (56 percent) than black women (46 percent) or white women (36 percent).

In addition, the findings indicated that white men were more likely than women to undergo procedures to open up blocked arteries (such as so-called balloon angioplasty and stent placement) or coronary artery bypass surgery. These procedures were performed in 73 percent of white men compared with only 58 percent of white women, 50 percent of Hispanic women and just over 47 percent of black women.

The study was presented Nov. 19 at the annual meeting of the American Heart Association in Dallas. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

The "findings of striking racial/ethnic, gender and age disparities in heart attack treatment patterns and outcomes" means that more must be done to help prevent heart disease in this population, study author Dr. Fatima Rodriguez, an internal medicine resident at Brigham and Women's Hospital, Harvard Medical School, noted in a heart association news release.

Doctors may not recognize risk factors and symptoms in young women -- Hispanic women in particular -- with heart disease, according to the researchers. Other factors may include language barriers, lack of access to health care, doctor bias and differences in treatment patterns.

More information

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

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 19, 2013 (HealthDay News) -- Treating persistent insomnia at the same time as depression could double the chances that the mood disorder will disappear, a new study shows.

Doctors have long reported a link between insomnia -- the inability to sleep -- and depression, but many thought that depression led to insomnia. Now, experts suspect sleep problems can sometimes precede depression.

If other ongoing studies confirm these results, it might lead to major changes in depression treatment, experts added. Such changes would represent the biggest advance in depression treatment since the antidepressant Prozac was introduced in 1987, The New York Times reported.

"The way this story is unfolding, I think we need to start augmenting standard depression treatment with therapy focused on insomnia," Colleen Carney, lead author of the small study, told the Times.

The study was funded by the U.S. National Institute of Mental Health.

The insomnia treatment relied on talk therapy, rather than sleep medication, for 66 patients.

Insomnia and depression are both common problems, and often interact, explained Dr. Steven Feinsilver, director of the Center for Sleep Medicine at Mount Sinai School of Medicine in New York City. He was not involved in the study.

"Clearly, poor sleep can cause depression and depression can cause poor sleep," he said.

Evidence does exist that for many people, symptoms of insomnia precede symptoms of depression by a few years, Feinsilver noted. "This could be taken to mean either that insomnia causes depression or that insomnia is the earliest symptom of depression," he said.

This study may help untangle that relationship. It "suggests that specifically treating the insomnia with behavioral techniques can substantially improve the outcome of patients with depression," Feinsilver added.

For the millions of people with depression, the findings offer a ray of hope.

"This relatively simple technique for treating insomnia could be tremendously helpful for those with this common psychiatric illness," Feinsilver said.

More than 20 million Americans suffer from depression -- disabling feelings of sadness and despair that don't go away, according to the U.S. National Library of Medicine. More than half of those with depression also suffer from insomnia.

The research team, from Ryerson University in Toronto, found depression lifted significantly among patients whose insomnia was cured. The insomnia treatment consisted of four talk therapy sessions over eight weeks, according to the Times.

During the sessions, patients were given certain instructions: set a specific wake-up time and don't veer from it; get out of bed when awake but don't eat, read or watch TV; and refrain from taking any daytime naps.

Almost 90 percent of patients who responded to the insomnia therapy also saw their depression lift after taking an antidepressant pill or an inactive placebo for two months. That was about double the rate of those who could not shake their sleeplessness, the news report said.

Study participants had to have had a month of sleep loss that had an effect on their jobs, family life or other relationships.

A smaller pilot study conducted at Stanford University produced similar findings, the Times reported.

Carney was to present the latest research Saturday at a conference of the Association for Behavioral & Cognitive Therapies, in Nashville, Tenn., the newspaper reported.

Research presented at meetings should be viewed as preliminary until published in a peer-reviewed medical journal.

More information

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

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 19, 2013 (HealthDay News) -- A "smart" pacemaker that kicks in only when a person's heartbeat becomes irregular can be more effective in preventing further heart damage than standard pacemakers that are always at work, researchers report.

These highly programmed pacemakers reduced by 26 percent patients' risk of death, hospitalization for heart disease and permanent irregular heartbeat, according to late-breaking research presented Monday at the American Heart Association annual meeting in Dallas.

"The more sophisticated pacemaker technology proved to be superior to the current standard of care," said study co-author Dr. Giuseppe Boriani, a professor at the Institute of Cardiology at the University of Bologna, Italy.

Standard pacemakers are used to continually regulate the heartbeat in people with bradycardia, a condition in which the heart beats slower than 60 beats per minute.

More than 128,000 people in the United States suffer from irregular heartbeat problems like bradycardia, and those cases account for about half the pacemakers implanted in the United States, Boriani said.

But the old-style pacemakers and their constant stimulation increase a person's risk of one of bradycardia's common complications, a rapid and irregular beating of the heart's upper chambers known as atrial fibrillation.

Heart patients with atrial fibrillation run a higher risk of heart failure, stroke and death.

Doctors have been experimenting with different methods to use pacemakers to stimulate the heart's upper chambers (the atria) and the heart's lower chambers (the ventricles) in a way that prevents atrial fibrillation.

This study focused on 1,166 patients who received pacemakers programmed in one of three different ways:

  • One program performed standard pace making, which sends electrical pulses to both chambers of the heart.
  • Another focused on pace making that would stimulate both the atria and the ventricles if the pacemaker sensed that an episode of atrial fibrillation was imminent.
  • The third combined that second approach with an additional feature: a number of different programs that stimulated the atria to both head off an irregular heartbeat and to restore normal heart rhythm.

The third program, which focused on a varied, off-and-on approach to the whole heart, was superior to the other two. By the end of the two-year study, it had reduced by 61 percent the number of heart patients who developed permanent atrial fibrillation.

Over the next two years, just over 15 percent of those with smart pacemakers were hospitalized and 4.6 percent died, compared to nearly 17 percent hospitalizations and 5.6 percent deaths for those without smart pacemakers.

The patients provided with smart pacemakers also reported that they felt less fatigue and enjoyed better quality of life.

This breakthrough came after a couple of dozen studies of different pacemaker programs that had shown no benefit, said Dr. Anthony Tang, a professor of medicine at Western University Canada in Ontario.

"It was a bit disappointing that it didn't universally show positive effect," Tang said of previous research. In this study, doctors appear to have figured out the best programs that will cause the pacemaker to kick in at the right time and for the appropriate heart chamber.

Boriani said this sort of pacemaker programming should be further evaluated.

"If applied to all patients requiring pacemakers, the benefits could help many thousands of patients in every country," he said.

The research was funded by Medtronic, a pacemaker company that provided the pacemakers used in the study.

Research presented at meetings should be considered preliminary until published in a peer-reviewed medical journal.

More information

Visit the American Heart Association for more on heart pacemakers.

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 19, 2013 (HealthDay News) -- Children across the globe can't run as far or as fast as their parents did at their age, according to new research.

In a one-mile footrace, a kid today would finish a minute and a half behind a typical child from 1975, said study lead author Grant Tomkinson, a senior lecturer in the University of South Australia's School of Health Sciences.

"We all live in an environment that's toxic for exercise, and our children are paying the price," Tomkinson said.

Children today are about 15 percent less aerobically fit than their parents were as youngsters, Tomkinson and his colleagues discovered. In the United States it's even worse -- kids' heart endurance fell an average 6 percent in each of the three decades from 1970 to 2000.

These levels of fitness in childhood will more than likely result in worse health in adulthood, Tomkinson said. Kids will have weaker hearts and thinner bones, and an overall lower quality of life.

Tomkinson is scheduled to present his findings Tuesday at the American Heart Association's annual meeting in Dallas.

Sam Kass, executive director of Michelle Obama's Let's Move! initiative, called the results of the one-mile cross-generational footrace "shocking."

"It's clear over the last four decades we've been in a cycle of inactivity, and that's leading to some devastating health outcomes," Kass said.

The researchers came to their estimates by analyzing 50 studies on running fitness between now and 1964 that involved more than 25 million kids aged 9 to 17 in 28 countries.

Studies included in their analysis measured heart endurance by how far kids could run in a set time or how long it took them to run a set distance. Tests usually lasted five to 15 minutes or covered between a half-mile and two miles of running.

Endurance declined significantly over the years, but in ways that were similar between boys and girls and younger and older kids across different regions of the globe.

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.

Tomkinson said there are many factors that have combined to create an increasingly inactive society, including the following:

  • Communities designed to discourage walking, bicycling and backyard play. "We have to travel farther to get to parks and green spaces, and they may not always be of the best quality," he said. "Kids are less likely to ride bikes or walk to school."
  • Schools that have either rid themselves of physical education or replaced it with a less strenuous version of the class. These days, only 4 percent of elementary schools, 8 percent of middle schools and 2 percent of high schools offer a daily physical education class, Kass said.
  • The prevalence of TV, computer, tablet and smartphone screens that sap a kid's will to venture outdoors.

Obesity also plays a part. "We are fatter today, so from a weight-bearing perspective it's harder to move our bodies through space," Tomkinson said, noting that about 30 percent to 60 percent of declines in endurance running performance can be explained by increases in body fat mass.

So what's the solution? To Tomkinson, it's simple -- kids need to be exposed to prolonged exercise that leaves them exhausted.

"You want exercise to be fun, but there needs to be some huff and puff there as well," he said. "It needs to make them somewhat tired."

Kids need to engage in at least 60 minutes of physical activity that uses the body's big muscles, like running, swimming or cycling, Tomkinson said.

It doesn't have to be all at once, however. Tomkinson said kids can "snack" on physical activity throughout their day -- engaging in a walk for 10 minutes in the morning, or playing an active game for 10 minutes at recess, for example.

Parents also need to engage with their kids, he added. They should limit a kid's sedentary time to no more than two hours a day, while also exposing them to a range of physical activities they might enjoy.

Kass of Let's Move! called on Americans to work toward making physical activity easier and more fun, both for children and adults.

"We know we need to break this cycle of passing physical inactivity down from one generation to the next," Kass said. "There's no one solution. It's got to happen in a comprehensive way. We have to integrate physical activity in our lives. It's got to be a part of our daily lives."

More information

For more about kids and physical activity, visit Let's Move!

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 19, 2013 (HealthDay News) -- A growing number of American seniors are having heart valve replacements, and their risk of complications and death from the surgery is decreasing, new research finds.

"Aortic valve replacement is standard treatment even for very elderly patients despite its risks in this age group," according to background information in the study, which appeared Nov. 17 in the Journal of the American Medical Association.

Traditionally, this surgery has involved coronary artery bypass graft surgery. In this procedure, a surgeon takes blood vessels from other parts of the body and uses them to reroute blood flow around a blocked blood vessel in the heart.

A less invasive method called transcatheter aortic valve replacement is a newer option that is also being used, the researchers said.

They wanted an updated look at results following heart valve replacement surgeries, so they analyzed data from nearly 83 million Medicare patients who underwent the procedure between 1999 and 2011. During that time, the amount of these surgeries being performed increased in all age, sex and race groups, and most notably among patients aged 75 and older.

Death rates 30 days after the procedure decreased by an average of 4.1 percent a year during the study period, while death rates one year after the procedure fell by 2.5 percent, according to a journal news release.

Readmissions to the hospital 30 days after the procedure decreased by 1.1 percent per year.

Use of the more invasive bypass surgery also decreased during the study period.

"These findings may provide a useful benchmark for outcomes of aortic valve replacement surgery for older patients eligible for surgery [who are] considering newer transcatheter treatments," said researcher Dr. Jose Augusto Barreto-Filho, of the Federal University of Sergipe, in Brazil.

More information

The Society of Thoracic Surgeons has more about heart valve replacement.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 19, 2013 (HealthDay News) -- Residents of American cities with high levels of air pollution are much more likely to develop dry eye syndrome than people who live in cities with cleaner air, a new study shows.

People living in and around cities such as Chicago and New York City were three to four times more likely to be diagnosed with dry eye syndrome than those in urban areas with lower levels of air pollution.

Dry eye syndrome -- a deficiency in tear production -- can severely hamper someone's quality of life and productivity. The condition affects up to 4 million Americans aged 50 and older. Its symptoms include excessive tearing, discomfort wearing contact lenses, and stinging and burning in the eyes.

In this new study, researchers analyzed the medical records of more than 600,000 U.S. veterans who were treated for dry eye syndrome in nearly 400 VA eye clinics between July 2006 and July 2011. The records were compared to air-pollution data collected during the same time.

While the study wasn't designed to prove cause-and-effect, the researchers said most major cities had high levels of air pollution and high rates of dry eye syndrome -- 17 percent to 21 percent. Those cities included Chicago, Los Angeles, Miami and New York City.

The researchers also found that the risk of dry eye syndrome was 13 percent higher in cities at high altitudes.

The findings suggest that doctors need to be aware of the link between environmental conditions and dry eye, the researchers said. They recommended that doctors get an environmental history when assessing patients with the condition.

"Undoubtedly, many people living in arid and polluted cities would readily attest to the irritating effect air pollution has on dry eye," study author Dr. Anat Galor, an assistant professor of clinical ophthalmology at the Bascom Palmer Eye Institute in Miami, said in a news release from the American Academy of Ophthalmology.

"Our research suggests that simple actions, such as maintaining the appropriate humidity indoors and using a high-quality air filter, should be considered as part of the overall management of patients suffering from dry eye syndrome," Galor said.

The study was presented Saturday at the American Academy of Ophthalmology's annual meeting in New Orleans. Data and conclusions presented at meetings typically are considered preliminary until published in a peer-reviewed medical journal.

More information

The U.S. National Library of Medicine has more about dry eye syndrome.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 19, 2013 (HealthDay News) -- A new study counters the commonly held belief that when most middle-aged men suffer cardiac arrest, it typically comes completely out of the blue.

Researchers found that the majority of victims have symptoms in the days and weeks before the emergency.

Most had chest pains between four weeks and one hour before a sudden cardiac arrest -- when the heart stops abruptly -- the study found. Others had noted shortness of breath, while a small percentage experienced dizziness, fainting or heart palpitations.

The study authors said that although middle-aged people are considered to be in the prime of life, they are not immune to cardiac emergencies.

"At least a third of cardiac arrests in men are happening in middle age," said study lead author Dr. Sumeet Chugh, a cardiologist at Cedars-Sinai Medical Center in Los Angeles.

The recent death of The Sopranos star James Gandolfini at the age 51 highlighted the fact that sudden cardiac arrest can affect relatively young people.

The study was scheduled for presentation Tuesday at the annual meeting of the American Heart Association, in Dallas.

Sudden cardiac arrest occurs when the heart suddenly starts beating either very quickly and erratically, or extremely slowly, due to a failure of its electrical system, said Dr. Gregg Fonarow, a cardiologist at the University of California, Los Angeles. "That's different than a heart attack, where there is a blockage that injures the muscle," he said.

About 360,000 out-of-hospital cardiac arrests are reported each year in the United States, according to the American Heart Association. Less than 10 percent of those who have a cardiac arrest outside the hospital survive.

For the study, the scientists focused on the population of Portland, Ore., assessing every man between the ages of 35 and 65 who had a sudden cardiac arrest within a period of almost 12 years. Of the more than 800 total cases, 31 percent of the medical records did not have enough information to identify whether symptoms were present before the attack.

The researchers also reviewed the accounts of family members, witnesses, emergency medical personnel and medical records from the time period around the cardiac arrest.

In the remaining cases, 53 percent had symptoms that ranged from episodes of chest pain to feeling like they had the flu.

Although the data helps point to the importance of recognizing symptoms and seeking help, Chugh said, there are still more questions than answers. For many people with early symptoms of potential heart problems, doctors' exams may not show anything definitive.

"We're trying to improve the scope of a complete [cardiac] work-up, but there are big gaps in what we know," Chugh said. "What happens in the hour before cardiac arrest? What about in the 24 hours before, the week before or the month before?"

Part of the challenge is that a variety of problems may trigger sudden cardiac arrest. Depending on genetic, anatomical and other factors, people may respond differently.

"We are teasing out a million different variables at this point," Chugh said. "The nature of heart disease isn't so different from cancer. There's a genetic component ... and then there are clinical factors and some lifestyle factors."

The study results do not apply to women, and more research is needed, Chugh said. "Women are different in so many ways," he said.

The research supports current recommendations for anyone having these kinds of symptoms -- especially chest pain, shortness of breath and dizziness -- to seek medical attention, UCLA's Fonarow said. "Many people don't follow these recommendations and they delay," he said. "Their health may really be at stake."

Chugh agreed. "We have not educated men in middle age very much, and we need to do that," he 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

Learn more about sudden cardiac arrest from the U.S. National Heart, Lung, and Blood Institute.

Copyright © 2013 HealthDay. All rights reserved.

Health Highlights: Nov. 19, 2013

By on

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

Bill Could Give FDA New Powers Over Compounding Pharmacies

A bill to increase the U.S. Food and Drug Administration's control over compounding pharmacies was passed by Congress on Monday and experts say it will help improve drug safety.

The bill does not give the FDA complete authority over these pharmacies -- which tailor-mix drugs for individual patients -- but still provides significant safeguards and is supported by many public health advocates, according to The New York Times.

"It has very sharp teeth," drug safety consultant Sarah Sellers said of the bill, which is expected to be signed into law by President Barack Obama.

The bill began taking shape shortly after tainted injectable drugs from a compounding pharmacy in Massachusetts caused a meningitis outbreak that killed 64 people across the U.S. just over a year ago, The Times reported.

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NYC to Ban Tobacco Sales to People Younger Than 21

Legislation banning the sale of tobacco products to anyone under the age of 21 is to be signed Tuesday by New York City Mayor Michael Bloomberg.

The new law would make New York the first large city or state in the country to ban tobacco sales to young adults. City health officials hope that raising the legal age to 21 will slash smoking rates among young people. Most smokers get addicted to cigarettes before age 21, the Associated Press reported.

The legislation also bans the sale of small cigars in packages of less than 20 and boosts penalties for retailers that violate sales regulations.

Also on Tuesday, Bloomberg was to sign legislation meant to keep the price of tobacco high by prohibiting coupons and other discounts, and by making the minimum price of cigarettes $10.50 a pack, the AP reported.

The increase in the minimum age for buying tobacco products will simply drive teenagers to the black market, according to tobacco companies and some retailers.

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Study Charges FDA Was Silent on Amphetamine-Like Compound in Supplements

U.S. government scientists found an amphetamine-like compound in nine dietary supplements but did not alert consumers, researchers say.

The Food and Drug Administration team tested 21 supposedly all-natural supplements and found that nine contained the compound beta-methylphenethylamine, according to an article in the Journal of Pharmaceutical and Biomedical Analysis.

All 21 products list an ingredient called Acacia rigidula, which is a plant found in Texas and Mexico. The FDA scientists said they couldn't find the amphetamine-like compound in verified samples of the plant, and also said that the compound appears to have never been tested for safety on humans, USA Today reported.

The supplements tested were marketed for things such as mood stabilization, weight loss and boosting energy. FDA officials would not comment on the study or release the names of the supplements that were tested or the nine found to contain the compound.

"This is a brand new drug being placed into a number of supplements under the guise of a natural ingredient," Pieter Cohen, an assistant professor at Harvard Medical School, told USA Today.

He was part of another team of scientists who last month reported finding a methamphetamine-like compound in a pre-workout supplement called Craze. He's dismayed that the FDA hasn't issued public warnings about Craze or the nine supplements in the new study.

"The laws are incredibly weak, but the FDA is not moving as fast as it could to remove hazardous products," Cohen told USA Today.

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Positive Drug Tests Declining Among U.S. Workers

The percentage of American workers testing positive for cocaine and marijuana has declined sharply since 1988, but the use of prescription drugs appears to be a growing problem, according to a new study.

Quest Diagnostics Inc. reviewed more than 125 million urine drug tests administered to U.S. employees from 1988 to last year. They found that 3.5 percent of samples came back positive in 2012, compared with 13.6 percent in 1988, the Wall Street Journal reported.

However, positive tests for amphetamines -- which includes prescription medicines such as Adderall -- more than doubled between 2002 and 2012. Positive tests for the painkillers Vicodin and OxyContin rose 172 percent and 71 percent, respectively, from 2005 to 2012.

The analysis also uncovered higher levels of painkiller use when testing workers after they have been involved in an accident on the job, WSJ reported.

"Even when used under prescription, these drugs can have an impact on workplace safety," said Barry Sample, director of drug-testing technology for Quest.

The data also showed that positive tests for methamphetamines fell after 2005, but recently started to rise again, especially among workers in safety-sensitive industries such as railroads and trucking.

The lower rate of positive tests for illegal drugs may be due to the fact that workers have become more adept at finding ways to pass urine drug tests. Labs are trying to develop oral swabs and hair tests to reduce the number of people who pass tests by substituting someone else's urine, WSJ reported.

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Medtronic Recalls Guidewires Used in Heart Procedures

About 15,000 Medtronic devices used in heart procedures are being recalled by the company because they have defects that could result in serious injury or death, the U.S. Food and Drug Administration announced.

The recalled products are guidewires. They are inserted through an artery and used to guide into place devices such as stents, the Associated Press reported.

The recall was implemented Oct. 21 after Medtronic was informed about four problems, including one patient who suffered cardiac arrest but was resuscitated, according to company spokesman Joseph McGrath.

The coating on the recalled guidewires could break off and possibly block a blood vessel. The coating is meant to help the wires slide through blood vessels more easily, the AP reported.

The FDA has classified the recall as Class I, a category reserved for products with reasonable potential to cause serious injury or death.

The recall covers certain lots of guidewires made since April. Medtronic said it has halted new shipments of the wires and alerted regulators worldwide about the problem, the AP reported.

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 19, 2013 (HealthDay News) -- Boys who drink more milk during their teenage years might not see any drop in their risk for hip fractures as adults, new research suggests. Just the opposite: Their risk actually might rise.

The finding, which was not observed among women, is based on the fracture history of nearly 100,000 white men and women, middle-aged and older, who recounted their milk-drinking habits decades earlier.

"I don't consider this to be a definitive finding that would change the public-health message concerning milk at this point," said lead study author Diane Feskanich. "But even though we're very focused on milk in this country, we don't really have studies that have documented how people drink milk as kids and then have waited 50 to 60 years to see what happens to their bones.

"What we found was a little surprising. Teen milk consumption was associated with a higher fracture risk among men, but not women," said Feskanich, an assistant professor in the department of medicine at Brigham and Women's Hospital and Harvard Medical School, in Boston.

Feskanich and her colleagues discussed their findings in the Nov. 18 online issue of the journal JAMA Pediatrics.

The researchers said milk has long been touted as an essential part of teen diets. The most recent dietary guidelines from the U.S. Department of Agriculture recommend that adolescents drink at least three glasses of milk (or a dairy equivalent) each day.

The guidelines' goal is to ensure proper skeletal growth and health during adolescence, the time during which boys and girls amass roughly 95 percent of their future adult bone mineral content, the researchers said.

But they also said growing taller -- which can be spurred by drinking milk -- has itself has been linked to a greater risk for fractures, perhaps complicating milk's overall protective role regarding hip-fracture risk.

The investigators analyzed teen milk-consumption patterns that had been reported in 1986 by women participating in the Nurses' Health Study, and in 1988 by men participating in the Health Professional Follow-Up Study.

All participants were white, and milk-consumption histories (primarily involving whole milk) focused on the ages of 13 to 18. The participants' histories were provided solely on the basis of personal recall.

More than 35,000 men and nearly 62,000 women were tracked for 22 years. During this time, 490 hip fractures occurred among men and more than 1,200 occurred among women.

First, the researchers accounted for a number of possible influencing factors, such as current diet, weight, smoking history, exercise patterns, prescription drug use and current milk-consumption habits. They then determined that a man's risk for a hip fracture actually increased 9 percent for every additional daily glass of milk he had consumed while a teen.

However, no increase in adult hip fracture risk was seen among teen girls who drank more milk.

"The gender difference might be explained by several things," Feskanich said. "Difference in when women attain full height and maturity, or the fact that bone density is a bigger issue for men than women -- perhaps more of an issue than height. But at this point we're just hypothesizing."

Although the study found an association between more milk consumption in boyhood and higher risk of hip fractures in adulthood, it did not establish a cause-and-effect relationship.

In an editorial accompanying the study, Connie Weaver, a distinguished professor in the department of nutrition science at Purdue University, suggested that the findings may be flawed due to problems with the study's premise.

"When you look at the different findings concerning men and women, there are a number of reasons to ask if there is some problem with the study approach," she said.

"First of all, basic physiology among men and women ought to be the same, because calcium is the major mineral in all our bones," she said. "Their theory holds together based on the proposition that drinking milk will make boys taller and more prone to breaking bones, but the impact on height really shouldn't be different for boys and girls."

"There's also the fact that, both sexually and in terms of bones, boys and girls do develop at a different rate," she said. "To get an accurate look at the impact of teenage milk consumption, maybe the timelines shouldn't have been lined up to be exactly the same."

She also questioned how accurate the self-reports of past milk consumption might be.

"The ability to estimate what you ate a year ago is pretty difficult, not to mention decades back," Weaver said. "Boys and girls have different self-image perceptions, which we know influence what they tell you they eat. Girls always under-report; boys always over-report. That might correspond with milk consumption too."

"This is a very interesting hypothesis, but the finding just doesn't play out very logically," Weaver said. "No one should walk away from this study thinking that they or their kids should avoid milk when young."

More information

For more on milk and teens, visit the U.S. National Institute of Child Health and Human Development.

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 19, 2013 (HealthDay News) -- Human error is the most common cause of infant asphyxiation at birth, according to a new Norwegian study.

Birth asphyxia occurs when a baby doesn't receive enough oxygen before, during or immediately after birth. It can lead to brain damage and death.

In this study, researchers looked at 161 compensation claims for birth asphyxia made in Norway between 1994 and 2008. In those cases, 54 infants died and 107 survived, including 96 who suffered brain damage.

Human error was the most common cause of birth asphyxia. Half of the cases were due to inadequate fetal monitoring, 14 percent were due to lack of clinical knowledge, 11 percent were due to failure to follow clinical guidelines, 10 percent were due to failure to ask for senior medical staff assistance and 4 percent were due to errors in drug administration.

In cases where there was substandard care, the obstetrician and midwife were identified as the responsible staff 49 percent and 46 percent of the time, respectively, according to the study, which was published recently in the journal Acta Obstetricia et Gynecologica Scandinavica.

"In most compensated cases, poor fetal monitoring led to an inadequate supply of oxygen to the infant," study author Dr. Stine Andreasen, of department of obstetrics and gynecology at Nordland Hospital in Bodo, Norway, said in a journal news release.

"Training for midwives and obstetricians, along with high-quality audits, could help to reduce claims for compensation after birth asphyxia," Andreasen said.

More information

The University of California, San Francisco, Children's Hospital has more about birth asphyxia.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 19, 2013 (HealthDay News) -- New insight into the heart's ability to repair itself could help scientists develop ways to improve recovery after a heart attack, a new study of mice suggests.

Researchers found that a signaling pathway -- called the Hippo pathway -- normally blocks heart repair in adult mice. When certain signals were removed, the animals' hearts were able to regenerate after being damaged.

This was because specialized heart cells called "cardiomyocytes" were able to multiply much better after the signals were removed, an ability that is normally lost in damaged hearts, according to the researchers from the Baylor College of Medicine and the Texas Heart Institute.

"The heart is very poor at repairing itself after various types of injury including the most common injury, the myocardial infarct [heart attack]," team leader James Martin said in a news release from The Company of Biologists.

"We were very excited to see full return of cardiac function in the Hippo-mutant hearts after injury. It was the culmination of a lot of hard work and also a little good luck," Martin said.

The study was recently published in the journal Development.

Previous research has shown that hearts can regenerate in embryos during their development, and also in newborn mice. But this ability is lost during adulthood. Some fish and amphibians can repair their hearts as adults, but it's believed that humans lost this ability during the course of evolution.

This new finding suggests that it may be possible to reactivate the human heart's ability to repair itself.

"The implications for treating heart disease are great. With recent advances, it is now clear that the heart muscle can be coaxed to make new muscle cells," Martin said.

Scientists note, however, that research with animals often fails to provide similar results in humans.

More information

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

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 19, 2013 (HealthDay News) -- People with a certain type of epilepsy have widespread, abnormal brain connections that could provide clues for diagnosis and treatment, new research suggests.

The study included 24 people with left temporal lobe epilepsy, the most common form of focal (partial) epilepsy. Partial seizures do not involve the entire brain. People with temporal lobe epilepsy experience seizures that start in the temporal lobe. These are located on each side of the brain, just above the ears.

Researchers used MRI to compare the brains of the epilepsy patients and a group of 24 people without epilepsy. Epilepsy patients had 22 percent to 45 percent fewer long-range connections in the brain's "default-mode network" compared to people without the condition.

This set of brain regions is active when the mind is at rest and allowed to wander or daydream.

The epilepsy patients also had 85 percent to 270 percent more local connections within and beyond the default-mode network. This may be an adaptation to having fewer long-range connections, noted the study authors.

The findings are published in the Nov. 19 online edition of the journal Radiology.

"Our long-term goal is to see if we can we predict . . . who will respond to surgery and who will not," Dr. Steven Stufflebeam, of Massachusetts General Hospital, said in a journal news release.

More information

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

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

Health Tip: When Your Child Is Overweight

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(HealthDay News) -- If your child is overweight, encouraging him or her to eat healthy foods and get plenty of exercise can help in the child's quest to lose weight. But don't forget to offer loving support.

The Weight-Control Information Network offers these suggestions:

  • Work with your child to set specific goals and help your child reach them, tracking progress along the way.
  • When your child succeeds, offer big hugs and plenty of praise.
  • Talk to your child, and listen to what he or she has to say about weight. Talk with the child about any concerns.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

Health Tip: Enjoy Raw Seafood Safely

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(HealthDay News) -- Before you dig into your sashimi, make sure the raw seafood you're about to enjoy is safe to eat.

The U.S. Academy of Nutrition and Dietetics offers these guidelines for raw seafood safety:

  • Raw seafood is generally safe for most people in good health who are not at increased risk of foodborne illness. Exceptions include people with weakened immune systems, gastrointestinal illness and pregnant women.
  • Babies, young children, seniors and anyone with an alcohol problem should avoid eating raw or partially cooked seafood.
  • Only consume raw seafood at a reputable restaurant with a highly trained chef.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 18 (HealthDay News) -- Cholesterol-lowering statin drugs do not appear to raise the risk of memory loss or dementia, a new review finds.

"In February 2012, largely based on anecdotal reports, the U.S. Food and Drug Administration issued a safety statement warning patients of possible adverse mental effects associated with statin use," said senior study author Dr. Emil deGoma, medical director of the preventive cardiovascular program at the University of Pennsylvania's Perelman School of Medicine.

However, the scientific evidence the researchers analyzed showed that statins -- which include drugs such as Crestor, Lipitor and Zocor -- aren't connected with memory loss or mental declines, deGoma said.

Some of the studies they reviewed showed that people taking statins actually reduce their risk for dementia by 13 percent, their risk for Alzheimer's disease by 21 percent and their risk for other mental problems by 35 percent, deGoma said.

"I would not let concerns about adverse effects on mental functioning influence the decision to start a statin in patients suffering from cardiovascular disease or [those who are] at risk for cardiovascular disease," he said.

In addition, deGoma said, doctors should not assume statins are to blame when someone taking them becomes forgetful. "We may be doing more harm than good if we withhold or stop statins -- medications proven to reduce the risk of heart attack and stroke -- due to fears that statins might possibly cause memory loss," he said.

The report was published in the Nov. 19 issue of the journal Annals of Internal Medicine.

Dr. Gregg Fonarow, a spokesman for the American Heart Association, said statins are important in reducing the risk of heart attacks and strokes, and have been proven safe and effective numerous times.

"These findings should be highly reassuring to people taking -- or who should be taking -- statins to reduce their risk of cardiovascular events and stroke," said Fonarow, a professor of cardiology at the University of California, Los Angeles.

"As cardiovascular disease remains the leading cause of death, disability and health care expenditures, statin therapy, together with a healthy diet and regular exercise, represents one of the most extensively studied, safe, effective and value-driven ways to improve individual and population-level cardiovascular health," he said.

For the review, deGoma and his colleagues looked at 57 published studies that examined statin use and any connection with mental functioning, and they further analyzed 25 of them to see if a particular pattern emerged in the results.

They found no evidence that statins increased the risk for memory loss or thinking declines. Moreover, test scores on memory and other mental functions did not differ between statin users and nonusers.

The researchers also analyzed FDA data, and couldn't come up with any differences in mental decline among people using statins and people taking two drugs that have not been associated with mental decline. Those drugs are the blood pressure medication Cozaar (losartan) and the blood thinner Plavix (clopidogrel).

Despite the findings, deGoma wasn't ready to say the FDA should backtrack on its decision to issue a warning about a rare risk for memory loss while using statins.

"I think it's hard to say whether or not adding mental impairment to the statin safety label may have been premature," he said. "I am hoping that the FDA provides greater detail regarding the rationale for their decision. Once their data analysis is made public, I think we can have a better discussion about the labeling."

An FDA official said, however, that the new finding doesn't warrant eliminating or changing the current safety warning on statins.

That warning states only that there have been rare cases in which statin use may have been associated with memory loss that wasn't serious and was reversed once the patient stopped taking the drug, said FDA spokeswoman Morgan Liscinsky.

Since Alzheimer's disease and dementia are progressive diseases and not temporary conditions, "a finding that statins are not associated with a risk for dementia, Alzheimer's disease or any decline [in thinking ability] would not necessarily conflict with the current labeling of statins," Liscinsky said.

This latest review should be reassuring to the approximately 30 million people in the United States taking statins, deGoma said. "I do not think mental impairment should be a significant concern with statin use," he said.

At the same time, the researchers would like to see more randomized trials conducted to confirm their findings.

More information

Visit the U.S. National Library of Medicine for more on statins.

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 18, 2013 (HealthDay News) -- People routinely get vaccinations to ward off the flu or prevent infectious diseases such as measles and whooping cough. Could there be a vaccine in the future that would prevent a heart attack?

Two animal studies suggest that vaccines might someday be used to reduce high cholesterol levels and lower blood pressure, according to findings presented Monday at the American Heart Association (AHA) annual meeting in Dallas.

In both cases, the vaccines interrupt processes in the body that, if left alone, can lead to high cholesterol and elevated blood pressure.

The first study, out of Vienna, found that mice and rats had lower cholesterol levels for a year following treatment with a vaccine that protects a cell's ability to remove "bad" LDL cholesterol from the bloodstream.

"This is one of the most exciting things that's now under development in the controllability of cholesterol," said Dr. James Howard, an AHA spokesperson and an endocrinologist and internist at MedStar Washington Hospital Center in Washington, D.C.

The vaccine targets an enzyme called PCSK9. This enzyme causes cells to become less able to yank LDL cholesterol from the bloodstream and convert it into hormones or other useful products, Howard said.

"When you make an antibody to it, it just can't function," he said of PCSK9.

By reducing the amount of active PCSK9 in a body, the vaccine also reduces the cholesterol levels as cells become more efficient in using cholesterol.

"It has incredible power to lower LDL cholesterol, and can be taken with statins," Howard said.

Scientists note that research conducted in animals often fails to provide similar results in humans.

The second study, this one from Japan, used a different vaccine to lower high blood pressure in laboratory rats for up to six months.

This vaccine interferes with a hormone called angiotensin II, which increases blood pressure by causing blood vessels to constrict. Medications already are widely used to block angiotensin II and control blood pressure, but they have to be taken daily to be effective.

"It's a hormone that increases blood pressure, and many of the common drugs antagonize it and reduce blood pressure," said Barbara Howard, a senior scientist at MedStar Health Research Institute and a professor at Georgetown University Hospital, in Washington, D.C. "The idea is if you can knock out the production, you can have a sustained reduction that will last longer."

There are some concerns about medicines or vaccines that target this hormone, however. "It's part of a very complex network of hormones that regulate sodium balance in your body," she said. "It has to be very tightly regulated, or it can cause damage to the whole vascular system."

In this study, the vaccine reduced the rats' blood pressure for months and reduced damage to the heart and blood vessels associated with high blood pressure. It also did not cause any damage to the kidneys, heart or liver.

While these findings are promising, Howard said there needs to be more study before it is ready as a vaccine for humans.

"There's a lot of danger of overshooting and disturbing that sodium balance, and they didn't give any real data in this report," she said. "It's got to be done in humans, and it's got to be accompanied by many more measures of functional safety. If you lower it enough to affect blood pressure, can you do that without affecting sodium balance?"

At this point, the vaccine is at least five to six years away from human trials, according to study co-author Dr. Hiroshi Koriyama of Osaka University, in Japan.

There likely will be a similar amount of time needed to bring the cholesterol vaccine to human trials, said AHA spokesperson Dr. James Howard.

However, he noted that human trials now are taking place for another form of the cholesterol vaccine that has to be taken every couple of weeks by injection.

In the meantime, the AHA recommends eating a heart-healthy diet, getting weekly aerobic and muscle-strengthening activity, and avoiding tobacco smoke as good ways to help control cholesterol.

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

More information

For more information on treatment of high cholesterol, visit the American Heart Association.

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 18, 2013 (HealthDay News) -- Taking birth control pills for more than three years may increase a woman's risk of developing the eye disease glaucoma, a new study suggests.

The findings are from an investigation involving more than 3,400 women aged 40 and older who took part in the U.S. National Health and Nutrition Examination Survey between 2005 and 2008.

"At this point, women who have taken oral contraceptives for three or more years should be screened for glaucoma and followed closely by an ophthalmologist, especially if they have any other existing risk factors," said lead researcher Dr. Shan Lin, professor of clinical ophthalmology at the University of California, San Francisco.

Women who took birth control pills for longer than three years were twice as likely to have been diagnosed with glaucoma, according to the study. The findings were presented Monday at the annual meeting of the American Academy of Ophthalmology in New Orleans.

The reasons why birth control pills might increase the risk of glaucoma were not examined, but previous studies have shown that estrogen may play an important role in the development of glaucoma, the researchers noted in an academy news release.

Birth control pills contain either estrogen and progestin combined, or progestin only.

The researchers also said that doctors should include long-term use of birth control pills in patients' risk profiles for the eye disease. Other known risk factors include being black, having a family history of glaucoma, increased eye pressure, and existing vision defects.

Although the study did not prove a cause-and-effect relationship between the use of birth control pills and glaucoma, the findings should help spur future research to explain the link, Lin noted in the news release.

Glaucoma affects nearly 60 million people worldwide and is a leading cause of blindness.

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. National Eye Institute has more about glaucoma.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

Use of Breast MRIs Way Up, Studies Find

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MONDAY, Nov. 18 (HealthDay News) -- Use of breast MRIs has nearly tripled in recent years, but the women who could benefit the most are not always getting the expensive imaging test, a new study suggests.

The research points ups an important message, said Dr. Shelley Hwang, chief of breast surgery at Duke University Medical Center in Durham, N.C. "More screening is not necessarily better. Smarter screening is better," said Hwang, author of a commentary accompanying the study. Both were published online Nov. 18 in the journal JAMA Internal Medicine.

The study found many more women at high lifetime risk of developing breast cancer -- a group advised to consider MRI -- are getting the test than in years past. Those numbers rose from 9 percent in 2005 to 29 percent in 2009.

These results "suggest that breast MRI is being used better," said lead researcher Karen Wernli, an assistant investigator at the Group Health Research Institute in Seattle.

However, in a separate but related study reported in the same issue, Harvard Medical School researchers found that breast MRIs between 2000 and 2011 jumped 20-fold, then declined and stabilized by 2011. But less than half of women with documented genetic mutations that raise the risk of breast cancer got the highly sensitive tests, they found.

Under guidelines on use of breast MRI, the American Cancer Society and the National Comprehensive Cancer Network advise considering MRI if a woman's lifetime risk of breast cancer is greater than 20 percent. In the general population, a woman's lifetime risk is about 12 percent.

Women considered high risk are those known to have the genetic mutations BRCA1 and BRCA2, those who had chest radiation during childhood, or those with a first-degree relative known to have the BRCA1 or BRCA2 mutation, Wernli said.

For high-risk women, annual MRIs and mammograms are recommended.

MRI uses a strong magnetic field and radio waves, not X-rays, to produce a detailed image. A scan takes about an hour. The patient lies inside a narrow tube, face down on a platform with openings so the breasts aren't compressed. Sometimes a contrast material is injected by IV to show tissue details.

The scan is more expensive than a mammogram. For instance, Medicare and Medicaid reimburse $880 to about $1,600 for MRIs of both breasts, and $300 for a digital mammogram. Fees for women not on Medicare range greatly.

Although MRIs are more sensitive in finding cancers than mammograms, false positive results are also more likely, according to research. And that can lead to unnecessary testing, anxiety and biopsies.

Wernli said she and her colleagues "wanted to see why women were getting MRIs and how these patterns changed over time." This is important to ensure that health care funds are used wisely, they said.

Her team looked at data from five national breast cancer registries from 2005 to 2011. They found the overall rate of breast MRIs nearly tripled, from about four exams for every 1,000 women to almost 12, during that period. Most commonly, MRI was used to diagnose or screen for breast cancer.

In the other study, the Harvard researchers evaluated more than 10,000 women, aged 20 and older, who had at least one breast MRI. They found breast MRIs increased dramatically from 2000 to 2009, before stabilizing. Most of the tests were done for screening or surveillance.

When they looked at a subset of the women who received MRIs, only 21 percent met the cancer society criteria.

More information

To learn more about breast MRI, visit American Cancer Society.

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 18, 2013 (HealthDay News) -- Pregnant women who are exposed to common chemicals known as phthalates may be at greater risk for delivering prematurely, a new study suggests.

Phthalates can be found in a variety of common products such as lotions, perfumes and deodorants, the researchers said. People can also be exposed to the chemicals through tainted food and water.

The research team believes steps should be taken to reduce pregnant women's exposure to phthalates, which have been tied to disrupted thyroid hormone levels, breast cancer and the uterine disorder known as endometriosis.

The study, led by Kelly Ferguson of the University of Michigan School of Public Health, involved 130 women who had a preterm delivery (before 37 weeks of pregnancy), as well as 352 women who did not delivery prematurely. The researchers used urine samples taken during pregnancy to measure each woman's level of phthalate-linked compounds or "metabolites."

The study, published online Nov. 18 in the journal JAMA Pediatrics, found that upswings in some phthalate metabolite concentrations in urine during pregnancy were tied to a greater risk for preterm birth.

The finding "solidifies prior laboratory and epidemiologic [population-based] evidence," Ferguson's team wrote. They believe the results apply to women elsewhere and "provide strong support for taking action in the prevention or reduction of phthalate exposure during pregnancy."

While the study found an association between higher phthalate levels and early delivery, it couldn't prove a cause-and-effect link. But in a journal commentary on the study, Shanna Swan of the Icahn School of Medicine at Mount Sinai, in New York City, said gathering more evidence of a phthalate-premature delivery connection is important.

That evidence would ideally come from a study looking at levels of certain compounds signaling phthalate exposures, as well as inflammation of the uterus, and linking both to a higher risk for spontaneous preterm delivery, Swan said.

However, she believes that Ferguson and her colleagues "have contributed the first robust study suggesting that phthalates, pervasive in the environment of prenatal women, may be important contributors to the unknown and other causes of preterm delivery."

More information

The U.S. Centers for Disease Control and Prevention provides more information on phthalates.

-- Mary Elizabeth Dallas

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 18, 2013 (HealthDay News) -- A new online cholesterol risk calculator produced by two leading U.S. heart organizations is flawed and overstates a person's risk of heart disease, a pair of Harvard Medical School professors say.

The professors contend that this flaw could lead the calculator to mistakenly suggest that millions of people should be taking cholesterol-lowering statin drugs, The New York Times reported Monday.

Key officials with the American Heart Association (AHA) and the American College of Cardiology (ACC) stood by the calculator during a hastily gathered news conference Monday morning at the heart association's annual meeting in Dallas.

Harvard professors Dr. Paul Ridker and Dr. Nancy Cook reportedly pointed out problems with the calculator a year ago, saying that it did not seem to work accurately when they tested it using patient data, the Times reported.

When the online calculator went live last week, Ridker and Cook again tested it and reported serious flaws that could overestimate a person's risk of heart disease by 75 percent to 150 percent, the newspaper reported. Their findings are to be published Tuesday in the medical journal The Lancet, according to the Times' report.

AHA and ACC officials said Monday that the Harvard professors' analysis of the calculator relied on patient data from three heart studies involving people both younger and healthier than the average American.

"These people exist in the U.S. population, but it's a very healthy, skewed group," said Dr. Donald Lloyd-Jones, chair of the department of preventive medicine at Northwestern University's Feinberg School of Medicine.

Lloyd-Jones said he and others met with Ridker on Saturday, as the AHA meeting got under way, and reviewed a limited amount of the Harvard doctors' data. He said he's still waiting to see the full report.

"I think all of us would like to see Dr. Ridker's data, and see that play out in scientific discussion rather than in the media," Lloyd-Jones said.

The two heart health groups said they created the calculator -- as well as a set of aggressive new cholesterol-lowering guidelines -- using a broad range of patient data that allowed them to incorporate factors that hadn't been included in previous risk assessments. For example, prior attempts did not include calculations for African-American populations, and did not attempt to include stroke risk.

"The truth is, the risk equations work exactly the way we asked them to," Lloyd-Jones said.

Officials from both heart groups added that just because the calculator suggests some people would benefit from statins doesn't mean they absolutely have to take them.

Instead, the calculator should prompt a conversation with their doctor about whether they need to take statins or undertake other lifestyle changes to lower their cholesterol.

"We're acknowledging the unique judgment of a physician when he looks at the patient's specific condition," said Dr. Neil Stone, chair of the AHA's cholesterol guideline committee and a professor of preventive cardiology at Northwestern's Feinberg School of Medicine.

Cardiologists are concerned that the confusion surrounding the calculator and new cholesterol treatment guidelines could cause patients to refuse to take statins.

"I fear that the confusion is going to shake the public's confidence in these lifesaving drugs," said Dr. Kevin Marzo, chief of cardiology at Winthrop-University Hospital in Mineola, N.Y. "It is my hope that the guideline writers will revise the online calculator so that any deficiencies created will be quickly corrected."

The two heart groups unveiled the calculator last week in connection with aggressive new guidelines for combating high cholesterol. Those guidelines call for the use of statins to treat more people.

Previously, doctors adhered to rigid clinical guidelines to prescribe a statin when cholesterol levels reached a certain threshold.

Under the new guidelines, people will be advised to take statins based on a number of different health risk factors. These risk factors include if they already have heart disease, if their bad (LDL) cholesterol is extremely high (190 milligrams per deciliter of blood or more) or if they're middle-aged with type 2 diabetes.

In addition, people between 40 and 75 years of age with an estimated 10-year risk of heart disease of 7.5 percent or more are advised to take a statin. Experts say this new rule could greatly alter the number of patients who will now be advised to take such a drug.

"We've come up with an approach that calls for treating about a third of adults between 40 and 75 years of age with statins for primary prevention," said Dr. David Goff, co-chair of the risk assessment working group for the guidelines and dean of the Colorado School of Public Health at the University of Colorado-Denver.

"I think it sounds about right," given that one out of three adults in America die from heart disease and stroke, Goff said.

The alleged problems with the calculator prompted at least one prominent cardiologist to tell the Times that implementation of the new cholesterol treatment guidelines should be delayed.

"It's stunning," Dr. Steven Nissen, chief of cardiovascular medicine at the Cleveland Clinic, told the newspaper. "We need a pause to further evaluate this approach before it is implemented on a widespread basis."

Dr. Sidney Smith, a cardiologist at the University of North Carolina at Chapel Hill and a past AHA president, said that would not happen.

"We intend to move forward with these guidelines and develop effective strategies to implement them," Smith said.

More information

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

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 18, 2013 (HealthDay News) -- Hospitalizations for the most common form of irregular heartbeat nearly doubled between 1998 and 2010, and are expected to continue to soar during the current decade, researchers say.

Ultimately, hospital treatment of atrial fibrillation could cost the United States more than $21 billion in 2020 alone, according to research presented Monday at the American Heart Association's annual meeting in Dallas.

Nearly 4.7 million people landed in the hospital with atrial fibrillation (sometimes called "a-fib") from 1998 to 2010. It's a disorder of the electrical impulses that coordinate the beating of a person's heart, said lead researcher Dr. Sadip Pant, an internist with the University of Arkansas for Medical Sciences in Little Rock.

The number of people hospitalized in 2010 alone represented a 46 percent jump from 1998, according to estimates Pant and his colleagues produced using a national hospital database.

"Right now, we all know that a-fib is a growing epidemic in the United States," Pant said. "The aging population is definitely a major cause of this trend, and with the aging population comes a number of other risk factors."

Other risk factors for atrial fibrillation include obesity, uncontrolled high blood pressure, diabetes and heart failure, Pant said.

Those numbers didn't shock Dr. Mary Ann Bauman, a heart association spokeswoman and a general practice internist in Oklahoma City.

"I know I'm seeing more atrial fibrillation in my practice than I did 10, 15 years ago," she said. "This is not a surprise to me."

Greater awareness of the heart disorder among primary care physicians also could contribute to the increase, Bauman added. More family doctors are detecting atrial fibrillation and sending patients to the hospital to get their heart rates under control.

In the disorder, rapid and disorganized electrical signals cause the heart's two upper chambers -- the atria -- to contract very rapidly and irregularly.

Symptoms include rapid and irregular heartbeat, heart palpitations, shortness of breath, dizziness, sweating, fatigue or chest pain. It's not a fatal disease, but it can increase a person's risk of stroke fivefold. This is because atrial fibrillation allows blood to pool in the atria and form clots, according to the heart association.

Using hospital data, the researchers predict that 541,000 hospitalizations will occur in 2020 because of atrial fibrillation -- 28 percent more than occurred in 2010. "It is increasing exponentially over time," Pant said.

They also ran estimates of the cost of these hospitalizations, concluding that each individual case will cost a little more than $40,000 by 2020. That's a 55 percent increase from 2010.

"It's a very costly disease, and it's going to be even more so in the future," Pant said.

Treatments are available for atrial fibrillation, according to the U.S. National Institutes of Health, and include the following:

  • Medications that return the heart to a normal rhythm
  • Medications that slow the heart rate
  • Low-level electrical shocks to jolt the heart back to a normal rhythm
  • Ablation therapy, in which radio-wave energy or intense cold is used to destroy abnormal heart tissue causing the problem
  • A pacemaker that will help maintain a normal heart rhythm

But prevention likely will be the key to keeping people out of the hospital, Pant said. And this will require teamwork among health professionals and patients.

"We think a collaborative care approach in which a physician works with specialists, with active patient participation, in risk factor management is really needed to reduce those hospitalizations," he said.

People at risk can exercise, adopt a healthy diet, cut back on their salt intake and reduce their stress. Physicians also can help by prescribing medications that lower blood pressure and manage cholesterol levels.

"Controlling the risk factors is important," Pant said. "That's where the role of the primary care physician comes into play."

Bauman agreed. "If we can begin to control [high blood pressure], obesity and other cardiovascular risk factors, then we might hope to slow that trend," she 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

For more information on atrial fibrillation, visit the American Heart Association.

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MONDAY, Nov. 18, 2013 (HealthDay News) -- Being an elite athlete, especially in an endurance sport, may help protect men against type 2 diabetes later in life, a small new study says.

Researchers looked at 392 Finnish men who were former elite athletes and a comparison group of 207 men who hadn't been athletes. Overall, being a former elite athlete reduced the risk of developing type 2 diabetes by 28 percent.

The amount of risk reduction varied, depending on the type of sport. It was 61 percent lower for endurance sports. A less significant trend for reduced risk was seen in power sports (23 percent lower) and for mixed sports (21 percent lower).

The study was published Nov. 15 in the journal Diabetologia.

The former elite athletes also had a 42 percent lower risk of having prediabetes, according to a journal news release.

"With aging, the former athletes maintained their physically active lifestyle better than the controls," wrote Dr. Merja Laine, at the University of Helsinki, and colleagues.

Although the study found a reduced risk of developing diabetes among elite athletes, it did not establish a cause-and-effect relationship.

More information

The U.S. Office of Disease Prevention and Health Promotion outlines steps to prevent type 2 diabetes.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 18, 2013 (HealthDay News) -- People who are hospitalized for a heart attack or angina are more likely to take their medication properly once they leave the hospital if they receive personal attention from a pharmacist, new research indicates.

One-third of these heart patients typically stop taking at least one of their medications just one month after being discharged from the hospital. But the researchers found cost-effective programs that include patient education, collaboration between doctors and pharmacists, and voicemail reminders can help more patients stick to their treatment plans.

The study looked at 241 patients from four U.S. Department of Veterans Affairs medical centers across the United States. The researchers, led by Dr. P. Michael Ho, of the Denver VA Medical Center, randomly assigned the patients to receive typical care or a personalized care program. The program included counseling with a pharmacist, information about their treatment and reminders to take their medication.

In the year after patients were discharged from the hospital, the researchers tracked how many followed their treatment plan. In addition, the patients were checked to see how many had blood pressure and cholesterol levels within a set target range.

The investigators found that only 74 percent of the patients who received typical care followed their treatment plan compared with over 89 percent of those who were in the personalized care program.

However, there was no difference between the two groups in the percentage who had blood pressure and cholesterol levels that were in the desired target range.

The study was published online Nov. 18 in the journal JAMA Internal Medicine.

The personalized care program cost roughly $360 per patient, the study authors noted.

The researchers pointed out that more studies are needed to understand the impact of helping patients adhere to their treatment plans.

For patients who already have high rates of taking of their medications, providing a personalized treatment plan for three to five years, or even longer, may not really improve outcomes, JAMA Internal Medicine editor Dr. Rita Redberg noted in a journal news release.

"Before recommending investment in this strategy, it would be prudent to know that patient outcomes will actually improve," Redberg said.

More information

The American Heart Association has more about acute coronary syndrome.

-- Mary Elizabeth Dallas

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 18, 2013 (HealthDay News) -- Having surgery as soon as possible after a hip fracture may reduce the risk of complications and death, a small new study suggests.

In many countries, hip fracture patients can wait 24 hours or longer before having surgery. This study included 60 patients, aged 45 and older, in Canada and India. Half of them had surgery within six hours of their hip fracture and half had surgery within 24 hours.

Death or major complications such as heart attack, stroke, pneumonia or major bleeds occurred in 47 percent of the patients who received surgery 24 hours after diagnosis, the investigators found. Among patients in the accelerated surgery group, the rate was 30 percent, they noted.

The findings are published in the Nov. 18 issue of CMAJ (Canadian Medical Association Journal).

"We believe that the shortest time possible to treatment may provide the greatest potential for benefit, as is the case in acute heart attack and stroke," co-principal investigator Dr. P.J. Devereaux, said in a McMaster University news release. Devereaux is an associate professor of medicine and epidemiology at McMaster University's Michael G. DeGroote School of Medicine, in Hamilton, Ontario.

Although the study found an association between shorter time from hip fracture to surgery and fewer complications, it did not prove a cause-and-effect relationship.

Hip fractures in seniors can lead to serious complications that may result in death or admission to long-term care facilities, the study authors noted in the news release.

More information

The U.S. Centers for Disease Control and Prevention has more about hip fractures among older adults.

-- Robert Preidt

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MONDAY, Nov. 18, 2013 (HealthDay News) -- Scientists say they're close to having a treatment that can quickly reverse the effects of the anti-clotting drug Pradaxa when necessary.

Pradaxa is a new kind of blood thinner. It was approved by the U.S. Food and Drug Administration in 2010 to prevent strokes caused by atrial fibrillation, a heart rhythm problem that puts people at risk for blood clots that can travel to the brain.

It's easier for patients to take Pradaxa than the older, standard blood thinner warfarin. But unlike warfarin, there's no way to rapidly reverse its action. That can be a life-threatening problem in emergency situations.

Doctors have reported cases of patients on Pradaxa who have died after accidents because their blood wouldn't clot.

"There's a perception among practitioners that they're a little bit concerned about using these new [anti-clotting drugs] because of the lack of a reversal agent," said Dr. Helmi Lutsep, chairwoman of the department of neurology at Oregon Health and Science University, in Portland.

Now researchers say they've discovered a way to block the drug.

Pradaxa works by stopping the action of the enzyme thrombin. Thrombin is key to blood clotting because it breaks a protein called fibrinogen into smaller fragments that glue platelets together, allowing a blood clot to form.

The antidote is a piece of a protein that sticks to one arm of Pradaxa's molecule. The protein essentially handcuffs the drug, which keeps it from attaching to thrombin, allowing blood to clot again.

In an early test, researchers gave 145 healthy men intravenous drips of either the new protein or a placebo. There were no apparent side effects.

In an additional step, the researchers had some of the men take Pradaxa for four days. They then measured the time it took their blood to clot before and after several different doses of the new antidote. The protein returned clotting times to normal almost immediately after the five-minute treatment.

"It's really exciting to see how well this drug works and what a good safety profile the drug has in this very first clinical study," said the study's lead author, Stephan Glund, a researcher with Boehringer Ingelheim, the drug company that makes Pradaxa.

The study was scheduled to be presented Monday at the annual meeting of the American Heart Association, in Dallas. Studies presented at medical conferences are considered preliminary since they haven't yet been scrutinized by independent researchers as part of publication in a peer-reviewed medical journal.

Still, one expert not involved in the research said it was exciting.

"It's a major thing," said Dr. Michiel Coppens, a vascular medicine specialist at the Academic Medical Center, in Amsterdam, the Netherlands.

"From the very first launch of these drugs, there has been an immediate concern about what do we do if a patient [has] major bleeding," Coppens said. "You want to get rid of the anticlotting effect as soon as possible to better control the bleeding."

"[The antidote] isn't vey toxic," he added. "There isn't any major side effect."

But more research is needed to show that the antidote will actually help patients.

"The next step will be actually demonstrating that, for patients who come in with a major bleed with Pradaxa, this does actually improve the outcome," Coppens said.

Study author Glund said his company plans to begin testing the antidote in patients starting in 2014.

More information

For more about the safe use of blood-thinning medications, head to the U.S. Agency for Healthcare Research and Quality.

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MONDAY, Nov. 18, 2013 (HealthDay News) -- Damage to the blood vessels of the eyes or kidneys might help identify people who are at raised risk for a common type of heart-rhythm disorder, a new study suggests.

The disorder, called atrial fibrillation, is common in older people and increases the risk of stroke. It also can trigger heart-related chest pain or heart failure in some patients, the researchers said.

In the new study, which is scheduled for presentation Monday at the annual meeting of the American Heart Association in Dallas, researchers followed more than 10,000 middle-aged people for an average of almost 14 years.

Researchers led by Sunil Agarwal, of Johns Hopkins University in Baltimore, found that microvascular changes -- trouble in the smaller vessels of the eyes or kidneys -- appeared to be linked to the presence of atrial fibrillation.

For example, while about six out of every 1,000 people with no microvascular disease developed the heart-rhythm disorder, that figure rose to about nine out of every 1,000 for people with micro-bleeds or micro-aneurysms in the smaller vessels of the eye's retina, the researchers said.

That number rose to almost 17 per 1,000 people for those with signs of vessel damage in the kidneys. It increased to more than 24 per 1,000 in people who had vessel damage in both the eyes and kidneys, the study found.

Why this vessel damage appears to be tied to a higher risk for atrial fibrillation remains unclear, the researchers said.

One expert not connected to the study theorized that small-vessel damage might be an underlying cause of atrial fibrillation.

"This [study] suggests that a potential trigger for developing atrial fibrillation may be worsening microvascular disease," said Dr. Neil Sanghvi, an electrophysiologist at Lenox Hill Hospital in New York City. "Therefore, treatments that are able to minimize or prevent microvascular damage may be able to decrease the incidence of atrial fibrillation."

Dr. Kenneth Ong is interim chief of cardiology at the Brooklyn Hospital Center in New York City. "Damage to the vessels in the eyes and kidneys are thought to reflect similar findings in the rest of the body, including the heart," he said.

He added that it's "reasonable to speculate" that patients with such damage might be at higher risk for heart disease.

Sanghvi said patients who have vessel damage in the eyes or kidneys "should consider long-term monitoring, on the order of one or two weeks," to gauge their risk for undetected atrial fibrillation.

Experts note that findings presented at medical meetings typically are considered preliminary until published in a peer-reviewed journal.

More information

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

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

Health Highlights: Nov. 18, 2013

By on

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

Obama Nominates Health Care Law Backer To Be Surgeon General

An early supporter and advocate for the Affordable Care Act has been nominated by President Barack Obama to be the country's next surgeon general.

Dr. Vivek Murthy is founder and president of Doctors for America, a group that campaigned for the controversial health care law before Congress passed it in 2010. He is a doctor at Brigham and Women's Hospital in Boston and an instructor at Harvard Medical School, The New York Times reported.

He also has been a leader in HIV prevention and AIDS education in both the U.S. and India.

Murthy "will be a powerful messenger" on health policy, according to a statement release Thursday by White House spokesman Jay Carney. His nomination is subject to Senate approval.

The previous surgeon general, Dr. Regina Benjamin, left her post in July to return to work at a clinic she founded in Bayou La Batre, Ala. Since then, Dr. Boris Lushniak has been acting surgeon general, The Times reported.

-----

New Drug for Rare Blood Cancer Approved by FDA

A new drug to treat a rare and aggressive form of blood cancer was approved Wednesday by the Food and Drug Administration.

Imbruvica was approved for patients with mantle cell lymphoma who have already undergone at least one previous drug treatment. This type of cancer typically begins in the lymph nodes but has usually spread to the bone marrow and other parts of the body by the time it's diagnosed, the Associated Press reported.

The new once-a-day capsule blocks a protein that enables the cancer to multiply and spread. The FDA's approval is based on a study of 111 patients. Tumors shrank or disappeared in 66 percent of the patients who took Imbruvica. However, it's not clear if the drug actually prolongs patients lives.

The new drug from Pharmacyclics and Janssen Biotech Inc. is the second to be approved under the FDA's breakthrough designation, which was approved by Congress last year. The classification is meant to accelerate development of promising drugs by giving companies additional meetings and earlier communication with FDA scientists, the AP reported.

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MONDAY, Nov. 18, 2013 (HealthDay News) -- American children get too many unnecessary antibiotic prescriptions for upper respiratory infections, a medical group says. Now the organization is urging both providers and parents to take steps to ensure that antibiotics are used only when truly needed.

More than one in five pediatric office visits results in an antibiotic prescription, according to the authors of a new report from the American Academy of Pediatrics (AAP). And about 10 million antibiotic prescriptions are written every year for upper respiratory infections that likely won't improve from antibiotic use.

In addition, physicians often prescribe broad-spectrum antibiotics. These are medications that can kill a wide variety of bacteria, rather than narrow-spectrum drugs that target certain types of bacteria. Narrow-spectrum drugs generally are preferred so bacteria don't become resistant to broad-spectrum drugs that may be needed to battle more serious infections.

"Our primary goal is the best outcome for a child," said lead report author Dr. Mary Anne Jackson, a member of the AAP committee on infectious diseases. "The best treatment for a child doesn't always include an antibiotic."

Although some progress has been made in reducing the amount of unnecessary antibiotic use, it's still a problem, said Jackson, division director of infectious disease at Children's Mercy Hospitals and Clinics, in Kansas City, Mo.

Unnecessary antibiotic use puts children at risk of side effects or a potential allergy to the medications, and increases the risk of antibiotic resistance, Jackson said.

The new report details the appropriate times to prescribe antibiotics for upper respiratory infections, which includes sinus infections, ear infections and strep throat.

"This clinical report from the AAP, done in conjunction with the U.S. Centers for Disease Control and Prevention, looks specifically at upper respiratory infections, because these are a common area where antibiotics are used injudiciously," Jackson said.

According to the report, however, upper respiratory infections are also an area where it can be difficult to distinguish whether the cause is viral or bacterial. Antibiotics won't be helpful if an upper respiratory infection is caused by a virus.

"[The report recommends] using stringent clinical criteria to establish the diagnosis before prescribing antibiotics," Jackson said.

For example, in the past, many children were routinely given antibiotics if they had fluid in their ear. But fluid in the ear is common, Jackson said, and on its own doesn't require antibiotics. The new report recommends looking in the ear to see if the eardrum is bulging significantly, and assessing how much pain a child is having before considering antibiotics. If the eardrum shows moderate or severe bulging, or if it's mildly bulging and the child is in pain, antibiotics might be useful.

Strep throat is another common childhood infection that can lead to an overprescription of antibiotics. The new report recommends that doctors don't test for strep throat unless a child is showing two or more symptoms of infection. About 15 percent to 20 percent of children are carriers of strep, and will test positive for the bug even when they don't have an active infection.

Another significant concern is the use of inappropriate antibiotics for certain infections. Amoxicillin is a good first treatment for ear infections, sinus infections and strep throat. Penicillin also is a good first-line treatment for strep throat, according to the report. Broad-spectrum antibiotics aren't necessary, and have the potential to cause more side effects.

Jackson said azithromycin often is prescribed for ear and sinus infections, but it's not an effective antibiotic to treat the bacteria that cause those infections.

One pediatric expert praised the new report.

"While there are no absolutes in medicine, this report has a lot of ideas and concepts that, if applied, will decrease the use of unnecessary antibiotics," said Dr. Kenneth Bromberg, chairman of pediatrics and director of the Vaccine Research Center at the Brooklyn Hospital Center, in New York City.

Bromberg said some patients may be more likely to adopt a wait-and-see approach to taking antibiotics for an infection, such as those who have a medical home. This means they have a primary-care physician with whom they have an ongoing relationship.

On the other hand, Bromberg said, people who rely on urgent-care facilities may be less willing to see if an infection starts to get better on its own, because of the time or cost involved in having to return for care a second time if an infection doesn't improve.

The new report and recommendations were released online Nov. 18 and in the December print issue of the journal Pediatrics.

More information

Learn more about when antibiotics are needed and when they're not from the U.S. Centers for Disease Control and Prevention.

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 18, 2013 (HealthDay News) -- Giving babies solid food while still breast-feeding, and waiting until 17 weeks to do so, might protect the infants from food allergies, British researchers say.

The overlap between starting solid foods while still breast-feeding teaches the immune system that food is safe and prevents food allergies, the researchers theorized.

"Mothers should continue to breast-feed beyond introducing solids into the diet so the immune system can benefit from the immunological factors in breast milk that educate the immune system," said lead researcher Kate Grimshaw, a research fellow and allergy specialist at the University of Southampton.

"My theory was that if food allergens -- those things that infants actually become allergic to -- aren't there at the same time as the breast milk, the breast milk can't educate the immune system," she said.

The researchers said they identified when this process is likely to begin. "Introducing solid food before 17 weeks was associated with an increased risk of children developing food allergies," Grimshaw said.

Although other studies have found an association between when solid food is started and the risk for food allergies, none has established when infants are most at risk for developing food allergies, she said.

"We have pinned down the risky period as being before 17 weeks," Grimshaw said.

The report was published Nov. 18 in the online edition of the journal Pediatrics.

At least one expert questioned the conclusions, however, saying the study doesn't prove Grimshaw's theory.

Dr. Vivian Hernandez-Trujillo, director of allergy and immunology at Miami Children's Hospital, said the study supports the importance of breast-feeding, but doesn't nail down why food allergies develop.

"Unfortunately, we still don't have all the answers when it comes to food allergies," Hernandez-Trujillo said. "It appears that breast-feeding may be protective, but we still don't know why."

Why breast milk might protect children from food allergies isn't really known, she said. "It may have to do with [antibodies], but that would be totally speculative," she said.

"Breast-feeding is good for the child in many different ways, and it may be helpful in possibly preventing food allergies," she said.

For the study, Grimshaw and her colleagues looked at the diets of 41 children who developed food allergies by age 2. They compared that with foods eaten by 82 children without food allergies.

The researchers found that the children with food allergies were started on solid foods earlier (at about 16 weeks or younger) than children without allergies. They also were less likely to be breast-feeding when introduced to any form of cow's milk protein, which is found in cow's milk and some processed foods.

"This study supports the current American Academy of Pediatrics' allergy-prevention recommendations and the European Society of Pediatric Gastroenterology, Hepatology and Nutrition's recommendations on complementary feeding to not introduce solid [foods] before four to six months of age," the researchers said.

"It also supports the American Academy of Pediatrics' breastfeeding recommendations that breastfeeding should continue while solid [foods] are introduced into the diet and that breastfeeding should continue for one year or longer, as mutually desired by mother and infant," they said.

More information

For more information on breast-feeding, visit the U.S. National Library of Medicine.

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MONDAY, Nov. 18, 2013 (HealthDay News) -- The influence of just one cigarette ad can last for seven days and increases the risk of smoking among college students, according to a new study.

Over three weeks, 134 students, aged 18 to 24, in Pittsburgh documented their exposure to cigarettes ads and other pro-smoking media messages. This included seeing positive depictions of smoking in movies, for example, the researchers noted.

The students, who included both smokers and nonsmokers, also recorded how these exposures affected their smoking intentions and ability to refuse cigarettes.

Immediately after seeing a cigarette ad or other pro-smoking media message, the students' smoking intentions rose by an average of 22 percent, the study found. Although their smoking intentions decreased with each passing day, they remained elevated for seven days.

All of the students said they were exposed to numerous smoking ads and pro-smoking media message multiple times during the three-week study. In total, the students reported more than 1,000 such exposures, according to the findings published online Nov. 18 in the Journal of Adolescent Health.

"We were surprised how long the influence of pro-smoking messages lasted," study co-author Steven Martino, a psychologist at the RAND Corporation, said in a news release from the nonprofit research organization. "The results suggest that positive media messages about smoking are likely to influence behavior even if opportunities to smoke occur infrequently," he noted.

"Our findings suggest that exposures that occur before the influence of a prior message 'wears off' could cause the risk of smoking to accumulate over the long term. This might explain why exposure to these media messages can have an enduring effect on people's attitudes and behaviors toward smoking," Martino explained.

He and his colleagues noted that the study results have important implications for policies that limit tobacco advertising and other efforts meant to reduce youth tobacco use.

Cigarette ads are banned from television and radio in the United States, but are still allowed at places where tobacco is sold, in newspapers and magazines, and on the Internet.

More information

The U.S. Centers for Disease Control and Prevention has more about youth and tobacco.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 18, 2013 (HealthDay News) -- Severely obese teens are at increased risk for a host of serious health problems as adults, including asthma, kidney disease and sleep disorders, according to a new study.

"Most people understand that the longer you carry extra weight, the higher your chances of developing heart disease or diabetes," said study author Dr. Thomas Inge, professor of surgery and pediatrics at Cincinnati Children's Hospital Medical Center, in Ohio. "But now it seems that an even larger number of conditions should be added to the list of health problems that some obese teenagers will likely face down the road."

The study, published online Nov. 18 in the journal Pediatrics, included more than 1,500 severely obese American adults, aged 19 to 76. All were about to undergo weight-loss surgery. They were asked about their weight at age 18 and then assessed for medical problems related to obesity.

Forty-two percent of the participants were normal weight at age 18, the researchers found. But 29 percent were obese at 18, including 13 percent who were severely obese. Ninety-six percent of the participants had at least one obesity-related health condition.

Severe obesity was defined as a body-mass index (BMI) of 35 or greater -- 220 pounds or more for an average-height woman. BMI is a calculation of body fat based on height and weight.

The researchers found that participants who were severely obese as teens had a greatly increased risk of serious health problems compared to those who were normal weight as teens.

They were four times more likely to have swollen legs with skin ulcers; more than three times more likely to have severe walking limitations and abnormal kidney function; and much more likely to have asthma, diabetes, obstructive sleep apnea and polycystic ovary syndrome, a condition that can cause cysts on a woman's ovaries.

"As the number of children with severe obesity continues to increase, it is important for pediatricians to inform families about the short- and long-term health issues linked to this weight gain," Inge said in a medical center news release.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases explains the health risks of being overweight.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 18, 2013 (HealthDay News) -- Exposure to television and video games could play a role in the sleep problems of children with autism, new research suggests.

Boys with the neurodevelopmental disorder who have TVs and game consoles in their bedrooms get less sleep than other boys with equal screen access, the study authors found.

"If parents of children with autism are noticing that their child struggles with sleep, they might consider monitoring -- and perhaps limiting -- pre-bedtime exposure" to video games and TV, said study lead author Christopher Engelhardt, a post-doctoral research fellow at the University of Missouri Thompson Center for Autism & Neurodevelopmental Disorders in Columbia, Mo.

It's not clear if the boys in the study get too little sleep, or if they're watching TV and playing video games because they have trouble sleeping. And the findings, reported online Nov. 18 in the journal Pediatrics, don't provide insight into whether the positive aspects of TV watching and video game playing might offset any effect on sleep.

It's estimated that 1 out of every 88 U.S. children has an autism spectrum disorder, according to the U.S. Centers for Disease Control and Prevention. Symptoms include problems with communication and socialization, and can range from mild, as in Asperger's syndrome, to severe autism. Boys face a much higher risk of autism than girls.

Sleep problems appear to be a hallmark of autism.

"Some sleep problems, such as taking longer to fall asleep and waking up at night, occur in 50 percent to 80 percent of children with autism," Engelhardt said. "The reasons for these problems are numerous, including trouble with sleep cycles and regulating hormones that are important and necessary for sleep."

Compared to typically developing children, children with autism also seem to be particularly drawn to TV and video games, Engelhardt pointed out.

"We suspect that this is the case, particularly with video games, because the environments, emotions and social interactions are much easier to control and interpret than in real life," he said.

For this study, the researchers wanted to explore the possible impact of TV-watching and gaming on the sleeping patterns of kids with autism. They surveyed parents of 49 boys with an autism spectrum disorder, 38 with attention-deficit/hyperactivity disorder, and 41 who had neither disorder. The boys were between 8 and 17 years old.

When computers were in the bedroom, sleep differences were significant: about 7 hours for boys with autism compared to more than 8.5 hours for the others.

Boys with autism and a bedroom TV also got less sleep: fewer than 8 hours a night compared to about 8.5 hours for the other boys.

However, the parents weren't asked questions designed to determine if the kids weren't getting enough sleep. And the research doesn't prove that media use deprives these boys of sleep.

It's possible that boys with autism and easy access to TV and video games need less sleep, Engelhardt said. Or they might watch and play because they are awake more.

Still, it's known that sleep disturbances can worsen problematic behaviors of children with autism and interfere with learning and family functioning, the authors noted.

Sleep problems are "one of the top complaints in families who are dealing with autism," said Matthew Belmonte, a neuroscientist at Groden Center in Providence, R.I.

But parents, not professionals, are key to figuring out the proper role of TV and video games in a child's life, added Belmonte, who was not involved with the study. "You don't need an M.D. or Ph.D. to tell you when a child is just relaxing with a video game or when it's keeping that child awake unnecessarily."

Engelhardt said he enjoys playing video games himself and isn't on a crusade against them. Video games and TV can benefit children with autism, he noted.

"Researchers have known for a long time that video games are excellent teachers, so it's possible that these media can be used to develop and shape the types of behaviors generally valued by society, such as behaviors intended to help and assist others," Engelhardt said. It's even possible, he added, that relaxing video games and TV shows could help kids with autism sleep better.

More information

For more about autism, visit the U.S. National Library of Medicine.

Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- Before you stuff the turkey or prepare holiday treats, make sure you take precautions to prepare your food and store it safely after the feast is over.

The Foodsafety.gov website offers these holiday guidelines:

  • Thoroughly wash your hands, produce and all surfaces and utensils.
  • While shopping, separate raw meat and poultry from any foods that won't be cooked.
  • Use a food thermometer to make sure all meat is cooked to an appropriate temperature.
  • Reheat any sauces, gravies and soups to a rolling boil.
  • Make sure all eggs are thoroughly cooked. Use only pasteurized egg products.
  • Promptly refrigerate all leftovers at 40 degrees or below. Use leftovers within four days, or toss them out.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- Physical activity can help people with diabetes lose weight and better control their blood sugar, but there's a right time and place.

The U.S. National Digestive Diseases Information Clearinghouse explains these "do's" and "don'ts" for diabetics who exercise:

  • Do work with your health care team to find the best time of day for you to exercise.
  • Do consider factors such as your medications, meal plan and daily schedule when figuring out the best time to exercise.
  • Do exercise if you're a type 2 diabetic and your health care team recommends it.
  • Don't exercise when you have ketones in your urine or blood.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

SUNDAY, Nov. 17, 2013 (HealthDay News) -- In the future, better care for heart patients may be just a text message away.

So says a new study that found patients recovering from heart attack took more of their medicines on time when they received regular text messages reminding them to do so.

People who received the text reminders were 16 percent to 17 percent better at taking anti-clotting medicines at the right time and in the correct dosage, according to a study to be presented Sunday at the annual meeting of the American Heart Association in Dallas.

"These medications are critical because patients can have serious life-threatening complications if they don't take them," explained study lead author Linda Park, a post-doctoral fellow at the San Francisco VA Medical Center.

The study followed 90 heart patients, averaging 59 years of age, for 30 days. All of the patients had either had a heart attack, had an artery-opening stent placed into a clogged vessel, or both. One third of the patients received two medication reminder texts every day, as well as a text containing a more general heart-health tip three times a week. Another third only received the heart-health tip texts, and the last group (the "control" group) received no texts at all.

Park said a medication reminder message might read: "John, take [blood thinner] Plavix at 9 a.m. Respond with 1." Patients then had to respond to let doctors know they received the reminder.

A heart-health tip might involve trimming the fat off of meat or exercising at least 150 minutes a week, Park said.

The researchers tracked the patients' medication use via pill bottles that kept a digital record of whenever they had been opened, she said. They also asked patients to report when they had taken medications and what dosage they had taken.

Patients who received either type of text message tended to keep up with their medication schedule better than those who received no communication, the researchers found.

For example, the group who received reminders and tips had an 88 percent rate of correct doses taken, compared with a 72 percent rate for people who received no texts. The group that received only heart-health tips had a 95 percent rate of number of doses taken, compared with 79 percent for those who received no texts.

"Just having contact with these patients over the month, they did better than the control group," Park said.

She said the technology is already in place for any health care organization to provide reminder texts to patients. Her team used an automated web-based system that allowed them to enter each patients' contact information, set reminders to go out at specific times, and customize the content of each text to the specific patient.

"It was a really easy system to use, and could be of particular help targeting high-risk populations who have frequent readmissions and may suffer life-threatening complications if they don't take their medications," she said.

Researchers will continue to tweak the messaging system to see what will work best for patients. "We're still trying to figure out the frequency and duration and content we need to deliver for these patients," Park said. "It might just take three times a week, or once a week if you're going to do this life-long."

But at this time it seems as though text messaging could be an effective way to help patients help themselves by taking their medications as directed.

"Medication adherence is a really big problem that we haven't been able to solve," Park said. "I think incorporating technology is the wave of the future for everything, including medicine. This method has good potential. It's not going to solve all of our problems, obviously, but it's a very promising start."

Experts note that findings presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

More information

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

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SUNDAY, Nov. 17, 2013 (HealthDay News) -- Overweight or obese people can cut their risk of trouble with a potentially fatal irregular heart beat if they lose a lot of weight, a new study has found.

Losing a bit more than 30 pounds, on average, caused people to have fewer and less severe bouts of heart palpitations related to atrial fibrillation.

The findings were presented Sunday at the American Heart Association annual meeting in Dallas, and published simultaneously in the Journal of the American Medical Association.

Atrial fibrillation is a disorder of the electrical impulses that coordinate the beating of the heart. Rapid and disorganized electrical signals cause the heart's two upper chambers -- the atria -- to contract in a fast and irregular way. The condition can increase a person's risk of stroke and contribute to heart problems.

The new study found that people on a strict weight-management plan experienced a five-fold decrease in the severity of their atrial fibrillation symptoms, compared with those who only received nutrition and fitness advice.

The dieters also had a 4.5-times better overall decrease in symptoms and a two-and-a-half-times greater decline in episodes of atrial fibrillation, the study authors said. Symptoms can include heart palpitations, shortness of breath, dizziness, fatigue, fainting and chest pain.

"Weight loss will help most people who are overweight" with their atrial fibrillation, said study co-author Dr. Prashanthan Sanders, director of the Centre for Heart Rhythm Disorders at the University of Adelaide in Australia. "Extra weight, through so many ways, has a significant impact on the atria [upper chambers of the heart]."

For example, obesity increases inflammation and can contribute to the thickening of the heart's wall, the study authors said.

The study authors called atrial fibrillation "the epidemic of the new millennium," projecting that by 2050 between 12 million and 15 million Americans will be affected by the heart disorder. The reason: the growing obesity epidemic.

The 19-month study involved 150 people with a body-mass index (BMI) greater than 27. In general, a person with a BMI -- a ratio of weight to height -- greater than 25 is considered overweight. Someone with a BMI greater than 30 is considered obese, according to the U.S. Centers for Disease Control and Prevention.

Obesity is thought to be a major contributor to atrial fibrillation, Sanders said. "Several epidemiological studies have suggested this," he said. "There are several reasons why -- sleep apnea, hypertension [high blood pressure] and metabolic syndrome."

According to background information provided in the study, people experience a 4 percent to 5 percent increased risk of atrial fibrillation every time their BMI increases by 1 point.

For the new study, half of the participants underwent a weight-management plan that for the first eight weeks required a very low-calorie diet of between 800 and 1,200 calories per day. They received a weight-loss shake for two of their daily meals, and a third meal with high levels of proteins.

These people also had to follow a written exercise plan that prescribed low-intensity exercise like walking or cycling three times a week, starting at 20 minutes per session and gradually increasing to up to 45 minutes.

The other study participants were just provided advice on nutrition and exercise.

The people in the weight management plan ended up losing 33 pounds on average, compared with an average 12.5 pounds lost by the advice group. Along with the weight, both groups also shed symptoms of atrial fibrillation. But the weight-management group experienced significantly greater reductions in problems with atrial fibrillation.

American Heart Association Past President Dr. Gordon Tomaselli said it makes sense that losing weight would help people who are experiencing an irregular heart beat.

"Anything that increases cardiac demand can increase the risk of atrial fibrillation," he said.

Tomaselli, chief of cardiology at Johns Hopkins University School of Medicine, added that a person doesn't have to go to the extremes undertaken by the weight-management group to get some benefit.

"Time and time again, any weight loss has been shown to help people," he said. "Exercise is good for you. If you exercise more tomorrow than you did today, you're doing the right thing."

More information

For more on atrial fibrillation, visit the U.S. National Heart, Lung, and Blood Institute.

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SUNDAY, Nov. 17, 2013 (HealthDay News) -- Being physically fit can help prevent heart attacks and increase survival in people with stable coronary artery disease, a new study finds.

This was true whether or not the patients underwent a procedure to open blocked heart arteries.

Researchers analyzed data from more than 9,800 adults with coronary artery disease who underwent a treadmill stress test. They were also followed for 11 years to see if they suffered a heart attack, had undergone a procedure to open blocked heart arteries or had died from any cause.

"We measured exercise capacity, expressed as metabolic equivalents, or METs, from the patients' stress test results," study co-investigator John McEvoy, a cardiology fellow at the Johns Hopkins University School of Medicine, said in a Hopkins news release.

The researchers found that each increase of one MET in a person's exercise capacity "was associated with a 13 percent reduction in risk of death, regardless of whether they had previously had a procedure to open a blocked artery," McEvoy said.

The study was scheduled for presentation Sunday at the annual meeting of the American Heart Association, held in Dallas.

"In our study, the patients who were most fit had a 75 percent lower risk of dying from any cause compared to those who were least fit. This was true regardless of whether the patient had previous stenting or bypass surgery to open up any blocked arteries," study author Rupert Hung, a Hopkins medical student, said in the news release.

Although the study found an association between greater exercise capacity and reduced risk of complications from heart disease, it did not prove a cause-and-effect relationship.

The findings highlight the importance of exercise and fitness for people with coronary artery disease, according to the researchers.

"Our results suggest that increasing physical fitness through cardiac rehabilitation programs and exercise may be an effective supplement to medications for preventing complications associated with coronary artery disease," study senior author Dr. Michael Blaha, an assistant professor of medicine at the Johns Hopkins University School of Medicine, said in the release.

"We hope that as a result of this study, more physicians will consider prescribing physical activity as a front-line therapy to improve survival and quality of life for their patients who are able to safely exercise," added Blaha, also a cardiologist with the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease.

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

More information

The American Academy of Family Physicians has more about coronary artery disease.

-- Robert Preidt

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SUNDAY, Nov. 17, 2013 (HealthDay News) -- Heart disease is the top cause of pregnancy-related deaths in California, but almost one-third of those deaths could be prevented, a new study suggests.

"Women who give birth are usually young and in good health. So heart disease shouldn't be the leading cause of pregnancy-related deaths, but it is," lead researcher Dr. Afshan Hameed, an associate professor of clinical cardiology, obstetrics and gynecology at the University of California, Irvine, said in an American Heart Association (AHA) news release.

From 2002 to 2005, there were 2.1 million live births in California. Hameed and her colleagues analyzed the medical records of 732 women in the state who died from all causes while pregnant or within one year of pregnancy, and found that 209 of those deaths were pregnancy-related.

About one-quarter (52) of the pregnancy-related deaths were from some form of heart disease. Only 6 percent of these women who died had been diagnosed with a heart condition before the pregnancy.

Two-thirds (33) of the heart-related deaths were from cardiomyopathy, a disease in which the heart muscle is weakened and that can lead to heart failure, irregular heartbeats, heart valve problems and death.

Women most likely to die from pregnancy-related heart disease were black, obese or were substance abusers during pregnancy. Nearly one-fourth of the pregnant women who died of heart disease had been diagnosed with high blood pressure during their pregnancies.

In about two-thirds of the deaths, the diagnosis was either incorrect or delayed or doctors gave ineffective or inappropriate treatments, according to the researchers. One-third of the patients who died had failed to seek or had delayed care, 10 percent refused medical advice and 27 percent did not recognize their symptoms as heart-related.

The findings, scheduled for presentation Sunday at the AHA's annual meeting in Dallas, likely apply to the rest of the United States, according to Hameed.

"Women should attain and maintain proper weight before and during pregnancy, and talk to their doctors if they have personal or family histories of heart disease," she said.

"And health care providers should be referring pregnant women who complain of symptoms consistent with cardiac disease to specialists, especially when these risk factors are present. Women with evidence of substance abuse should receive early referral for treatment," Hameed added.

However, it is impossible to be certain whether earlier diagnosis and intervention would have prevented death in these cases "as missed cues to the presence of heart disease were common," she said.

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

Maternal death rates have been rising in California and the United States since the mid-1990s, according to the California Department of Public Health.

More information

The Cleveland Clinic has more about heart diseases and pregnancy.

-- Robert Preidt

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SUNDAY, Nov. 17, 2013 (HealthDay News) -- Children who survive cancer often have treatment-related changes to their arteries that may put them at risk for heart disease while still in childhood, a new study says.

The finding suggests doctors need to monitor these patients earlier, and manage their risk factors for heart diseases while they are still young.

"Research has shown childhood cancer survivors face heart and other health problems decades after treatment," study author Donald Dengel, a kinesiology professor at the University of Minnesota in Minneapolis, said in an American Heart Association news release. "But researchers had not, until now, looked at the heart health effects of childhood cancer treatment while survivors are still children."

The researchers assessed artery stiffness, thickness and function in more than 300 boys and girls, ages 9 to 18, who had survived at least five years since their diagnosis of leukemia or cancerous tumors. Arteries are blood vessels that take blood away from the heart.

These patients were compared with more than 200 siblings who did not have cancer.

The childhood cancer survivors were more likely to have a decline in arterial function that indicated premature heart disease, according to the study, scheduled for presentation Sunday at the annual meeting of the American Heart Association in Dallas.

The researchers also found that childhood leukemia survivors had a 9 percent decrease in arterial health after completing chemotherapy, compared to the children without cancer.

"Given this increased risk, children who survive cancer should make lifestyle changes to lower their cardiovascular risk," Dengel said. "Health care providers who are managing chemotherapy-treated childhood cancer survivors need to monitor cardiovascular risk factors immediately following the completion of their patients' cancer therapy."

The children in the study were predominantly white, so the findings might not apply to other racial and ethnic groups. In addition, the researchers were unable to link heart changes to any specific chemotherapy agent.

The five-year survival rate for childhood cancers in the United States increased from about 58 percent in 1975-77 to about 83 percent in 2003-09.

Data and conclusions presented at meetings are typically considered preliminary until published in a peer-reviewed medical journal.

More information

The U.S. National Cancer Institute talks about late effects of childhood cancer treatment.

-- Robert Preidt

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SATURDAY, Nov. 16, 2013 (HealthDay News) -- Experts agree that after someone's heart stops, the sooner CPR is started the better the chances of survival.

And now Japanese researchers report that continuing CPR for a half hour or more may help more victims survive with good brain function.

The study found that even after 38 minutes of CPR, people could still recover and have good brain function.

The findings are scheduled for presentation Saturday at the American Heart Association's annual meeting in Dallas.

Not everyone is convinced that performing CPR for longer periods is necessarily better, however.

"I think this study has to be looked at with a lot of caution. Thirty-eight minutes is a long time, even for a young patient," said Dr. Hector Medina, a cardiologist at Scott and White Healthcare in Round Rock, Texas. "In routine practice, after 30 minutes ... we give really good thought about the feasibility of continuing the resuscitation effort, particularly in older patients."

Medina said that because the study is being reported at a meeting and hasn't yet been published in a peer-reviewed journal, it's difficult to come to any firm conclusions or recommend changes to clinical practices.

To arrive at the findings, the researchers reviewed data on more than 280,000 people who had experienced cardiac arrest outside a hospital. When the patients' hearts stopped, there had been at least one other person nearby.

The researchers then narrowed that large group down to those whose hearts started beating on their own after resuscitation. Doctors call this "return of spontaneous circulation." This group included almost 32,000 people.

When the researchers examined those patients 30 days after their cardiac arrest, they found that just more than 27 percent had good brain function.

Those who had good brain function averaged 13 minutes from the moment their heart stopped until their heart started beating again on its own. Those with less favorable outcomes averaged almost 22 minutes of resuscitation efforts before their hearts started beating again.

Some people even had favorable outcomes after as long as 38 minutes of resuscitation efforts.

But, with each minute that passed when the heart wasn't beating, the odds of surviving without severe brain damage dropped by 5 percent.

Dr. Suzanne Steinbaum, a preventive cardiologist at Lenox Hill Hospital in New York City, weighed in on the findings. "This study suggests that a return to spontaneous circulation by 13 minutes offered the best neurological outcomes, and beyond 38 minutes probably won't have favorable neurological outcomes," she said.

Both experts said it wouldn't be possible for one person to do 38 minutes of resuscitation care on their own. In a hospital, Medina said, health care workers trade off every three minutes or so because CPR is a pretty intense workout.

Steinbaum also said the American Heart Association recently simplified its resuscitation care recommendations, and they're now suggesting that people practice hands-only resuscitation.

Hands-only CPR guidelines advise calling 911 and then pushing hard and fast on the center of the chest (to the beat of the song "Stayin' Alive") until help arrives. Doing hands-only CPR can double a person's chance of survival, according to the AHA.

Other research to be presented at the same meeting on Saturday found that when people at a shopping mall were shown a one-minute video detailing hands-only CPR, they were more likely to call 911 if they witnessed someone collapse. They also were more likely to initiate hands-only CPR sooner.

"Don't feel like you can't do anything," Steinbaum said. "Call for help and start compressions."

More information

Learn more about how you can save someone's life at the American Heart Association.

Copyright © 2013 HealthDay. All rights reserved.

SATURDAY, Nov. 16, 2013 (HealthDay News) -- Giving blood transfusions to severely injured patients while they're on the way to the hospital could save their lives, at least in the short term, new research suggests.

The study included 97 trauma patients who received transfusions of either plasma or red blood cells in a ground or air ambulance before they arrived at the hospital. These patients were compared with 480 trauma patients who didn't receive transfusions on the way to the hospital.

Patients who received the transfusions were 8 percent less likely to die within six hours after arriving at the hospital, compared to those in the comparison group. Those in the transfusion group were also 13 percent more likely to survive to hospital discharge, although the researchers said this was not statistically significant.

The study was scheduled to be presented Saturday at the annual meeting of the American Heart Association in Dallas.

"Earlier, effective intervention seems to have the best effect on outcomes, such as pre-hospital transfusions on trauma patients that can save lives," study lead researcher Dr. John Holcomb said in a heart association news release.

Trauma is the leading cause of death in people aged 44 and younger in the United States, and the leading cause of years of life lost, according to the researchers.

Because the 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 College of Emergency Physicians offers injury prevention tips.

-- Robert Preidt

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FRIDAY, Nov. 15, 2013 (HealthDay News) -- Although today's fathers pitch in with routine child care more than dads did a few decades ago, a new study finds that mothers are still doing more. Even when both parents work outside the home.

Researchers looking at middle-class, dual-income households found that mothers took on the majority of child care-related tasks, and were still spending more of their free time on child care than men.

"Both parents may think they should divide child care responsibilities equally, but mothers still feel a special pressure to show they are being the best parent they can be," study co-author, Sarah Schoppe-Sullivan, an associate professor of human sciences at Ohio State University, said in a university news release.

The study, published online in the December issue of the journal Family Relations, involved 182 couples living in double-income households. The researchers collected data on the parents from the third trimester of pregnancy through the first nine months of parenthood.

The couples kept diaries of both a workday and a non-workday, recording everything they did in each 24-hour period. The participants filled out this diary when their child was 3 months old and again at 9 months old.

The researchers divided parenting duties into four categories:

  • Positive engagement: parents played with, talked to or read to their child
  • Responsibility: providing indirect care, such as scheduling check-ups
  • Accessibility: supervising the child, but no other parenting activities
  • Routine care: bathing, feeding and diapering

Both mothers and fathers were highly involved with their children, the study revealed. On non-workdays, parents spent more than 2.75 hours of positive engagement with their 9-month-old babies.

Mothers, however, spent more than twice as much of their parenting time on routine care than fathers. This was true even after taking into account time spent breast-feeding and pumping breast milk.

"Mothers spent more time on the challenging but vital activities like feeding and bathing," Letitia Kotila, study lead author and a doctoral student in human sciences at Ohio State, said in the news release. "The fathers were most involved in positive engagement and accessibility which, while important, may not be as demanding as the routine care. They took on more of a helping role rather than that of the primary caregiver."

Women's greater parenting burden started soon after their baby was born, the study found. By the time their children were 9 months old, women spent almost 70 percent of their time on an average weekday, when they were not working or sleeping, on some type of child care. Meanwhile, fathers spent 50 percent of their free time on similar tasks involving their children.

"Although the mothers and fathers had similar work constraints, the mothers still invested significantly more time into parenting," Kotila noted.

The researchers added that parents are likely to keep their routines and behave the same way with additional children as they do with their first child. They advised women to be careful not to do too much and to give themselves a break.

"We have always talked about fathers doing more, but it may be that mothers should do less. They need to relinquish some control," Schoppe-Sullivan said. "Today's dads are likely doing much more child care than fathers of previous generations. But the mothers are also doing more."

More information

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

-- Mary Elizabeth Dallas

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 15, 2013 (HealthDay News) -- Reducing your consumption of certain types of fried foods can help lower the amount of a possible cancer-causing chemical in your diet, according to U.S. health officials.

Acrylamide can form in some foods -- including potatoes, cereals, crackers or breads, dried fruits and coffee -- during high-temperature cooking processes such as frying and baking. Acrylamide is found in 40 percent of the calories consumed in the average American diet, according to the Grocery Manufacturers Association.

High levels of acrylamide have been found to cause cancer in animals, which makes scientists believe that the chemical is likely to cause cancer in people as well, the U.S. Food and Drug Administration said.

"Generally speaking, acrylamide is more likely to accumulate when cooking is done for longer periods or at higher temperatures," FDA chemist Lauren Robin said in an agency news release. She added that boiling and steaming foods do not typically cause acrylamide to form.

Because it's so common in foods, it isn't feasible to eliminate acrylamide from your diet. However, there are things you can do to reduce the amount of acrylamide consumed by you and your family, Robin said.

She offered the following tips:

  • When frying frozen french fries, follow the manufacturer's recommendations on time and temperature and avoid overcooking, heavy crisping or browning.
  • Toast bread to a light brown color rather than a dark brown color. Do not eat very brown areas.
  • Cook cut potato products such as frozen french fries to a golden yellow color rather than a brown color. Brown areas tend to contain more acrylamide.
  • Don't store potatoes in the refrigerator, because this can increase acrylamide levels during cooking. Keep potatoes outside the refrigerator in a dark, cool place, such as a closet or a pantry.

Acrylamide has probably been around as long as people have been baking, roasting, toasting or frying foods. But it was only in the last 10 years that scientists first discovered the chemical in food, according to the FDA.

Since then, the agency has been investigating the effects of acrylamide as well as potential measures to reduce it.

More information

The U.S. National Cancer Institute has more about acrylamide in food.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 15, 2013 (HealthDay News) -- Bad news for caffeine addicts: That midday coffee pick-me-up might increase your odds for a sleepless night, new research shows.

The small study, which was done with caffeine pills equivalent to two or three cups of coffee, found that taking in caffeine even as long as six hours before bedtime significantly harmed sleep.

"Drinking a big cup of coffee on the way home from work can lead to negative effects on sleep just as if someone were to consume caffeine closer to bedtime," lead author Christopher Drake said in a news release from the Journal of Clinical Sleep Medicine, which published the study Nov. 15.

"People tend to be less likely to detect the disruptive effects of caffeine on sleep when taken in the afternoon," said Drake, an investigator at the Henry Ford Sleep Disorders and Research Center in Detroit.

The new study involved 12 healthy people who were normal sleepers and who were all told to continue their normal sleep schedules. Each participant, however, was given three pills per day for four days. Pills were taken at three intervals during the day: six hours before bedtime, three hours before bedtime and immediately before bedtime.

One of the three pills contained 400 milligrams of caffeine (equivalent to two or three cups of coffee) while the other two were caffeine-free placebos. On one of the four days, all three pills were a placebo.

The researchers said the participants' sleep was disrupted no matter when they took the caffeine pill. Even when they took the caffeine pill six hours before bedtime, they lost more than one hour of sleep during the night.

Drake's team said this is the first study to track the effects of a specific dose of caffeine taken at different times before bed. They said people should try to avoid caffeine after 5 p.m. if they want to get a good night's sleep.

Two experts said they weren't surprised by the findings.

"Most people have had the experience of insomnia after drinking coffee in the evening," said Dr. Len Horovitz, an internist at Lenox Hill Hospital in New York City. "This study shows that caffeine ingestion even late in the afternoon and in the evening definitely has a negative impact on sleep quality and quantity."

And Dr. Steven Feinsilver, director of the Center for Sleep Medicine at Mount Sinai Hospital in New York City, said "many of us are unaware of the amount [of caffeine] we consume routinely. Caffeine has an effect on both getting to sleep and staying asleep, and the effects may last up to 12 hours."

"One of the first things any poor sleeper should do is limit caffeine, particularly after noon or least eight hours before bedtime," Feinsilver said.

What about that morning brew to clear out the cobwebs? Horovitz said that's probably still fine. "Morning coffee drinking does not appear to affect sleep, and should probably be the limit on caffeine intake," he said.

More information

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

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 15, 2013 (HealthDay News) -- If you need a corneal transplant to improve your vision, don't worry too much about the donor's age, a new study says.

According to new research, corneas from 71-year-old donors are as likely to be as healthy as those from donors half that age a decade after their transplant.

The cornea, the outermost layer of the eye, is the clear window that allows light into the eye and helps focus it. Damage to the cornea caused by injuries or infections, inherited conditions, or complications of cataract surgery can lead to blurred vision. A corneal transplant is performed when vision problems or discomfort from corneal damage cannot be corrected with lenses or medication.

The new study included 663 people who received corneal transplants. After 10 years, the overall transplant success rate held at 75 percent for corneas from donors aged 34 to 71. But differences were noted when the researchers looked at smaller age groups. Success rates for corneas from the youngest pool -- donors age 12 to 33 -- were 96 percent, but only 62 percent for donors aged 72 to 75.

The study began in 2000, and at that time, many surgeons would not accept corneas from donors over 65 years of age, the researchers noted in a news release from the U.S. National Eye Institute (NEI).

The findings from the U.S. National Institutes of Health-funded study were published online Nov. 15 in the journal Ophthalmology. The study was presented the same day at a meeting of the Eye Bank Association of America and the Cornea Society in New Orleans.

"Our study supports continued expansion of the corneal donor pool beyond age 65," study co-chair Dr. Edward Holland, professor of ophthalmology at the University of Cincinnati, said in a NEI news release.

"We found that transplant success rates were similar across a broad range of donor ages," added Holland, who is also director of the Cornea Service at the Cincinnati Eye Institute.

Maryann Redford, a clinical research program director at NEI, pointed out that the supply of corneas does not meet the demand internationally. The need for corneal transplants is expected to grow along with the aging population, she said in the news release. The study "was designed to address whether making use of donor corneas across the full range of ages available might help solve this problem," Redford added.

More information

The Eye Bank Association of America has more about corneal transplantation.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 15 , 2013 (HealthDay News) -- Death rates from pancreatic cancer in the United States are increasing among whites and decreasing among blacks, but rates among blacks remain much higher than among whites, study findings show.

Researchers from the American Cancer Society analyzed data on pancreatic cancer deaths in the United States between 1970 and 2009. Rates among white men decreased by 0.7 percent per year from 1970 to 1995, and then went in the opposite direction -- increasing 0.4 percent per year through 2009.

Rates among white women rose slightly between 1970 and 1984, stabilized until the late 1990s, then increased 0.5 percent per year through 2009, according to the study published online Nov. 7 in the Journal of the National Cancer Institute.

Pancreatic cancer death rates among blacks increased between 1970 and the late 1980s for women and in the early 1990s for men, and then began to fall. However, death rates remained substantially higher among black men and women than among white men and women, the investigators found.

The researchers said the disparities in pancreatic cancer death rates between blacks and whites are not fully explained by differences in smoking rates, which have decreased among blacks and whites since 1965. Smoking is one of the major causes of pancreatic cancer.

This suggests that other factors may be affecting pancreatic cancer death rates, the study authors pointed out in an American Cancer Society news release.

"This study underscores the need for urgent action on several fronts," study senior author Ahmedin Jemal said in the news release. "We need to invest more into pancreatic cancer research to understand why this disease is rising or falling in different races. In the meantime, we have to address modifiable risk factors such as obesity and smoking to reduce the future burden of pancreatic cancer in all populations."

Pancreatic cancer is the fourth leading cause of cancer death in the United States and it is estimated that it will cause more than 38,000 deaths in 2013, according to the news release. While deaths from most other major cancers have been dropping for more than two decades, deaths from pancreatic cancer have been rising.

Smoking, obesity and eating red or processed meat have been linked to the disease, but not much is known about its major causes. Other lifestyle-related risk factors may include low vegetable and fruit consumption, physical inactivity and alcohol use.

More information

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

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 15, 2013 (HealthDay News) -- Posting the calorie content of menu items at restaurants is designed to make diners stop and think, tally up the total and make wiser choices.

In real life, that doesn't seem to be the case, according to new research.

In a poll of 2,000 Philadelphia fast-food customers, aged 18 to 64, few used the information, even if they noticed it, said study author Brian Elbel, an assistant professor of population health and health policy at the NYU School of Medicine.

"Forty percent of the sample saw it and about 10 percent [overall] said they used it and reported to us that they purchased fewer calories," he said.

The study is published in the November issue of the journal Obesity. Elbel is scheduled to present the findings Friday at the Obesity Society's annual meeting in Atlanta.

Elbel's team collected receipts from customers at McDonald's and Burger King restaurants and asked them a series of questions. These included how often they visited fast-food restaurants, if they noticed the calorie information and if they used it. They did that before and after February 2010, when the Philadelphia calorie-count label law went into effect.

At the same time, a telephone survey was done of other Philadelphia residents asking them if they ate at fast-food restaurants and if they noticed the calorie labeling.

The researchers also surveyed customers of both chains in Baltimore, a city that does not mandate calorie labels.

Elbel found no differences in the number of visits or calories purchased after the policy went into effect in Philadelphia. The amount of calories in food purchased and the number of fast-food restaurant visits did not change much at all in either city over time.

Philadelphia residents reported eating nearly six times a week at a fast-food chain before the law and about seven times after. Baltimore residents ate at a fast-food chain about seven times a week both before and after.

Under the U.S. health law known as the Affordable Care Act, restaurant chains with 20 or more locations nationally must post the calorie content of all regular drink and food items on their menu board or on printed menus. Final regulations on that provision are pending from the U.S. Food and Drug Administration, Elbel said.

The provision is meant to help stem the obesity epidemic. Currently, one-third of Americans are obese, raising their risk of heart disease, diabetes and other health problems.

In general, obesity rates are higher among minorities. In the survey, 70 percent of those polled were black.

Elbel can't completely explain the findings. However, he said, "it is hard to counteract the fact that fast-food is cheap and tastes pretty good."

He does not think it's time to abandon the calorie-label idea. Rather, he views it as one way to help people make wiser choices, along with many other strategies.

One expert not involved with the study said the calorie-label program may need to go further.

"Providing calorie information is not enough," said Alice Lichtenstein, a distinguished professor of nutrition science and policy at Tufts University. "If we want people to use the information, we need to raise awareness about its availability and most importantly, educate about its use."

This is especially crucial, she said, for those who haven't put a high priority on good nutrition.

Lichtenstein suggested a study that looks at the effects of an informational campaign on the use of calorie labels. Other research, she said, indicated that ''those people who report using the calorie labeling order fewer calories."

More information

To learn more about how to make healthy food choices, visit the U.S. National Heart, Lung, and Blood Institute.

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 15, 2013 (HealthDay News) -- Only about one-quarter of orthopedic trauma surgeons have the training needed to recognize broken bones caused by domestic abuse, according to new research.

And many of these bone specialists significantly underestimate how often these types of injuries occur among their patients, even though they treat many victims of this kind of violence, the study authors noted.

"In the United States, most orthopedic surgeons receive training in techniques for recognizing signs of child abuse, but training to recognize abuse of adults is far less common," Dr. Gregory Della Rocca, an associate professor of orthopedic surgery at the University of Missouri School of Medicine, said in a university news release.

Della Rocca's team surveyed 153 orthopedic trauma surgeons, mostly in North America. The surgeons were asked about medical professionals' ability to recognize and respond to signs of intimate-partner violence, and whether that's important. They were also questioned regarding their beliefs about the causes of domestic violence. In addition, they were asked to estimate how many of their patients suffered domestic-violence injuries.

A recently published study found that 40 percent of North American patients at orthopedic trauma clinics have experienced domestic violence. However, this University of Missouri survey found that 74 percent of orthopedic surgeons estimated that only 5 percent or less of their patients were victims of domestic abuse.

"In our study, we found that most orthopedic surgeons believe identifying injuries caused by domestic violence is an important aspect of providing medical care, and they also believe that receiving education to recognize signs of intimate-partner violence could help them to stop violence in some cases," Della Rocca said.

However, "only 23 percent of the surgeons we surveyed had received any training on recognizing and responding to intimate-partner violence," he added.

The study was recently published in the journal Clinical Orthopaedics and Related Research.

"Based on our research about the high prevalence of intimate-partner violence among orthopedic trauma patients and the misconceptions about how common it actually is, I encourage orthopedic surgeons to seek out education on the topic and learn about community resources where they can refer patients for help," Della Rocca suggested.

About 30 percent of women in North and South America suffer domestic violence at some point in their lives, according to the World Health Organization. In North America, domestic violence also is the most common cause of nonfatal injuries among women, often resulting in broken bones.

More information

The American Academy of Family Physicians has more about domestic violence.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

How to Handle a Child's Seizure

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FRIDAY, Nov. 15, 2013 (HealthDay News) -- Seeing a child suffer a seizure can terrify a parent. As part of Epilepsy Awareness Month in November, an expert offered some advice on how to deal with such a situation.

All first seizures in children require a medical evaluation, said Dr. Adam Hartman, a pediatric neurologist and epilepsy expert at Johns Hopkins Children's Center in Baltimore.

"If this is the first time your child is having a seizure, seek emergency medical care," he said in a Johns Hopkins news release.

Children with known epilepsy who have a breakthrough seizure -- one that occurs despite treatment -- do not typically require urgent medical attention unless:

  • The seizure lasts more than five minutes.
  • The seizure looks different from previous seizures.
  • Several seizures occur in a cluster.
  • The child remains unconscious for a few minutes following the seizure.
  • The child struggles for air and is not getting enough oxygen, signaled by bluish lips or complexion.

The symptoms listed above may mean that the child is going into status epilepticus, a persistent, severe and life-threatening seizure that always requires emergency treatment, Hartman said.

During a seizure, don't put anything in the child's mouth and don't try to hold the child down. Clear the surrounding area and have the child lie on one side, rather than flat on their back, Hartman said. You can put a small pillow under the child's head.

After the seizure ends, allow the child to rest and check for injuries. Do not give the child anything to eat or drink until fully alert. Note the length of the seizure and the date and time it occurred.

Keep a seizure diary and inform the child's neurologist or primary-care pediatrician about all seizures. Pay attention to what might have triggered the seizure. Sleep deprivation, high fever, illness, and emotional or physical stress increase seizure risk among children with epilepsy.

"Children respond individually to stressors, so it's important to notice the factors that precipitate a seizure in your child and avoid them when and if possible," Hartman said.

Epilepsy, an umbrella term that encompasses more than 40 seizure disorders, affects nearly 3 million people in the United States. More than 320,000 of them are children under 15, according to the Epilepsy Foundation. About 45,000 children in the United States develop epilepsy each year.

More information

The Epilepsy Foundation has more about epilepsy.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 15, 2013 (HealthDay News) -- No link seems to exist between the common eye condition known as age-related macular degeneration and either dementia or Alzheimer's disease, a large new study shows.

Age-related macular degeneration is a leading cause of vision loss among people aged 50 and older, according to the U.S. National Eye Institute. The condition leads to damage to the macula, which is a small spot near the center of the retina. The macula is needed for sharp central vision, which allows people to see objects straight ahead of them.

Dementia, Alzheimer's disease and age-related macular degeneration are all strongly associated with aging. These conditions share risk factors such as smoking, high blood pressure and high cholesterol. However, the genetic risk factors for the eye condition and Alzheimer's or other dementia seem to be different, according to study background information.

British researchers examined whether people with age-related macular degeneration were more likely to develop dementia/Alzheimer's or vice versa. The study included nearly 66,000 patients with the vision condition, more than 168,000 patients with Alzheimer's or other dementia, and more than 7.7 million people in a comparison group.

The results showed that people with macular degeneration condition did not have an increased risk of Alzheimer's or other dementia. The report is published online Nov. 14 in the journal JAMA Ophthalmology.

However, patients with dementia appeared to be less likely to receive treatment for their macular degeneration. Several factors may contribute to this. One might be that people with dementia are less likely to get eye exams, the researchers said in a journal news release.

"These data provide evidence that there is no positive association between [age-related macular degeneration] and dementia or [Alzheimer's disease]," wrote Tiarnan Keenan, of the University of Manchester, and colleagues.

"However, people with dementia in England are substantially less likely to undergo treatment for [the vision condition] than those without dementia," they added. "Potential barriers to care for these vulnerable individuals need to be examined and addressed in the near future."

More information

The U.S. National Eye Institute has more about age-related macular degeneration.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 15, 2013 (HealthDay News) -- Dogs are practically part of many human families, but it wasn't always that way.

At some point in history, biologists think humans figured out how to tame wolves. Over time, the ones that lived with humans evolved to have traits more suited to being treasured pets than fearsome predators.

Exactly when and where that process began has been the subject of fierce debate. Now, research from Finland moves the origins of the dog-human bond far back in history, to the hunters of ancient Europe.

"There have been a lot of studies looking at this question," said Kathryn Lord, an evolutionary biologist who studies the origins of dog and wolf behavior.

"A lot of different people have a lot of different answers, and they all disagree with each other, of course," said Lord, who is currently an adjunct professor at Gettysburg College, in Pennsylvania.

Previous studies comparing genetic material from ancient and modern dogs claimed that the first dogs began to be domesticated by farmers in the Middle East or Asia about 15,000 years ago.

Today a new study, published in the Nov. 15 issue of Science, suggests yet another point of origin for man's best friend.

By comparing genetic material from ancient and modern dogs and wolves, an international team of researchers says it looks more likely that dogs were first domesticated earlier than was previously believed.

"All our modern dogs have some roots in Europe," said Olaf Thalmann, a postdoctoral research fellow at the University of Turku, in Finland. "What we think is likely is that it happened something like 19,000 to 32,000 years ago."

During that time, humans were nomadic. They hunted and gathered food to survive. So if that's when wolves were first tamed, Thalmann believes both species somehow began to use each other to track and kill food.

"One could easily imagine that there was a mutually beneficial relationship between dogs and humans," he said. "You can think the wolf might have benefited from the leftovers at hunting sites. On the other hand, humans might have been benefiting from wolves [being] around during hunting," Thalmann added. Wolves might have driven animals in a certain direction, or helped to protect humans from other predators.

There is some precedent for the idea that two species can work together to hunt. A 1992 study from the University of California, Davis, found that coyotes and badgers work together to hunt small animals like ground squirrels. The coyote chases down the prey while badgers plug the underground escape routes to keep the small animals from getting away. The relationship increases their mutual hunting success. The pairs catch about a third more animals together than if they go it alone.

Still, Lord thinks it's unlikely that humans domesticated the dog to help with hunting. One theory is that ancient humans began to raise wolf puppies and started to select the most docile animals among them.

"It doesn't ring true to me. I've raised wolf puppies. And that's a really difficult process in order to do it properly," explained Lord, who was not involved with the new study.

She thinks early humans probably didn't have the resources to make sure young wolves got regular feedings of first milk and then regurgitated meat -- their standard diet.

"That's a lot of energy to put into something. You're already living on the edge of survival yourself," Lord noted.

"We don't see any evidence of any of this happening, either," she added. "We don't see hundreds of baby wolves near humans. It's just not in the archeological evidence."

Lord offers the alternative theory, that dogs domesticated themselves by beginning to eat human garbage after humans settled down to become farmers.

"When we sit in one place, we generate a lot of garbage and refuse," she pointed out. "And that, to this day, is a really valuable niche for a lot of animals. A lot of animals can survive by eating our garbage."

What's more, she added, most gene studies are based on faulty assumptions about what gene changes in dog and wolf DNA mean. She said that experts have poked holes in many such gene studies.

"It's always good to go out and look. It's great that they went out and gathered the data," Lord said.

However, "I don't think it's gotten us any closer to understand where dogs come from," she concluded.

More information

For more on dog evolution, head to the Public Broadcasting Service.

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 15, 2013 (HealthDay News) -- Breast cancer in men occurs only rarely. But among men who have breast cancer, mastectomy rather than breast-conserving surgery is by far the more common choice, new research shows.

Scientists used a national database to compare treatment and outcomes between women and men with breast cancer. They found that males undergo mastectomy surgery far more often than females -- a whopping 87 percent of the time for men, compared with 38 percent for women.

Less than 5 percent of men diagnosed with early stage disease received a breast-conserving lumpectomy, according to the study. However, their survival rates didn't differ significantly from the 70 percent treated with mastectomy.

"I hope people will know there's a data set showing it's an appropriate [option] for select men with early stage breast cancer to undergo breast-conserving surgery," said study author Dr. Rachel Rabinovitch, a professor of radiation oncology at the University of Colorado School of Medicine. "That most men are treated with mastectomy for early stage breast cancer is not surprising, but this was a nice opportunity to compare outcomes and raise that issue."

The researchers said the study is among the largest to track how male breast cancer is treated in the United States. It was published in the November issue of the International Journal of Radiation Oncology, Biology and Physics.

About 0.6 percent of the 240,000 cases of breast cancer diagnosed each year in the United States occur in men, typically among those between 60 and 70 years old. Between 400 and 500 men die of the disease each year, according to the U.S. National Cancer Institute.

Breast cancer risk factors for men include radiation exposure, family history and unusually high estrogen levels.

For the study, Rabinovitch and her team used a National Cancer Institute database with treatment information from about 4,200 cases of male breast cancer and more than 700,000 cases of female breast cancer collected between 1973 and 2008.

The study also suggested that radiation therapy may be underused in men. Only 34 percent of the men in the study with locally advanced disease -- which had spread to the area surrounding the breast but not to distant organs -- were treated with radiation following mastectomy. However, 45 percent of women with similar disease received radiation.

Dr. Otis Brawley, chief medical officer at the American Cancer Society, said he thinks men are typically less concerned about losing their breast tissue, leading more male breast cancer patients to choose mastectomy over lumpectomy.

"If you do a mastectomy in a man, he still has the same shape and contour of his chest that most men have," Brawley said. "Many men have a little bit of breast tissue as they age, and it's undesirable. It's an opportunity to have that removed."

But Rabinovitch disagreed. Although most men are flat-chested, she said, "a mastectomy scar is typically an enormous scar" and can trigger psychological or sexual issues in men who are concerned about their appearance.

"I think we've also overlooked the medical issues," Rabinovitch said. "Mastectomy requires longer anesthesia times. Patients leave the hospital with a drain [from the surgical incision]."

Brawley said the study serves as a useful reminder that breast cancer isn't a female-only disease.

"We do need to realize that while it's a small percentage, men do get breast cancer," he said, adding that most men are diagnosed after finding a lump. "They do have nodules or masses that they feel in their breast and may ignore them when they should not."

More information

Visit the U.S. National Cancer Institute to learn more about male breast cancer.

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 15, 2013 (HealthDay News) -- A device implanted within the skull to help reduce the frequency of epileptic seizures has been approved by the U.S. Food and Drug Administration.

The RNS Stimulator is placed under the scalp and sends electrical pulses to the part of the brain where seizures are suspected to originate, the agency said in a news release.

Epilepsy, estimated to affect nearly 3 million people in the United States, is the third most common neurological disorder behind Alzheimer's disease and stroke. Some 40 percent of those treated for epilepsy continue to have seizures, the FDA said.

Approval for the new device was based on clinical studies involving 191 people with drug-resistant epilepsy. Three months after the device was implanted, participants had about 38 percent fewer seizures per month compared to a 17 percent decrease in seizures among people who had the implanted device turned off, the FDA said. The most common adverse reactions included implant site infection and premature battery discharge.

People who have had the device implanted cannot have magnetic resonance imaging (MRI) or similar procedures, which could lead to permanent brain damage, the FDA noted.

The RNN Stimulator is produced by Neurospace Inc., based in Mountain View, Calif.

More information

For more about epilepsy, visit the U.S. National Institute of Neurological Disorders and Stroke.

-- Scott Roberts

Copyright © 2013 HealthDay. All rights reserved.

Health Highlights: Nov. 15, 2013

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

Obama Nominates Health Care Law Backer To Be Surgeon General

An early supporter and advocate for the Affordable Care Act has been nominated by President Barack Obama to be the country's next surgeon general.

Dr. Vivek Murthy is founder and president of Doctors for America, a group that campaigned for the controversial health care law before Congress passed it in 2010. He is a doctor at Brigham and Women's Hospital in Boston and an instructor at Harvard Medical School, The New York Times reported.

He also has been a leader in HIV prevention and AIDS education in both the U.S. and India.

Murthy "will be a powerful messenger" on health policy, according to a statement release Thursday by White House spokesman Jay Carney. His nomination is subject to Senate approval.

The previous surgeon general, Dr. Regina Benjamin, left her post in July to return to work at a clinic she founded in Bayou La Batre, Ala. Since then, Dr. Boris Lushniak has been acting surgeon general, The Times reported.

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New Drug for Rare Blood Cancer Approved by FDA

A new drug to treat a rare and aggressive form of blood cancer was approved Wednesday by the Food and Drug Administration.

Imbruvica was approved for patients with mantle cell lymphoma who have already undergone at least one previous drug treatment. This type of cancer typically begins in the lymph nodes but has usually spread to the bone marrow and other parts of the body by the time it's diagnosed, the Associated Press reported.

The new once-a-day capsule blocks a protein that enables the cancer to multiply and spread. The FDA's approval is based on a study of 111 patients. Tumors shrank or disappeared in 66 percent of the patients who took Imbruvica. However, it's not clear if the drug actually prolongs patients lives.

The new drug from Pharmacyclics and Janssen Biotech Inc. is the second to be approved under the FDA's breakthrough designation, which was approved by Congress last year. The classification is meant to accelerate development of promising drugs by giving companies additional meetings and earlier communication with FDA scientists, the AP reported.

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Car Mechanic Develops Birth-Assist Device

An Argentine car mechanic's device to ease difficult births has been endorsed by the World Health Organization and other major donors, and has been licensed for production by an American medical technology company.

Jorge Odon, 59, said the idea for the Odon Device came to him after watching a YouTube video about how to extract a cork trapped in a wine bottle. He realized that the same approach could be used to save a baby stuck in the birth canal, The New York Times reported.

Odon built the first prototype in his kitchen. He used a glass jar for a womb, his daughter's doll for the trapped baby, and a fabric bag and sleeve sewn by his wife as his lifesaving device.

With the actual device, an attendant slips a plastic bag inside a lubricated plastic sleeve around the head, inflates it to grip the head and pulls the bag until the baby emerges, The Times reported.

The device has enormous potential to save babies in poor countries, and perhaps to reduce cesarean section births in rich nations, according to doctors.

"This is very exciting," Dr. Mario Merialdi, the WHO's chief coordinator for improving maternal and perinatal health, told The Times. "This critical moment of life is one in which there's been very little advancement for years."

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 15, 2013 (HealthDay News) -- Beyond slimming the waistlines of morbidly obese patients, weight-loss surgery also may help reverse the aging process in some patients, turning back the clock on a key sign of decline in the body's cells, a small, early study suggests.

Investigators said the finding could be an unforeseen positive side effect of invasive weight-loss (bariatric) surgery for some people with cholesterol and inflammation problems. Such surgery comes in a variety options, all designed to prompt a dramatic shedding of pounds following intestinal rerouting or a reduction in stomach size.

The upshot: One year following weight-loss surgery, some patients were found to experience a notable lengthening of the ends of their genes' tips or caps, referred to as "telomeres." The wearing down and shortening of telomeres over time has long been viewed as a genetic indicator for aging. Meanwhile, longer telomeres have been associated with health and youthfulness.

"We know that we age on a genetic level," said study co-author Dr. John Morton, chief of bariatric and minimally invasive surgery at the Stanford University School of Medicine. "It's not just about wrinkles. It's the whole system, in which our body replaces cells continuously. The more they divide over time -- or the sicker you are -- the more the ends get frayed. Like a cap on a shoelace.

"But now we found that some -- not all, but some -- obese patients who lost a lot of weight after surgery saw significant improvements in telomere length," Morton added. "This is a pretty unique finding that we haven't seen before."

Morton is scheduled to present the findings Friday at Obesity Week, the annual meeting of weight-loss surgeons and other obesity specialists, held in Atlanta.

In recent years, bariatric surgery has taken its place alongside diet and exercise as a possible intervention for those struggling to lose weight, particularly among the morbidly obese. Morbidly obese is defined as those people with a body-mass index (BMI) of at least 40. BMI is a measurement of body fat based on a ratio of height to weight.

For their current effort, Morton and his colleagues focused on 51 bariatric surgery patients, with an average BMI of about 44. On average, the patients were just shy of 49 years old, and more than three-quarters were women.

The researchers saw that by the one-year mark following surgery, patients had lost an average of 71 percent of so-called "excess" weight.

Such dramatic weight loss appeared to have a positive impact on key measures of health. For example, a year after surgery, patients' levels of C-reactive protein (CRP) -- a sign of inflammation -- had plummeted by more than 60 percent on average. Those who previously had high levels of so-called "bad" LDL cholesterol also saw their numbers drop. Meanwhile, fasting insulin levels decreased to just a quarter of what they had been pre-surgery, suggesting a lower risk for type 2 diabetes.

But blood tests conducted at three, six and 12 months post-surgery revealed that, among the group as a whole, telomere length did not change all that much.

However, patients who had relatively high levels of both CRP and LDL cholesterol before the surgery did see a significant lengthening of their telomeres, when compared to those with low CRP and LDL levels pre-surgery.

"All the patients lost weight and showed big improvements in cardiac health," Morton said. "But those who had very high inflammation and bad cholesterol before surgery were found to have longer telomeres following surgery, when inflammation and bad cholesterol went down. And the lengthening wasn't so subtle. We're talking about real, significant improvements."

"What this suggests is that some bariatric surgery patients are metabolically receptive to positive change that can improve markers for aging at a genetic level," he said.

Morton said more longer-term research is planned.

Joseph Lee, associate professor of clinical epidemiology at the Columbia University Mailman School of Public Health, in New York City, reacted to the current findings with a degree of skepticism.

"Number one, it's a very small sample of patients," said Lee, a human geneticist. "It's difficult to make too much out of this. And number two, they measured telomere length within just 12 months of surgery. Now some people show telomere lengthening with age. Even some cancer patients show telomere lengthening. So is what they're seeing a true biological effect resulting from radical surgery, or is it due to a certain amount of experimental error?

"It's a very complicated issue, and I don't think it's really clear what this finding means," Lee said. "It's certainly an interesting concept. But it remains to be seen in follow-up, with a larger sample over a much longer period of time, what's really going on."

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

For more on weight-loss surgery, visit the U.S. National Library of Medicine.

Copyright © 2013 HealthDay. All rights reserved.

FRIDAY, Nov. 15, 2013 (HealthDay News) -- Boys are 14 percent more likely than girls to be born prematurely, and preterm boys have a greater risk of disability and death than preterm girls, new research finds.

These disabilities range from learning problems, blindness or deafness, to motor problems such as cerebral palsy, according to the authors of six studies published in the journal Pediatric Research in advance of World Prematurity Day on Nov. 17.

"Baby boys have a higher likelihood of infections, jaundice, birth complications and congenital conditions, but the biggest risk for baby boys is due to preterm birth," research team leader Dr. Joy Lawn, a professor and neonatologist and epidemiologist at the London School of Hygiene & Tropical Medicine in England, said in a journal news release.

"For two babies born at the same degree of prematurity, a boy will have a higher risk of death and disability compared to a girl," Lawn said. "Even in the womb, girls mature more rapidly than boys, which provides an advantage, because the lungs and other organs are more developed," she explained.

"One partial explanation for more preterm births among boys is that women pregnant with a boy are more likely to have placental problems, pre-eclampsia [a serious complication], and high blood pressure," conditions which are all associated with preterm births, Lawn added.

However, the study authors pointed out, preterm girls are more likely than boys to die in the first month of life in some countries where girls receive less nutrition and medical care than boys.

The risk of disability and death varies depending on where a preterm baby (less than 37 weeks' gestation) is born, the investigators found. More than 80 percent of preterm infants in high-income countries survive and thrive. The risk of death and disability is greatest for those born at less than 28 weeks.

In middle-income countries, the risk of disability for infants born at 28 to 32 weeks is double that of those in high-income countries. In low-income countries, preterm babies are 10 times more likely to die than those in high-income countries. Death is twice as likely as disability for preterm babies in these countries.

For the study, the researchers analyzed data from more than 15 million preterm babies worldwide. Of the 13 million who survived beyond the first month of life, 4.4 percent had mild disability and 2.7 percent had moderate or severe disability.

The largest number of problems among preterm infants occurred in low-income countries in South Asia and sub-Saharan Africa, where 2.2 million died and more than 600,000 had some degree of disability, according to the study findings.

India had the greatest number of preterm births at over 3.2 million. China had less than half that number -- 1.3 million -- followed by Nigeria, Pakistan and Indonesia. The United States recorded nearly 498,000 preterm births.

Malawi had the highest rate of preterm birth at 18.1 per 1,000 live births, the report noted.

More information

The American Academy of Pediatrics outlines health issues faced by premature babies.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- Strep throat is a bacterial infection that causes a severe sore throat, which can make swallowing and eating quite painful.

The Nemours Foundation suggests how to soothe the pain of strep throat in children:

  • Offer fluids such as ginger ale or water, but avoid acidic beverages such as orange juice, lemonade or grapefruit juice.
  • Feed your child warm soup.
  • Give your child warm sweetened tea or hot chocolate.
  • Make sure your child finishes any prescription antibiotic.
  • Encourage your child to cover the nose and mouth when coughing or sneezing. Do not share utensils with your child.
  • Ask your child's doctor when he or she can return to school.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

Health Tip: Cutting Down on Fat

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(HealthDay News) -- Cutting back on dietary fat can help you lose weight and improve your heart health.

The Cleveland Clinic suggests how to choose lower-fat foods:

  • Read product labels, and opt for those titled nonfat, low-fat or reduced fat.
  • Focus on total fat consumed for the day, instead of fat in a specific food.
  • Stick to lean cuts of meat. Aim to eat less than 6 ounces of meat per day.
  • Choose low-fat proteins, such as tofu, dried beans and peas, low-fat dairy products and water-packed tuna.
  • Drink 1 percent milk or skim milk, and eat reduced-fat or nonfat spreads and cheeses.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

Schools Can Set Tone for Healthy Eating

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THURSDAY, Nov. 14 (HealthDay News) -- Offering students healthier food choices at school helps improve their eating habits, a new study suggests.

The research included 55 middle schools in Michigan with mostly low-income students. Some of the schools made only limited changes to their nutrition policies and practices, while others introduced major changes.

Some of the new programs included raising nutrition standards for snacks and beverages, offering taste tests of healthy foods and beverages to students, marketing healthy foods in school, and removing ads for unhealthy foods.

In schools that introduced three or more new nutrition practices and policies, students ate 26 percent more fruits, 14 percent more vegetables and 30 percent more whole grains. They also increased their consumption of fiber, calcium and vitamins A and C, according to the study, which was published online Nov. 11 in the journal Childhood Obesity.

The findings suggest that new federal nutrition standards for schools that are scheduled to take effect during the 2014-'15 school year may help improve students' eating habits.

The U.S. Department of Agriculture standards will set limits on calories, salt, sugar and fat in foods and beverages, and promote snack foods with more whole grains, low-fat dairy, fruits and vegetables.

"When healthy food options are offered, students will select them, eat them and improve their diet," study author Katherine Alaimo, an associate professor in the department of food science and human nutrition at Michigan State University, said in a Robert Wood Johnson Foundation news release.

The foundation funded the study through its Healthy Eating Research program.

Contributing study author Shannon Carney Oleksyk, a registered dietitian and healthy living adviser for Blue Cross Blue Shield of Michigan's social mission, added: "Creating school environments where the healthy choice is the easy choice allows students to practice lessons learned in the classroom and form healthy habits at an early age, laying a foundation for a healthy future."

More information

The U.S. Centers for Disease Control and Prevention has more about school nutrition for children and teens.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, Nov. 14 (HealthDay News) -- Although breast cancer treatments have dramatically improved outcomes for women with the disease, ongoing pain continues to trouble many survivors long after they undergo a mastectomy, a new study finds.

In conducting the study, researchers examined 611 women who had a partial or total mastectomy to determine which factors contributed to their pain following the surgery. Those factors included tumor size, stress or demographics. The women had also received chemotherapy and radiation with or without hormone therapy.

One-third of the women reported persistent pain in their breast, underarm, side or arm that had not improved in the three years following their surgery.

Researchers Dr. Inna Belfer, an associate professor of anesthesiology at the University of Pittsburgh, and her colleagues found no evidence that the type of mastectomy a woman had, the size of her tumor or treatment side effects were associated with pain following surgery, according to a journal news release.

Instead, certain psychological factors were implicated -- with anxiety, depression and trouble sleeping linked to ongoing pain following a mastectomy.

The study also found that "somatization," or psychological distress that is expressed as physical pain, was related to persistent pain after the procedure. The same held true for "catastrophizing," or a tendency to fixate about pain and feel unable to cope with it, the researchers said.

The study findings were published in a recent issue of the Journal of Pain.

More information

Visit the American Cancer Society to learn more about mastectomy.

-- Mary Elizabeth Dallas

Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, Nov. 14 (HealthDay News) -- The U.S. Food and Drug Administration on Thursday gave its approval to a new implanted device that lowers the rate of seizures among people with epilepsy.

"The neurostimulator detects abnormal electrical activity in the brain and responds by delivering electrical stimulation intended to normalize brain activity before the patient experiences seizure symptoms," Christy Foreman, director of the Office of Device Evaluation in the FDA's Center for Devices and Radiological Health, said in an agency news release.

Kelly O'Brien, 28, has epilepsy and said the device -- called the RNS Stimulator -- has been life-changing.

"It has given me an independence I did not have before," said O'Brien, who lives in Columbus, Ohio. "Since getting the device, my seizures have stopped and I am doing things I was not able to do in the past. The biggest thing is, I'm now able to drive again."

Smaller and thinner than an implantable heart defibrillator, the battery-powered, programmable device is placed just under the skull during surgery. Electrodes reach from the device to the one or two places in the patient's brain that create the abnormal electrical activity that causes seizures. The RNS System, made by California-based company NeuroPace, works by short-circuiting nerve cells in that area to normalize brain activity before a seizure is triggered.

The FDA decision follows a unanimous vote in February in favor of the device by an FDA panel that assessed its effectiveness and safety. According to the FDA, the new pre-marketing approval granted to the RNS System was based on a three month clinical trial involving 191 patients whose epilepsy had not responded to drug therapy.

The study found that patients with a switched-on device saw their rate of monthly seizures fall by an average 38 percent, compared to a 17 percent reduction among patients who had received the implant but had had it switched off. For some patients, the device worked especially well, according to the FDA -- 29 percent of patients with a switched-on device saw the number of seizures they experienced per month fall by half.

Reductions in seizure frequency linked to the RNS System continued over a 2-year follow-up period, the agency added.

"These are patients who have no other resort for treatment of their epilepsy, and this device offers new hope for them," said Dr. Dileep Nair, an epileptologist and Section Head of the Cleveland Clinic's Epilepsy Center. The center was one of 15 sites in the United States to participate in clinical trials.

"We badly need new, effective therapies for the hundreds of thousands of people in this country as well as the millions around the world who live with uncontrolled seizures," Warren Lammert, chairman of the patient advocacy group the Epilepsy Foundation, said in a Neuropace news release.

He said the new device "integrates the best of technology and neurology, and is an important new treatment option for these individuals and their families."

Dr. Orrin Devinsky is director of the NYU Comprehensive Epilepsy Center in New York City. He said the center has been involved in the RNS Stimulator trials, "and have seen significant clinical improvements, including patients who are now seizure-free and driving for the first time in their life."

The device is designed specifically for people 18 and older with partial-onset epilepsy, which occurs when one or more fixed locations in a person's brain start the cascade of nerve firing that creates a seizure.

NeuroPace has also done two studies involving a total of 256 patients who were monitored for a period of between two and nine years, without any significant problems, according to Neuropace president and CEO Frank Fischer.

Epilepsy is a brain disorder in which a person suffers repeated seizures over time. It affects more than 2 million Americans, according to the Epilepsy Foundation, making it the third most common neurological disorder in the United States, after Alzheimer's and stroke. Seizures are episodes of disturbed brain activity that cause changes in attention or behavior. Brain cells keep firing instead of acting in an organized way. The malfunctioning electrical system of the brain causes surges of energy that can cause a person to have muscle contractions or to black out.

Physicians can modify the programming of the device even after it has been implanted, to reflect a patient's needs over time, Fischer said. They can also observe the brain activity of a patient from a laptop computer in their office -- to help them manage a patient's treatment, he said.

Speaking in February at the time of the FDA panel's approval, Fischer said it was too soon to say what the device might cost. However, comparable systems for heart problems range in price from $30,000 to $35,000, not including the cost of the surgery to implant the device. The battery that powers the epilepsy device lasts about three years. When it fails, a new device has to be substituted in a 30-to-60-minute outpatient surgical procedure, Fischer said.

The FDA did note some important safety issues with the RNS System. Users cannot undergo MRI procedures, or other procedures such as diathermy (electrically induced heat), electroconvulsive ("electroshock") therapy or transcranial magnetic stimulation. "The energy created from these procedures can be sent through the neurostimulator and cause permanent brain damage, even if the device is turned off," the FDA explained.

Health issues that could also occur include infections at the site of the implant and premature battery depletion, the FDA said.

More information

For more on epilepsy, visit the Epilepsy Foundation .

Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, Nov. 14 (HealthDay News) -- Two drugs are not always better than one, a new study indicates.

Combining two blood pressure medications that normally help people with kidney disease that is triggered by diabetes didn't lead to greater improvement. And using both actually harmed the kidneys, researchers report.

The worse the kidney disease was to start with, the more likely it was that the drug duo caused problems, they added.

The two types of drugs used are called angiotensin-converting-enzyme (ACE) inhibitors and angiotensin-receptor-blockers (ARBs), and they lower blood pressure and help reduce the amount of protein in the urine. Protein in the urine is a sign of kidney damage.

"We thought that in this high-risk group of people, a combination of the two would help. We thought it might slow the progression of their kidney disease," said study author Dr. Linda Fried, a staff physician in the renal section of the Veterans Affairs Pittsburgh Healthcare System.

"We saw a small, but not statistically significant, benefit in progression. But, we also had serious adverse events. We saw more hospitalizations, people required more treatments. Overall, the risk-benefit ratio just doesn't support use [of both drugs]," Fried said.

The findings were published in the Nov. 14 issue of the New England Journal of Medicine.

Kidney disease in diabetes is the leading cause of end-stage kidney disease in the United States, according to background information in the study. People with diabetes who have protein in their urine are at a higher risk of developing end-stage kidney disease. Treatment with either an ACE inhibitor or an ARB alone can help delay the progression of diabetic kidney disease, but it's not enough to stop it, according to the study.

To see if a combination of the two could provide more protection than just one of the drugs alone, Fried and her colleagues had more than 1,400 volunteers take an ARB called losartan at a dose of 100 milligrams (mg), and then randomly assigned them to take either an ACE inhibitor called lisinopril at a dose of 10 mg to 40 mg per day or an inactive placebo.

The average age of the study volunteers was 65, and nearly all were male. Three-quarters were white, and just under one-quarter were black. All had diabetes and significant kidney disease, but were not yet considered to have end-stage kidney disease.

The study began recruiting people in July 2008, but it was stopped in October 2012 due to safety concerns. Those concerns included dangerously high potassium levels and acute kidney injury in those taking both medications.

The researchers found no difference in death rates or heart-related events.

However, the combination therapy did lead to more than double the risk of high potassium levels, which can be deadly; and almost twice the risk of acute kidney injury compared to therapy with just the ARB.

"We thought there might be some people who would not tolerate the therapy, but we did not expect to see that much of a difference in increased risk," said Fried.

The study authors suggest there seems to be a threshold for how much you can block angiotensin, and after you pass that threshold more harm than benefit occurs.

"The message from this study is an important one. It's not safe to use both of these drugs together," said Dr. Robert Provenzano, chair of the department of nephrology at St. John Providence Health System in Detroit.

"When you decrease pressure inside the kidney and decrease blood flow in the kidney too much, the kidney will respond as if in failure, and the ability to get rid of potassium goes down," he explained.

"If someone is on both classes of the medications, they should bring it up to their doctor. Ask, 'Is this a safe combination for me?' There is evidence that this combination is problematic for people with [protein in their urine]," said Provenzano. And, he added, it's important to bring your medications or a list of medications to each doctor you see.

Although this study was done almost exclusively in men, Fried said it's likely that the findings would be similar in women.

More information

Learn more about kidney disease and diabetes from the American Diabetes Association.

Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, Nov. 14 (HealthDay News) -- The rapidly growing use of electronic cigarettes, hookahs and other smoking alternatives by middle school and high school students concerns U.S. health officials.

While use of these devices nearly doubled in some cases between 2011 and 2012, no corresponding decline has been seen in cigarette smoking, the U.S. Centers for Disease Control and Prevention reported Thursday.

"We have seen, between 2011 and 2012, a big increase in the percentage of middle- and high-school students who are using non-conventional tobacco products, particularly electronic cigarettes and hookahs," said Brian King, a senior scientific adviser in CDC's office on smoking and health.

These products are marketed in innovative ways on TV and through social media, he said. "So, it's not surprising that we are seeing this increase among youth," he added.

E-cigarettes and hookah tobacco come in flavors, which appeals to kids. And since hookahs are often used in groups, they also provide a social experience, which may be adding to their popularity, King said.

Teens may also believe that e-cigarettes are safer than tobacco, said Stanton Glantz, director of the Center for Tobacco Control Research and Education at the University of California, San Francisco. However, nicotine is addictive and can hamper the developing brains of teens.

"This paper shows that the return of nicotine advertising to TV and radio, combined with an aggressive social media presence and use of flavors is promoting rapid uptake of electronic cigarettes by youth," said Glantz.

The report, based on data from the 2012 National Youth Tobacco Survey, was published in the Nov. 15 issue of the CDC's Morbidity and Mortality Weekly Report.

King said efforts are needed to curb use of these tobacco products and prevent other teens from ever trying them. "We know that 90 percent of smokers start in their teens, so if we can stop them from using tobacco at this point, we could potentially prevent another generation from being addicted to tobacco," King noted.

Smoking is the leading cause of preventable death and disease in the United States, killing more than 1,200 people every day.

E-cigarettes simulate the experience of smoking without delivering smoke. They are shaped like cigarettes but users inhale a vaporized, nicotine-based liquid.

"Nicotine is an addictive drug that affects brain development, especially in adolescents, whose brains are still developing," he said.

According to the report, from 2011 to 2012 use of e-cigarettes among middle-school students rose from 0.6 percent to 1.1 percent. Their use by high school students jumped from 1.5 percent to 2.8 percent.

Over the same period, hookah use among high schoolers jumped from 4.1 percent to 5.4 percent, the researchers found.

Currently, electronic cigarettes, hookah tobacco, cigars and certain other new tobacco products are not regulated by the U.S. Food and Drug Administration.

The FDA has said it intends to classify these products as tobacco products, putting them under the agency's control.

The popularity of these new products hurts ongoing tobacco-prevention efforts, experts say. "This proliferation of novel tobacco products that are priced and marketed to appeal to kids are slowing our progress in reducing tobacco use among kids," said Danny McGoldrick, research director for Campaign for Tobacco-Free Kids.

"You have the marketing of electronic cigarettes that are using all the themes and tactics that have been used by cigarette companies for decades to market to kids, like flavors, the use of celebrities, the use of sports and entertainment, as well as glamour, sex and rebellion," he said.

This is why the FDA needs to assert jurisdiction over all tobacco products, McGoldrick said.

Cigar use is also rising among adolescents. Their use by black high school students rose from about 12 percent to nearly 17 percent from 2011 to 2012, and since 2009 has more than doubled, according to the report.

Cigars and cigarettes were smoked by about the same number of boys in 2012 -- more than 16 percent.

Cigars include so-called "little cigars," which are similar in size, shape and filter to cigarettes, King said. But since they are taxed at lower rates than cigarettes, they are more affordable. "You can buy a single, flavored little cigar for mere pocket change, which could increase their appeal among youth," he said.

Fruit and candy flavors, which are banned from cigarettes, are added to some of these little cigars, King said.

According to the CDC, about one in three middle- and high-school students who smoke cigars use flavored little cigars.

Every day, more than 2,000 teens and young adults start smoking. Smoking-related diseases cost $96 billion a year in direct health care expenses, according to the CDC.

More information

For more information on stopping smoking, visit the American Cancer Society.

Copyright © 2013 HealthDay. All rights reserved.

Walking May Cut Stroke Risk in Older Men

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THURSDAY, Nov. 14 (HealthDay News) -- Older men may reduce their risk of stroke by taking a daily walk. And that walk doesn't have to be especially brisk, British researchers report.

The new study suggests that walking for an hour or two might lower the risk of stroke by as much as one-third, and walking three hours or more daily might cut the risk by two-thirds.

"Stroke is a major cause of death and disability and it is important to find ways to prevent stroke, especially in older people who are at high risk," said lead researcher Barbara Jefferis, a senior research associate in the department of primary care and population health at University College London.

This study suggests that maintaining an active lifestyle, specifically by walking, could prevent stroke in older adults, she said.

"Getting into the habit of walking every day for at least an hour could protect against stroke," Jefferis said. "Walking could be for transport, such as doing errands and going to the shops, walking around indoors as well as walking for leisure, such as walking in a park."

Moreover, it doesn't seem to matter how fast a man walks. Just walking does the trick, regardless of pace, she said.

The report was published Nov. 14 in the online edition of the journal Stroke.

Dr. Ralph Sacco, chairman of neurology at the University of Miami Miller School of Medicine, said this is yet another study that confirms the benefits of exercise in regard to stroke prevention.

Sacco said physical activity in general, not just walking, is important in reducing stroke risk for both men and women.

"All forms of physical activity, including walking, can promote ideal [heart] health and reduce stroke risk," he said.

Study author Jefferis also spoke out in favor of a variety of activities.

"We know that physical activity has benefits for a wide range of mental and physical health outcomes," she said. "Aiming for 150 minutes per week of moderate physical activity, which includes walking at a brisk pace or light gardening, or 75 minutes per week of vigorous activities, such as jogging or tennis ... would protect against heart disease and diabetes, as well as protecting against stroke."

Although the study found an association between greater weekly walking time and lower stroke risk in men, it did not establish a cause-and-effect relationship.

For the study, Jefferis's team collected data on nearly 3,500 healthy men aged 60 to 80 who were taking part in a larger heart study involving 24 British towns. The men were asked how far they walked each week.

The researchers divided the men into five groups: those who walked zero to three hours a week, four to seven hours a week, eight to 14 hours a week, 15 to 21 hours a week and more than 22 hours a week.

During the next 10 years, men who walked eight to 14 hours a week cut their risk for stroke by about one-third compared to men who walked zero to three hours a week, the researchers found.

For men who walked more than 22 hours a week, the risk for stroke dropped by about two-thirds, they found.

Among all the men, 42 percent walked for more than eight hours a week and 9 percent walked more than 22 hours a week, according to the report.

Men who walked zero to three hours a week had strokes at a rate of 80 per 1,000 men over 10 years. Meanwhile, those who walked eight to 14 hours a week had strokes at a rate of 55 per 1,000 men, the researchers said.

The benefit of walking was seen regardless of how fast the men walked. "The protective effects of spending more time walking on risk of stroke weren't explained by differences in walking pace," Jefferis said.

More information

To learn more about stroke, visit the American Stroke Association.

Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, Nov. 14 (HealthDay News) -- Manufacturers of antiseptic swabs and solutions are being asked to make voluntary labeling and packaging changes, the U.S. Food and Drug Administration said Thursday.

The goal is to improve the products' safety when applied to the skin before surgery or injections.

Reports of infections linked to the over-the-counter antiseptics are infrequent but continuing, the agency said in a statement explaining its request.

When used properly, these antiseptic swabs and solutions safely reduce the number of bacteria on patients' skin before they undergo an operation or receive shots. But use of contaminated antiseptics has led to localized infections and even death, according to the FDA.

"Most often, contamination of [antiseptic products] occurs when organisms are introduced into the product by users," the agency said in the news release.

The FDA is asking for labeling changes and single-use packaging for antiseptic products that contain widely used ingredients such as alcohol, iodophors, chlorhexidine gluconate, and quaternary ammonium. The products are sold as solutions, swabs, solution-saturated pads and applicators in both single-use and multiple-use formulations.

Antiseptic products sold in the United States do not have to be manufactured as sterile. If an antiseptic product is labeled as sterile, it means it underwent a process during manufacturing to eliminate all potential germs.

But even antiseptic products manufactured with a sterile process can become contaminated if proper care is not taken when using them, the experts warn. The term nonsterile on the product label means it was not sterilized during manufacturing, but it does not mean the product contains harmful bacteria, the FDA explained.

To reduce the risk of contamination with bacteria during use, the FDA is asking manufacturers to package these antiseptic products in single-use containers and to label the products as sterile or nonsterile.

That would mean applying the antiseptics in these single-use containers only one time to one patient. Applicators and any unused solution should be discarded after the single application, the agency said. Health care providers and patients should not dilute these products after opening them and should use them according to the directions on the label, the FDA advised.

More information

The U.S. Food and Drug Administration outlines proposed labeling and packaging changes for antiseptic products.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, Nov. 14 (HealthDay News) -- Genetic tests aimed at gauging a person's risk for an array of health issues are now readily available, but a new survey finds that most people prefer the help of a physician in interpreting the results.

"Genetic risk percentages require interpretation and context," study co-author Rene Almeling, a sociologist at Yale University, said in a university news release.

Almeling said experts have long had "concerns about companies that offer genetic tests directly to consumers. What we did that was new was to ask members of the public whether they thought this was a good idea."

The study involved 2,100 people who were asked about direct-to-consumer genetic tests, among other things.

Almeling and co-author Shana Kushner Gadarian, of Syracuse University, found that the majority of Americans support federal spending on genetic research. They also found broad support for laws that prevent discrimination based on the results of a genetic test.

The research also found that 65 percent of Americans agree that doctors should explain genetic test results to their patients.

That's in line with current recommendations from the American Medical Association and the American College of Medical Genetics, which both recommend that people undergo genetic testing under the guidance of their doctor. Physicians can take into account factors such as family history and environment when interpreting gene test results, according to these groups.

Given the overwhelming support for the involvement of doctors in interpreting the results of genetic testing, the researchers said their findings may prompt lawmakers to make doctor-patient consultations a requirement in the future.

"In the ongoing debates over policy issues in genetics, it's important to keep in mind the views of those most affected by such debates," Almeling said. "These results are useful for scientists designing studies, clinicians working with patients, federal agencies setting budget priorities and legislators designing regulations."

The findings were published online recently in the journal Genetics in Medicine.

More information

The U.S. National Institutes of Health provides more information on genetic testing.

-- Mary Elizabeth Dallas

Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, Nov. 14 (HealthDay News) -- All pregnant women should be screened for diabetes at their first prenatal check up, according to new recommendations from an international group of endocrinology experts.

The test should be done before women are 13 weeks pregnant or as soon as possible after that milestone is reached, according to new clinical practice guidelines released by the Endocrine Society to help doctors improve the level of care for pregnant women with diabetes.

Up to one in five women may develop gestational diabetes -- a form of diabetes that begins during pregnancy. Traditional testing methods, however, only detect about 25 percent of these cases. As a result, the experts caution that many pregnant women with gestational diabetes are going undiagnosed, which could increase their risk of having an overly large baby and complications during delivery.

"Many women have type 2 diabetes but may not know it," Dr. Ian Blumer, chair of the guidelines task force, said in a society news release. "Because untreated diabetes can harm both the pregnant woman and the fetus, it is important that testing for diabetes be done early on in pregnancy so that if diabetes is found appropriate steps can be immediately undertaken to keep both the woman and her fetus healthy."

The guidelines also recommend using lower blood sugar levels to diagnose gestational diabetes, which will allow doctors to detect more cases.

"Once the diagnosis is made, treatment can be given to help the fetus grow normally," said Blumer, from the Charles H. Best Diabetes Center in Whitby, Ontario.

"Thanks to important new studies of the interplay between diabetes and pregnancy, diabetes specialists and obstetricians have identified best practices for caring for pregnant women with this condition," Blumer added. "The guideline synthesizes evidence-based strategies to support women who have diabetes during pregnancy."

Other recommendations from the Endocrine Society task force include the following:

  • Women who have never been diagnosed with diabetes should undergo an oral glucose tolerance test to screen for gestational diabetes between 24 and 28 weeks of pregnancy.
  • Women who are overweight or obese are advised to lose weight before becoming pregnant.
  • Initially, women with gestational diabetes should be treated with medical nutrition therapy and 30 minutes of daily moderate exercise.
  • If lifestyle therapy doesn't effectively control gestational diabetes, medication to lower blood sugar levels should also be used.
  • Women with gestational diabetes should have a repeat oral glucose tolerance test six to 12 weeks after delivery to ensure they do not have pre-diabetes or diabetes.
  • Women who have ever been diagnosed with gestational diabetes need to be tested for diabetes regularly, particularly before becoming pregnant again.
  • Women with either type 1 or type 2 diabetes should undergo a thorough eye exam to make sure they do not have diabetic retinopathy. Any damage to the retina should be treated before women become pregnant.

The new guidelines were published in the November issue of the Journal of Clinical Endocrinology and Metabolism.

More information

The American Diabetes Association has more about gestational diabetes.

-- Mary Elizabeth Dallas

Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, Nov. 14 (HealthDay News) -- Bending to political pressure, President Barack Obama on Thursday announced a plan to allow Americans to keep their health insurance plans for another year, even if that coverage would have been cancelled because it fails to meet new rules under the Affordable Care Act.

Under Obama's plan, health insurers may renew health plans that fail to meet the controversial health law's stricter standard, but only for existing customers.

State insurance commissioners will have the final word on which plans can and cannot be sold in their states, Obama said during a White House briefing.

"The bottom line is insurers can extend current plans that would otherwise be cancelled into 2014, and Americans whose plans have been cancelled can choose to re-enroll in the same kind of plan," Obama said.

The White House proposal comes as the House of Representatives prepares to vote Friday on a bill sponsored by Rep. Fred Upton (R-Mich.) that would allow everyone to buy those older policies, not just existing customers.

House Minority Leader Nancy Pelosi (D-Calif.) said such legislation would be "completely disruptive."

In recent weeks, millions of Americans with health policies that they had purchased through the individual insurance market have received notices that their coverage would be cancelled effective Jan. 1. Many of these health plans fail to meet new standards under the health-reform law -- sometimes called Obamacare -- that requires plans to cover a standard set of health benefits.

News of the policy cancellations roused ire on both sides of the political aisle, fueling a bipartisan backlash against the President whose promise that Americans could keep coverage they liked turned out not to be true.

"I completely get how upsetting this can be for a lot of Americans, particularly after assurances they heard from me that if they had a plan that they liked, they could keep it," Obama said. "And to those Americans: I hear you loud and clear," he added.

Under the proposed change, health insurers must tell customers what protections the renewed plans don't include and inform people of health insurance options through the new online marketplaces created by the Affordable Care Act.

"This fix won't solve every problem for every person," Obama said, "but it's going to help a lot of people."

Republicans, who have fought against the health-reform law since its passage in 2010, were unimpressed with Obama's proposal.

House Speaker John Boehner said it was time to "scrap this law once and for all."

"You can't fix this government-run health care plan called Obamacare. It's just not fixable," he added, according to the Associated Press.

The proposed change to the health law comes as the Obama administration works to regain credibility after the disastrous launch of the new online federal health marketplace -- or exchange -- where consumers may buy health insurance, in many cases with the help of federal tax credits.

"That's on me. We fumbled the roll-out on this health-care law," Obama said Thursday, adding that he's confident that next year people will look back and find that the new law is working well.

In addition to fixing the HealthCare.gov website, Obama said his administration would be taking steps to make the process of purchasing health insurance simpler by streamlining the application process, giving people more assistance and communicating people's health-plan options in a clear way.

In response to Obama's remarks, America's Health Insurance Plans, an insurance trade association, issued a statement saying that consumers may still face higher premiums.

"Changing the rules after health plans have already met the requirements of the [health-reform] law could destabilize the market and result in higher premiums for consumers," AHIP president and CEO Karen Ignagni said in a news release. "Premiums have already been set for next year based on an assumption of when consumers will be transitioning to the new marketplace.

"If now fewer younger and healthier people choose to purchase coverage in the exchange, premiums will increase and there will be fewer choices for consumers," she added. "Additional steps must be taken to stabilize the marketplace and mitigate the adverse impact on consumers."

Ignagni said that the "only reason consumers are getting notices about their current coverage changing is because the ACA [Affordable Care Act] requires all policies to cover a broad range of benefits that go beyond what many people choose to purchase today."

Obama's proposal Thursday followed the White House's release late Wednesday of a report revealing a disappointing number of health plan enrollments through the new federal and state online insurance exchanges.

Just over 106,000 Americans enrolled in health plans through the new marketplaces from Oct. 1 through Nov. 2, U.S. Health and Human Services Secretary Kathleen Sebelius said during a news conference.

That figure includes people who have not yet paid their health-plan premium and, of those, only 26,794 enrolled through the troubled federal health marketplace HealthCare.gov.

Another 975,000 people have applied for coverage and received a determination of eligibility for coverage "and are currently still shopping for a plan," Sebelius said.

In addition, more than 396,000 people have been deemed eligible for Medicaid or the Children's Health Insurance Program, the report indicated.

More information

Learn how to get insurance coverage through the new health exchanges.

Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, Nov. 14 (HealthDay News) -- Teens who stay up late are more likely to have lower grades and more emotional problems, a new study suggests.

Researchers analyzed data from 2,700 U.S. teens, aged 13 to 18. Of those, 30 percent said they went to bed later than 11.30 p.m. on school nights and 1:30 a.m. in the summer.

By the time they graduated from high school, the teens who stayed up late during the school year had lower GPA scores and were more likely to have emotional problems than those with earlier bedtimes, the University of California, Berkeley, team found.

Going to bed late in the summer did not appear to affect school performance, but there was an association between later summer bedtimes and emotional problems in young adulthood, according to the study published online Nov. 10 in the Journal of Adolescent Health.

The researchers said their findings support later middle and high school morning start times. While the study found an association between lack of sleep and lower grades, it did not prove a cause-and-effect relationship.

"Academic pressures, busy after-school schedules and the desire to finally have free time at the end of the day to connect with friends on the phone or online make this problem even more challenging," study author Lauren Asarnow, a graduate student in UC Berkeley's sleep and mood research clinic, said in a university news release.

On a positive note, the findings highlight how healthy sleep habits provide academic and emotional benefits for teens.

"The good news is that sleep behavior is highly modifiable with the right support," Asarnow said.

More information

KidsHealth.org has more about teens and sleep.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

THURSDAY, Nov. 14 (HealthDay News) -- Dangerous myths about tobacco persist 50 years after the U.S. Surgeon General first warned Americans about the harm caused by smoking, experts say.

The first Surgeon General's Report on smoking and health was released in January 1964.

"Since 1964, smoking rates have dropped by more than half as a result of successful education, legislative and smoking cessation efforts. Still, lung cancer remains the number one cancer killer and the leading preventable cause of death in the United States," Dr. Lewis Foxhall, vice president for health policy at the University of Texas MD Anderson Cancer Center in Houston, said in a center news release.

One of the biggest myths is that there's been a dramatic decline in the number of smokers. However, nearly 44 million (about one in five) Americans still smoke.

"The current percentage of smokers is 19 percent. That's significantly lower than the 42 percent in 1965. However, the actual number of people smoking today is close to the same," Foxhall said.

In 1965, about 50 million Americans smoked. "Because our population is much larger, it just seems like we have a lot fewer smokers," Foxhall said.

Another myth is that infrequent, so-called "social" smoking is harmless. But any smoking is dangerous.

"Science has not identified a safe level of smoking, and even a few cigarettes here and there can maintain addiction," David Wetter, chair of health disparities research at MD Anderson, said in the news release. "If you are a former smoker, data suggests that having just a single puff can send you back to smoking."

Many people wrongly believe that smoking outdoors eliminates the dangers of secondhand smoke. However, there is no risk-free level of exposure to secondhand smoke and even brief exposure can cause harm. Families should ban smoking both in and around the home, Wetter said.

Another myth is that e-cigarettes, cigars and hookahs are safe alternatives to cigarettes. They all contain nicotine, which is highly addictive.

"The tobacco industry comes up with these new products to recruit new, younger smokers," Dr. Alexander Prokhorov, director of the Tobacco Outreach Education Program at MD Anderson, said in the news release. "And, they advertise them as less harmful than conventional cigarettes. But once a young person gets acquainted with nicotine, it's more likely he or she will try other tobacco products," he pointed out.

Paul Cinciripini, professor and deputy chair of behavioral science and director of the Tobacco Treatment Program at MD Anderson, explained: "While e-cigarettes may contain less harmful substances than combustible tobacco, they're presently unregulated so quality control over the nicotine content and other components is left to the manufacturer."

So, he added, "At this time, it's far too early to tell whether or not e-cigarettes can be used effectively as a smoking cessation device."

In the United States alone, over 200,000 people are diagnosed with lung cancer and about 150,000 people die from the disease each year, and it is estimated that smoking contributes to nearly 90 percent of those lung cancer deaths. In addition, 30 percent of all cancer deaths have been linked to smoking.

More information

BeTobaccoFree.gov explains the health effects of smoking.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

Health Highlights: Nov. 14, 2013

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

New Drug For Rare Blood Cancer Approved by FDA

A new drug to treat a rare and aggressive form of blood cancer was approved Wednesday by the Food and Drug Administration.

Imbruvica was approved for patients with mantle cell lymphoma who have already undergone at least one previous drug treatment. This type of cancer typically begins in the lymph nodes but has usually spread to the bone marrow and other parts of the body by the time it's diagnosed, the Associated Press reported.

The new once-a-day capsule blocks a protein that enables the cancer to multiply and spread. The FDA's approval is based on a study of 111 patients. Tumors shrank or disappeared in 66 percent of the patients who took Imbruvica. However, it's not clear if the drug actually prolongs patients lives.

The new drug from Pharmacyclics and Janssen Biotech Inc. is the second to be approved under the FDA's breakthrough designation, which was approved by Congress last year. The classification is meant to accelerate development of promising drugs by giving companies additional meetings and earlier communication with FDA scientists, the AP reported.

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Car Mechanic Develops Birth-Assist Device

An Argentine car mechanic's device to ease difficult births has been endorsed by the World Health Organization and other major donors, and has been licensed for production by an American medical technology company.

Jorge Odon, 59, said the idea for the Odon Device came to him after watching a YouTube video about how to extract a cork trapped in a wine bottle. He realized that the same approach could be used to save a baby stuck in the birth canal, The New York Times reported.

Odon built the first prototype in his kitchen. He used a glass jar for a womb, his daughter's doll for the trapped baby, and a fabric bag and sleeve sewn by his wife as his lifesaving device.

With the actual device, an attendant slips a plastic bag inside a lubricated plastic sleeve around the head, inflates it to grip the head and pulls the bag until the baby emerges, The Times reported.

The device has enormous potential to save babies in poor countries, and perhaps to reduce cesarean section births in rich nations, according to doctors.

"This is very exciting," Dr. Mario Merialdi, the WHO's chief coordinator for improving maternal and perinatal health, told The Times. "This critical moment of life is one in which there's been very little advancement for years."

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New Brain and Physical Health Program for Ex-NFL Players

Three medical schools and the National Football League Players Association (NFLPA) have launched a new program focused on the brain and physical health of former players.

The program, called The Trust, will provide ex-NFL players with physical and neurological assessments and short- and long-term treatment plans. It's free for players who spent at least two seasons in the NFL, CBS News reported.

The Cleveland Clinic, Tulane University and the University of North Carolina are working with the NFLPA on the initiative.

"Athletic injuries and sports-related brain trauma have become part of the public consciousness and are being viewed as legitimate public health problems," Dr. Jay Alberts, director of the Cleveland Clinic Concussion Center, said in a news release, CBS News reported.

"Former professional football players, in particular, are at increased risk for neurological disease. The goal of this program is to identify potential problems -- physical, neurological or cognitive -- earlier, which may lead to earlier interventions and treatments," he explained.

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Bill to Encourage Schools to Stock Food Allergy Drug Signed by President

A new law meant to increase the availability of life-saving epinephrine in U.S. schools was signed Wednesday by President Barack Obama.

Epinephrine can help prevent severe reactions (anaphylaxis) and death in children with severe food allergies. The law provides a financial incentive to states to maintain a supply of epinephrine in their schools and to permit trained school staff to administer it, the Wall Street Journal reported.

Only four states -- Maryland, Nebraska, Nevada and Virginia -- currently require schools to stock epinephrine, according to the Food Allergy Research & Education organization. Another 20 states permit schools to stock the medication but don't require they do so.

"This is something that will save children's lives," Obama said at a ceremony to sign the bill, WSJ reported.

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THURSDAY, Nov. 14 (HealthDay News) -- Women with asthma seem to experience delays in getting pregnant, Danish researchers report.

Whether this trend is because asthma has a direct biological effect on fertility or because having asthma reduces the frequency of intercourse isn't clear, however, the researchers said.

"There is an association between asthma and infertility due to an increased time to pregnancy," said lead researcher Dr. Elisabeth Juul Gade, of the Respiratory Research Unit at Bispebjerg University Hospital in Copenhagen.

"At present, our findings can only indicate a trend. There is a need for clinical studies examining this issue in general," she said. "We can, however, based on our data, trace a trend that suggests that it is just as important to be well treated for one's asthma while trying to get pregnant as it is during pregnancy itself."

The report was published Nov. 14 in the online edition of the European Respiratory Journal.

Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City, said the association between asthma and delays in pregnancy is clear.

Asthma is an inflammatory disease and inflammation can happen anywhere in the body, Horovitz said. "The inflammatory part of asthma may well be affecting not only bronchial tubes but also fallopian tubes," he said.

This theory is supported by the fact that when women were treated for asthma, their ability to get pregnant improved, Horovitz said.

Dr. Avner Hershlag, chief of the Center for Human Reproduction at North Shore University Hospital in Manhasset, N.Y., said, however, that the explanation might be much simpler.

Citing a British study of more than 500,000 women published in 2007 in the American Journal of Epidemiology, he said there is no difference in the fertility rates between women with and without asthma.

"This Danish study is not looking at real fertility rates, but at delay in getting pregnant," Hershlag said.

"It makes a lot of sense that, when you have a condition such as asthma, conception would be delayed," he said. "I bet that if you studied almost any chronic illness, you would find similar results. Simply, maybe these couples have less frequent intercourse during the period of time they don't feel well, and conception is delayed."

The older British study is reassuring, Hershlag said. "Overall, patients with and without asthma have the same fertility," he said. "Patients with asthma should not feel anxious, because there is absolutely no basis to assume that fertility will suffer from asthma."

For the new study, Gade's team collected data on more than 5,200 Danish female twins who were up to 41 years old. The women completed questionnaires that asked about asthma and fertility.

Using the data, the researchers were able not only to compare the twins, but also use them as a model for the whole population.

Gade's group divided the women into those with and without asthma, as well as those whose asthma was being treated and those whose asthma wasn't being treated. In addition, the women were asked whether they had been trying to get pregnant for more than a year without success and how many children they had.

Nearly 1,000 of the women had asthma. More of these women had a harder time getting pregnant than women without asthma (27 percent versus 21.6 percent), the researchers found.

Delayed pregnancy was significantly longer among women whose asthma was not treated compared with women whose asthma was being treated (30.5 percent of the untreated asthma group versus 23.8 percent of those receiving treatment), the researchers said.

In addition, women over 30 with asthma were more likely to experience delays in getting pregnant (32.2 percent of women over 30 versus 24.9 percent of women under 30).

Overall, however, women with asthma ultimately had the same average number of children as women without asthma, as those with asthma tended to have children earlier in life than those without asthma, the researchers said.

"Our hope is that our findings can give female asthmatics in infertility treatment a possible explanation as to why they experience prolonged time to pregnancy and thus are in need of fertility treatment," Gade said. "It is well known that one of the greatest frustrations among [women with] unexplained infertility is lacking a reason behind their fertility problems."

Whether asthma may also have an effect on male infertility isn't known, Gade said. "Unfortunately, we do not have any data on that," she said. "We have so far only focused on female fertility."

More information

For more on asthma and pregnancy, visit the March of Dimes.

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THURSDAY, Nov. 14 (HealthDay News) -- The first confirmed case of a person infected with a new H6N1 bird flu virus subtype has been reported by scientists in Taiwan.

They said further research is needed to assess the potential threat posed by the H6N1 virus, which is found in wild and domestic birds in many parts of the world.

The patient was a 20-year-old woman from central Taiwan who arrived at a hospital in May 2013 with flu-like symptoms and shortness of breath. She responded to treatment with Tamiflu (oseltamivir) and has since fully recovered.

Tests on throat-swab samples taken from the woman revealed that she was infected with a new H6N1 bird flu virus that closely resembled chicken H6N1 viruses that have been circulating in Taiwan since 1972.

Further investigation showed that the virus had evolved the ability to target receptors in the upper respiratory tract of humans, which could make it more infectious to humans, said study lead author Dr. Ho-Sheng Wu, from the Centers for Disease Control in Taiwan.

The source of the woman's infection is unknown. She worked in a delicatessen, had not been out of the country for three months before she was infected, and had not been in close contact with poultry or wild birds. No H6N1 virus was found in two poultry breeding facilities close to the woman's home.

The woman was in close contact with 36 people, and six of them developed a fever or respiratory tract infection. However, infection with H6N1 was ruled out in those cases, according to the study published online Nov. 14 in The Lancet Respiratory Medicine.

The findings suggest that a new group of H6N1 viruses with the ability to target receptors in the human respiratory tract have become common in poultry in Taiwan, according to the researchers.

"As these viruses continue to evolve and accumulate changes, they increase the potential risk of human infection. Further investigations are needed to clarify the potential threat posed by this emerging virus," Wu said in a journal news release.

More information

The World Health Organization has more about bird flu.

-- Robert Preidt

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THURSDAY, Nov. 14 (HealthDay News) -- Will Heininger was a 295-pound defensive tackle for the University of Michigan at the end of his freshman year when he realized he had a big problem: He was severely depressed.

Surrounded by a collegiate culture of superathletes in a sport known for its toughness, Heininger was afraid to let anyone know how desperate he was.

"I had consuming thoughts from the time I woke up to the time I went to bed," he said. "My parents had gotten divorced the year before, we were in a new house and nothing seemed happy. Nothing seemed worthwhile."

For a long time, Heininger was able to hide his depression. "I was functioning at such a high level, going to football workouts, going to work and going to class -- keeping it all in," he said. "Then I broke down."

First, Heininger opened up to his mother and she helped him find a therapist. But the relationship wasn't a good fit, he said. The therapist recommended that Heininger quit football, the only thing he really cared about at the time. So Heininger decided to try to cope on his own.

Not long after that, at football practice, he suddenly became completely overwhelmed. His athletic trainer noticed something was wrong, Heininger recalled.

The athletic trainer brought him to a therapist who was part of the university's athletic program.

"I hadn't even known she was there," Heininger said.

He sat down with her and started to cry. "That was a big turning point for me. It started the healing process, one of the hardest things I've ever had to go through," he said.

Heininger started daily therapy and was given medication to help treat the depression. He gradually began to open up to his fellow athletes and friends. Now, five years later, he works in the financial services industry in Chicago, and has overcome his depression.

Heininger isn't alone. The National Athletic Trainers' Association (NATA) estimates that about one in four U.S. youths meets the criteria for having a mental-health disorder.

To help professionals working with college athletes recognize and refer students with psychological issues, the NATA recently published guidelines in the Journal of Athletic Training.

The guidelines highlight the need to take away the stigma of mental health issues and teach people working with student-athletes how to spot psychological concerns early and get the necessary help.

"We're addressing a public-health issue, and if we can shed more light on what athletes go through we can help educate the public," said Timothy Neal, the author of the guidelines and the assistant director for sports medicine at Syracuse University.

Neal said the vast majority of schools need to develop plans for dealing with mental health issues among student-athletes.

"There are unique stressors for student-athletes," Neal said. "They're compelled to exercise, miss holidays, miss summer vacations, and their failures and successes -- in athletics and in school -- stand out." They also spend long hours with the same group of teammates, he added.

The culture of athletics also demands a certain toughness and rigor that makes it hard for students to feel comfortable admitting they have problems or weaknesses.

"We have to de-stigmatize mental health issues," Neal said. "I tell athletes it is normal to have these kinds of situations; if you hurt your knee you're going to go to a specialist. In the same way, an athletic trainer can refer you to a mental health professional to see if you need help."

That "culture of resistance" was noted in a report released last month by the U.S. Institute of Medicine. Despite evidence that concussions cause some degree of brain injury, many athletes don't report their head injuries.

Although football-related concussions have been in the news recently, mental-health issues among student-athletes are not as well known, Neal said. Yet the risk of mental-health issues is higher among athletes than is the chance of getting a concussion, he said.

"Most universities have four to five times more students receiving care for psychological issues than those receiving care for concussions," he said.

In treating student-athletes for mental-health issues, Neal said athletic trainers and counselors should understand that athletes are naturally goal-oriented.

"Tell them they'll have a more functional life if they get help," he said.

More information

For tips on staying healthy while in college, visit the U.S. Centers for Disease Control and Prevention.

Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- Balloons may appear to be a soothing toy for young children, but experts say uninflated balloons are the leading cause of child suffocation.

The U.S. Consumer Product Safety Commission offers this additional information:

  • Children may accidentally inhale an uninflated balloon and suffocate.
  • Children may also swallow or inhale broken pieces of a popped balloon and suffocate.
  • Children under 8 years old should never play with an uninflated balloon.
  • If a balloon bursts, immediately take all pieces away from a young child.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- Some children have trouble falling asleep at night because they fear separation from their parents.

The University of Michigan Health System suggests how to help children cope with this issue:

  • Allow your child choices during the bedtime routine, such as the order and type of activities.
  • Set a reasonable bedtime, and a reasonable bedtime routine that precedes it.
  • Establish firm rules (such as don't get out of bed), and make sure your child understands them.
  • Adjust the morning wake time if your child takes a long time to fall asleep.
  • Talk about the nightly bedtime routine in advance, so kids know what to expect when bedtime comes.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 13 (HealthDay News) -- The Obama administration late Wednesday released a report revealing a disappointing number of health plan enrollments through the new federal and state insurance exchanges.

Just over 106,000 Americans enrolled in health plans through the new marketplaces from Oct. 1 through Nov. 2, U.S. Health and Human Services Secretary Kathleen Sebelius said during a news conference.

That figure includes people who have not yet paid their health-plan premium and, of those, only 26,794 enrolled through the troubled federal health marketplace HealthCare.gov.

Another 975,000 people have applied for coverage and received a determination of eligibility for coverage "and are currently still shopping for a plan," Sebelius said.

In addition, more than 396,000 people have been deemed eligible for Medicaid or the Children's Health Insurance Program, the report indicated.

"In every part of our country, Americans are very interested in the affordable health coverage that's being offered through the marketplace and through Medicaid," Sebelius said. "And even with the issues we've had, the marketplace is working and people are enrolling."

Health-plan premiums for coverage that takes effect Jan. 1 are not due until Dec. 15.

"By the 15th of December, we will be able to tell you how many people have paid for the first month of coverage," she said.

The federal and state exchanges are intended to be the gateway for private health plan coverage for some 30 million uninsured Americans under the health-reform law known as the Affordable Care Act.

HealthCare.gov, the federally run website, is being used by 36 states. The remaining state and the District of Columbia are running their own insurance enrollment sites.

Interest in the new health care exchanges has been high, with Health and Human Services tallying almost 27 million visits to the state-run and federal websites. Over 3.1 million phone calls have also been made to health care exchange call centers, the agency said.

More information

Learn how to get insurance coverage through the new health exchanges.

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WEDNESDAY, Nov. 13 (HealthDay News) -- The nation's chief of information technology would not confirm on Wednesday whether the hobbled HealthCare.gov insurance exchange website would be fixed by month's end.

Todd Park, U.S. chief technology officer, who serves as an advisor to the White House, said the team's goal is to get the site "working smoothly for the vast majority of Americans" by Nov. 30.

"The team is working incredibly hard to meet that goal," he told the House Oversight and Government Reform Committee under oath.

His comments came the same day that federal officials released enrollment figures for the first time. U.S. Health and Human Services Secretary Kathleen Sebelius said that 106,185 Americans have selected plans from the federal and state insurance exchanges, sometimes called marketplaces.

The Obama administration had hoped to enroll as many as 500,000 people through HealthCare.gov by the end of October, according to internal memos.

Meanwhile, politicians on both sides of the aisle amped up the pressure on the administration -- not only for a fix to the troubled website but for a solution to the loss of insurance coverage that many Americans are facing effective Jan. 1.

On Tuesday, former President Bill Clinton joined Republican opponents of Obamacare in calling for changes in the health-reform law to allow insurance companies to retain policies that do not meet new standards under the law, The New York Times reported.

"I personally believe even if it takes a change in the law, the president should honor the commitment the federal government made to those people and let them keep what they got," Clinton said in the interview published by the web magazine Ozy, the Times reported.

White House officials are struggling to keep President Barack Obama's promise that Americans can keep their health insurance without undermining or adding to its costs, the Times said, adding that administration officials would not say how they might achieve that goal.

Six weeks after the botched rollout of HealthCare.gov, members of the administration have appeared multiple times before key House and Senate committees where they were asked what went wrong with the implementation of the Affordable Care Act, President Obama's signature domestic policy achievement.

HealthCare.gov is the federally run health exchange where people in 36 states may enroll in private health coverage, oftentimes with federal tax subsidies. Fourteen states and the District of Columbia are running their own health exchanges.

At Wednesday's House Oversight committee hearing, the administration's top information technology experts conceded problems with the federal website. But they denied assertions by committee Chairman Darrell Issa (R-Calif.) and other Republicans that the rocky launch was partly due to a White House directive to pull a key function off the site.

"Clearly on Day One the system was overwhelmed by volume," acknowledged Park, the U.S. chief technology officer.

Both Park and Henry Chao, deputy director of the Office of Information Services at the U.S. Centers for Medicare and Medicaid Services, insisted that a last-minute decision to have HealthCare.gov users complete an application before seeing their health-plan options was not by White House dictate. Rather, it was that the "shopping" function did not work well.

"In this case, it failed so miserably that we could not consciously let people use it," Chao said.

In testimony, Karen Evans, a former U.S. Office of Management and Budget official, told the committee that HealthCare.gov's functionality and shortcomings "are the result of bad management decisions made by policy officials within the administration; they did this to themselves."

More information

Learn how to get insurance coverage through the new health exchanges.

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WEDNESDAY, Nov. 13 (HealthDay News) -- When doctors suspect a patient has a urinary tract infection, they often request a urine sample so they can test for the presence of bacteria. Now, new research suggests this step may be unnecessary.

Nearly one-quarter of women who had signs of a urinary tract infection -- a burning feeling when urinating or feeling an urgent need to pee -- had no evidence of bacteria in their urine or in their bladders, the study found. And although a number of urine culture tests found a variety of different bacteria, only one bug -- Escherichia coli -- was found in both the urine test and the bladder.

These findings suggest that today's lab tests may not be refined enough to detect very small quantities of bacteria in the bladder. It's also possible that the symptoms may not be caused by a bladder infection, but instead may be caused by an infection in the urethra, the tube that allows urine to pass out of the body. Or, inflammation in the urethra might be causing the symptoms, rather than bacteria.

"Our study provides further evidence that midstream urine cultures don't routinely need to be done. Most labs don't quantify low enough unless you specifically ask them to. Most women are treated right away for symptoms anyway, because the urine culture doesn't come back for two days," explained the study's lead author, Dr. Thomas Hooton, a professor of medicine at the University of Miami Miller School of Medicine in Florida.

Hooton added that a short course of antibiotics is likely to be effective, and that it's important to keep studying urinary tract infections. In particular, he said, "we need to know more about exactly what causes symptoms."

Results of the study were published in the Nov. 14 issue of the New England Journal of Medicine.

Urinary tract infections (also called UTIs or acute cystitis) are common bacterial infections, responsible for about 9 million doctor's visits in the United States every year, according to the study.

The bacteria responsible for the infection is generally found through a test of urine collected when someone goes to the bathroom. Urine collected directly from the bladder would yield more accurate results because there are fewer places for the urine to potentially become contaminated. But collecting urine from the bladder requires insertion of a catheter, an uncomfortable, invasive and more expensive procedure.

However, the 226 women included in the current study volunteered to collect a midstream urine sample, and immediately after allowed another sample to be collected directly from their bladder via a catheter.

All of the women were healthy, premenopausal women who had symptoms of a bladder infection.

When the researchers found E. coli in the midstream urine sample, it was also quite likely that they would find it in the bladder urine, too. However, when other types of bacteria were found in the midstream urine sample, they often didn't correlate to bacteria in the bladder.

The researchers also found that when other bacteria were in the midstream urine sample, E. coli was often present in the bladder urine samples.

"E. coli is probably causing most infections," said Hooton.

"Our findings are further confirmation that collection of urine has limited usefulness. You don't get the results back for two days, and just practically speaking, it's an added cost because we know E. coli causes most UTIs," noted Hooton.

If your physician decides to treat you without asking for a urine sample to culture, that's reasonable, said the author of an accompanying journal editorial, Dr. Michael Donnenberg, a professor of medicine, microbiology and immunology at the University of Maryland School of Medicine in Baltimore.

But Donnenberg noted that this study raises a number of questions, too: "Do bacteria in the urethra cause symptoms? And, if they do, does treating them make the symptoms go away more quickly?"

The test relied on today needs to be refined if it continues to be used in clinical practice, he suggested. Millions of these tests are still performed annually, he wrote in the editorial.

Both experts said more research on when antibiotics are helpful and when they're not might help reduce potentially unnecessary antibiotic use. Reducing unnecessary antibiotic use is important because of concerns about growing antibiotic resistance.

More information

Learn more about urinary tract infections from the U.S. National Library of Medicine.

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 13 (HealthDay News) -- U.S. taxpayers help fund many of the trials testing heart disease treatments, but the results of those studies often take years to be published, a new government study finds.

The study of trials funded by the U.S. National Heart, Lung, and Blood Institute found that well over one-third -- 43 percent -- took longer than 30 months to get published after the research ended.

The institute is a major sponsor of U.S. research into drugs, devices and lifestyle measures to treat and prevent heart disease. The sooner a study is published, the sooner doctors will learn about the effects of the treatment -- and, presumably, the sooner patients will benefit.

When it comes to taxpayer-funded studies, "the public has a right to expect that those results will be published, and be published quickly," said Dr. Michael Lauer, director of the institute's division of cardiovascular sciences.

That is not what's happening, however, Lauer and his colleagues report in the Nov. 14 issue of the New England Journal of Medicine.

The researchers found that of 244 institute-funded trials completed between 2000 and 2011, just 64 percent had been published as of March 2012.

The process was much speedier for large clinical trials that looked at "clinical events." Those are the longer-term, expensive studies that see, for instance, whether a drug prevents heart attacks, or a surgery prolongs people's lives.

Those trials were typically published nine months after completion, Lauer's team found.

That was in sharp contrast to trials that looked at "surrogate" results. Those types of studies are smaller and focus on shorter-term effects of a treatment -- such as whether a drug lowers blood pressure, or a diet change cuts people's cholesterol levels.

Typically, the results of those studies took 31 months to get into a medical journal.

Lauer said it's not surprising that the big trials were published faster. "Those studies are the most interesting," he said. "The journals find them more interesting, and think they'll be more important to the public."

What was surprising, Lauer stressed, was the "magnitude of the difference" between those trials and the smaller ones focused on surrogate results -- with the former getting into print around two years sooner.

Yet those important trials accounted for only a small percentage of the studies the institute funded. Of the 244 trials in this study, just 45 focused on clinical events.

One expert said the findings are cause for concern.

"I think we need a change in funders' priorities," said Dr. Philip Devereaux, of McMaster University in Hamilton, Canada. "The funding bodies want to support a lot of researchers, but we need more focus on the trials looking at clinical endpoints."

Large trials looking at the important, long-term effects of treatment generate more reliable results, said Devereaux, who wrote an editorial published with the study.

In contrast, he said, the smaller trials often suggest short-term benefits, such as lower blood pressure, that ultimately make little or no difference in heart patients' treatment. "So often, these things don't pan out," Devereaux said.

Diverting more funds to bigger trials would mean that fewer studies will get done, he acknowledged. "But the results would be more reliable," he added.

Lauer agreed, and said the National Heart, Lung, and Blood Institute is looking at how it prioritizes funding. "We need to redirect our funds toward trials that are more likely to produce important results," he said.

There are, however, many other reasons that trials are often slow to reach medical journals, Lauer and Devereaux pointed out.

The journals and the "peer review" process to choose studies can be at fault. And researchers may hinder themselves by unrealistically aiming for publication in one of the top medical journals, Lauer noted.

Plus, there are just not enough large trials being done, Devereaux said.

Not surprisingly, small studies are easier to run than large ones, which are generally done at multiple medical centers across the country -- or more than one country.

Devereaux said that easing up on the "enormous bureaucracy" involved in large trials could encourage more of them, and get them done with more efficiency and less cost. "We have endless regulations," he said, "and many of them are of questionable benefit."

Smaller trials are still important, Devereaux said, but they are not always necessary. If a particularly promising treatment has proven safe in initial studies, it could move right into a larger, more definitive trial, he said.

Lauer said that as far as the heart, lung and blood institute's role, "our main leverage is in funding." But, he added, the agency can also act as a "think tank" to bring together the different groups involved in running and publishing clinical trials.

"There are a lot of players in this who can come together to talk," Lauer said. "We have a problem, but there's no one party to blame."

More information

The U.S. National Heart, Lung, and Blood Institute explains how clinical trials work.

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 13 (HealthDay News) -- A British family harbors a deadly inherited illness that destroys the brain in a way that is similar to the dreaded mad cow disease, researchers report.

The newly discovered condition doesn't appear to be contagious, unlike mad cow disease. As a result, it seems to pose no threat to people who aren't part of the family.

But researchers believe members of the family face a 50 percent likelihood that they'll develop the disease in mid-life and die. There is no treatment.

"It has been passed on from generation to generation," said study author Dr. Simon Mead, a neurologist and lead clinician at London's National Prion Clinic. "But we are developing treatments, and hope to start clinical trials soon."

Researchers believe the condition isn't caused by any of the usual suspects that make people sick -- bacteria, viruses, parasites and fungus. Instead, the culprits are "prions" -- renegade proteins that cause death by poking holes, Swiss cheese-style, in the brain.

Mad cow disease, spread by the consumption of infected tissue, is the most famous form of prion disease, but there are several others. One, fatal familial insomnia, is inherited and causes increasing sleeplessness that leads to death. Another, sporadic Creutzfeldt-Jakob disease, occurs in people for no apparent reason. Yet another type, called kuru, has been found in cannibals who eat infected human brains.

In the new study, researchers say they've confirmed that a disease caused by prions has infected multiple members of the British family who are descended from a single couple who had three children; it's not clear if the disease was present in even earlier generations. They reached their conclusions after studying six of 11 family members who seem to have been affected.

It appears that physicians misdiagnosed those family members with the disease after they began suffering from chronic diarrhea in their 30s and a series of other symptoms, such as nerve pain. The apparent sufferers developed thinking problems and seizures in their 40s and died, on average, at the age of 57, although one lived to be 70.

The researchers believe that nine people in five generations had the illness and died; another two, from the most recent generation, have the disease and are still alive.

Mead said the disease is unusual because the prions seem to have damaged the intestines, not just the brain, leading to the diarrhea. It's possible that the prions damaged nerves in the bowels, he said. "Most prion diseases cause damage in the nervous system," he said. "Prions are toxic to brain cells."

Mead said researchers are trying to develop a treatment that will rally the body's immune system against the renegade proteins.

Robert Rohwer, an associate professor of neurology at the University of Maryland at Baltimore School of Medicine who is familiar with prion diseases, said the study is "an excellent piece of work."

Unfortunately, he said, there's no way for members of the family to prevent the spread of the disease other than by simply not having children.

In the bigger picture, he said, scientists are studying the possible connections between prion disease and conditions like Alzheimer's disease, which slowly destroys the brain in a similar fashion. That leads to the prospect that better understanding of one type of disease could lead to more insight into the other.

The study appeared in the Nov. 14 issue of The New England Journal of Medicine.

More information

For more about prion diseases, try the U.S. National Library of Medicine.

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 13 (HealthDay News) -- The use of powerful narcotic painkillers is common among U.S. hospital patients who have not had surgery, a new study finds.

The finding comes amid growing concern about the overuse of these narcotics -- such as morphine, Oxycontin and fentanyl -- which are associated with high rates of addiction and overdose.

The rate of fatal overdoses from these drugs nearly quadrupled over the past decade and it's estimated that more than 14,000 Americans die each year from such overdoses, according to the U.S. Centers for Disease Control and Prevention.

In this study, researchers analyzed data from more than 1 million admissions to 286 hospitals around the country between mid-2009 and mid-2010, and found that more than 50 percent of patients who did not have surgery were prescribed narcotics, often at very high doses.

More than half of the nonsurgical patients who were given these painkillers were still receiving them on the day they were discharged from the hospital, the Beth Israel Deaconess Medical Center team said.

They also found widespread regional variation in the use of these narcotics in nonsurgical hospital patients, with a 37 percent difference between the highest (West) and lowest (Northeast) prescribing regions.

Patients who received narcotics at hospitals that prescribe them more often were at greater risk for serious complications related to these drugs than those who received the drugs at hospitals that prescribe them less often, according to the study published online Nov. 13 in the Journal of Hospital Medicine.

"In other words, hospitals that used these drugs more frequently did so less safely," study author Dr. Shoshana Herzig, a hospitalist in Beth Israel's division of general medicine and primary care and an instructor in medicine at Harvard Medical School, said in a medical center news release.

"Taken together, our findings really emphasize the importance of good communication between inpatient and outpatient providers," Herzig said.

"It's important that primary care physicians know what medications their patients have been exposed to during hospitalizations," she added. "We hope this information will prompt hospitals to take a closer look at their own opioid-prescribing practices."

More information

The U.S. Food and Drug Administration offers a guide to the safe use of pain medications.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 13 (HealthDay News) -- American adults are far more likely than those in 10 other high-income countries to go without health care due to cost, or to have trouble paying their medical bills, a new study finds.

The study, from independent think tank The Commonwealth Fund, also found more Americans complaining of hassles over health insurance disputes and paperwork.

"The U.S. spends more on health care than any other country, but what we get for these significant resources falls short in terms of access to care, affordability and quality," Commonwealth Fund president Dr. David Blumenthal said in the group's news release.

The survey of 11 high-income countries found that 37 percent of U.S. adults went without recommended care, did not see a doctor when sick or did not fill prescriptions because of the cost, compared with as few as 4 to 6 percent of adults in the United Kingdom and Sweden.

Nearly one-quarter (23 percent) of American adults also either had serious trouble paying medical bills or were unable to pay them, compared to less than 13 percent in France (which had the next-highest rate), and 6 percent or fewer of those in the United Kingdom, Sweden and Norway, according to the survey.

The investigators also found that 41 percent of U.S. adults spent $1,000 or more out-of-pocket for health care in the past year. That's by far the highest rate of any other country in the survey, according to the study published online Nov. 13 in the journal Health Affairs.

The 2013 survey included more than 20,000 adults in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the United States.

Thirty-two percent of American adults also said they had either spent a lot of time dealing with insurance paperwork and disputes, or their insurer had denied a claim and/or paid less than anticipated. This contrasted with 25 percent of adults in Switzerland, 19 percent in the Netherlands and 17 percent in Germany, all countries with competitive health insurance markets.

The poll also found that three-quarters of U.S. adults said the country's health system needs to undergo fundamental changes or be rebuilt. In comparison, 51 percent of Dutch adults, 54 percent of Swiss adults and 63 percent of U.K. adults had strong positive views of their health systems, saying they required only minor tweaking.

However, the U.S. spent $8,508 per person on health care in 2013, which is more than any other nation. The next highest-spending countries were Norway ($5,669) and Switzerland ($5,643). New Zealand was the lowest at $3,182.

The United States also had the highest health insurance administrative costs at $606 per person. The next-highest countries were France ($277) and Switzerland ($266), the results showed.

High administrative spending is a symptom of the complex, more fragmented health insurance system in the United States, according to the study authors.

Finally, many Americans say they have to wait for primary care if they fall ill. The poll found that fewer than half said they got seen by a practitioner the same day or the next day, and one-quarter of respondents said it took them six days or longer to receive care.

Cathy Schoen, Commonwealth Fund senior vice president and lead author of the study, said the findings haven't changed much over the years.

"For more than 10 years now, The Commonwealth Fund has compared the U.S. health system to the systems of other industrialized nations, and the U.S. has always been an outlier when it comes to costs, access and affordability," she said. "Far too many people go without care or can't afford to be sick, even when they have health insurance."

More information

The U.S. Agency for Healthcare Research and Quality offers tips for choosing quality health care.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

Imbruvica Approved for Mantle Cell Lymphoma

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WEDNESDAY, Nov. 13 (HealthDay News) -- Imbruvica (ibrutinib) has been approved by the U.S. Food and Drug Administration to treat mantle cell lymphoma (MCL), a rare but aggressive form of blood cancer.

MCL represents about six percent of non-Hodgkin lymphoma cases, the agency said Wednesday in a news release. By the time it's usually diagnosed, it has spread to other areas such as the lymph nodes or bone marow.

Imbruvica, designed to inhibit an enzyme that cancer cells need to spread, was granted the FDA's rare "breakthrough therapy" status as a drug that promises to offer a "substantial improvement over available therapies for patients with serious or life-threatening diseases," the agency said.

Imbruvica was evaluated in a study of 111 participants. Of those who took the drug daily, 66 percent had their cancer shrink or disappear, the FDA said. The most common side effects included: low blood platelets, diarrhea, low white blood cells, anemia, fatigue, musculoskeletal pain, swelling and upper respiratory infection.

Imbruvica is co-marketed by Sunnyvale, Calif.-based Pharmacyclics, and Raritan, N.J.-based Janssen Biotech.

More information

To learn more about non-Hodgkin lymphoma, visit Medline Plus.

-- Scott Roberts

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 13 (HealthDay News) -- Premature babies have an increased risk of retinal detachment later in life, according to a large new study.

Retinal detachment can lead to vision loss and even blindness unless it is treated with surgery.

Researchers analyzed data from more than 3 million people born in Sweden between 1973 and 2008. Those born at less than 37 weeks' gestation were divided into two groups: preemies born between 1973 and 1986, and preemies born between 1987 and 2008.

In 1986, Sweden introduced a national screening program for the eye condition known as "retinopathy of prematurity." This condition causes abnormal blood vessels to grow in the retina -- the back of the eye -- and can cause retinal detachment, according to background information in a news release from the American Academy of Ophthalmology.

Compared with babies born at full-term, people born extremely prematurely (less than 28 weeks of gestation) between 1973 and 1986 had a 19-fold increased risk of retinal detachment, while those born extremely prematurely between 1987 and 2008 had a ninefold increased risk, the investigators found.

Meanwhile, those born very prematurely (28 to 31 weeks of gestation) between 1973 and 1986 had a fourfold increased risk and those born very prematurely between 1987 and 2008 had a threefold greater risk than those born at term.

Moderately premature birth (32 to 36 weeks of gestation) was not associated with an increased risk of retinal detachment, according to the study in the November issue of the journal Ophthalmology.

"We may just be seeing the tip of the iceberg of late [eye] complications after preterm birth," lead researcher Dr. Anna-Karin Edstedt Bonamy, a pediatrician at Karolinska Institute in Stockholm, said in an academy news release.

"Not only does the risk of retinal detachment increase with age, but there has also been an increase in survival among people born prematurely since the 1970s. This provides opportunities for future research to address if the increased risk persists among those born prematurely as they age," she added.

The findings show the need for eye care follow-up of children and adults who were born extremely or very prematurely, the researchers said.

Although the study found a higher risk for future retinal detachment in very premature infants, it did not prove a cause-and-effect relationship.

With more than a half a million premature babies born each year, the United States has the sixth largest number of premature births worldwide, according to the news release.

More information

The U.S. National Eye Institute has more about retinal detachment.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 13 (HealthDay News) -- Pain in the surgical incision site might contribute to the temporary memory and learning problems that can occur after surgery, according to a new study performed on mice.

Up to 80 percent of surgical patients in the United States have some level of pain after surgery, and several studies have suggested that such pain could cause problems with thinking ability after surgery.

To investigate the possible connection, Massachusetts General Hospital researchers made small incisions on the mice's paws while they were under general anesthesia. The mice were tested one, three and seven days after the procedure to see how sensitive their paws were to discomfort. The animals' paws showed increased sensitivity to pressure at one and three days, but not at seven days.

Compared to mice with no incisions, those with incisions had poorer performance on some learning and memory tests at days three and seven, but not on day 30, according to the study, which was published Nov. 6 in the Journal of Neuroscience.

Thinking problems associated with incision-related pain occurred in middle-aged mice, while young-adult mice showed few signs of such problems, the researchers said.

The researchers also found that a subgroup of mice with incisions that were treated with local anesthetic after the procedure did not have the increased level of discomfort at the incision site nor the types of mental problems seen in the other mice with incisions.

This suggests that pain after surgery and not the incision itself contributed to the learning and memory problems.

"These findings suggest ... that pain is one of the factors that contribute to the risk of [problems with thinking ability] in surgical patients -- in addition to the surgery itself, anesthetics, sleep disturbance and other factors," Dr. Zhongcong Xie, director of the geriatric anesthesia research unit in the Mass General department of anesthesia, critical care and pain medicine, said in a hospital news release.

"While postoperative [thinking-ability problems] may be temporary, it still can have a major impact on the quality of life of patients and their caregivers at a time when patients' ability to participate in their own care is very important," Xie said.

Scientists note that research conducted in animals often fails to provide similar results in humans. And this study showed only an association between post-surgery pain and memory problems; it did not prove a cause-and-effect relationship.

More information

The U.S. Agency for Healthcare Research and Quality outlines questions you should ask before surgery.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 13 (HealthDay News) -- People with diabetes have to prick their fingers multiple times a day to monitor their blood sugar levels, but researchers report that someday patients may be able to do that simply by checking their breath.

A hand-held device would measure levels of the chemical acetone in someone's breath. Acetone levels rise when blood sugar levels rise, and acetone is responsible for the sweet, fruity smell on the breath of people with diabetes who have high blood sugar levels.

What hasn't yet been proven is whether or not blood sugar levels reliably rise and fall with acetone levels, according to the study's lead researcher, Ronny Priefer, a professor of medicinal chemistry at Western New England University in Springfield, Mass.

"If we can successfully show that there is a linear correlation between acetone levels and blood glucose [sugar] levels, the ease of which an individual with diabetes can monitor their disease state should be dramatically simplified," Priefer said.

He added that a simple breath test to measure blood sugar levels might help patients better manage their disease, too, because it won't hurt like a finger prick to get the information needed to guide treatment decisions.

Results of the study were scheduled to be presented Wednesday at the annual meeting of the American Association of Pharmaceutical Scientists, held in San Antonio, Texas.

People with either type 1 or type 2 diabetes have to measure their blood sugar levels to monitor how well treatments are working. Blood sugar checks are especially important for people with type 1 diabetes, an autoimmune disease that always requires treatment with insulin. People with type 1 diabetes may check their blood sugar levels as many as six or more times a day, according to JDRF (formerly the Juvenile Diabetes Research Foundation).

People with type 2 diabetes who use insulin also need to check their blood sugar levels more frequently than those who don't use insulin. For those dependent on insulin, a blood sugar check tells them whether or not they need more insulin, and helps guide the decision on how much insulin is needed.

Priefer and his colleagues developed a hand-held device that uses layers of a film that react with acetone to quantify the amount of acetone present in breath samples.

Right now, the breathalyzer is about the size of a book. The researchers are working to make the device smaller, so that it's similar to what's used by the police to measure blood alcohol levels. Priefer said that would make it about the size of a large coffee mug.

He said they have two clinical trials planned for 2014 to see if the levels of acetone go up linearly with a rise in blood sugar levels.

Priefer said he expects that the researchers will find that certain foods may affect the readings. And, of course, the presence of acetone in the environment would affect readings. So, if someone had just removed nail polish with an acetone-based remover, that would affect the readings.

"The ultimate goal is to replace the finger prick," he said. However, he said it remains to be seen whether the blood sugar measurements will be accurate enough to guide insulin dosing, or if the technology might just be useful for people with type 2 diabetes who don't use insulin.

One diabetes expert said he was glad to see treatment innovations but didn't think this one would be appropriate for all patients.

"I'm happy to learn that there are novel things in technology in development. But, the relationship between acetone and blood sugar isn't always one to one," said Dr. Joel Zonszein, director of the clinical diabetes center at Montefiore Medical Center, in New York City.

"People can have high blood sugars with low acetone, and low blood sugars with high acetone," Zonszein said. "I don't think acetone will be a good way of managing blood sugars, at least not for people with type 1 diabetes, where they really need very precise numbers to know how much insulin to give. It may be a help for people with type 2 diabetes, who aren't taking insulin."

More information

Learn more about methods to check blood sugar from the American Diabetes Association.

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 13 (HealthDay News) -- Most teens who misuse narcotic painkillers hope to get relief from pain, a new study reveals.

Researchers found that four out of five teens who misused prescription pain medications such as OxyContin or Vicodin by taking more than directed or using someone else's prescription cared less about getting high than they did about easing their discomfort.

Although research has shown that most teens given prescriptions for narcotic pain relievers use them properly, some young people do not. Sean McCabe and colleagues from the University of Michigan surveyed about 3,000 teens in 2011 and 2012 to determine why they abused these pain medications. They also took the teens' gender, race and ethnicity into account.

Although the majority of the teens surveyed said they took the drugs to relieve pain, the investigators noted that 30 percent of the teens who didn't take their medication as directed and 47 percent of the teens who used another person's prescription were also motivated by other factors, such as the desire to get high.

The study, published in the October issue of The Journal of Pain, also revealed that teenage girls were nearly twice as likely to have misused prescription painkillers in the past year than teenage boys. The researchers noted, however, there were no gender differences in the teens' motives for taking the medication.

Black teens were more likely than whites to not take their prescription as directed by their doctor, the study authors pointed out in a news release from the American Pain Society. Among this group, three in four reported being motivated by pain relief. The researchers noted these racial differences could be associated with poor pain management and communication, as well as lack of availability of these drugs or under-prescribing of black patients.

The researchers concluded use of narcotic painkillers by teens should be more closely monitored to identify possible abuse of these medications.

More information

The U.S. National Institute on Drug Abuse has more about drug use among teens.

-- Mary Elizabeth Dallas

Copyright © 2013 HealthDay. All rights reserved.

Health Highlights: Nov. 13, 2013

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

J&J Reaches Tentative Settlement in Hip Implant Lawsuits

A tentative deal to settle thousands of lawsuits over a defective hip implant has been reached by Johnson & Johnson and could cost the company up to $4 billion, according to two lawyers briefed on the plan.

They told The New York Times that an announcement about the settlement, which must win court approval, is expected in the coming days. If it goes ahead, it would be one of the largest payouts for product liability claims involving a medical device.

The lawsuits center on an all-metal replacement hip called the Articular Surface Replacement (ASR). It was sold by J&J's DePuy Orthopaedics unit until mid-2010, when it was recalled due to high failure rates. As it wears, the product releases metallic debris that damages tissue and can cause crippling injuries.

Under the settlement, each patient would receive an average of about $350,000, but that figure will vary depending on factors such as a patient's age and health, the lawyers told The Times.

The deal is limited to patients who have been forced to have the ASR device removed and replaced with another artificial hip. Patients with the device who have not had a replacement won't be eligible for compensation.

A DePuy Orthopaedics spokesperson declined to comment on the possibility of a settlement, The Times reported.

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Bill to Get Schools to Stock Food Allergy Drug Goes to President

A bill that offers a financial incentive to states if their schools stock a medication for severe food allergies is expected to be signed by President Barack Obama.

Epinephrine is considered the first-line treatment for people with severe allergies and is administered by injection through preloaded EpiPens or similar devices., It can be used to treat severe allergic reactions -- called anaphylaxis -- to food as well as insect bites, medications, and latex, the Associated Press reported.

Having epinephrine on hand is one of the recommendations in recently-released Centers for Disease Control and Prevention guidelines to schools on how to protect students with food allergies. And several states have passed or are considering bills making epinephrine available in schools.

"Everything is moving in the direction which adheres to our mission, which is to keep kids safe and included in schools," John Lehr, the chief executive officer of the Food Allergy Research and Education advocacy organization, told the AP.

A recent CDC survey found that about 1 in 20 U.S. children have food allergies, a 50 percent increase from the late 1990s.

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NASCAR Driver Trevor Bayne Has Multiple Sclerosis

Race car driver Trevor Bayne has been diagnosed with multiple sclerosis but says he will continue to race in NASCAR.

Bayne, 22, underwent extensive testing at the Mayo Clinic in Minnesota and has been cleared to race by doctors and NASCAR. He said Tuesday he isn't taking medication and doesn't expect to make any lifestyle changes, USA Today reported.

The diagnosis was made in the summer, a few weeks after Bayne won at Iowa Speedway. The Roush Fenway Racing driver had symptoms such as numbness in his arm, blurred vision, nausea and fatigue.

It was Bayne's decision to reveal his MS diagnosis, which will not affect his status with sponsors or the team, said Roush Fenway Racing president Steve Newmark, USA Today reported.

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Emergency Care Providers Have Poor Hand Hygiene: Survey

Only 13 percent of emergency medical personnel say they clean their hands before touching patients, according to a survey of nearly 1,500 emergency care providers.

It also found that only 52 percent of the respondents -- which included first responders, emergency medical providers, paramedics and doctors -- said that they wear gloves for every patient contact, CBS News reported.

Only one-third of emergency medical providers said they cleaned their hands after performing invasive procedures, according to the findings presented in October at the American College of Emergency Physicians annual meeting.

"What we found was a little concerning," Dr. Josh Bucher, a resident at Robert Wood Johnson Hospital and one of the study's authors, told CBS News.

Good hand hygiene by health care providers is crucial in reducing the risk of transmitting germs to patients, the Centers for Disease Control and Prevention says.

In the United States, about one in every 20 hospital patients develops a health care-related infection each year. Such infections can lead to death, CBS News reported.

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 13 (HealthDay News) -- Women who suffer a concussion may heal more slowly if the injury occurs in the two weeks leading up to their menstrual period, a small new study suggests.

"The phase of the menstrual cycle when a woman suffers a concussion has a lot to do with the outcome," said study researcher Dr. Jeffrey Bazarian, an associate professor of emergency medicine at the University of Rochester School of Medicine and Dentistry.

Bazarian studied 144 women who had a concussion, evaluating them both in the hospital and a month later. During the follow-up evaluation, he said, those women who had the concussion in the two weeks before their period "perceived their overall general health to be worse and were more likely to have headaches and dizziness."

On the other hand, women who had the concussion in the two weeks after their period or women on birth-control pills fared better, Bazarian said.

The study was published Nov. 13 in the Journal of Head Trauma Rehabilitation.

Bazarian suspects that the differences in recovery has to do with levels of progesterone, a hormone believed to protect the brain. A concussion, like any stressful event, can shut down the brain's pituitary gland, which generates progesterone.

Bazarian's team looked into whether a decrease in progesterone from its highest levels in the two weeks before menstruation would make a difference in recovery. Bazarian speculated that a concussion that occurs when progesterone levels are high is worse than one that occurs during other parts of the monthly cycle, when the levels are already lower.

Although concussions are often thought of as an injury linked mostly with men's football, that's not accurate, according to a recent report from the Institute of Medicine. The report found that rates appear to be higher among female athletes and those with a history of concussions. Although concussions do occur in football, they also are common in hockey, lacrosse, wrestling, soccer and women's basketball.

A concussion is known medically as a type of mild traumatic brain injury.

In Bazarian's study, the 144 women, aged 18 and older, got to the hospital within four hours of their head injury. They gave blood samples, and the researchers measured progesterone levels.

Of the 144 participants, 37 were in the high-progesterone group, 72 were in the low-progesterone group and 35 were on birth-control pills.

Those on birth-control pills with progestin would be expected to have a good outcome, Bazarian said, because the pills would prevent any drop in progesterone.

More research is needed, Bazarian said, but he suggested that women who suffer a hit to the head tell their doctor what phase of their cycle they are in. "Relaying the information to the health care provider might help the health care provider know what to expect in terms of outcome," he said.

The new findings are intriguing, said Kenneth Podell, co-director of the Methodist Concussion Center and director of the neuropsychology section at the Houston Methodist Neurological Institute. He was not involved with the study.

"The results are extremely preliminary," Podell said, and they don't prove cause and effect. However, he said, "this suggests people who take care of those with concussions should pay more attention to this [phase of the cycle]."

The number of women studied was relatively small, Podell said, and the differences among groups weren't extreme.

More information

To learn more about concussions, visit the Institute of Medicine.

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 13 (HealthDay News) -- Adults with autism face a shortage of housing and support services in the United States, according to a new survey.

Within the next decade, at least 500,000 U.S. teens with autism will enter adulthood. Many will require access to the adult services system, which is already overburdened, the Autism Speaks survey found.

"The results of the National Housing and Residential Supports Survey underscore the overwhelming need for more housing and residential support options and services," Lisa Goring, vice president of family services at Autism Speaks, said in a news release from the organization.

The survey findings were scheduled for presentation Wednesday at an autism policy summit in Washington, D.C.

The nationwide poll involved more than 10,000 respondents, including caregivers and nearly 400 people with autism. More than 84 percent of caregivers said they had an adult with autism living at home, and only 24 percent of those adults were currently on a waiting list to receive housing and residential support services.

Nearly 78 percent of caregivers said the person with autism required some daily support; nearly 70 percent of caregivers said they did not have outside help to care for their loved ones with autism; and more than half of caregivers said they need assistance.

"It was important that we hear from our community, both those with autism and the caregivers of those who cannot respond themselves," Goring said. "Adults with [autism] should be able to live as independently as possible, and this survey is the first step in understanding what that may look like for some individuals."

People with an autism spectrum disorder have problems with communication and social behavior. These problems can range from mild to severe and cause difficulties in many areas of life.

More information

The National Alliance on Mental Illness has more about adults with autism.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 13 (HealthDay News) -- Babies born to women who've had weight-loss surgery are more likely to be premature and to have low birth weights, a new study found.

These pregnancies should be considered at-risk and require careful monitoring by doctors, said the researchers at the Karolinska Institute, in Sweden.

The investigators compared more than 2,500 babies born between 1992 and 2009 to women who'd had weight-loss surgery with a comparison group of 12,500 babies born to women who had not had this type of procedure, known as "bariatric" surgery.

The analysis revealed that 5.2 percent of infants born to women who'd had weight-loss surgery were small for gestational age and 4.2 percent were large for gestational age. This compared to 3 percent and 7.3 percent, respectively, of those infants whose mothers had not had the surgery.

The researchers also found that 9.7 percent of the infants born to mothers who'd had weight-loss surgery arrived prematurely (before 37 weeks), compared with 6.1 percent of other infants.

No differences were seen between the two groups in rates of stillbirth or death within the first 27 days after birth, according to the study published online Nov. 12 in the journal BMJ.

Although the study found an association between women having weight-loss surgery and higher risk of pregnancy with prematurity or lower birth weight, it did not establish a cause-and-effect relationship.

"The mechanism behind how [weight-loss] surgery influences fetal growth we don't yet know, but we do know that people who have bariatric surgery are at increased risk of micronutrient deficiencies," Dr. Olof Stephansson, an obstetrician and associate professor at the clinical epidemiology unit at Karolinska, said in an institute news release.

The researchers noted that an increasing number of people are having weight-loss surgery and said that the pregnancies of women who've had the surgery should be considered at-risk and require particularly close attention. For example, they should have extra ultrasounds to check fetal growth or be given special dietary supplement recommendations.

But the study authors also pointed out that weight-loss surgery has numerous benefits for mothers, such as reducing the risk of diabetes, heart disease, cancer and stroke. In addition, obesity is a known risk factor for both mother and baby during pregnancy and childbirth.

More information

The March of Dimes has more about pregnancy after weight-loss surgery.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 13 (HealthDay News) -- Hormone therapy helps with menopause-related symptoms such as sleep and memory problems only if a woman also has hot flashes, according to new research.

The study included 150 Finnish women who had recently gone through menopause. Of those, 72 had seven or more moderate-to-severe hot flashes a day, while 78 had three or fewer mild hot flashes daily or no hot flashes.

In each group, half of the women were treated for six months with hormone therapy of various kinds, while the other half were given an inactive placebo with no hormones, according to the study published online Nov. 13 in the journal Menopause.

Among women with moderate-to-severe hot flashes, hormone therapy helped with menopause-related symptoms such as insomnia, memory and concentration problems, anxiety and fear, exhaustion, irritability, swelling, joint and muscle pain, hot flashes, vaginal dryness and general health, the investigators found.

However, hormone therapy provided no such benefits for women with mild or no hot flashes, the findings showed.

"There has been a long debate over this issue. This new, well-designed study puts forth good evidence that hormone therapy does not improve quality of life in recently menopausal women who do not have numerous hot flashes," Dr. Margery Gass, executive director of the North American Menopause Society, said in a society news release.

Hot flashes are episodes of intense, spreading heat experienced by some women after their monthly periods stop. Changing hormone levels are believed to cause hot flashes and other menopausal symptoms.

The researchers noted that the women in the study were white, healthy and lean, so the results may not apply to women in other racial/ethnic groups or those with other health conditions.

More information

The U.S. National Institute on Aging has more about hormones and menopause.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

WEDNESDAY, Nov. 13 (HealthDay News) -- Many Americans say they'd submit to insurance company medical tests and lifestyle monitoring in exchange for lower-cost premiums, a new Harris Interactive/HealthDay poll finds.

The poll of more than 2,000 adults found that a majority would be "very willing" to have various tests and share the results with their health insurer -- provided there was a financial incentive, such as a lower monthly premium or smaller co-pays.

Many were even open to intrusive measures. Just over half said they'd agree to let their health plan monitor any exercise regimen they were using to lose excess pounds or control diabetes.

What's more, nearly half said they'd undergo genetic tests to gauge their risks of "cancer or inherited medical conditions."

"That's kind of shocking," said Jennifer Blumenthal-Barby, an assistant professor of medicine and medical ethics at Baylor College of Medicine in Houston.

There is nothing "inherently wrong" with offering people financial incentives aimed at improving their health and reining in health care costs, Blumenthal-Barby said. But divulging your risk of potentially developing a disease at some point in the future is another matter.

"You have to wonder to what extent people understand the implications of that," Blumenthal-Barby said. Privacy has been a long-time concern with genetic testing, because employers or insurers could potentially discriminate against people at increased risk of a given disease.

Of course, survey respondents' answers to theoretical questions need to be taken with a grain of salt. In real life, people might not be so quick to have genetic testing, Blumenthal-Barby added.

But, she said, the poll results raise concerns about how informed people are when it comes to genetic testing and privacy.

In recent years, many U.S. companies that provide health insurance to their employees have started offering financial incentives. Workers who undergo blood pressure, cholesterol or blood sugar tests, or who join an exercise or disease-management program, can get a break on what they pay into their insurance. Some employers also base the financial reward on the results of those tests.

In the new survey, most people were open to those simpler types of tests: Three-quarters said they'd have a blood pressure check, while 68 percent were willing to undergo blood sugar or cholesterol tests.

But fewer were willing to have their lifestyle choices scrutinized for a financial reward.

Just over half said they'd take part in a health plan-monitored exercise regimen to lose weight or control diabetes. And only about 38 percent would follow a specific diet to help lower their blood pressure or cholesterol.

"This survey shows that there is a substantial opportunity for health plans to test and monitor the health status and health risk behaviors of health plan members, but that they would have to be extremely careful to avoid a potentially explosive backlash," said Harris Poll Chairman Humphrey Taylor.

Blumenthal-Barby agreed on the need for a cautious deployment of financial incentives. "We need to make sure that incentives do not become coercive," she said.

Taylor pointed out that "all such monitoring and testing would have to be, and be seen to be, strictly voluntary. Any suggestion that pressure was being put on people to participate would be disastrous."

According to Blumenthal-Barby, one of the striking findings from the poll was that while 49 percent of people were "very willing" to undergo genetic tests, only 28 percent would attend a health class or keep an online diet-and-exercise diary.

"People would rather have genetic tests than keep a diary," she said.

That could be because a blood test sounds much easier, or because people often believe they are unlikely to have any "bad" genes, Blumenthal-Barby noted. But again, she said, the results suggest that many people do not grasp the full implications of giving away genetic information.

The poll, which surveyed 2,033 Americans online between Oct. 21-23, asked about hypothetical situations -- what people "would" do if a health plan were to offer incentives for various tests.

Blumenthal-Barby said she wasn't aware of any employers or insurers currently offering incentives in exchange for genetic tests -- which, in addition to being intrusive, are costly.

But she said that when people do get real offers of financial reward in exchange for medical tests, they should make sure they understand the deal.

"I don't think incentives are 'bad,'" Blumenthal-Barby said. "If the aim is to help you be healthier and cut down on overall health care costs, they could be good."

But, she added, "people may just think about the money. They need to be a little cautious and read the fine print, too."

More information

There's more on medical privacy issues at the U.S. Department of Health and Human Services.

For more about the poll and Harris Interactive click here.

Copyright © 2013 HealthDay. All rights reserved.

Health Tip: Cooking With Beans

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(HealthDay News) -- Beans are a high-fiber source of protein that contain little fat and cholesterol.

The Academy of Nutrition and Dietetics suggests how to prepare and cook beans:

  • Add beans to your favorite soups, stews or casseroles, or serve them as a side dish.
  • Reduce cooking time by as much as half by soaking beans in advance. To soak them overnight, place them in a large pot with plenty of room-temperature water.
  • To soak dried beans more quickly, bring a pot of water to a boil and then add beans, allowing them to soak for up to four hours.
  • To ease digestive gas, discard the soaking water, rinse the beans and cook them in fresh water.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

Health Tip: Practicing Tai Chi

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(HealthDay News) -- Tai chi is ancient Chinese martial art that involves slow movement and coordinated breathing.

The National Center for Complementary and Alternative Medicine says people who practice tai chi say they do so for these reasons:

  • It helps promote aerobic and low-impact exercise.
  • It may help coordination and muscle condition.
  • It may help reduce stiffness and pain.
  • It may help improve general wellness and quality of sleep.

The agency says scientific study of these potential benefits is ongoing. It recommends that anyone who is thinking of starting tai chi speak to a physician first, especially if you're pregnant or if you have hernia, joint or bone problems.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 12 (HealthDay News) -- New research suggests that some patients with anorexia or bulimia who receive targeted, noninvasive magnetic brain stimulation may experience relief from their binge eating and purging behaviors.

Doctors used a procedure called "repetitive transcranial magnetic stimulation" on 20 patients with entrenched cases of anorexia or bulimia. The treatment prompted measurable symptom improvement among half of those in the group, and the finding raises hopes for an alternative way to battle tough-to-treat eating disorders.

"The upshot is that between 50 and 60 percent of the time you're getting at least a 50 percent reduction in bingeing behavior," said study author Dr. Jonathan Downar, a clinician scientist in the department of psychiatry at the University Health Network in Toronto. "And this is among patients who had already tried everything for their eating disorder, and nothing had worked. So, what we're talking about is completely unprecedented."

Downar was to present his team's findings Tuesday at the Society for Neuroscience annual meeting, in San Diego. Research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed journal.

About 8 million North Americans suffer from chronic eating disorders such as bulimia and anorexia, the researchers noted. While prescription drugs and behavioral therapy help some people, they do not help everyone.

The notion that brain stimulation might work for these patients came about almost by accident, Downar said, after the treatment helped patients who struggled with depression.

It was a 2011 case study in particular that pointed the way, after a patient diagnosed with both depression and bulimia experienced almost complete relief from both conditions after just two weeks of brain stimulation.

In this latest study, 20 patients suffering from anorexia or bulimia received 45-minute sessions of brain stimulation, given 20 times over a four- to six-week period (at a cost of roughly $6,000). The stimulation was directed toward the region of the brain considered critical in the execution of self-control with respect to thoughts, emotions and behavior.

The result: enhanced activity in the targeted regions resulted in a 50 percent drop in binge eating and purging behaviors among nearly half the patients; another third saw their problems dip by at least 80 percent, and in some cases the behaviors disappeared altogether.

Brain scans indicated that those who responded to the treatment may have distinctly different brain-activity patterns than those who didn't.

"Those who did well with [brain stimulation] showed a lack of connection -- of physiological circuitry -- between the part of the brain that is supposed to tamp down on urges and cravings and the regulation area," Downar noted. "So stimulating that area repeatedly helped make the missing connection," he explained.

"But nonresponders seemed to actually have more connections to the regulatory circuitry than average. So [brain stimulation] did nothing for them because a need for more stimulation is not their problem," he added.

"But we think that maybe if we change the stimulation target for these patients, and change it to inhibit rather than excite stimulation, we might ultimately be able to help even these patients," Downar suggested. "We think it's possible."

Dr. Doug Klamp, a specialist in eating disorders with a private practice in Scranton, Pa., said the approach "seems promising."

"Bulimia can be a very difficult problem," Klamp explained. "When patients come to me, 60 to 70 percent will be cured within a year or so. But those other 30 to 40 percent are tough. They can try all the standard antidepressants and antipsychotic medications, and all the behavioral therapy options, but their problem behavior may still go on. For decades," he added.

"So, a new therapy would be very helpful," Klamp said. "And this idea makes sense to me, because I tend to see the same impulsive and destructive behavioral characteristics over and over again in my patients, as if it's hard-wired into people -- hard-wiring that maybe, with this, we can change."

Suzanne Mazzeo, a professor of psychology at Virginia Commonwealth University in Richmond, cautioned that it's still unclear why brain stimulation seems to help some -- but not all -- patients.

"Certainly, we do need more approaches. Eating disorders are very difficult problems to treat because our food environment is stacked against us, with food manufactured to be highly palatable and hard to resist," Mazzeo pointed out.

"So, overcoming any kind of emotional eating issue is going to be hard," she added. "And what we currently have for treatment is certainly not working for everyone."

But, Mazzeo noted, "in addition to ensuring the safety of this new technique and testing it for long-term maintenance, we have to be sure why it works for some and not others, so we can know who would be the most appropriate candidates for it."

More information

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

Copyright © 2013 HealthDay. All rights reserved.

New Guidelines May Widen Use of Statins

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TUESDAY, Nov. 12 (HealthDay News) -- New guidelines introduced Tuesday by the nation's leading heart experts could greatly expand the number of Americans taking cholesterol-lowering statins.

The fundamental shift: Doctors are now being told to no longer adhere to rigid clinical guidelines that trigger the use of a statin when cholesterol levels reach a certain threshold.

Instead, people will be advised to take a statin if they already have heart disease, if their bad (LDL) cholesterol is extremely high (190 milligrams per deciliter of blood or more) or if they're middle-aged with type 2 diabetes.

People between 40 and 75 years of age with an estimated 10-year risk of heart disease of 7.5 percent or more will also be advised to take a statin. Experts say this new rule could greatly alter the number of patients who will now be advised to take such a drug.

In crafting the new guidelines, experts from the American Heart Association and American College of Cardiology spent four years examining the data on heart disease care. The new criteria for who should take a statin also now factors in a person's risk for stroke -- something experts believe may also boost the number of people deemed eligible for the drugs.

"We focused specifically on the use of cholesterol-lowering therapy to determine what works best to reduce the risk of heart attack and stroke," Dr. Neil Stone, a professor of medicine at the Northwestern University Feinberg School of Medicine and chairman of the cholesterol committee, said during a press conference.

The revised cholesterol policy "suggests treatment should be individualized and that, depending on your risk, you may need a higher dose of a more potent statin than if your risk is lower," Dr. Hector Medina, a cardiologist at Scott & White Healthcare in Round Rock, Texas, told HealthDay.

Statins, which include Crestor, Lipitor and Zocor, remain the most effective drugs for reducing cholesterol and should be combined with lifestyle changes for the best results, according to the new report. This approach is better than trying to get cholesterol as low as possible by combining statins with other drugs, the report's authors said.

The committee also said matching patients with the appropriate level of statin therapy is more important than achieving any specific target number, as was common in the past.

For young adults, preventing high cholesterol in the first place can go a long way toward avoiding heart attacks and strokes, the committee added.

Assessing Risk

About one-third of adults at risk for a heart attack or stroke have not been diagnosed but could benefit from primary prevention -- including taking statins -- according to the report.

Doctors should use known risk factors -- such as age, cholesterol levels, blood pressure, smoking and diabetes -- to assess cardiovascular risk. "These are the strongest predictors of 10-year risk for cardiovascular disease," Dr. Donald Lloyd-Jones, a professor of preventive medicine at the Northwestern University Feinberg School of Medicine and co-chairman of the committee, said during the press conference.

Patients at risk of a heart attack or stroke within the next 10 years should get immediate drug therapy and be encouraged to change their lifestyle, Lloyd-Jones said.

On the other hand, those at lower risk of heart attack or stroke should be counseled to make lifestyle changes and probably do not need drug therapy, he said.

Tackling Obesity

Reducing obesity also cuts heart-health risks, and the new guidelines may help doctors and their plus-sized patients devise an effective -- and perhaps lifesaving -- weight-loss plan.

What works best are lifestyle changes, not crash diets, the authors of the new guidelines said.

"Our recommendation is that doctors prescribe a diet to achieve reduced caloric intake as part of a comprehensive lifestyle intervention," guideline co-author Dr. Donna Ryan, a professor emeritus at Louisiana State University's Pennington Biomedical Research Center in Baton Rouge, said during the press conference. The diet should be tailored to patient preferences and any drugs they take, she said.

Diet, physical activity and face-to-face behavioral counseling combined can lead to "clinically meaningful health improvement," Ryan said. "These benefits begin with weight loss in the range of 3 percent to 5 percent." The most effective behavior programs include two to three meetings a month for six months or more, according to the report.

Nearly 155 million American adults are overweight or obese, which puts them at risk of heart attack, stroke, diabetes and early death. Weight loss will lower blood pressure, improve blood cholesterol levels and reduce the need for medication to manage heart health, Ryan said.

For Americans, heart disease is the leading cause of death.

The experts said doctors should use a patient's body-mass index (BMI) to assess whether a patient is obese or not. BMI is a measure of body fat based on height and weight; a BMI of 25 or more is overweight.

"BMI is a quick and easy first screening step," Ryan said. Calculating BMI at least once a year will help identify those at a higher risk of heart disease and stroke because of their weight, she added. Waist circumference is also an indicator of risk.

Weight-loss surgery, also called bariatric surgery, may be the right option for those who are severely obese (a BMI of 35 or higher), especially if they have two other cardiovascular risk factors, such as diabetes and high blood pressure.

This emphasis on obesity is critical, said Medina, who was not involved with the report.

The problem? "Most patients don't think they are overweight or obese even with a BMI above 40," he said.

Besides reducing obesity, the new guidelines emphasize the need to maintain safe cholesterol levels, eat a healthful diet and assess other risk factors for heart attack and stroke.

Healthy Diet and Exercise

A healthy diet -- not necessarily a low-calorie diet -- and exercise reduce the risk for cardiovascular disease by lowering blood pressure and cholesterol.

"Dietary patterns that are heart-healthy... include lots of fish, vegetables and whole grains, and limit saturated fats, trans fats and sodium," cholesterol committee co-chairman Dr. Robert Eckel, a professor of medicine at the University of Colorado Anschutz Medical Campus in Aurora, said during the press briefing.

A heart-healthy diet of 2,000 calories per day should include:

  • Four or five servings of fruit daily,
  • Four or five servings of vegetables daily,
  • Six to eight servings of whole grains daily,
  • Two or three servings of fat-free or low-fat dairy products daily,
  • Six or fewer ounces of poultry or fish daily,
  • Four or five servings of nuts, legumes and seeds a week,
  • Two or three servings of healthy oils a day,
  • Limited sweets and sugars.

To reduce high blood pressure, limit salt intake to 1,500 milligrams a day, the committee said. U.S. adults currently consume an average of about 3,600 milligrams a day.

One key to heart-healthy eating is avoiding trans fats, which serve no nutritional purpose but are often added to foods to extend shelf life or improve texture. The U.S. Food and Drug Administration announced a plan last week to ban these man-made fats from all processed foods. These are often listed on labels as partially hydrogenated oils.

The guidelines also recommend moderate- to vigorous-intensity aerobic exercise, such as brisk walking, for about 40 minutes three or four times a week.

More information

For more information on preventing heart attack and stroke, visit the American Heart Association.

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 12 (HealthDay News) -- A small new study suggests that parts of your brain may differ depending on whether you're a social butterfly or a lone wolf.

The research is preliminary, but it could lead the way to more insight into how humans -- and other primates -- interact with others.

"The big message is that your brain is reflecting your current social environment, and your social skills at a wider level. The brain is flexible and reflecting all of these behaviors," said study author Maryann Noonan, a postdoctoral researcher at Oxford University, who worked on the study while at the Montreal Neurological Institute.

There's also the question of which comes first. Is the brain pre-programmed to turn certain people into more social creatures? Or does your brain change as a result of whether you're willing to engage with lots of other people in your life?

At issue is the connection between your brain and your ability to socialize with others of your species.

"There is a theory that social complexity drove the evolution of bigger brains in humans," said Paul Zak, chairman of the Center for Neuroeconomics Studies at Claremont Graduate University, who's familiar with the findings.

If that's the case, it may be possible that human brains are different depending on how social people are. That's what the authors of the new study tried to find out.

The researchers recruited 18 people, aged 27 to 70, and asked them about how many people they encountered over the past seven and 30 days. The researchers were trying to determine "social contact," according to Noonan: "Any phone call, any physical interaction, any email."

The researchers also scanned the brains of the 18 people and looked for anything that people with similar social lives had in common. They discovered that three parts of the brain appeared to be larger and more strongly connected to other regions of the brain in people who had larger social networks, Noonan said.

The findings reflect previous research that found similarities in the brains of monkeys who lived in larger groups. "This is telling, and perhaps could show some sort of common mechanism across primates," she noted.

Noonan suspects -- but can't yet prove -- that it's the brain that adjusts to how social people are. "While I have to hedge my bets, I think the brain is able to adapt to all of your current skills and needs," she explained. "But we're not able to make the claim that it's getting bigger or better connected."

Zak, the neuroeconomist, said it is indeed hard to figure out which comes first -- better social skills or certain types of brains. However, "their findings are consistent with studies showing that lonely people have differences in brain volume than non-lonely people," he said.

Noonan said the next step is to better understand which areas of the brain are crucial to being social.

In the big picture, though, it may be difficult to understand what's going on because it will be hard to design a study that follows people from a young age and specifically determines how their brains affect their social lives, Zak said. "We are unlikely to have a definitive answer as to how our innate brain structure affects our behavior," he added.

Still, study lead author Noonan said this kind of research can lead to better understanding of how conditions like autism and schizophrenia disrupt people's abilities to be social in a normal way.

The findings were scheduled to be presented Tuesday at the annual meeting of the Society for Neuroscience, in San Diego. Research presented at meetings is viewed as preliminary until it is published in peer-reviewed medical journals.

More information

People who have trouble socializing with others may suffer from a psychiatric disorder. For more about mental illness, visit the U.S. National Library of Medicine.

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 12 (HealthDay News) -- Teenage bullies are prone to engage in risky sexual behavior, a new study finds.

Casual sex and sex while drunk or high was more common among bullies and bully-victims than among other teens, a survey of more than 8,600 high school students found. Bully-victims are children who are both bullies and bullied.

"The time has come to acknowledge that bullying is a recognized health issue and that methods of prevention and help for those involved are important and necessary," said Dr. Jefry Biehler, chair of pediatrics at Miami Children's Hospital.

"Risk-taking behaviors among adolescents can and do have potential life-long consequences for the child and society," said Biehler, who was not involved in the study.

Programs aimed at preventing bullying and reducing unhealthy sexual practices should address the potential link between bullying and sexual risk-taking, the researchers suggested. However, the study does not prove that bullying causes teens to engage in risky sex.

"Findings from this study add to our understanding of the ways in which bullying affects youth and provide preliminary evidence that bullies and bullies who are also victims might be at heightened risk for sexual risk-taking behaviors," said lead researcher Melissa Holt, an assistant professor of counseling and human development at Boston University.

Because these risky sexual behaviors were seen mostly among heterosexual teens, Holt said the findings might be less applicable to gay or lesbian adolescents.

Also, Holt said, students who were solely victims of bullying weren't at "increased risk for sexual risk-taking."

The report, published online Nov. 11 in Pediatrics, did not directly address why bullies and bully-victims might engage in risky sexual behaviors, Holt noted.

"It may be that bullying and sexual risk reflect a coping response to stressors not captured in the study, such as harsh parenting," she said.

The increased risk for sexual risk-taking among bullies and bully-victims held even after taking into account factors such as dating violence, physical abuse and sexual abuse, Holt added.

Adolescence is a time when risk-taking is a concern, another expert noted. "We know that frontal lobes are still developing and judgment is not well-formed," said Dr. Victor Fornari, director of the division of child and adolescent psychiatry at North Shore-LIJ Health System in New Hyde Park, N.Y.

"Teens who are bullies may resort to higher-risk behavior, including higher-risk sexual behavior," he said.

"Bullying has all kinds of consequences," Fornari added. "This is one more negative consequence."

For the study, Holt's team reviewed answers provided by 8,687 teens who attend a Midwestern high school.

If they had ever had sex with someone they had just met or didn't know, the teens were considered to have engaged in casual sex. Similarly, if they had ever had sex while under the influence of alcohol, marijuana or other drugs, they were categorized as having sex under the influence.

Overall, about 6 percent of respondents admitted to being a bully, and 6 percent said they were bully-victims. Nine percent said they were victims of bullying.

Asked about sexual risk-taking, about one in four teen bullies and nearly one in five bully-victims had engaged in casual sex, the study found. By comparison, only 8 percent of victims and roughly 7 percent of teens not involved in bullying had had casual sex.

Having sex while drunk or high was reported by 34 percent of bullies and 23 percent of bully-victims, but only 11 percent of victims and 12 percent of teens who had no experience with bullies, the investigators found.

More information

For more information on bullying, visit Stopbullying.gov.

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 12 (HealthDay News) -- Men who are overweight or obese when they're diagnosed with prostate cancer face a higher risk of dying from the disease, a new study suggests.

Researchers looked at more than 750 prostate cancer patients who had surgery to remove their prostate and surrounding tissue.

Patients who eventually died from prostate cancer were 50 percent more likely to be overweight or obese at the time of diagnosis than those who did not die from the disease. The association between overweight/obesity and increased risk of death was highest among men with more aggressive types of prostate cancer.

The study was published recently in the journal Obesity Research & Clinical Practice.

"We found among patients undergoing surgical treatment for prostate cancer, weight at time of diagnosis is more strongly correlated with prostate cancer survival than many other factors researchers have studied in the past, including some prostate cancer treatments," study lead author Reina Haque, a researcher at Kaiser Permanente Southern California, said in a Kaiser news release.

The study found an association between being overweight when diagnosed with prostate cancer and a higher risk of death, but it did not prove cause-and-effect.

"Moving forward, we are hoping future studies will examine the effect of weight loss and other lifestyle modifications on prostate cancer mortality," Haque said.

Additional studies are needed to determine if the study findings also apply to prostate cancer patients who have other treatments, such as radiation or hormone therapy, the researchers said.

More information

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

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 12 (HealthDay News) -- Playing a musical instrument can cause fundamental changes in a young person's brain, shaping both how it functions and how it is physically structured, researchers say.

A trio of studies presented this week at the annual meeting of the Society for Neuroscience, in San Diego, suggested that musical training can accomplish the following:

  • Improve a person's ability to effectively process information from several senses at once,
  • Affect the way a young person's brain develops if they begin playing music prior to age 7,
  • Enhance connectivity between the parts of the brain associated with creativity and improvisation.

All these findings ultimately could lead to improved therapies for people with brain injuries or learning disabilities, Dr. Gottfried Schlaug, director of the Music and Neuroimaging Laboratory at Harvard Medical School, said in a Monday afternoon news conference.

"Music might provide an alternative access into a broken or dysfunctional system within the brain," said Schlaug, an associate professor of neurology at Harvard. "Music has the unique ability to go through alternative channels and connect different sections of the brain."

The first study, conducted by Canadian researchers, asked trained musicians and non-musicians to respond to sound and touch sensations at the same time.

Two sounds were delivered at the same time a person received one touch sensation, which was intended to create the perceptual illusion that the person actually had received two touch sensations.

Since musicians have to simultaneously work their instrument, read sheet music and listen to the tones they produce, the researchers predicted that they would be better able to sort out sound from touch.

This prediction proved correct. Non-musicians fell for the illusion, but musicians did not, researcher Julie Roy, of the University of Montreal, said during the news conference.

"Musicians are able to ignore the auditory stimuli and only report what they are feeling," Roy said, adding that this is solid evidence of an improved ability to process information from more than one sense at the same time.

The second study involved brain scans of 48 Chinese adults aged between 19 and 21, who had at least a year of musical training while growing up.

Researchers found that brain regions related to hearing and self-awareness appeared to be larger in people who began taking music lessons before age 7. Specifically, these areas tended to have a thicker cortex, which is the outer layer of the brain.

These findings seem to indicate that musical training can have a huge impact on the developing brain, since brain maturation tends to peak around age 7, said lead researcher Yunxin Wang, of the State Key Laboratory of Cognitive Neuroscience and Learning at Beijing Normal University.

The third study found that brain circuitry can be reshaped by musical training.

Swedish researchers performed MRI scans of 39 pianists who were asked to tickle the ivories on a special 12-key piano keyboard while the scans took place.

Pianists who were more experienced in jazz improvisation showed higher connectivity between three major regions of the brain's frontal lobe while they improvised some music, said lead author Ana Pinho of the Karolinska Institute, in Stockholm.

At the same time, they showed less activity in brain regions associated with executive functions such as planning and organizing, which could mean that trained improvisers are able to generate music with little conscious attention or thought, Pinho said.

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

The new findings all seem to indicate that training with a musical instrument can affect the brain in profound ways that could prove useful both in education and in therapy, Harvard's Schlaug said.

"Listening to and making music is not only an auditory experience, but it is a multisensory and motor experience," he said. "Making music over a long period of time can change brain function and brain structure."

More information

For more about music therapy, visit the American Music Therapy Association.

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 12 (HealthDay News) -- When willpower doesn't work, smokers who want to quit may have a new tool someday: magnetic brain stimulation.

A study of 115 smokers found that 13 sessions of the treatment over three weeks helped some heavy smokers quit for as long as six months.

This noninvasive technique, called repeated high-frequency transcranial magnetic stimulation, sends electric impulses to the brain. It is sometimes used to treat depression.

"Using noninvasive stimulation can reduce nicotine craving and smoking," said lead researcher Abraham Zangen, an associate professor at Ben-Gurion University of the Negev in Beer-Sheva.

"If you stimulate regions in the brain that are associated with craving for drugs, you can change the circuitry in the brain that mediates this dependence and eventually reduce smoking," he said. "And many of those treated stop smoking."

The study participants smoked at least a pack a day and had failed at least two previous attempts to quit, said Zangen, who has a financial interest in the equipment used in the study.

The researchers divided the participants into three groups. One group received high-frequency brain stimulation, another low-frequency stimulation, and the third received a phony treatment. The groups were further divided into those who saw a visual cue -- a picture of a lit cigarette -- just before stimulation and those who didn't.

The idea of the cue is to make sure attention is directed at smoking and not some other craving, Zangen said.

After 13 treatments, those who received the highest level of stimulation plus the visual cue had the best results -- 44 percent of them had quit. After six months, one-third of this group were still not smoking compared to 28 percent of those who weren't shown the visual cue before treatment.

The results of the study were scheduled for presentation Tuesday at the annual meeting of the Society for Neuroscience in San Diego.

Although magnetic brain stimulation is approved by the U.S. Food and Drug Administration for treating depression, it is not yet approved for helping people quit smoking, Zangen said.

Dr. Alan Manevitz, a clinical psychiatrist at Lenox Hill Hospital in New York City, said, "It's a very effective treatment for depression and anxiety."

Manevitz thinks using it to help people stop smoking makes sense. Other studies, he noted, have found that stimulating an area of the brain called the insula can reduce the desire to smoke.

"Adding brain stimulation to other smoking cessation methods like nicotine substitution might make it even more effective," he said.

When used for depression, magnetic brain stimulation costs from $300 to $350 a session, and the treatment may not be covered by insurance, Manevitz said.

For the treatments, participants wear a helmet fitted with coils that deliver magnetic stimulation to the areas of the brain -- the prefrontal cortex and the insula -- associated with nicotine addiction.

Dan Jacobsen, from the Center for Tobacco Control at North Shore-LIJ Health System in Great Neck, N.Y., thinks the idea is interesting but he doesn't see this becoming a viable treatment option anytime soon.

"This treatment is not a simple procedure," he noted. And the six-month results weren't as good as the success rates for other treatments, including medication and nicotine replacement, combined with behavioral components, he said.

Side effects from the treatment were mild and included headaches or muscle twitching. These symptoms went away with continued treatment, Zangen said. One potentially serious but rare side effect is that brain stimulation can induce a seizure, especially in those prone to epilepsy, he noted.

Data and conclusions presented at meetings are typically considered preliminary until published in a peer-reviewed medical journal.

More information

To find out more about quitting smoking, visit the U.S. Centers for Disease Control and Prevention.

Copyright © 2013 HealthDay. All rights reserved.

Divorce May Raise Risk of Accidental Death

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TUESDAY, Nov. 12 (HealthDay News) -- Divorce may have another downside: a higher chance of meeting up with a fatal accident.

That's the finding of a new study that also finds higher rates of accidental death for people with low levels of education. The report was published online recently in the journal Social Science Research.

The study authors tracked data from 1.3 million Americans aged 18 and older who survived or died in accidents between 1986 and 2006.

Divorced people were two times more likely than married people to die from the most-preventable causes of accidental death -- hazards such as fire or poisoning. Both groups had an equal risk of dying from the least-preventable causes of accidental death, for example, things such as airplane or boat accidents.

Single people were also two times more likely than married people to die from the most-preventable causes of accidental death and just as likely to die from the least-preventable causes, the investigators found.

People with low levels of education were more than twice as likely as those with higher levels of education to die from the most-preventable causes of accidental death. Education level did not play a role the least-preventable causes of death, however.

"Well-educated individuals, on average, have greater [financial] resources, which can be used to their advantage to prevent accidental death (i.e., safeguarding a home from fire)," study lead author Justin Denney, an assistant professor of sociology at Rice University, said in a university news release.

According to Denney, better-educated people are often better informed about common health hazards, such as alcohol and drug abuse. He also believes that married folk tend to offer each other encouragement and support in staying healthy, and may be on hand to help when a partner faces a health emergency.

More information

The National Safety Council offers advice on home and recreational safety.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 12 (HealthDay News) -- Fewer than 50,000 people have enrolled in health insurance through the federal HealthCare.gov website, according to published reports.

The tally represents enrollment in the troubled federal health insurance exchange from its launch date on Oct. 1 through last week, the Wall Street Journal reported Monday.

The Obama administration had expected some 500,000 people to enroll in coverage by the end of October through HealthCare.gov, according to internal memos cited by House Ways and Means Chairman Dave Camp (R-Mich.).

But slow response times, timed-out pages and bugs have snarled attempts by many Americans to complete an online application for health insurance coverage.

The administration's information technology team, including individuals from private-sector technology companies like Oracle and Red Hat Inc., is working through a "punch list" of fixes while adding new items to the list as additional problems are discovered with the website.

HealthCare.gov serves as the insurance exchange for people in 36 states.

Separately, a report released Monday by the research and analysis firm Avalere Health LLC found that state-run health insurance exchanges are also experiencing lower-than-expected volume.

Twelve of the nation's 14 state exchanges had enrolled 49,100 people as of Nov. 10, according to the analysis. The initial count represents just 3 percent of the 1.4 million people that Avalere projects to enroll in coverage through those state exchanges by the end of 2014.

The report was based on data released by the states and for the most part extracts enrollment in Medicaid. California, which has only released the number of started applications, not completed enrollments, is not included in the analysis. Nor is Massachusetts, which established its health exchange in 2006 as part of a state health-reform initiative. It is requiring some current enrollees to reapply for coverage.

The two reports suggest that enrollment through the federal and state exchanges is sharply lagging the administration's target of 7 million people by the end of March.

The federal and state exchanges are intended to be the gateway for private health plan coverage for some 30 million uninsured Americans under the health-reform law known as the Affordable Care Act.

Administration officials are expected to release official enrollment data sometime this week.

Meanwhile, some insurance companies are pushing the administration for an end-run around the hobbled HealthCare.gov exchange to allow them to directly enroll people entitled to federal subsidies, The New York Times reported.

The Times said the administration has so far resisted the idea, because of concerns about giving insurance companies access to personal data. But, the newspaper added, senior White House officials may now be more open to ways to allowing insurers to handle more enrollments because of the federal website's technical problems.

Chris Jennings, a senior health care adviser to President Obama, said in a statement that the administration was "continuing to pursue additional avenues by which people can enroll, such as direct enrollment through insurance companies, that will help meet pent-up demand," the Times reported.

State websites, overall, have experienced fewer problems than the federal health insurance exchange. Yet compared with early enrollment in Medicare's prescription drug program, which took effect in 2006, state-based enrollment through the Affordable Care Act is lagging.

"When Medicare Part D began, two-thirds of people who voluntarily enrolled in a plan did so after coverage began on Jan. 1," Avalere reported.

More information

Learn how to get insurance coverage through the new health exchanges.

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 12 (HealthDay News) -- Contrary to popular belief, the biggest reason for the rise in U.S. health care spending is not an aging population or patient demand but rather the increasing costs of drugs, procedures and hospital care, a new study finds.

Researchers found that since 2000, those yearly price increases have accounted for 91 percent of the rise in national health care spending, which totaled $2.7 trillion in 2011.

"That was surprising," said lead researcher Dr. Hamilton Moses, of the Johns Hopkins University School of Medicine, in Baltimore. Often, he noted, people point to the aging population, or doctors ordering too many tests and treatments, as the main drivers of soaring health care spending.

"I think the origin of that misperception comes from the politicizing of the issue," said Moses, who is also chairman of Alerion Institute, a Virginia-based consulting firm.

The new study, reported in the Nov. 13 issue of the Journal of the American Medical Association, is an attempt to add more actual data to the debate.

In the current political climate, Moses said, "rational discussions based on valid information" are hard to come by.

"But the fact is," he said, "we spend more on health care than other developed countries, and the U.S. still lags behind in outcomes."

Life expectancy is a case in point, Moses said. It's improving in the United States, but not as fast as it is in other developed countries.

The reasons for the poorer outcomes are not completely clear, and probably complicated, Moses noted. But, he said, the bottom line is, "U.S. patients should be demanding a much higher degree of service than they're getting."

For the study, Moses's team analyzed a range of public data sources to look at trends in health care spending since 1980.

What they found counters some conventional beliefs. First, price increases have driven the increase in health care costs since 2000. The price of drugs and devices has risen by about 4 percent a year, on average. Hospital charges have shown a similar increase. Meanwhile, administrative costs -- what doctors and hospitals expend getting payments from insurers and patients -- have gone up by nearly 6 percent each year.

And "market forces" don't come into play. "Patients never see 90 percent of these costs," Moses said, and even doctors may not know how much a treatment costs. With medical devices, like implantable heart devices, for example, hospitals sign confidentiality agreements with manufacturers that prevent them from sharing price information -- and knowing whether they are getting a good deal or not.

Another finding that may surprise many patients: Americans have been paying for an increasingly smaller share of their medical care over time.

In 2011, consumers footed the bill for 11 percent of national health care costs (in the form of insurance premiums, co-pays and other spending). That was down from 23 percent in 1980.

And while there is a lot of worry about the aging baby boomers straining the health care system, right now it's not the elderly breaking the bank. Chronic conditions among people younger than 65 -- from heart disease to high blood pressure to back pain -- account for two-thirds of health care costs, the study found.

"Chronic illness is a problem for everyone, not just the elderly," Moses said. For the general public, he added, that's another reminder to follow a healthy lifestyle to reduce your chances of developing common health problems like high blood pressure, high cholesterol and diabetes.

But no one is saying that healthy diets and exercise are going to fix the U.S. health care problem. Whether the Affordable Care Act will make a dent remains to be seen, Moses said.

Dr. Joshua Sharfstein, the secretary of Maryland's health department, said it might. The law gives more flexibility to states to find "innovative ways" to cut costs, according to Sharfstein, who co-wrote an editorial published with the study.

In Maryland, Sharfstein said, an independent commission has been setting hospital prices since the 1970s. And now his state is working on a plan that would keep hospital spending from growing faster than the economy. It's also supposed to decrease incentives for hospitals to perform more procedures, and instead reward them for better quality of care.

"We need to move toward incentives for efficiency," Sharfstein said.

Capping health care costs to grow no more quickly than the economy should be a national goal, according to Dr. Ezekiel Emanuel, chair of medical ethics and health policy at the University of Pennsylvania, in Philadelphia.

"It would require us to stretch. It would require us to rethink the current system," said Emanuel, who also wrote a commentary in the same journal issue. But, he added, it would be "feasible" to ensure that per-person health care spending rose no faster than the gross domestic product.

Along with Maryland, Emanuel said, Massachusetts and Arkansas have adopted cost-cutting plans with a goal like that in mind. For it to happen on a national level, he noted, "first people have to agree that it's a worthy goal."

How would it happen? Emanuel said that one way would be to reduce how much care is performed in hospitals, and move it to much less costly settings -- including people's homes.

There is a precedent to such a goal. For a few years in the 1990s, Emanuel noted, U.S. health care spending did grow at roughly the rate of the economy. That was when managed care plans briefly reined in spending. But doctors' and patients' dissatisfaction with managed care's restrictions -- like prior authorization for tests and treatments -- led to a "backlash," Emanuel said.

Still, he said he thinks lessons have been learned since that time, and more is known now about where the key cost controls need to be made. "I don't think we'd have the same kind of backlash," Emanuel said.

More information

The Kaiser Family Foundation has more on U.S. health care costs.

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 12 (HealthDay News) -- People with high levels of the metal tungsten in their bodies are at increased risk for stroke, according to a new study.

Tungsten is widely used in consumer items such as cell phones and computers, as well as many industrial and military products.

Researchers analyzed data collected from more than 8,600 Americans, aged 18 to 74, over 12 years. People with higher tungsten levels in the body (measured by urine samples) had double the normal risk of stroke, according to the study, which was published Nov. 11 in the journal PLoS One.

The researchers at the University of Exeter, in England, also found that tungsten could be a significant risk factor for stroke in people younger than 50.

"While currently very low, human exposure to tungsten is set to increase," study lead author Dr. Jessica Tyrrell said in a university news release. "We're not yet sure why some members of the population have higher levels of the metal in their make-up, and an important step in understanding and preventing the risks it may pose to health will be to get to the bottom of how it's ending up in our bodies."

Although the study found an association between higher levels of tungsten in the body and increased stroke risk, it did not establish a cause-and-effect relationship.

"The relationship we're seeing between tungsten and stroke may only be the tip of the iceberg," study co-author Dr. Nicholas Osborne said in the news release.

"As numerous new substances make their way into the environment, we're accumulating a complex 'chemical cocktail' in our bodies," Osborne said. "Currently, we have incredibly limited information on the health effects of individual chemicals and no research has explored how these compounds might interact together to impact human health."

With largely unknown health effects, tungsten has been identified as a toxic substance of emerging concern. This study is the most comprehensive analysis to date of the potential health effects of the metal, the researchers said.

Stroke is the second leading cause of death in the Western world, according to the World Health Organization, and it's the leading cause of disability in adults.

More information

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

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 12 (HealthDay News) -- Older adults can boost their brain health by engaging in aerobic exercise, according to a new study.

Researchers found that, in addition to improving physical fitness, activities such as running or biking can enhance memory and brain function by increasing blood flow in specific parts of the brain.

The study authors said their findings are particularly important since staying mentally sharp is a greater concern than social security or physical health among U.S. adults aged 50 and older.

"Science has shown that aging decreases mental efficiency, and memory decline is the No. 1 cognitive complaint of older adults," study author Sandra Bond Chapman, chief director of the Center for BrainHealth at the University of Texas, Dallas, said in a center news release. "This research shows the tremendous benefit of aerobic exercise on a person's memory and demonstrates that aerobic exercise can reduce both the biological and cognitive consequences of aging."

The 12-week study involved sedentary adults between the ages of 57 and 75. The participants were divided randomly into two groups: an exercise group and a comparison group that didn't exercise. The exercise group had supervised training sessions that involved either riding a stationary bike or working out on a treadmill for one hour three times a week. The participants' thinking ability, brain blood flow and cardiovascular fitness were assessed when the study began, after six weeks and again after 12 weeks.

"One key region where we saw increase in brain blood flow was the anterior cingulate," study collaborator Sina Aslan, founder and president of Advance MRI, said in the news release. "The anterior cingulate has been linked to superior [mental ability] in late life."

The study, published online in the journal Frontiers in Aging Neuroscience, also found that those in the exercise group who showed improvements in their memory also had increased blood flow to the hippocampus, the key brain region affected by Alzheimer's disease.

Since noninvasive brain-imaging techniques allowed the researchers to identify brain changes before any improvement to the participants' memory, measuring brain blood flow could help doctors assess brain health and the effectiveness of treatment strategies.

"The combination of physical and mental exercise may be the best health measures to improve overall cognitive brain health," Chapman said. "We have just begun to test the upper boundaries of how we can enhance our brain's performance into late life. To think we can alter and improve the basic structure of the mature brain through aerobic exercise and complex thinking should inspire us to challenge our thinking and get moving at any age."

More information

The U.S. Centers for Disease Control and Prevention provides more information on the health benefits of exercise.

-- Mary Elizabeth Dallas

Copyright © 2013 HealthDay. All rights reserved.

Health Highlights: Nov. 12, 2013

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

Women Less Likely to Have Orgasm During Casual Sex: Study

Women are less likely to have orgasms during casual sex than when they're in committed relationships, according to new research.

One study of 600 college students found that women were twice as likely to reach orgasm from intercourse or oral sex in serious relationships, compared to hookups. The findings were presented at the annual meeting of the International Academy of Sex Research and at the Annual Convention for Psychological Science this year, The New York Times reported.

Another study of 24,000 college students found that about 40 percent of women had an orgasm during their most recent casual encounter. In comparison, 75 percent of women had an orgasm the last time they had sex while in a committed relationship.

"We attribute that to practice with a partner, which yields better success at orgasm, and we also think the guys care more in a relationship," study author Paula England, a New York University sociologist, told the Times.

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ABC News' Amy Robach to Have Breast Cancer Surgery

ABC News correspondent Amy Robach said Monday that she has breast cancer and will undergo a double mastectomy and reconstructive surgery this week.

Her announcement comes a month after she underwent a mammogram for a story on "Good Morning America." The 40-year-old mother of two was chosen for the assignment because she's at an age when it's recommended that women check regularly for breast cancer, the Associated Press reported.

A few weeks after the mammogram, Robach learned she had breast cancer. Following Thursday's surgery, she will find out what further treatment she may require.

Robach said she was initially reluctant to have the public mammogram, but decided to do it after "Good Morning America" anchor Robin Roberts said it would be worth it if the story saved one life, AP reported.

"It never occurred to me that life would be mine," Robach said.

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Prepared Sandwiches, Salads Recalled by California Caterer

A California catering company is recalling more than 90 tons of ready-to-eat sandwiches and salads after 26 people in three states were sickened by E. coli, the USDA's Food and Safety Inspection Service says.

Glass Onion Catering is recalling nearly 182,000 pounds of salads and sandwich wraps that contain cooked chicken and ham. They were produced between Sept. 23 and Nov. 6 and sent to distribution centers in Arizona, California, Nevada, New Mexico, Oregon, Utah, Washington and Texas, the Associated Press reported.

The company supplies food to Trader Joe's, Super Fresh Goods and Delish, according to the Contra Costa Times.

A full list of the recalled products is available on the Food and Drug Administration website, the AP reported.

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Meningitis Outbreak Declared at Princeton University

New Jersey health officials have declared a meningitis outbreak on the Princeton University campus, where there have been six confirmed and one suspected case of the disease since March.

The possible case involves a male student who developed symptoms on Saturday and is in hospital. Five of the six confirmed cases involved students and all the patients have recovered, the Associated Press reported.

The outbreak was declared in an effort to raise awareness on the campus, according to state health officials.

They said meningitis can be spread through kissing, coughing or lengthy contact. Symptoms include headache, fever, vomiting and rashes, the AP reported.

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 12 (HealthDay News) -- The cells of people who have had depression may age more quickly, a new study suggests.

Dutch researchers compared cell structures called telomeres in more than 2,400 people with and without depression.

Like the plastic tips at the ends of shoelaces, telomeres cap the ends of chromosomes to protect the cell's DNA from damage. Telomeres get a bit shorter each time a cell divides, so they are useful markers for aging.

The researchers found that the telomeres of people who had ever been depressed were significantly shorter -- about 83 to 84 base pairs of DNA shorter, on average -- than those of people who had never suffered from depression.

The results remained even after researchers accounted for a host of lifestyle factors that can also damage DNA, such as heavy drinking and cigarette smoking.

Since people naturally lose about 14 to 20 base pairs of DNA in the telomeres each year, the researchers said the difference represents about four to six years of advanced aging.

The study showed only an association between depression and shorter telomeres, and didn't prove a cause-and-effect link. The researchers said they aren't entirely sure what the shorter telomeres might mean in depression.

On one hand, study author Josine Verhoeven said, it could be that having shorter telomeres somehow sets a person up for mental troubles. But it's more likely that depression causes damage that leaves traces even at the cellular level, she said.

Depression is known to disrupt many physical systems. It alters hormones, suppresses the immune function and changes how nerves work. People with a history of depression have greater risks for diseases of aging, such as heart disease, type 2 diabetes, dementia and cancer.

"Results like ours suggest that psychological distress, as experienced by depressed persons, has a large, detrimental impact on the wear and tear of a person's body, resulting in accelerated biological aging," said Verhoeven, a doctoral researcher at VU University Medical Center in Amsterdam.

The study was published online Nov. 12 in the journal Molecular Psychiatry.

One expert said the study is significant in the number of people it involved.

"The strength of this report is its size," said Etienne Sibelle, an associate professor of psychiatry at the University of Pittsburgh. He is studying how depression ages the brain.

Sibelle said previous research on the same question had mixed results -- probably because the studies were too limited to pick up the effect, which is small and varies from person to person.

"It's a small effect, but it's real," he said.

The next question science needs to answer, Sibelle said, is whether telomere shortening really matters and if reversing it could improve health. Other studies have shown that a healthier diet, exercise and measures to control stress may lengthen telomeres.

"It's just not known whether it has an impact on cell function," he said. "If that's the case, it has potential therapeutic importance."

More information

Head to the U.S. Centers for Disease Control and Prevention for more on healthy aging.

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 12 (HealthDay News) -- To avoid developing type 2 diabetes, you may have been told to watch your calories and kick up your activity level. Now researchers say there's something else you might consider: your so-called dietary acid load.

A diet heavy in animal products and other acidic foods can cause an acid load in the body, resulting in health complications. This includes reduced insulin sensitivity, which can lead to type 2 diabetes, according to the new study.

"We have demonstrated for the first time in a large prospective study that dietary acid load was positively associated with type 2 diabetes risk, independently of other known risk factors for diabetes," the researchers said. "Our results need to be validated in other populations, and may lead to promotion of diets with a low acid load for the prevention of diabetes."

The term animal products refers to meat, eggs and dairy. Greater consumption of fruits and vegetables is believed to lead to a lower acid load, the researchers said.

The study included more than 66,000 women in Europe who were followed for more than 14 years. During that time, nearly 1,400 of the women were diagnosed with type 2 diabetes.

Those with diets highest in acidic foods were 56 percent more likely to develop diabetes than those with diets lowest in acidic foods, according to the study, which was published recently in the journal Diabetologia.

This link between a highly acidic diet and increased risk of diabetes remained even after the researchers adjusted for dietary patterns, meat consumption and intake of fruit, vegetables, coffee and sweetened beverages. The study did not, however, prove that a highly acidic diet actually causes diabetes.

"A diet rich in animal protein may favor net acid intake, while most fruits and vegetables form alkaline precursors that neutralize the acidity," wrote Dr. Guy Fagherazzi and Dr. Francoise Clavel-Chapelon, of the Center for Research in Epidemiology and Population Health at INSERM, in Paris. "Contrary to what is generally believed, most fruits -- such as peaches, apples, pears, bananas and even lemons and oranges -- actually reduce dietary acid load once the body has processed them."

INSERM is the French equivalent of the U.S. National Institutes of Health.

More information

The U.S. Office of Disease Prevention and Health Promotion outlines ways to prevent type 2 diabetes.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 12 (HealthDay News) -- South Asian people have lower amounts of so-called "brown fat" than white people do, which might help explain why they have a much greater risk of developing type 2 diabetes, according to a small new study.

Unlike white fat, brown fat burns calories instead of storing them, and some studies have shown that brown fat has beneficial effects on glucose (blood sugar) tolerance, fat metabolism and body weight.

Research has shown that compared to whites, South Asians are much more likely to develop type 2 diabetes, to develop it at a younger age and at a lower body mass index, which is a measurement of body fat based on height and weight. However, little has been known about the reasons behind these differences between South Asians and whites, the study authors noted.

This study compared brown fat volume and activity in 12 healthy, lean South Asian men, about 25 years old, and 12 matched white men, after exposing them to cold temperatures. Using an imaging device, the researchers found that brown fat amounts and activity levels were lower in the South Asians.

The results were published online Nov. 12 in The Lancet Diabetes & Endocrinology.

"Our findings suggest that making more [brown fat] or increasing its activity could have great therapeutic potential in South Asians, helping them increase the clearance of glucose and fatty acids and converting surplus white fat into heat, potentially lessening the risk of diabetes," lead authors Mariette Boon and Patrick Rensen, from Leiden University Medical Center in the Netherlands, said in a journal news release.

The study authors noted that recent research has shown that 10 days of exposure to cold can boost brown fat in humans, and said that future studies should examine the effectiveness of this strategy, and other methods such as medication, in increasing brown fat activity.

Although the researchers suggested that there may be a link between lower levels of brown fat and a higher risk of type 2 diabetes in South Asian people, this study does not prove a cause-and-effect relationship.

More information

The U.S. National Institutes of Health has more about brown fat.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

TUESDAY, Nov. 12 (HealthDay News) -- Rising rates of obesity among people younger than 65 may be the main reason for the rapidly increasing number of knee replacements in the United States, according to a new study.

The findings dispel the popular belief that aging baby boomers and weekend warriors are behind the unprecedented rise in knee replacement surgeries, the researchers said.

The study authors looked at data from 9,000 knee replacement patients that was gathered by more than 125 orthopedic surgeons from 22 states. The analysis revealed that 55 percent of patients younger than 65 were obese, compared with 43 percent of those who were 65 or older.

Compared with those 65 and older, twice as many of the patients younger than 65 were severely obese (5 percent versus 11 percent, respectively). The younger group of patients also had higher rates of smoking and lower mental health scores, the investigators found.

"What was once thought of as a procedure for older people or those with sporting injuries is changing. Our study shows that younger patients are more obese and experience the same amount of pain and functional disability as older patients and in some cases even more," study author Dr. David Ayers, director of the Musculoskeletal Center of Excellence at the University of Massachusetts Medical School, said in a university news release.

"What we're seeing is that the rise in obesity rates in younger people is having a dramatic influence on the number of total joint replacement surgeries. These are not premature or unnecessary procedures," added Ayers, who is also chair and professor of orthopedics and physical rehabilitation at the medical school, in Worcester, Mass.

The study was presented at a recent meeting of the American College of Rheumatology and the Association of Rheumatology Health Professionals in San Diego. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

Knee replacement surgeries are one of the most common procedures in the United States, with about 600,000 performed each year at a cost of $9.9 billion. The number is expected to grow to 3.48 million procedures a year by 2030.

"Unless we see a significant reduction in obesity, we will continue to see the necessity for more and more of these procedures," Ayers said.

More information

The American Academy of Orthopaedic Surgeons has more about total knee replacement.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

(HealthDay News) -- When your sports season ends, it's time to take a break from competition and give your body a rest.

The American Council on Exercise has this advice:

  • Take two to four weeks off to let your body rest. If you've been injured during the prior season, talk to your doctor about when it's safe to resume training.
  • If you felt your body lagging during the latter part of the season, it's time to improve your endurance.
  • Focus on improving speed, strength and power. Work on goals specific to your sport.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

Health Tip: Packing Food for a Road Trip

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(HealthDay News) -- Packing a cooler for a road trip can help you enjoy delicious foods without worrying that they'll spoil and make you sick.

The University of Minnesota Extension explains how to pack your cooler:

  • Transfer foods directly from the refrigerator or freezer to the cooler.
  • Separate meat and poultry from other foods that do not need to be cooked. Use a leakproof bag or a separate cooler for these items.
  • Use a cooler that's appropriate for what you need, and pack it full. A fully stocked cooler will keep foods colder than a partially filled one.
  • Use watertight packaging to prevent food from mixing with the cooler's ice.
  • Make sure the cooler's temperature is 40 degrees Fahrenheit or lower.
  • Store the cooler inside the car, not in the trunk. Limit opening the cooler.
  • Cover the cooler with a heavy towel to provide insulation.

-- Diana Kohnle

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 11 (HealthDay News) -- Research with baboon brains has provided new insight into the evolution of the human brain, a new study contends.

The genetics behind the development of folds in the human brain have been a mystery, but there are new clues in a study scheduled for presentation Sunday at the annual meeting of the Society for Neuroscience, in San Diego.

As the human brain evolved, there was a dramatic increase in the number of brain cells and connections, the researchers said. But this growth was restricted by the size of the skull in relation to the birth canal, leading the brain to fold into ridges and valleys.

"The evolution of the human brain over time is a very complex process," Elizabeth Atkinson, of Washington University in St. Louis, said in a Society for Neuroscience news release. "Our study connects the folding of the brain with the underlying genetics, and provides unique insight into how the evolution of our genes has driven the shape, and ultimately the function, of our brains."

The researchers analyzed nearly 1,000 baboon brain scans and pinpointed a handful of chromosome segments and genes that affect the way the brain is folded.

It's thought that thinking capacity is determined by the growth these folds can accommodate.

Human brains have 30 percent more folds than chimpanzee brains, our closest evolutionary relative, according to the news release.

Research presented at meetings typically are considered preliminary until published in a peer-reviewed medical journal.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about the human brain.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 11 (HealthDay News) -- A simple urine test can help identify kids with type 1 diabetes who are at risk for heart and kidney disease and would benefit from early treatment to prevent these serious health problems, a new study suggests.

It is estimated that up to 40 percent of young people with type 1 diabetes may have an increased risk of developing kidney disease, which also raises their risk of heart disease, researchers at the University of Cambridge, in England, said in a university news release.

In type 1 diabetes, the body does not produce insulin, a hormone that converts sugars and other food into energy for the body.

The researchers examined the link between levels of albumin (a protein found in blood) in the urine of older children with type 1 diabetes and the risk of heart and kidney diseases.

Elevated albumin levels in the urine are used to identify adults with diabetes who are at higher risk of kidney and heart disease, the researchers said, but this is the first study to show that normal variation in these levels can be a sign of increased risk in youngsters with type 1 diabetes.

The researchers measured albumin levels in the urine of more than 3,300 diabetes patients aged 10 to 16, and also checked them for early signs of kidney and heart disease.

Those whose urinary albumin levels were in the top 30 percent -- but still within what is considered the normal range -- had more evidence of early kidney and heart disease than those with lower levels, according to the study, which was published Nov. 6 in the journal Diabetes Care.

"Managing type 1 diabetes is difficult enough without having to deal with other health problems," study lead author David Dunger, of the University of Cambridge, said in the news release. "By using early screening, we can now identify young people at risk of heart and kidney disease."

"The next step will be to see if drugs used to treat heart and kidney disease -- such as statins and blood-pressure-lowering drugs -- can help prevent kidney and heart complications in this young, potentially vulnerable population," he said.

Worldwide, more than 490,000 kids aged 14 and younger have type 1 diabetes.

More information

The Nemours Foundation has more about type 1 diabetes.

-- Robert Preidt

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 11 (HealthDay News) -- Even though millions of Americans pop a vitamin, mineral or multivitamin supplement every day, an influential government-appointed panel of experts says the jury is still out on whether they help boost health or not.

In its draft guidelines, the U.S. Preventive Services Task Force said that in some cases, certain supplements, such as beta carotene or vitamin E, may actually do more harm than good. Instead of focusing on supplements, they recommend that people focus on the health benefits of a well-balanced diet instead.

"In general, the Task Force found that there is not enough evidence to determine whether you can reduce your risk of cardiovascular disease or cancer by taking single or paired nutrients, or a multivitamin," Task Force Co-Chair Dr. Michael LeFevre said in a news release. "However, there were two major exceptions: beta carotene and vitamin E, both of which clearly do not help prevent these diseases."

Citing a lack of evidence, the panel concluded it could not recommend taking certain vitamins and minerals alone, together or in a multivitamin for the prevention of heart disease or cancer. The expert panel noted, however, it didn't have enough data to advise against taking most of these supplements, either.

The exceptions to that recommendation: beta carotene and vitamin E. In that case, the experts advised that people not use these supplements for the prevention of heart disease or cancer. Vitamin E supplements were found to have no disease-fighting benefit and beta carotene could actually be harmful, since it appears to boost the risk of lung cancer in people already at greater risk for this disease.

"Many people take dietary supplements to support their general health and wellness," panel member Dr. Wanda Nicholson said in the Task Force news release. "In the absence of clear evidence about the impact of most vitamins and multivitamins on cardiovascular disease and cancer, health care professionals should counsel their patients to eat a healthy, well-balanced diet that is rich in nutrients. They should also continue to consider the latest scientific research, their own experiences, and their patient's health history and preferences when having conversations about nutritional supplements."

The Council for Responsible Nutrition, which represents the vitamin supplement industry, had this to say about the Task Force's recommendation:

"As the researchers have indicated, there is limited evidence for multivitamins in preventing cancer or cardiovascular disease; however, we believe the paucity of clinical trial evidence should not be misinterpreted as a lack of benefit for the multivitamin," Duffy McKay, vice president of scientific and regulatory affairs at the council, said in a statement. "We know for sure that multivitamins can fill nutrient gaps, and as so many people are not even reaching the recommended dietary allowances for many nutrients, that's reason enough to add an affordable and convenient multivitamin to their diets."

The Task Force panel posted its draft recommendation on the use of vitamin, mineral and multivitamin supplements to prevent heart disease and cancer on its website on Monday. The evidence-based recommendations will be available for public comment until Dec. 9. The Task Force's evidence report is also published in the Nov. 12 online edition of the Annals of Internal Medicine.

More information

The U.S. Food and Drug Administration provides more information on dietary supplements.

-- Mary Elizabeth Dallas

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 11 (HealthDay News) -- New research may help connect the dots between traumatic brain injury and the risk for memory and other brain-related problems later in life.

Brain imaging technology known as positron emission tomography (PET) shows that people who have had a traumatic brain injury develop so-called "plaques" in their brain like those seen in the brains of people with Alzheimer's disease, the most common type of dementia.

"Our research has shown, for the first time, that PET imaging can show amyloid deposits in the brain after head injury," said study author Dr. David Menon of the anesthesia division at the University of Cambridge, England. And these deposits can show up within hours of the blow to the head.

Previous studies have linked a history of head injury with higher odds of developing memory problems later in life, but it is too early to say that the head injury is the cause. "Patients can be imaged with PET to detect early amyloid deposition, and then followed up to see whether this early amyloid deposition resolves, whether it recurs, and how these processes relate to later cognitive [mental] decline," Menon said.

For this study, researchers used PET imaging to look at the brains of 15 people with traumatic brain injury and 11 healthy individuals with no history of brain trauma. The images were taken between one day and close to a year after the head injury.

The researchers also examined brain tissue samples taken from people who died after head injury and those who died of non-brain-related causes. The findings are published in the Nov. 11 online edition of JAMA Neurology.

The greater the blow to the head, the more amyloid plaque accumulation and dementia risk was seen, Menon said. Individuals most at risk may include those who also have a genetic predisposition to Alzheimer's disease, he said.

In recent years, former professional athletes who sustained head injuries and went on to develop such memory and mood problems have received a lot of media attention. But this study did not include athletes, just people with injuries severe enough to warrant admission to an intensive care unit. On average, they were in their 30s.

Other experts not involved with the study stress the significance of these findings.

"The study shows evidence of these plaques days after the accident," said Dr. Mony de Leon, director of the Center for Brain Health at NYU Langone Medical Center in New York City. "It is not like someone got hit on the head at age 32 and can't remember anything at age 60. The damage is immediate, and now we have a way of seeing it."

He pointed out that amyloid plaques are a hallmark of Alzheimer's disease in the brain, but they are not the only marker. Tangled or twisted strands of another protein are also seen in the brains of people with Alzheimer's disease. "This study is highly suggestive that there is an Alzheimer's disease-like effect in the brain after head injury, but it's not definitive because we can't see the tangles," said de Leon.

Still, the potential at-risk group is huge, he said. It includes athletes, soldiers and individuals hurt in car crashes.

The study, while small, is important, said Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital in New York City and a former sideline physician with the N.Y. Jets. "This type of imaging may potentially play a role in helping to understand how traumatic brain injury affects the brain and serve as a marker to evaluate such patients over the long term," he said. If treatments are developed, this type of imaging will help determine whether or not they work.

Dr. Sam Gandy, director of the Mount Sinai Center for Cognitive Health in New York City, cautioned that the imaging research is still in the early stage. "There is currently great interest in identifying objective biomarkers [or indicators] to document the structural and functional [consequences] of chronic and mild traumatic brain injury," Gandy said.

But PET scans have been used far less often in diagnosing sports-related brain damage than brain harm caused by traffic accidents, he noted.

More information

The U.S. Centers for Disease Control and Prevention has more about the risks associated with traumatic brain injury.

Copyright © 2013 HealthDay. All rights reserved.

MONDAY, Nov. 11 (HealthDay News) -- Women who are obese as they near retirement age have a higher risk of early death and may find their remaining years blighted by disability, researchers say.

Obese women are three to six times more likely to suffer a disability late in life that will make it difficult for them to get around, with the risk rising with their level of obesity, according to a new study published online Nov. 11 in JAMA Internal Medicine.

A second study in the same journal issue found that being overweight or obese raises your risk of heart attack and heart disease even if you are otherwise healthy.

The number of women aged 85 years and older in the United States is increasing, according to study background information, with 11.6 million women expected to reach 85 by 2050.

Obesity rates also continue to increase, and nearly one-third of U.S. women 75 years and older are obese. This extra weight not only reduces life span, but also can severely harm an older woman's quality of life.

"For dying and losing the ability to walk, the risks were alarmingly high -- over threefold to upwards of over sixfold," said study co-author Eileen Rillamas-Sun, a staff scientist at the Fred Hutchinson Cancer Research Center, in Seattle. "I believe that remaining mobile is very important to most older people, especially since it is useful for retaining one's independence."

The new findings aren't that surprising, but they're important, one expert noted.

Together, the two studies "verify something that we knew, but give us some more ammunition to craft more programs and pay more attention to women's body weight and obesity overall," said Dr. Georges Benjamin, executive director of the American Public Health Association (APHA).

"The obesity epidemic isn't just our kids, and if you are thinking forward we are having this enormous growth as the baby boomers age through society," he said. "We're going to have to spend a lot of time encouraging women to achieve a sensible body weight."

Rillamas-Sun's study examined the health records of nearly 37,000 older women participating in the Women's Health Initiative, a long-term study sponsored by the U.S. National Institutes of Health.

The researchers found that about 12 percent of healthy-weight women had become disabled by age 85, requiring a walker or some other assistance for getting around.

By comparison, between 25 percent and 34 percent of obese women were disabled, with incidence rising with the patient's body mass index (BMI), a measurement of body fat that takes height and weight into account.

Overall, a waist circumference greater than 35 inches was associated with a higher risk of early death, along with new diseases developing during the study period and mobility disability, the researchers said.

These findings, while focused on women, should also give men pause, Rillamas-Sun said.

"I do expect that these findings would be similar in men," she said, noting that her study was modeled on a Honolulu-based heart and aging study, which looked at Japanese-American men. "In that study, they showed that men who were leaner in midlife were more likely to survive to late-age and be healthy."

In the second new study, Danish researchers reviewed the health data of nearly 72,000 people to determine the effects of overweight and obesity on heart health.

The investigators found that people who are overweight or obese have a higher risk of heart attack or heart disease even if they do not have other metabolic syndrome risk factors such as high blood pressure, high cholesterol or type 2 diabetes.

In people without metabolic syndrome, heart attack risk increased 26 percent if they were overweight and 88 percent if they were obese, the researchers said. Obese people without metabolic syndrome also had a 45 percent increased risk of heart disease.

These findings show it is never too late to lose weight, Rillamas-Sun said.

"Obesity, even in older ages as this study shows, is a risk factor for numerous negative health outcomes," she said. "There are weight-loss interventions that have been shown to be effective for older populations, and older adults who have lost weight have been shown to have improvements in their health."

APHA's Benjamin agreed, noting that losing weight can help control diabetes, improve arthritis pain, boost heart health and make a person better able to recuperate from knee or hip replacement surgery.

"This study emphasizes the importance of maintaining a healthy weight and avoiding excessive weight gain after menopause or in your late mid-life. By doing this, you will improve your chances, not only of living longer, but of being healthy and ambulatory in late-age," Rillamas-Sun concluded.

More information

For more about obesity, visit the U.S. National Library of Medicine.

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MONDAY, Nov. 11 (HealthDay News) -- Some women with early breast cancer might benefit from a "one-and-done" treatment, in which they receive a single dose of targeted radiation therapy during the surgery that removes their tumor.

A pair of new studies found that this procedure works about as well as current protocols that require six weeks of daily radiation therapy following surgery.

The new procedure uses miniature devices that deliver radiation directly to the site of the tumor, while the site remains exposed by surgery following lumpectomy.

"It's right in front of the surgeon's and the radiation oncologist's eyes, so we can put the beam precisely where it is needed," said study co-author Dr. Michael Baum, emeritus professor of surgery and a principal research associate at the University College London Medical School. "We can form the cavity to the shape of the beam. It's elegant and dead simple."

The procedure also appears safer, in terms of radiation exposure. Fewer women who received targeted therapy died during Baum's study, an occurrence they chalked up to the patients' more limited exposure to radiation.

In Baum's trial, women received one dose of radiation therapy for 20 to 45 minutes following surgery. About 15 percent of the patients had tumor complications that required them to return for the standard weeks of radiation therapy. However, radiation treatment was completed for the rest of the women, and with cancer recurrence rates comparable to standard treatment.

"You can say 80 percent or more of these women will complete their therapy at the time of surgery," Baum said.

This therapy could prove an advantage for women who live in remote areas without easy access to a radiation therapy center, Baum said.

He said these women often have to undergo a full mastectomy even if they are eligible for breast-saving cancer surgery, simply because they can't make it to the follow-up radiation therapy sessions that will prevent their cancer from recurring.

"I think this will be a boon for American women, even though you are a wealthy country," Baum said. "Even for the wealthiest country in the world, there are many women living in rural areas who don't have the option of traveling two or three hours a day back and forth to a radiotherapy center. This will cut down on the number of mastectomies."

However, only certain women with early-stage breast cancer will be able to benefit, noted Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital, in New York City.

Women best suited for the procedure are over age 45, will have small, single tumors, and the cancer will not have