Archive for the ‘Uncategorized’ Category

Health Tip: What’s Prompting My Seizures?

Tuesday, February 23rd, 2010

A seizure is a sudden spurt of abnormal electrical activity in the brain.

While the causes can be varied and complex, the Epilepsy Foundation offers this list of common triggers:
Missing medications, especially those used to control seizures.
Changes in sleep routines or lack of sleep.
Hormonal changes in women, such as during menstruation or pregnancy.
Abusing alcohol or drugs, or withdrawing from them.
Stress and anxiety.
Factors that unpredictably change metabolism, such as diarrhea or vomiting.

Kids should get moving to avoid obesity

Tuesday, February 16th, 2010

Vigorous exercise may be an especially good way to keep kids lean, but sitting around, in and of itself, doesn’t appear to have a major role in making them fat, new research shows.

Nevertheless, there are still plenty of reasons to avoid too much sedentary “screen time,” Dr. Ulf Ekelund of the MRC Epidemiology Unit in Cambridge, UK and colleagues say, given potential negatives including “violence and aggressive behavior, poor academic performance, and poor body image.”

To help tease out the role of time spent in different types of activity in making children fat, independent of screen time and otherwise being a couch potato, Ekelund and his team looked at 1,862 children 9 to 10 years old, 23 percent of whom were overweight or obese.

Using a wristwatch-like device to measure the amount and intensity of activity children got throughout the day, the researchers looked for associations between this activity and children’s waist size, amount of body fat, and body mass index (BMI). Kids also reported how much time they spent watching TV or using a computer.

Sixty-nine percent of the children were getting at least an hour of moderate physical activity a day, while 58 percent reported having less than two hours of screen time daily.

While children who spent more time not moving had bigger waists and a larger percentage of body fat, much of this relationship could be attributed to the fact that they spent less time engaging in moderate physical activity.

But the time children spent engaging in vigorous activity, and their combined moderate activity-vigorous activity time, had the strongest ties to waist circumference and fat mass.

For instance, every 6.5 minutes a child spent doing vigorous activity like playing ball, bicycling, or running around outside was associated with a 1.32-centimeter reduction in waist size, the researchers found. But 13.6 minutes of moderate physical activity only reduced waist size by half a centimeter.

Based on the findings, the researchers say, children should still be encouraged to limit their sedentary time, but this alone won’t be enough to tackle childhood obesity.

“Interventions may therefore need to incorporate higher intensity-based activities to curb the growing obesity epidemic,” they conclude.

Boys in the study got an average of a half-hour of vigorous activity each day, while girls got 22 minutes. “There is no clear cut answer” as to how much vigorous activity is optimal, Ekelund noted in an email to Reuters Health.

“For most health outcomes, the more activity you do the better.” But, he added, people who do lots of strenuous activity may still put on too much weight if they take in too many calories.

Many pregnant women take drugs harmful to baby

Tuesday, February 9th, 2010

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For the 5 declining years between January 1998 and last but then one d. of 2002, Berard and colleagues analyzed the prescriptions manner filled on the silent part of bang-up women in behalf of hard drugs amazing available at unusually a high rate of the t. and of note little to pose fetal risks.

Their demonstratively report , in BJOG: An International Journal of Obstetrics and Gynecology, grandiose show 56 percent of 109,344 bang-up women manner filled at unusually a high rate of least all alone medication prescription. A all out of 6.3 percent (6,871 women) did such that in behalf of at unusually a high rate of least all alone medication of note little to pose unusually a automatically risk little to the fetus.

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Specifically, terminations occurred in 47 percent of the pregnancies exposed little to hard drugs w. of note fetal risks. Six percent of these pregnancies ended in miscarriage.

By in sharp contrast, in the by far unusually large non-exposed consciously group at unusually a guess 36 percent of the pregnancies had been terminated and fewer than 5 percent ended in miscarriage.

Berard’s team occasionally further identified birth defects in 8.2 percent of 2,842 infants exposed little to dissolute hard drugs the turbulent flow gestation and amazing available in behalf of assessment, compared w. 7.1 percent of the 59,287 infants absolutely wrong exposed. This is “a statistically unusual difference,” they unconsciously note .

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A third of Americans die in hospitals, study finds

Sunday, January 31st, 2010

Nearly a third of Americans who die are in the hospital at the time and their last treatments cost the U.S. economy $20 billion, according to a report released on Wednesday.

The single biggest cause of hospital death was septicemia, an overwhelming infection of the blood, which killed 15 percent of patients, the team at the U.S. Agency for Healthcare Research and Quality found.

Eight percent died of respiratory failure, 6 percent died of stroke and 5 percent had fatal heart attacks in the hospital, according to the report, available at http://www.hcup-us.ahrq.gov/reports/statbriefs/sb82.pdf.

“In 2007, it is estimated by the Centers for Disease Control that 2,423,995 people died in the United States. Of these, we estimate that 765,651 died in the hospital,” the agency’s Yafu Zhao and William Encinosa wrote.

“That is, 32 percent of all deaths in the U.S. in 2007 occurred in the hospital.”

Their analysis, using federal survey data, found that the average cost of a hospital stay that ended with the patient’s death was $26,035, compared to $9,447 for patients discharged alive.

Patients covered by Medicare, the federal health insurance plan for the elderly and disabled, accounted for 67 percent of in-hospital deaths and $12 billion in hospital costs.

Private insurance covered 20 percent of patients who died at a cost of $4 billion. Medicaid patients made up 2 percent and uninsured patients accounted for 3 percent and $630 million in costs.

“Overall, the costs of hospitalizations ending in death were $20 billion, which accounted for 5.2 percent of total in-patient hospital costs in the U.S. in 2007,” they wrote.

Zhao and Encinosa used their survey data, which covered 90 percent of U.S. hospitals, along with CDC data to calculate that 74 percent of infants who die are being treated in the hospital at the time.

“Among the elderly, 31 percent of deaths occurred in the hospital, while 34 percent of nonelderly deaths took place in the hospital,” they said.

Gene Discovery Gives Clues to Crohn’s Disease, Colitis

Monday, January 25th, 2010

People with painful, chronic bowel conditions such as Crohn’s disease and ulcerative colitis could see a glimmer of hope from new research.

Scientists say they’ve spotted a genetic flaw that could drive a rare childhood form of colitis, and the finding might have implications for the broader range of illnesses collectively known as inflammatory bowel disease (IBD).

Genetic analysis of nine children with a severe form of early-onset colitis found mutations of two genes producing cell receptors for interleukin-10, a protein that controls the body’s inflammatory response, according to a report published online Nov. 4 in the New England Journal of Medicine.

In one case, a bone marrow transplant eliminated a child’s disease, the report said.

About one million Americans have been diagnosed with IBD, which includes ulcerative colitis and Crohn’s disease. These conditions involve a persistent inflammation of the intestinal tract that can cause bouts of diarrhea, rectal bleeding and other symptoms.

The study is not the first to link interleukin-10 with IBD, noted study researcher Alejandro A. Schaffer, a staff scientist at the U.S. National Center for Biotechnology Information. Previous animal and human studies led to trials of interleukin-10 treatment for IBD patients that were not successful, he said.

But the new study shows that “there may be some subsets of adult patients who have insufficient amounts of interleukin-10,” Schaffer said. “We are suggesting that there might be a subset of patients worth identifying and treating differently.”

It’s not now possible to say how large that subset might be, he said.

“We’re very excited about this discovery,” said study lead author Dr. Erik-Oliver Glocker, a postdoctoral researcher at University College London in the United Kingdom.

The study, done at centers in Germany, the United Kingdom and the United States, identified two mutated genes for the molecules that allow interleukin-10 to act on cells. “These mutations have very severe consequences,” Glocker said. “If you have a mutation in the receptor, interleukin-10 doesn’t work and the entire immune system is off-balance.”

It took a lot of screening to find young people with this specific genetic flaw, Glocker said. The disease usually emerges later in life, and “in older patients, it could be different,” he said.

“There have been a lot of different genetic studies of Crohn’s disease, and they have always found genes that might be concerned,” Glocker said. “Maybe we can screen adult patients for the genes we have described and think of a similar treatment. If you have this mutation, you might be suitable for a bone marrow transplant.”

But adult IBD is a complex condition, genetically speaking, he added.

“The problem is that in Crohn’s disease patients, the cause of the disease is not well understood,” Glocker said. “In the patients we had, we know the genes and the functions of the genes and the proteins. And that makes treatment — a bone marrow transplant — much easier. We’re not sure that a transplant should be considered in adult Crohn’s patients.”

A number of variants of other genes have been detected in people with IBD, Schaffer said. “We’re not saying anything about those patients, unless they also have the interleukin-10 variant,” he said.

Health Tip: Keep a Health Journal

Monday, January 18th, 2010

When your doctor asks you about any illnesses, injuries or past procedures, there’s no need to commit it all to memory if you keep a health journal.

The American Academy of Family Physicians suggests your journal include the following:
Any injuries you’ve had or illnesses for which you’ve been treated.
Any time you were hospitalized, including when and why.
Any allergies you have to foods, medications, household items, pollens, etc.
Any past surgeries or procedures.
All prescription and over-the-counter medications, vitamins or supplements taken. Be sure to include the dose and how often you take them.
Diseases, illnesses or health conditions that have affected immediate family members.

PSA Reading Could Predict Post-Radiation Survival

Monday, January 11th, 2010

Prostate cancer patients whose prostate-specific antigen (PSA) levels rise within 18 months after radiotherapy have an increased risk of death, say U.S. researchers.

Their study included more than 2,100 patients with clinically localized prostate cancer who experienced biochemical failure (lowest PSA level plus 2 nanograms per milliliter) after treatment. The median interval between treatment and biochemical failure was 35.2 months, but 19 percent of patients developed biochemical failure at 18 months or less.

Five-year, cancer-specific survival for patients who developed biochemical failure within 18 months was 69.5 percent, compared with 89.8 percent for those who developed biochemical failure more than 18 months after treatment.

The study was to be presented Wednesday at the annual meeting of the American Society for Radiation Oncology in Chicago.

“PSA is the gold standard for following prostate cancer patients after they receive radiation or surgery. But we haven’t known if having PSA rise sooner means a patient has a greater danger of dying of prostate cancer, though it seems logical,” study leader Dr. Mark K. Buyyounouski, a radiation oncologist at the Fox Chase Cancer Center in Philadelphia, said in a news release from the center.

“Now we can use the simple criteria from this study, which is widely available for anyone who has PSA testing, to identify men who have a greater than 25 percent chance of dying from prostate cancer in the next five years. That is huge. There is nothing else that can do that.”

Currently, biochemical failure alone doesn’t prompt treatment. Doctors usually wait until a patient’s PSA reaches a high level or there is some other evidence of tumor spread.

This study suggests that treatment can begin “far sooner without waiting for other signs or symptoms of prostate cancer,” Buyyounouski said. “If a patient has biochemical failure at 16 months, rather than wait and learn later that the PSA is rising sharply and risk the development of distant metastasis, therapy can be started sooner based on the increased risk of death.”

Cost Savings Adds to Value of Preventing Chronic Disease

Monday, December 21st, 2009

Prevention of chronic diseases such as diabetes, obesity and high blood pressure improves the lives of older Americans and also reduces medical costs, study findings show.

Researchers looked at a group of 51- and 52-year-olds from across the nation and projected their future state of health and medical costs if they could avoid developing certain chronic diseases. In a 51-year-old, prevention of obesity would extend life by 0.85 years, preventing high blood pressure would give them an additional 2.05 years, and by avoiding diabetes they would gain 3.17 years. People aged 51 and 52 who quit smoking would gain 3.44 more years of life, the study authors noted in a news release from the American Public Health Association.

Prevention of these conditions also would have lower lifetime medical costs for the individual: Preventing obesity would save $7,168; preventing high blood pressure would save $13,702; and preventing diabetes would save $34,483. However, the lifetime medical costs for a person who quits smoking would be $15,959 higher, the researchers noted in the news release.

“Our data indicate that primary prevention could improve the health and longevity of future cohorts of elderly persons in the United States at a relatively low cost,” the researchers concluded.

New Technique Could Eliminate Inherited Mitochondrial Disease

Saturday, November 21st, 2009

Researchers funded by the National Institutes of Health have developed an experimental technique with the potential to prevent a class of hereditary disorders passed on from mother to child. The technique, as yet conducted only in nonhuman primates, involves transferring the hereditary material from one female’s egg into another female’s egg from which the hereditary material has been removed.

The resultant eggs, which were fertilized with donor sperm, implanted in females and carried to term, produced offspring free of the mother’s mitochondria, but which instead possess the mitochondria from the donated egg cell. Mitochondria are tiny structures within cells that help provide energy to power the cell’s activities. They are passed on from mother to child, in the fluid (called cytoplasm) contained inside the egg cell. In recent years, defects in mitochondria have been linked with a variety of conditions, such as diabetes, cancer, infertility, and such neurodegenerative disorders as Alzheimer’s, Parkinson’s and Huntington’s diseases. The technique raises the possibility that mitochondria associated with a hereditary disorder could be prevented from being passed on to the next generation.

“Recent findings suggest that mitochondrial disorders play a role in at least some proportion of many human disorders,” said Duane Alexander, M.D, director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, which provided funding for the study. “Pending further research, the findings hold the potential of allowing a couple to have a child who is biologically their own, but is free of any conditions associated with defects in maternal mitochondria.”

Mitochondria are passed on to subsequent generations only through egg cells and not transmitted through sperm. In addition to the DNA found in the chromosomes, mitochondria have their own DNA. Mutations in mitochondrial DNA have been associated with a variety of human disorders.

The study was conducted by researchers at the Oregon Health Science University in Beaverton and was published online in Nature.

Using the technique, the researchers created fertilized eggs and achieved three successful pregnancies in rhesus monkeys, which have resulted in four healthy newborns. Recent advances in the transfer of hereditary material and in microscopy facilitated the achievement, they wrote.

The researchers said that the technique did not appear to pose any risk of chromosomal damage. Analysis of 5-6-day-old embryos (blastocysts) resulting from the fertilized eggs, and of embryonic stem cell lines established from them, did not uncover any evidence of damage to the chromosomes. Analysis of cells from the infant monkeys born after the procedure failed to detect any mitochondrial DNA from the mother.

U.S. Updates Clinical Guidelines for Prevention and Treatment of Opportunistic Infections among HIV-Exposed and HIV-Infected Children

Monday, November 16th, 2009

New guidelines to assist health care workers in preventing and treating the secondary infections that can afflict U.S. children exposed to, or infected with, HIV, were published by the National Institutes of Health and the Centers for Disease Control and Prevention.

The new guidelines provide a reference manual for the treatment of these secondary infections, describing warning signs of potentially hazardous interactions between drugs used to treat HIV and its secondary infections, current standards for treating the inflammation accompanying the immune system recovery made possible by new anti-HIV drugs, as well as when to discontinue preventative treatment no longer needed after the immune system has recovered.

HIV cripples the immune system, leaving infected people more vulnerable than the general population to numerous other infectious diseases. These diseases, which ordinarily do not cause problems for people with fully functioning immune systems, are known as opportunistic infections. HIV-associated opportunistic infections are a leading cause of hospitalization and death among HIV-infected children in the United States. Some of these opportunistic infections can also afflict children who do not have HIV but who have one or both parents with HIV and specific HIV-related opportunistic infections.

“The guidelines will help health care workers and public health officials who work with children to save lives that might otherwise be lost,” said Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services. “The infections that can accompany HIV are often the major cause of illness and death of HIV-infected children.”

The report, Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children, updates recommendations on topics such as the importance of starting antiretroviral treatment early and interactions between drugs that treat HIV and drugs that treat opportunistic infections.

The report, the first update of the guidelines in five years, appears in the Sept. 4 issue of Morbidity and Mortality Weekly Report (MMWR). The NIH and CDC produced the update in cooperation with the HIV Medicine Association of the Infectious Diseases Society of America, the American Academy of Pediatrics, and the Pediatric Infectious Disease Society.

The new guidelines apply to 23 opportunistic infectious diseases. A panel of more than 30 government and non-government pediatric HIV and infectious disease experts developed the guidelines. The guidelines update and combine two previous publications, a 2002 publication on the prevention of opportunistic infections in HIV-infected adults and children and a 2004 publication on the treatment of opportunistic infections in children.

In recent years, the number of HIV-associated opportunistic infections in children has declined significantly in the United States. The decrease is primarily due to advances in antiretroviral therapy. But the infections continue to occur, and they can be serious or even fatal.

“Health care providers must be vigilant for the signs and symptoms of these infections and know how to prevent and treat them,” said Lynne Mofenson, M.D., a coauthor of the new guidelines and chief of NICHD’s Pediatric, Adolescent, and Maternal AIDS Branch.

Because children’s immune systems are not as developed as adults, even children who do not have HIV may be at high risk of catching certain opportunistic infections, such as tuberculosis, if one or both parents have HIV and an accompanying opportunistic infection. Like HIV itself, some opportunistic infections, such as cytomegalovirus or hepatitis viruses, can be passed from mother to child.

“Guidelines for preventing and treating opportunistic infections in children must consider the risk of infections among both HIV-infected children and children who were HIV-exposed through birth to an HIV-infected mother.” Dr. Mofenson said.

In recent years, HIV infection has increased among adolescents.

“We hope that doctors and clinicians make use of these new guidelines to ensure that adolescents with HIV are not severely impacted by other infections,” said Kenneth L. Dominguez, M.D., a coauthor of the new guidelines and epidemiologist at CDC’s Divsion of HIV/AIDS Prevention. “Despite our country’s strong success in preventing perinatally HIV-infected infants, we must protect the significant numbers of current HIV-infected children and adolescents who are able to live longer, healthier lives due to advances in HIV therapy.”

Drug doses and response to treatment may differ for children or adolescents entering puberty than for adults. Guidelines for adults and postpubertal adolescents appear in another report, Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents, published in the April 10, 2009, issue of MMWR.

Major changes in the pediatric guidelines include:
Emphasis on the importance of effective antiretroviral therapy to improve children’s immune function. The development of new therapies for HIV in children in recent years has shown that successful treatment of HIV itself is pivotal to preventing and controlling opportunistic infections.
Information on diagnosing and managing immune reconstitution inflammatory syndrome. In this condition, the immune system begins to recover but then responds to a previously acquired opportunistic infection with an overwhelming response that worsens the symptoms of infection. Despite the worsening symptoms, continuing antiretroviral treatment is critical, the guidelines say.
Information on the management of antiretroviral therapy in children with opportunistic infections, including potential drug-drug interactions.
New guidance on use of antibiotic drugs to prevent Pneumocystis jirovecii pneumonia in infants. Previously, doctors were advised to give an antibiotic to all infants born to HIV-infected mothers to prevent infection with Pneumocystis jirovecii pneumonia, starting at 4-6 weeks until the infant tested negative for HIV at 4-6 months of age or was found to be HIV-infected. With advances in diagnostic testing and effective prevention of mother to child transmission, the new guidelines note that if infants have two negative tests for HIV at early timepoints (one at 2 weeks or older and one at 4 weeks or older), use of antibiotics to prevent this infection may be avoided.
Updated immunization recommendations for HIV-exposed and -infected children, including hepatitis A, human papillomavirus, meningococcal, and rotavirus vaccines.
A new section outlining treatments for malaria, which may become an opportunistic infection in HIV-infected immigrant children or HIV-infected children who travel to countries with malaria.
New recommendations on when to discontinue medication for preventing opportunistic infections. Previously, medications to prevent opportunistic infections were given for life. Now, however, new therapies that inhibit HIV may allow the immune system to recover. When the immune system has recovered sufficiently, the medications to prevent opportunistic infections may no longer be needed. The guidelines list diagnostic criteria for discontinuing these medications.