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Exercise may help older women maintain their bone density, but adding the supplement black cohosh to the routine does not bring any extra benefits, a new study suggests.

Researchers found that among 128 postmenopausal women they studied for one year, those who were randomly assigned to regularly exercise generally maintained their bone density. In contrast, women who were assigned to a “wellness” group that got only light, infrequent exercise showed a decline in their bone density, on average.

But while exercise appeared to help women hang on to their bone mass, the herb black cohosh showed no added effects. Among exercisers, those who were randomly assigned to take the supplement each day showed no bone-density advantage after one year.

Black cohosh extracts are marketed as a “natural” form of hormone replacement therapy and most commonly used to treat hot flashes and other symptoms of menopause. Some lab research, but not all, suggests the herb may have estrogen-like activity in the body.

The new study appears to be the first to look at the effects of black cohosh on bone density, according to lead researcher Michael Bebenek of the University of Erlangen, in Germany.

While in theory, a substance with estrogen-like effects could protect women’s bone density, the benefits of black cohosh for bone health is “still doubtful,” Bebenek told Reuters Health in an email.

He and his colleagues report the findings in the medical journal Menopause.

For their study, the researchers recruited 128 women who had gone through menopause within the past one to three years.

They randomly assigned 86 women to an exercise program that interspersed six weeks of higher-intensity activities designed to protect bone mass — like high-impact aerobics and strength training — with 10 weeks of more-moderate exercise designed to improve heart health. The latter included activities like brisk walking and step aerobics.

Half of the exercisers also took a 40-milligram black cohosh supplement each day.

The remaining 42 women were assigned to a “wellness” group that performed low-intensity activities, like light walking, stretching and balancing exercises, for one hour a week.

After one year, women in both exercise groups showed no significant change in bone density at the spine, while those in the wellness group showed a 2 percent decline, on average. Exercisers had a slight increase in bone mass at the hip — about 0.5 percent — versus an average dip of 0.6 percent in the wellness group; that difference was not, however, significant in statistical terms.

The researchers found no significant bone-mass differences between exercisers on black cohosh and those who did not take the supplement.

Bebenek’s team also looked for any changes in the study participants’ Framingham risk scores — an estimate of a person’s odds of suffering a heart attack or dying from heart disease in the next 10 years. The score is based on age, smoking history, blood pressure and cholesterol levels and whether a person has diabetes.

Overall, the researchers found no clear effects of exercise or exercise-plus-black-cohosh on the women’s risk scores.

At the end of the study, women in the exercise-only group were estimated to have a 6 percent chance of suffering a heart attack or dying from heart disease in the next 10 years; that risk was 7 percent and 7.8 percent in the black cohosh and wellness groups, respectively. However, the differences in the groups’ score changes over time were not significant in statistical terms.

The bottom line, according to the researchers, is that the study “again clearly demonstrated” the positive effects of exercise on postmenopausal women’s bones. Whether black cohosh has any bone-health benefits, however, remains in question.

New research links consumption of high-fructose corn syrup, the extremely popular sweetener that shows up in food products from ketchup to jelly, to liver damage in people with non-alcoholic fatty liver disease.

It’s not clear if the sweetener directly causes liver scarring, also known as fibrosis, but those who consumed more of the sweetener appeared to have more liver scarring, according to the report released online in advance of publication in an upcoming print issue of the journal Hepatology.

“We have identified an environmental risk factor that may contribute to the metabolic syndrome of insulin resistance and the complications of the metabolic syndrome, including liver injury,” Dr. Manal Abdelmalek, associate professor of medicine in the division of gastroenterology/hepatology at Duke University Medical Center and leader of a team of scientists behind the new research, said in a university news release.

The researchers examined the medical records of 427 adults with non-alcoholic fatty liver disease (NAFLD), along with questionnaires the patients completed about their diets.

Only 19 percent of adults with non-alcoholic fatty liver disease said they never drank beverages containing the sweetener; 29 percent did so every day, the investigators found.

“Non-alcoholic fatty liver disease is present in 30 percent of adults in the United States,” Abdelmalek said in the news release. “Although only a minority of patients progress to cirrhosis, such patients are at increased risk for liver failure, liver cancer, and the need for liver transplant. Unfortunately, there is no therapy for non-alcoholic fatty liver disease. My hope is to see if we can find a factor, such as increased consumption of high-fructose corn syrup, which if modified, can decrease the risk of liver disease.”

Representatives of the corn refining industry took issue with the findings, noting that the study involved a wide range of sources of fructose, not just beverages sweetened with high-fructose corn sugar.

Furthermore, “fructose has not been proven to be a cause of NAFLD in humans, and NAFLD subjects are compromised individuals with significant health problems which have very little to do with fructose intake,” according to a news release from the Corn Refiners Association released late Friday.

“Moreover, associative studies of this kind are widely judged to be of low scientific value when trying to establish cause-and-effect, data from studies like this that are dependent on recollection of the study subjects are notoriously imprecise, and these studies are full of confounding variables and exceedingly difficult to control,” the CRA added.

Mild to moderate hypoglycemia (low blood sugar) increases the risk of death in critically ill patients, a new study shows.

It included 4,946 critically ill patients at six medical centers in Australia, Japan and New Zealand. Of those patients, 1,109 experienced hypoglycemia while the remainder served as a non-hypoglycemic control group.

It had been believed that mild to moderate hypoglycemia was clinically unimportant. But this study found that patients with hypoglycemia had a death rate of 36.6 percent, compared with 19.7 percent for those without hypoglycemia.

“Even after the adjustment for insulin therapy or timing of hypoglycemic episode, the more severe the hypoglycemia, the greater the risk of death,” study co-investigator Dr. Rinaldo Bellomo, of Austin Health in Melbourne, said in a news release.

“Our results suggest that any tolerance of mild to moderate hypoglycemia by intensive care clinicians may be undesirable. In this regard, newer technologies such as continuous glucose monitoring in the ICU setting might help avoid hypoglycemia or identify it earlier,” Bellomo said.

The study appears in the issue of Mayo Clinic Proceedings.

An industry group representing the top five manufacturers of CT equipment said on Thursday the companies will add new safeguards to their machines to help prevent patients from being exposed to too much radiation.

The Medical Imaging & Technology Alliance said manufacturers will add a color-coded warning system to give health care providers clear warning when they are doing scans that give patients potentially dangerous doses of radiation.

A CT or computed tomography scan gives doctors a view inside the body, often eliminating the need for exploratory surgery.

But CT scans deliver a much higher radiation dose than conventional X-rays. A chest CT scan exposes the patient to more than 100 times the radiation dose of a typical chest X-ray. High doses of radiation can cause skin burns, cataracts and other injuries.

The new safeguards would apply to machines made by General Electric, Toshiba Corp, Hitachi Ltd, Siemens and Philips.

The changes, which would be phased in starting this year, would provide a yellow alert screen when the dose is higher than expected. It would also offer a red alert warning when a patient is about to be given a dangerous dose of radiation.

The system would also allow hospitals and imaging centers to set their machines to prevent these scans from being done.

“Some of our companies will be able to provide features before the end of this year based on when new releases become available,” Dave Fisher, executive director of the alliance, told reporters in a telephone briefing.

The group also promised that it will standardize the way radiation doses are recorded.

“The dose information would be saved in a standard format, making it easier to integrate the information into a national dose registry, identical to what the president identified as one of the goals in his budget,” Fisher said.

The changes follow the U.S. Food and Drug Administration’s call earlier this month for makers of CT machines and other medical imaging equipment to add new safety features to their machines.

Fisher said the alert system “will definitely be included in new equipment. It also is going to be included in some versions of older equipment.”

On Friday the group will testify before the Committee on Energy and Commerce’s Health subcommittee hearing on radiation exposure.

The FDA said in December it was investigating several cases of patients who received up to eight times the normal level of radiation from brain scans performed with equipment from GE and Toshiba.

CT scan use in the United States has grown sharply. About 70 million CT scans were done on Americans in 2007, up from 3 million in 1980.

(Editing by Eric Walsh)

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.

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.

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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.

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.

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.