Chinese Horseshoe Bat is SARS Carrier
The Chinese horseshoe bat is a healthy carrier for SARS and the hiding place for the virus in nature, say two separate studies published this week.
This information is significant because it could enable scientists to sever the SARS transmission chain and prevent outbreaks of the disease, which has killed 774 people worldwide, The New York Times reported.
Many people in Asia eat bats or use bat feces in traditional medicine to treat kidney problems and asthma.
One team from the University of Hong Kong reported its findings in this week's issue of the journal Proceedings of the National Academy of Sciences. The other team, which included researchers from Australia, China and the United States, published its study Thursday in the online version of Science.
"It's pretty pleasant to see two teams that did not know each other reach similar findings," Dr. Lin-Fa Wang, a virologist at the Australian Animal Health Laboratory, told the Times.
The teams collected hundreds of bats from their natural habitat and from Chinese markets. Both studies found that the bats carried viruses from the coronavirus family, which is closely related to the SARS virus.
Gene May Predict Aggressive Ovarian Cancer
A gene called Rsf-1 that may predict aggressive ovarian cancer has been identified by Johns Hopkins Kimmel Cancer Center researchers.
This is the first study to establish a role for a gene in ovarian cancer and may lead to development of a test that can predict at an early stage which patients will develop aggressive cancer. The findings were published in this week's Proceedings of the National Academy of Sciences.
"We hope new therapies can be tailored to target Rsf-1, in the same way that Herceptin for breast cancer attacks the Her2/neu gene pathway," researcher Tian-Li Wang, assistant professor of gynecology/obstetrics and oncology, said in a prepared statement.
In their study, the researchers found a surge in the number of Rsf-1 gene copies in 13.2 percent (16 of 121) of high grade ovarian cancers. They did not find the same thing in low grade or benign ovarian tumors.
The 16 ovarian cancer patients with this surge in Rsf-1 gene copies lived an average of 29 months compared to 36 months for patients who did not have Rsf-1 amplification.
The Hopkins team said a surge in Rsf-1 may cause changes that promote tumor growth.
Infection May be Linked to OCD
An immune reaction following an infection may be responsible for some cases of obsessive compulsive disorder (OCD) in some children, says a U.K. study in the British Journal of Psychiatry.
The study compared 50 children with OCD to 190 children in a control group. Children with OCD were much more likely (42 percent) to have anti-basal ganglia antibodies than the children in the control group (5 percent), BBC News reported.
These antibodies are associated with streptococcal infection.
The study authors, from the Institute of Psychiatry and the Institute of Neurology, said the findings suggested that, "autoimmunity may have a role in the genesis and/or maintenance of some cases of OCD."
"Further examination of this autoimmune subgroup may provide insight into the neurobiology of OCD, and explain whether the antibodies concerned are causing the disease," the researchers wrote.
More research is needed to confirm these findings, they added.
6 U.S. States Chosen for Youth and Environment Study
Pregnant women and others of childbearing age in six states will be the first participants in the largest-ever U.S. study of children that will track 100,000 kids from the womb to age 21 to learn how the environment affects their health, the Associated Press reported.
Participating communities and the institutions leading the research will include:
Orange County, Calif.; University of California, Irvine.
Duplin County, N.C.,; University of North Carolina at Chapel Hill.
Queens County, N.Y.; Mount Sinai School of Medicine.
Montgomery County, Pa.; Children's Hospital of Philadelphia and Drexel University.
Salt Lake County, Utah; University of Utah.
Waukesha County, Wis.; University of Wisconsin-Madison and Medical College of Wisconsin.
The researchers plan to enroll 1,500 women in each county over five years. They will record environmental exposures during pregnancy and assess how each one may have contributed to the subsequent onset of pediatric diseases, including asthma, learning disabilities, and autism, the AP reported.
Initial results could come as early as 2010, a National Institutes of Health spokesman told the wire service.
New Hormone Therapy for Menopause Approved
The U.S. Food and Drug Administration has approved the Berlex Inc. drug Angeliq (drospirenone and estradiol) as a form of hormone-replacement therapy for moderate-to-severe menopausal symptoms, according to a company statement issued Thursday.
The active ingredient drospirenone, already found in the company's Yasmin oral contraceptive approved in 2001, acts as a mild diuretic, the company said. Berlex said it is studying whether it could help reduce blood pressure in menopausal women with hypertension.
The estrogen component is estradiol, the same estrogen produced by the ovaries prior to menopause, the company said.
Women with liver, kidney or adrenal disease shouldn't take Angeliq, and patients on drugs that increase body levels of potassium should ask their doctor before beginning Angeliq, Berlex said.
Since 2002, when a major U.S. study found that women taking HRT had a higher incidence of heart attacks, strokes, blood clots and breast cancer, doctors have been asked to prescribe drugs containing estrogen at the lowest effective doses and for the shortest duration possible. Estrogen therapy shouldn't be used by women with undiagnosed abnormal vaginal bleeding or a suspected or known history of breast cancer, Berlex said.
Why Most Children Don't Walk to School
Despite the benefits of walking -- including a lower risk of heart disease, diabetes, high blood pressure, and colon cancer -- only 15 percent of American children walk to school, the U.S. Centers for Disease Control and Prevention has concluded from new research.
Distance from home to school is seen as the biggest barrier, followed by the perceived dangers of too much traffic, crime, and inclement weather, the CDC said in Thursday's Morbidity and Mortality Weekly Report.
Compared with a similar survey in 1969, when nearly half of American children walked to school, distance has become a growing factor. There was an increase of 2 million students from 1969 to 2001, and a corresponding decrease in the number of schools, from 70,869 to 69,697. More students and fewer schools means a greater percentage of kids now live farther than 1 mile from their schools, the CDC said.
The survey involved 1,705 adults who reported having at least one child aged 5 to 18, the agency said.
Health Tip: Is Your Catch Safe to Eat?
For many people, fishing is more than just a sport -- it's a way of putting food on the table.
But before you make your catch tonight's dinner, heed this advice from the Virginia Department of Health:
Eat smaller, younger fish, because they're less likely to contain harmful levels of contaminants.
Remove the skin, the fat from the belly and top, and the internal organs before cooking the fish.
Bake, broil, or grill on an open rack to allow fats to drain away from the meat.
Discard the fats that cook out of the fish.
Eat less deep-fried fish since frying seals contaminants into the fatty tissue.
Health Tip: Avoid Gum Disease
Your risk of developing gum (periodontal) disease increases as you age. Over time, your gums may begin to detach from your teeth.
Left untreated, the supporting bone may dissolve, and when this happens, your teeth may become loose and fall out, says the Maryland Department of Health & Mental Hygiene.
So if you notice that your gums are swollen, red, tender or bleed easily, or that your teeth feel loose, see your dentist as soon as possible. Meanwhile, don't forget to floss and brush your teeth after every meal using a fluoride toothpaste.
Friday, September 30, 2005
Thursday, September 29, 2005
Health Headlines - September 29
Prolonged Fever Can Be Sign of Some Cancers
A fever of unknown origin can sometimes be a sign of cancer, including lymphoma, kidney and liver cancer, according to a new Danish study.
Such a fever is one that lasts more than three weeks with temperatures above 38.3 degrees Celsius (about 101 degrees Fahrenheit), with an unidentifiable cause. Patients with these fevers appear to be at a slightly higher risk of cancer, according to the report.
"We found an association between fever and cancer," said study author Dr. Henrik Toft Sorensen, a professor of medicine in the Department of Clinical Epidemiology at Aarhus University Hospital, in Denmark.
However, "the absolute risk is very low. Much lower than reported in other studies," he added.
The new research appears in the Sept. 28 online issue of The Lancet Oncology.
Previous studies had shown an association of fever and cancer of 20 percent to 30 percent, Sorensen said. "But we found very few cases of cancer related to fever compared with the incidence of cancer in the general population," he said.
In their study, Sorensen and his colleagues collected data on 43,205 patients who had been treated in Danish hospitals for fever of unknown origin from 1977 through 1998. During more than six years of follow-up, the researchers compared the incidence of cancer among these patients with the general population.
They found that patients with fever were at a 2.3 percent increased risk of developing cancer. After one year, the risk was highest for cancers of the blood, and cancers of the liver, brain, and kidney.
In addition, more of the people diagnosed with cancer had cancer that had spread to other organs, compared with patients who didn't have a fever. The increased risk continued after one year, but at a lower level, the researchers noted.
Some cancer patients with fever also had worse outcomes, including a slight increase in mortality compared with other cancer patients.
Because the increased risk of cancer associated with fever is slight, Sorensen doesn't think there needs to be extensive cancer workups for patients with fever. "You probably do not need to look for cancer and do a lot of tests in a patient coming into a hospital with fever of unknown origin, because your risk of cancer is very low."
One expert thinks the finding concerning fever-related cancers may reflect better diagnosis of fever and better cancer diagnoses.
"We know some cancers are associated with fever," said Dr. Yelena Novik, an oncologist at New York University Cancer Institute and an assistant professor of oncology at New York University School of Medicine.
There are still some cases of fever of unknown origin that may be a sign of cancer, Novik said. "But we are probably better at diagnosing fever and cancer better," she said.
Novik advises that if you have a fever of unknown origin, it should be checked, including a screening for cancer. "Don't let the fever go on," she said. "Make sure all the possible causes for the fever have been explored."
Health Tip: Athletes Can Avoid Skin Infections
Because of the close body contact involved in sports like football, rugby or hockey, participants face an increased risk of skin infection, according to the Utah Department of Health.
If you play contact sports, use these skin-safety guidelines:
Skin lesions that are red, warm, swollen, tender or draining fluid or pus are more likely to be infectious.
Before playing, check areas of your body where skin lesions are more common, such as your knees and knuckles.
If you have a suspicious skin lesion, excuse yourself from playing until it has healed.
Avoid sharing equipment that touches the skin, such as helmets and pads.
Wash your playing clothes in hot water and dry them on the high setting.
Health Tip: Signs You May Be Diabetic
About 20 million Americans have diabetes, but half of them don't know they have it, according to the University Of Washington.
Signs and symptoms of diabetes include:
Frequent urination.
Always being thirsty or hungry.
Often feeling tired.
Blurred vision.
Slow wound healing.
Recurring urinary tract infections.
Obesity.
A family history of diabetes also increases a person's risk.
If you're concerned that you may have diabetes, tell your doctor. You can also take a screening test to determine your level of risk.
A fever of unknown origin can sometimes be a sign of cancer, including lymphoma, kidney and liver cancer, according to a new Danish study.
Such a fever is one that lasts more than three weeks with temperatures above 38.3 degrees Celsius (about 101 degrees Fahrenheit), with an unidentifiable cause. Patients with these fevers appear to be at a slightly higher risk of cancer, according to the report.
"We found an association between fever and cancer," said study author Dr. Henrik Toft Sorensen, a professor of medicine in the Department of Clinical Epidemiology at Aarhus University Hospital, in Denmark.
However, "the absolute risk is very low. Much lower than reported in other studies," he added.
The new research appears in the Sept. 28 online issue of The Lancet Oncology.
Previous studies had shown an association of fever and cancer of 20 percent to 30 percent, Sorensen said. "But we found very few cases of cancer related to fever compared with the incidence of cancer in the general population," he said.
In their study, Sorensen and his colleagues collected data on 43,205 patients who had been treated in Danish hospitals for fever of unknown origin from 1977 through 1998. During more than six years of follow-up, the researchers compared the incidence of cancer among these patients with the general population.
They found that patients with fever were at a 2.3 percent increased risk of developing cancer. After one year, the risk was highest for cancers of the blood, and cancers of the liver, brain, and kidney.
In addition, more of the people diagnosed with cancer had cancer that had spread to other organs, compared with patients who didn't have a fever. The increased risk continued after one year, but at a lower level, the researchers noted.
Some cancer patients with fever also had worse outcomes, including a slight increase in mortality compared with other cancer patients.
Because the increased risk of cancer associated with fever is slight, Sorensen doesn't think there needs to be extensive cancer workups for patients with fever. "You probably do not need to look for cancer and do a lot of tests in a patient coming into a hospital with fever of unknown origin, because your risk of cancer is very low."
One expert thinks the finding concerning fever-related cancers may reflect better diagnosis of fever and better cancer diagnoses.
"We know some cancers are associated with fever," said Dr. Yelena Novik, an oncologist at New York University Cancer Institute and an assistant professor of oncology at New York University School of Medicine.
There are still some cases of fever of unknown origin that may be a sign of cancer, Novik said. "But we are probably better at diagnosing fever and cancer better," she said.
Novik advises that if you have a fever of unknown origin, it should be checked, including a screening for cancer. "Don't let the fever go on," she said. "Make sure all the possible causes for the fever have been explored."
Health Tip: Athletes Can Avoid Skin Infections
Because of the close body contact involved in sports like football, rugby or hockey, participants face an increased risk of skin infection, according to the Utah Department of Health.
If you play contact sports, use these skin-safety guidelines:
Skin lesions that are red, warm, swollen, tender or draining fluid or pus are more likely to be infectious.
Before playing, check areas of your body where skin lesions are more common, such as your knees and knuckles.
If you have a suspicious skin lesion, excuse yourself from playing until it has healed.
Avoid sharing equipment that touches the skin, such as helmets and pads.
Wash your playing clothes in hot water and dry them on the high setting.
Health Tip: Signs You May Be Diabetic
About 20 million Americans have diabetes, but half of them don't know they have it, according to the University Of Washington.
Signs and symptoms of diabetes include:
Frequent urination.
Always being thirsty or hungry.
Often feeling tired.
Blurred vision.
Slow wound healing.
Recurring urinary tract infections.
Obesity.
A family history of diabetes also increases a person's risk.
If you're concerned that you may have diabetes, tell your doctor. You can also take a screening test to determine your level of risk.
Wednesday, September 28, 2005
Health Headlines - September 28
Scientists find wider uses for cholesterol drugs
Cholesterol-lowering drugs could help to prevent diabetics and people at high risk of heart disease from suffering a heart attack or stroke even if their cholesterol level is not high, scientists said on Tuesday.
Millions of patients around the world are prescribed the drugs, known as statins, to reduce their cholesterol, but an international team of researchers said an even bigger group of people would benefit from the treatment.
"What we have shown is that the key thing is to find people who are at risk of coronary heart disease or stroke and treat them with a regimen that reduces LDL cholesterol substantially," said Dr Colin Baigent, an epidemiologist at Britain's Medical Research Council (MRC), who co-ordinated the study.
LDL, or bad cholesterol, deposits fat in the arteries while HDL, or good cholesterol, carries it away.
Baigent said lowering LDL with a statin could cut the risk of a heart attack or stroke by as much as a third.
"The size of the reduction in the risk of major vascular events -- coronary heart disease or stroke -- is proportional to the size of the absolute reduction in LDL cholesterol," he explained.
Pfizer's Lipitor, Merck's Zocor and AstraZeneca's Crestor are among the leading statins. The drugs lower cholesterol by inhibiting an enzyme that controls how much is produced in the body.
A raised cholesterol level, along with smoking, diabetes, high blood pressure and being overweight or obese, is a risk factor for heart disease, one of the biggest killers in Western countries.
The researchers studied the results of 14 previous trials involving statin treatment in 90,000 people. In addition to high-risk patients with low cholesterol showing positive results, they said people who had the largest reduction in their cholesterol level reaped the highest benefit.
Professor Anthony Keech, of the National Health Medical Research Council at the University of Sydney, who co-ordinated the study team in Australia, said the size of the cholesterol cut was important.
"So, bigger cholesterol reductions with more intensive treatment regimens should lead to great benefits," he said in a statement.
Baigent said the scientists found no evidence of an increased risk of cancer or that very low cholesterol levels were associated with increased odds of suffering from other diseases.
He said higher doses of statins were associated with a raised risk of serious muscle problems but that this was very rare.
Bayer AG's) cholesterol drug Baycol was pulled from the market in 2001 after being linked to dozens of deaths.
"When we have patients who have a very high risk of heart disease or stroke then the size of the benefits far outweighs any risks," Baigent added.
Health Tip: Get Enough Fruits and Vegetables
According to the U.S. National Cancer Institute, 35 percent of cancer deaths in the United States can be attributed to diets that are high in fat and low in fruit, vegetables and fiber.
And people who eat adequate amounts of fruit and vegetables -- five to nine servings daily -- may cut their cancer risk in half compared to those who don't.
To increase your consumption, the Virginia Department of Health suggests you:
Eat fruit or drink 100 percent fruit juice for breakfast.
Have a fruit or vegetable snack every day.
Buy fresh, frozen, canned and dried fruits and vegetables.
Steam or microwave vegetables for dinner.
Health Tip: Disposing of Expired Drugs
While flushing unwanted or expired medications down the toilet is common practice, Health Canada says this may have a harmful effect on the environment.
Here's how to properly dispose of medications:
Check to see if your pharmacy has a drug recycling program.
See if your municipality incinerates drugs. If so, take your unused medications to your municipality's waste disposal depot.
At least once a year, go through your medicine cabinet and remove prescription drugs that are old or that you no longer take. Dispose of them as suggested above.
Cholesterol-lowering drugs could help to prevent diabetics and people at high risk of heart disease from suffering a heart attack or stroke even if their cholesterol level is not high, scientists said on Tuesday.
Millions of patients around the world are prescribed the drugs, known as statins, to reduce their cholesterol, but an international team of researchers said an even bigger group of people would benefit from the treatment.
"What we have shown is that the key thing is to find people who are at risk of coronary heart disease or stroke and treat them with a regimen that reduces LDL cholesterol substantially," said Dr Colin Baigent, an epidemiologist at Britain's Medical Research Council (MRC), who co-ordinated the study.
LDL, or bad cholesterol, deposits fat in the arteries while HDL, or good cholesterol, carries it away.
Baigent said lowering LDL with a statin could cut the risk of a heart attack or stroke by as much as a third.
"The size of the reduction in the risk of major vascular events -- coronary heart disease or stroke -- is proportional to the size of the absolute reduction in LDL cholesterol," he explained.
Pfizer's Lipitor, Merck's Zocor and AstraZeneca's Crestor are among the leading statins. The drugs lower cholesterol by inhibiting an enzyme that controls how much is produced in the body.
A raised cholesterol level, along with smoking, diabetes, high blood pressure and being overweight or obese, is a risk factor for heart disease, one of the biggest killers in Western countries.
The researchers studied the results of 14 previous trials involving statin treatment in 90,000 people. In addition to high-risk patients with low cholesterol showing positive results, they said people who had the largest reduction in their cholesterol level reaped the highest benefit.
Professor Anthony Keech, of the National Health Medical Research Council at the University of Sydney, who co-ordinated the study team in Australia, said the size of the cholesterol cut was important.
"So, bigger cholesterol reductions with more intensive treatment regimens should lead to great benefits," he said in a statement.
Baigent said the scientists found no evidence of an increased risk of cancer or that very low cholesterol levels were associated with increased odds of suffering from other diseases.
He said higher doses of statins were associated with a raised risk of serious muscle problems but that this was very rare.
Bayer AG's) cholesterol drug Baycol was pulled from the market in 2001 after being linked to dozens of deaths.
"When we have patients who have a very high risk of heart disease or stroke then the size of the benefits far outweighs any risks," Baigent added.
Health Tip: Get Enough Fruits and Vegetables
According to the U.S. National Cancer Institute, 35 percent of cancer deaths in the United States can be attributed to diets that are high in fat and low in fruit, vegetables and fiber.
And people who eat adequate amounts of fruit and vegetables -- five to nine servings daily -- may cut their cancer risk in half compared to those who don't.
To increase your consumption, the Virginia Department of Health suggests you:
Eat fruit or drink 100 percent fruit juice for breakfast.
Have a fruit or vegetable snack every day.
Buy fresh, frozen, canned and dried fruits and vegetables.
Steam or microwave vegetables for dinner.
Health Tip: Disposing of Expired Drugs
While flushing unwanted or expired medications down the toilet is common practice, Health Canada says this may have a harmful effect on the environment.
Here's how to properly dispose of medications:
Check to see if your pharmacy has a drug recycling program.
See if your municipality incinerates drugs. If so, take your unused medications to your municipality's waste disposal depot.
At least once a year, go through your medicine cabinet and remove prescription drugs that are old or that you no longer take. Dispose of them as suggested above.
Tuesday, September 27, 2005
Health Headlines - September 27
Katrina Displaces Nearly 6,000 Doctors
Nearly 6,000 doctors along the Gulf Coast were uprooted by Hurricane Katrina in the largest displacement of physicians in U.S. history, university researchers reported Monday.
How many of those doctors will set up shop permanently in other cities, or decide to retire instead of reopening their practices, remains as unclear as New Orleans' future.
"We don't know what this is going to mean to health care," said Dr. Thomas Ricketts, who led the study by researchers at the University of North Carolina-Chapel Hill. "We've never had to deal with something like this before."
The study was released the same day that New Orleans Mayor Ray Nagin said residents of the city's Algiers section and business owners in other parts of the storm-ravaged city would be allowed back in to inspect property and clean up. But he cautioned those returning that the city remains without critical hospital services.
Ricketts' study found that 5,944 doctors were displaced in the 10 counties and parishes in Louisiana and Mississippi that were directly affected by Katrina-related flooding. That number covers doctors caring for patients, not those who are administrators or researchers, said Ricketts, a professor of health policy and administration at UNC's School of Public Health.
The finding is based on an analysis of American Medical Association data from March, information posted by the Federal Emergency Management Agency and other records.
More than two-thirds of the doctors displaced, or 4,486, came from the immediate New Orleans parishes of Orleans, Jefferson and St. Bernard.
More than half were specialists, with 1,292 in primary care and 272 in obstetrics and gynecology, the study said. Also, about 1,300 medical students at Tulane and Louisiana State University moved to other programs in the region, mostly in Baton Rouge and East Texas.
Among those displaced is Dr. Susan McLellan. Along with her family, she fled to Atlanta from New Orleans and her home near the 17th Street Canal, where a levee broke after Katrina hit.
When it became clear she could not return to her water-logged house or her job at Tulane University Hospital, she applied for a temporary medical license to practice in Georgia. A friend steered her to an AIDS clinic, where she volunteers three days a week, working to make sure about 45 AIDS patients who also fled Katrina are taking their medications.
"I don't want to jump ship," McLellan said. "But if I can be useful in Atlanta, then I will stay until I get called back."
Ricketts believes it is likely many doctors won't return. "This is both an opportunity for places that need physicians, as well as a dire problem for the population that will remain."
Dr. Mark Peters, the chief executive and president of East Jefferson General Hospital in the New Orleans suburb of Metairie, said those doctors who didn't flee are having a hard time making ends meet. Their patient loads dropped dramatically following the evacuation of the New Orleans area.
To help, he is trying to get the federal government to relax regulations that prohibit hospitals from providing free rent and office space to doctors.
"Physicians are no different than you or me. They have a mortgage payment. They have tuition payments," Peters said. "They are still here on their own good will, but they are not getting paid for it."
Peters, whose hospital remained open after Katrina struck, also said the cost of retaining a staff is much less than recruiting replacements.
"If they are (getting) offers of other opportunities throughout the country, for some, relocation can become very tempting," he said, "so that is why we feel like we have to be very supportive in all aspects of assisting them."
Tenet Healthcare Corp., which operates five hospitals in the New Orleans area, is helping physicians at its closed facilities to find jobs at the company's other hospitals.
"There are several physicians who are feeling like they want to stay in the New Orleans area," said Tenet spokesman Steven Campanini. "They want to stay any way they can and they are looking at the hospitals that are likely to offer services when New Orleans is restored."
Health Tip: Is Your Teen Drinking?
For many teenagers, alcohol is the drug of choice. It's used and abused more than any other substance, according to the Texas Medical Center.
Here are some signs your teen's drinking may be out of control:
Increased defiance.
Failing grades.
A sudden lapse in school attendance.
Lying about where he's been or who he's been with.
Giving up usual activities, such as sports and homework.
Depressed attitude or mood swings.
Weight loss, change in sleep habits or energy level.
Mental confusion.
Increased physical complaints, such as upset stomach, and headaches.
Getting into trouble with the law.
Traffic accidents.
If this description sounds like your child, consult a professional.
Health Tip: Cap Your Child's Soda Habit
There's little doubt that the amount of soda kids drink has contributed to the obesity epidemic in the United States.
Help your child break his soda habit with these tips from the Texas Department of Health:
Save soda for a special treat.
Stock your fridge with low-fat milk, fruit-flavored seltzers and low-sugar juices.
Serve water with meals.
Have a soda-free week once a month.
Refrigerate only a few cans at a time.
Buy large-size containers for special occasions only.
Nearly 6,000 doctors along the Gulf Coast were uprooted by Hurricane Katrina in the largest displacement of physicians in U.S. history, university researchers reported Monday.
How many of those doctors will set up shop permanently in other cities, or decide to retire instead of reopening their practices, remains as unclear as New Orleans' future.
"We don't know what this is going to mean to health care," said Dr. Thomas Ricketts, who led the study by researchers at the University of North Carolina-Chapel Hill. "We've never had to deal with something like this before."
The study was released the same day that New Orleans Mayor Ray Nagin said residents of the city's Algiers section and business owners in other parts of the storm-ravaged city would be allowed back in to inspect property and clean up. But he cautioned those returning that the city remains without critical hospital services.
Ricketts' study found that 5,944 doctors were displaced in the 10 counties and parishes in Louisiana and Mississippi that were directly affected by Katrina-related flooding. That number covers doctors caring for patients, not those who are administrators or researchers, said Ricketts, a professor of health policy and administration at UNC's School of Public Health.
The finding is based on an analysis of American Medical Association data from March, information posted by the Federal Emergency Management Agency and other records.
More than two-thirds of the doctors displaced, or 4,486, came from the immediate New Orleans parishes of Orleans, Jefferson and St. Bernard.
More than half were specialists, with 1,292 in primary care and 272 in obstetrics and gynecology, the study said. Also, about 1,300 medical students at Tulane and Louisiana State University moved to other programs in the region, mostly in Baton Rouge and East Texas.
Among those displaced is Dr. Susan McLellan. Along with her family, she fled to Atlanta from New Orleans and her home near the 17th Street Canal, where a levee broke after Katrina hit.
When it became clear she could not return to her water-logged house or her job at Tulane University Hospital, she applied for a temporary medical license to practice in Georgia. A friend steered her to an AIDS clinic, where she volunteers three days a week, working to make sure about 45 AIDS patients who also fled Katrina are taking their medications.
"I don't want to jump ship," McLellan said. "But if I can be useful in Atlanta, then I will stay until I get called back."
Ricketts believes it is likely many doctors won't return. "This is both an opportunity for places that need physicians, as well as a dire problem for the population that will remain."
Dr. Mark Peters, the chief executive and president of East Jefferson General Hospital in the New Orleans suburb of Metairie, said those doctors who didn't flee are having a hard time making ends meet. Their patient loads dropped dramatically following the evacuation of the New Orleans area.
To help, he is trying to get the federal government to relax regulations that prohibit hospitals from providing free rent and office space to doctors.
"Physicians are no different than you or me. They have a mortgage payment. They have tuition payments," Peters said. "They are still here on their own good will, but they are not getting paid for it."
Peters, whose hospital remained open after Katrina struck, also said the cost of retaining a staff is much less than recruiting replacements.
"If they are (getting) offers of other opportunities throughout the country, for some, relocation can become very tempting," he said, "so that is why we feel like we have to be very supportive in all aspects of assisting them."
Tenet Healthcare Corp., which operates five hospitals in the New Orleans area, is helping physicians at its closed facilities to find jobs at the company's other hospitals.
"There are several physicians who are feeling like they want to stay in the New Orleans area," said Tenet spokesman Steven Campanini. "They want to stay any way they can and they are looking at the hospitals that are likely to offer services when New Orleans is restored."
Health Tip: Is Your Teen Drinking?
For many teenagers, alcohol is the drug of choice. It's used and abused more than any other substance, according to the Texas Medical Center.
Here are some signs your teen's drinking may be out of control:
Increased defiance.
Failing grades.
A sudden lapse in school attendance.
Lying about where he's been or who he's been with.
Giving up usual activities, such as sports and homework.
Depressed attitude or mood swings.
Weight loss, change in sleep habits or energy level.
Mental confusion.
Increased physical complaints, such as upset stomach, and headaches.
Getting into trouble with the law.
Traffic accidents.
If this description sounds like your child, consult a professional.
Health Tip: Cap Your Child's Soda Habit
There's little doubt that the amount of soda kids drink has contributed to the obesity epidemic in the United States.
Help your child break his soda habit with these tips from the Texas Department of Health:
Save soda for a special treat.
Stock your fridge with low-fat milk, fruit-flavored seltzers and low-sugar juices.
Serve water with meals.
Have a soda-free week once a month.
Refrigerate only a few cans at a time.
Buy large-size containers for special occasions only.
Monday, September 26, 2005
Health Headlines - September 26
S. African AIDS Expert Urges Circumcision
A South African AIDS expert Sunday advocated male circumcision as the best available "vaccine" against the virus in his country, where an estimated 6 million people are infected and more than 600 people die every day.
Francois Venter told a congress of health activists in the Treatment Action Campaign that a recent survey in the Soweto township indicated that circumcised men were 65 percent less likely to contract AIDS than those who had not been circumcised.
"We dream of a vaccine which has this efficacy," said Venter, clinical director of the Reproductive Health and HIV Research at the University of Witwatersrand. "The results are phenomenal."
The association between circumcision and a reduced risk of HIV was noted as early as 1987, when Dr. William Cameron of the University of Manitoba in Canada reported findings from a study in Kenya. Some researchers in early studies have said they believe cells in the foreskin may be particularly susceptible to infection.
Venter urged the Treatment Action Campaign, an influential movement of 13,000 activists, to consider promoting circumcision as a vital prevention tool, given that existing methods were failing to slow the spread of the epidemic.
South Africa has the highest number of people living with HIV/AIDS in the world. Nearly 30 percent of pregnant women are infected, according to a health department survey published in July, and in the hardest hit province of KwaZuluNatal this rises to 41 percent. The disease is now one of the main causes of death among young adults and infants.
Some traditional communities in South Africa practice circumcision, but there are calls for tighter medical controls to limit health risks from blunt and contaminated instruments.
"We don't want our men to go to the chop shop but have medical circumcision," said Zackie Achmat, an AIDS activist who said the congress — which meets every two years — would debate whether to encourage mass circumcision.
Achmat, who is HIV positive, said much more needed to be done on prevention. He said that even though government distribution of condoms increased from one million in 1994 to 40 million in 2004, this still only amounted to 35 condoms per sexually active male per year.
He said that 73 percent of young people without the virus believed that they were not at risk of catching, and 62 percent of young people with the virus also believed there was no risk.
Achmat criticized the government's record on treatment. Of the 500,000 people who need AIDS therapy, only 76,000 are currently receiving it through the public health sector. The World Health Organization has singled out slow progress in South Africa as one of the main reasons it will likely miss its target of putting 3 million people worldwide on therapy by the end of this year.
"We are dying. We are still dying," he said.
Achmat has for years attacked the government for doing too little too late against the AIDS epidemic. In a sign of the mutual antagonism, health ministry officials refused invitations to attend the congress.
"President Thabo Mbeki tragically still shows symptoms of AIDS denialism," said Achmat. Mbeki reputedly doubts the link between HIV and AIDS. Health Minister Manto Tshabalala-Msimang has repeatedly voiced doubts about the safety and efficacy of antiretrovirals, instead stressing the benefits of a diet heavy in garlic, lemon and olive oil.
The Soweto study, was conducted by French researchers between 2002 and 2005 with more than 3,000 healthy, sexually active males between 18 and 24. About half the volunteers were circumcised by medical professionals, and the rest remained uncircumcised.
All the men received counseling on AIDS prevention. But after 21 months, 51 members of the uncircumcised group had contracted HIV, the AIDS virus, while only 18 members of the circumcised group had gotten the disease.
The World Health Organization and UNAIDS welcomed the results of the study, released at a conference in Brazil in July, but says that more trials should be conducted before circumcision can be recommended as a preventive method.
A study conducted by the U.S. National Health Institute involving 5,000 individuals is now under way in Uganda.
Bones to Blame for Aging Face
Beauty, and age, is more than skin deep. In fact, it's bone-deep, a new study finds.
Researchers say shrinking facial bones play a major role in facial aging and that women experience this type of facial bone loss at a younger age than men.
"Many people believe that only gravity creates wrinkles; however, we have discovered the loss of volume in the face and changes in bone structure also contribute to making us look older," study co-author Dr. David Kahn said in a prepared statement.
"As we age, not only do we lose fat in our faces but our bones actually change in contour, often making us look older than we feel," Kahn said.
The findings were presented Sunday at a conference of the American Society of Plastic Surgeons in Chicago.
Kahn's team analyzed computed tomography scans of 30 women and 30 men ranging in age from 25 to more than 65 years old.
He and his colleagues found that, as individuals age, their facial bones dissolve, shrink and leave empty spaces. Since skin also loses elasticity as we age, it's not able to tighten around the spaces left by facial bone loss. Thus, we end up with drooping and wrinkles.
Kahn said the fact that women tend to experience facial bone loss at a younger age than men may explain why women are more likely to seek facial cosmetic enhancement at a younger age than men.
In some cases, cosmetic enhancement can restore lost volume, he said. "By using fillers, along with other cosmetic plastic surgery techniques such as forehead lifts and soft tissue repositioning, plastic surgeons can recreate volume loss caused by dissolving or shrinking bone and lift the skin to create better, more refined results for patients," he said.
Lead Exposure Plus Hypertension May Cause Cognitive Decline
Exposure to lead in childhood and adolescence may contribute to high blood pressure-related problems that can harm cognitive abilities later in life, a new study finds.
Lead exposure and high blood pressure are associated with cognitive impairments in older adults. And being exposed to lead early in life may have a long-term effect on cognitive ability and motor function that carries through to adulthood, the researchers suggest.
The study results were to be presented Saturday at the American Heart Association's annual high blood pressure conference, in Washington, D.C.
"Many of the things that happen with age are not just a byproduct of age," said lead author Dr. Domenic Sica, a professor of medicine and pharmacology at Virginia Commonwealth University. "Your catalog of diseases and exposures comes back to haunt you over time. Lead exposure probably carries a long-term determinative function on some of the changes that occur with hypertension" -- another name for high blood pressure.
Lead is associated with a greater risk of hypertension and also with a greater tendency to chronic kidney disease, Sica said.
Using data from the Third National Health and Nutrition Survey (NHANES III), Sica's team found that lead exposure early in life, combined with high blood pressure in working-age adults, may lead to diminishing cognitive abilities in later life.
NHANES III involved 4,835 people ages 20 to 59. Of these, 51 percent were female, 35.4 percent were white, 31.4 were percent black and 29.7 percent were Hispanic.
The researchers looked at the relationships involving pulse pressure, blood lead level and C-reactive protein -- a marker of inflammation. They also looked at the results of neurobehavioral tests and simple reaction-time tests.
There was a correlation between blood pressure and these measures, Sica said. In neurobehavioral tests, which included measures of reaction time, the researchers found slower and less stable reaction time associated with increases in pulse pressure and blood lead levels.
"We have to be more careful in understanding the impact of blood lead levels," Sica said.
One expert finds the study results too preliminary to draw definitive conclusions.
"It may be that environmental conditions conducive to lead exposure independently harm brain function," said Dr. David L. Katz, an associate professor of public health and director of the Prevention Research Center at Yale University School of Medicine. "Such conditions might include poverty during childhood or adverse environmental conditions."
More work is needed to determine if lead exposure and blood pressure combine to form a unique threat to the brain, Katz said. "Given the prevalence of these exposures and the intense public interest in strategies to forestall dementing diseases, such efforts will be awaited with impatience."
Another expert thinks the findings point to a serious public health problem.
The impact of lead on cognitive function has been well known, and the impact of high blood pressure on cognitive function is also well known. "The fact these two may be synergistic is not a surprise," said Hillel W. Cohen, an associate professor of epidemiology and public health at Albert Einstein College of Medicine in New York City.
"This is more evidence to address lead in the environment and blood pressure as well," he said.
When Job Ups Blood Pressure, Spouse Can Help
A supportive spouse can help soothe the negative effects of job stress on blood pressure, new research shows.
The year-long study of 216 men and women found that a combination of job stress and lack of spousal support was associated with an increase of 2.8 mm Hg in systolic blood pressure.
However, study volunteers who experienced job stress but had a supportive spouse showed a decrease in their hypertension of 2.5 mm Hg in systolic blood pressure.
Spousal support means talking things over on a daily basis, and it's a key component of what the researchers called "marital cohesion," researcher Dr. Sheldon Tobe, assistant professor of medicine, University of Toronto, said in a prepared statement. "Did partners talk about their daily activities? Did one partner pay attention and sympathize when the significant other had a stressful day? Did the partners spend time together?"
Tobe said that people with high job stress and/or low marital cohesion should see their family doctor for a blood pressure check. He also advised people to get their blood pressure checked if they're in a formerly harmonious relationship that's deteriorated.
"The medical model of healthcare does not include job strain, but stress at work and at home can modify the health of patients," Tobe said.
The findings were presented Saturday at the American Heart Association's annual fall High Blood Pressure Research meeting in Washington, D.C.
A South African AIDS expert Sunday advocated male circumcision as the best available "vaccine" against the virus in his country, where an estimated 6 million people are infected and more than 600 people die every day.
Francois Venter told a congress of health activists in the Treatment Action Campaign that a recent survey in the Soweto township indicated that circumcised men were 65 percent less likely to contract AIDS than those who had not been circumcised.
"We dream of a vaccine which has this efficacy," said Venter, clinical director of the Reproductive Health and HIV Research at the University of Witwatersrand. "The results are phenomenal."
The association between circumcision and a reduced risk of HIV was noted as early as 1987, when Dr. William Cameron of the University of Manitoba in Canada reported findings from a study in Kenya. Some researchers in early studies have said they believe cells in the foreskin may be particularly susceptible to infection.
Venter urged the Treatment Action Campaign, an influential movement of 13,000 activists, to consider promoting circumcision as a vital prevention tool, given that existing methods were failing to slow the spread of the epidemic.
South Africa has the highest number of people living with HIV/AIDS in the world. Nearly 30 percent of pregnant women are infected, according to a health department survey published in July, and in the hardest hit province of KwaZuluNatal this rises to 41 percent. The disease is now one of the main causes of death among young adults and infants.
Some traditional communities in South Africa practice circumcision, but there are calls for tighter medical controls to limit health risks from blunt and contaminated instruments.
"We don't want our men to go to the chop shop but have medical circumcision," said Zackie Achmat, an AIDS activist who said the congress — which meets every two years — would debate whether to encourage mass circumcision.
Achmat, who is HIV positive, said much more needed to be done on prevention. He said that even though government distribution of condoms increased from one million in 1994 to 40 million in 2004, this still only amounted to 35 condoms per sexually active male per year.
He said that 73 percent of young people without the virus believed that they were not at risk of catching, and 62 percent of young people with the virus also believed there was no risk.
Achmat criticized the government's record on treatment. Of the 500,000 people who need AIDS therapy, only 76,000 are currently receiving it through the public health sector. The World Health Organization has singled out slow progress in South Africa as one of the main reasons it will likely miss its target of putting 3 million people worldwide on therapy by the end of this year.
"We are dying. We are still dying," he said.
Achmat has for years attacked the government for doing too little too late against the AIDS epidemic. In a sign of the mutual antagonism, health ministry officials refused invitations to attend the congress.
"President Thabo Mbeki tragically still shows symptoms of AIDS denialism," said Achmat. Mbeki reputedly doubts the link between HIV and AIDS. Health Minister Manto Tshabalala-Msimang has repeatedly voiced doubts about the safety and efficacy of antiretrovirals, instead stressing the benefits of a diet heavy in garlic, lemon and olive oil.
The Soweto study, was conducted by French researchers between 2002 and 2005 with more than 3,000 healthy, sexually active males between 18 and 24. About half the volunteers were circumcised by medical professionals, and the rest remained uncircumcised.
All the men received counseling on AIDS prevention. But after 21 months, 51 members of the uncircumcised group had contracted HIV, the AIDS virus, while only 18 members of the circumcised group had gotten the disease.
The World Health Organization and UNAIDS welcomed the results of the study, released at a conference in Brazil in July, but says that more trials should be conducted before circumcision can be recommended as a preventive method.
A study conducted by the U.S. National Health Institute involving 5,000 individuals is now under way in Uganda.
Bones to Blame for Aging Face
Beauty, and age, is more than skin deep. In fact, it's bone-deep, a new study finds.
Researchers say shrinking facial bones play a major role in facial aging and that women experience this type of facial bone loss at a younger age than men.
"Many people believe that only gravity creates wrinkles; however, we have discovered the loss of volume in the face and changes in bone structure also contribute to making us look older," study co-author Dr. David Kahn said in a prepared statement.
"As we age, not only do we lose fat in our faces but our bones actually change in contour, often making us look older than we feel," Kahn said.
The findings were presented Sunday at a conference of the American Society of Plastic Surgeons in Chicago.
Kahn's team analyzed computed tomography scans of 30 women and 30 men ranging in age from 25 to more than 65 years old.
He and his colleagues found that, as individuals age, their facial bones dissolve, shrink and leave empty spaces. Since skin also loses elasticity as we age, it's not able to tighten around the spaces left by facial bone loss. Thus, we end up with drooping and wrinkles.
Kahn said the fact that women tend to experience facial bone loss at a younger age than men may explain why women are more likely to seek facial cosmetic enhancement at a younger age than men.
In some cases, cosmetic enhancement can restore lost volume, he said. "By using fillers, along with other cosmetic plastic surgery techniques such as forehead lifts and soft tissue repositioning, plastic surgeons can recreate volume loss caused by dissolving or shrinking bone and lift the skin to create better, more refined results for patients," he said.
Lead Exposure Plus Hypertension May Cause Cognitive Decline
Exposure to lead in childhood and adolescence may contribute to high blood pressure-related problems that can harm cognitive abilities later in life, a new study finds.
Lead exposure and high blood pressure are associated with cognitive impairments in older adults. And being exposed to lead early in life may have a long-term effect on cognitive ability and motor function that carries through to adulthood, the researchers suggest.
The study results were to be presented Saturday at the American Heart Association's annual high blood pressure conference, in Washington, D.C.
"Many of the things that happen with age are not just a byproduct of age," said lead author Dr. Domenic Sica, a professor of medicine and pharmacology at Virginia Commonwealth University. "Your catalog of diseases and exposures comes back to haunt you over time. Lead exposure probably carries a long-term determinative function on some of the changes that occur with hypertension" -- another name for high blood pressure.
Lead is associated with a greater risk of hypertension and also with a greater tendency to chronic kidney disease, Sica said.
Using data from the Third National Health and Nutrition Survey (NHANES III), Sica's team found that lead exposure early in life, combined with high blood pressure in working-age adults, may lead to diminishing cognitive abilities in later life.
NHANES III involved 4,835 people ages 20 to 59. Of these, 51 percent were female, 35.4 percent were white, 31.4 were percent black and 29.7 percent were Hispanic.
The researchers looked at the relationships involving pulse pressure, blood lead level and C-reactive protein -- a marker of inflammation. They also looked at the results of neurobehavioral tests and simple reaction-time tests.
There was a correlation between blood pressure and these measures, Sica said. In neurobehavioral tests, which included measures of reaction time, the researchers found slower and less stable reaction time associated with increases in pulse pressure and blood lead levels.
"We have to be more careful in understanding the impact of blood lead levels," Sica said.
One expert finds the study results too preliminary to draw definitive conclusions.
"It may be that environmental conditions conducive to lead exposure independently harm brain function," said Dr. David L. Katz, an associate professor of public health and director of the Prevention Research Center at Yale University School of Medicine. "Such conditions might include poverty during childhood or adverse environmental conditions."
More work is needed to determine if lead exposure and blood pressure combine to form a unique threat to the brain, Katz said. "Given the prevalence of these exposures and the intense public interest in strategies to forestall dementing diseases, such efforts will be awaited with impatience."
Another expert thinks the findings point to a serious public health problem.
The impact of lead on cognitive function has been well known, and the impact of high blood pressure on cognitive function is also well known. "The fact these two may be synergistic is not a surprise," said Hillel W. Cohen, an associate professor of epidemiology and public health at Albert Einstein College of Medicine in New York City.
"This is more evidence to address lead in the environment and blood pressure as well," he said.
When Job Ups Blood Pressure, Spouse Can Help
A supportive spouse can help soothe the negative effects of job stress on blood pressure, new research shows.
The year-long study of 216 men and women found that a combination of job stress and lack of spousal support was associated with an increase of 2.8 mm Hg in systolic blood pressure.
However, study volunteers who experienced job stress but had a supportive spouse showed a decrease in their hypertension of 2.5 mm Hg in systolic blood pressure.
Spousal support means talking things over on a daily basis, and it's a key component of what the researchers called "marital cohesion," researcher Dr. Sheldon Tobe, assistant professor of medicine, University of Toronto, said in a prepared statement. "Did partners talk about their daily activities? Did one partner pay attention and sympathize when the significant other had a stressful day? Did the partners spend time together?"
Tobe said that people with high job stress and/or low marital cohesion should see their family doctor for a blood pressure check. He also advised people to get their blood pressure checked if they're in a formerly harmonious relationship that's deteriorated.
"The medical model of healthcare does not include job strain, but stress at work and at home can modify the health of patients," Tobe said.
The findings were presented Saturday at the American Heart Association's annual fall High Blood Pressure Research meeting in Washington, D.C.
Sunday, September 25, 2005
Health Headlines - September 25
Nutrition Answers Just a Mouse Click Away
Folks with an appetite for info on healthy eating can now order up answers online at the American Institute for Cancer Research (AICR).
"There is a lot of confusion about the shape of a healthy diet today, and AICR is committed to dispelling misconceptions and setting out applicable guidelines for healthy meals and snacks. Many people are less reticent about asking questions online than they are on the phone. So we have added the 'online hotline' to our education offerings," Jeffrey R. Prince, AICR vice president for education, said in a prepared statement.
Answers from AICR dietitians are based on a thorough review of existing research on diet, cancer and weight management. When there is no definitive research, the dietitians provide helpful but qualified suggestions.
Questions to the hotline often focus on the appropriate diet for preventing cancer and other chronic diseases.
"Announcements about health or new research results also prompt questions. After the 2005 U.S. Dietary Guidelines appeared with their heavy emphasis on physical activity, we received a lot of inquires about intensity and duration of activity intended to reduce cancer risk. People were also curious about how to find and cook with whole-grain products," Prince said.
More information:
You can submit questions to the AICR Nutrition Hotline by calling 1-800-843-8114 from 9 a.m. to 5 p.m. Eastern Monday through Friday and asking for the nutrition hotline. You can also go to the online hotline.
http://www.aicr.org/information/hotline/index.lasso
Health Tip: Heading Home From the Hospital
Going home after a hospital stay can be unnerving. It's a good idea to coordinate as much as possible before your return.
Here are some pointers from the Naval Hospital in Camp Pendleton, Calif.:
Make sure you have written instructions regarding your discharge and at-home medical routine.
Take all prescribed medications at the assigned time.
Ensure your home environment is conducive to your recovery.
Avoid using steps unless otherwise instructed.
If you're staying in bed, choose a bedroom that's close to a bathroom.
Keep a phone and phone numbers handy for emergencies and medical questions.
Health Tip: Why is My Mouth Dry?
Dry mouth used to be considered a normal symptom of aging.
However, it's now clear that dry mouth is often a side effect of certain medications -- such as antihistamines, heart drugs and pain killers -- according to the Maryland Department of Health and Mental Hygiene. A decrease in hormones in postmenopausal women can also lead to dry mouth.
A lack of saliva causes food and bacteria to remain in the mouth for longer periods, which can lead to more plaque and cavities.
While there is no cure for dry mouth, you can get relief by drinking water, using saliva substitutes, using a humidifier or nasal spray, and by avoiding caffeine, alcohol and tobacco products.
Folks with an appetite for info on healthy eating can now order up answers online at the American Institute for Cancer Research (AICR).
"There is a lot of confusion about the shape of a healthy diet today, and AICR is committed to dispelling misconceptions and setting out applicable guidelines for healthy meals and snacks. Many people are less reticent about asking questions online than they are on the phone. So we have added the 'online hotline' to our education offerings," Jeffrey R. Prince, AICR vice president for education, said in a prepared statement.
Answers from AICR dietitians are based on a thorough review of existing research on diet, cancer and weight management. When there is no definitive research, the dietitians provide helpful but qualified suggestions.
Questions to the hotline often focus on the appropriate diet for preventing cancer and other chronic diseases.
"Announcements about health or new research results also prompt questions. After the 2005 U.S. Dietary Guidelines appeared with their heavy emphasis on physical activity, we received a lot of inquires about intensity and duration of activity intended to reduce cancer risk. People were also curious about how to find and cook with whole-grain products," Prince said.
More information:
You can submit questions to the AICR Nutrition Hotline by calling 1-800-843-8114 from 9 a.m. to 5 p.m. Eastern Monday through Friday and asking for the nutrition hotline. You can also go to the online hotline.
http://www.aicr.org/information/hotline/index.lasso
Health Tip: Heading Home From the Hospital
Going home after a hospital stay can be unnerving. It's a good idea to coordinate as much as possible before your return.
Here are some pointers from the Naval Hospital in Camp Pendleton, Calif.:
Make sure you have written instructions regarding your discharge and at-home medical routine.
Take all prescribed medications at the assigned time.
Ensure your home environment is conducive to your recovery.
Avoid using steps unless otherwise instructed.
If you're staying in bed, choose a bedroom that's close to a bathroom.
Keep a phone and phone numbers handy for emergencies and medical questions.
Health Tip: Why is My Mouth Dry?
Dry mouth used to be considered a normal symptom of aging.
However, it's now clear that dry mouth is often a side effect of certain medications -- such as antihistamines, heart drugs and pain killers -- according to the Maryland Department of Health and Mental Hygiene. A decrease in hormones in postmenopausal women can also lead to dry mouth.
A lack of saliva causes food and bacteria to remain in the mouth for longer periods, which can lead to more plaque and cavities.
While there is no cure for dry mouth, you can get relief by drinking water, using saliva substitutes, using a humidifier or nasal spray, and by avoiding caffeine, alcohol and tobacco products.
Saturday, September 24, 2005
Health Headlines - September 24
Thalassemias
Thalassemias is the name for the group of genetic blood diseases which vary widely in severity.
As frightening as thalassemias can be, the outlook is encouraging. In the past 20 years, new therapies have greatly improved the quality of life and life expectancy in kids who are diagnosed with this disease.
What Is Thalassemia?
Thalassemia is a genetic disorder that involves the decreased and defective production of hemoglobin, a molecule that's found inside all red blood cells and is necessary to transport oxygen throughout the body.
Hemoglobin contains two different kinds of protein chains named alpha and beta chains. Any deficiency in these chains causes abnormalities in the formation, size, and shape of red blood cells.
There are two types of thalassemia: alpha-thalassemia and beta-thalassemia. Their names describe which part of the hemoglobin molecule that is effected, the alpha or the beta chain.
Thalassemia can cause ineffective production of red blood cells, and the destruction of red blood cells. As a result, people with thalassemia often have a reduced number of red blood cells in the bloodstream, a condition called anemia, which can affect the transportation of oxygen to the body tissues that need it. In addition, thalassemia can cause red blood cells to be smaller than normal, or the amount of hemoglobin in the red blood cells to be below normal levels.
Kids who have with different forms of thalassemia have different kinds of health problems resulting from the disorder. Some children only have mild anemia with little or no effects, while others require frequent serious medical treatment.
What Causes Thalassemia?
Thalassemia is always inherited, passed on from parents to children through their genes. A child cannot develop the disease unless both parents carry the thalassemia gene.
If only one parent passes the gene for thalassemia on to the child, then the child is said to have thalassemia trait. Thalassemia trait will not develop into the full-blown disease, and no medical treatment is necessary. Many families have thalassemia carriers, but the trait often goes undiagnosed because the trait produces no or few symptoms. Frequently, thalassemia is not diagnosed in a family until a baby is born with the disease. So if someone in your family carries the gene, it's a good idea to have genetic counseling when you're thinking of having children.
At one time it was believed that the disease affected only people of Italian or Greek descent. It is now known that in addition to people living in areas on the Mediterranean Sea (Italy, Greece, and Turkey), many people with thalassemia also come from or are descended from Africa, Malaysia, China, and many parts of Southeast Asia.
Because of a recent pattern of migration from Southeast Asia, there has been an increase in the past decade of thalassemia in North America. Testing for thalassemia is generally recommended for anyone from Southeast Asia with unexplained anemia. If your healthcare providers determine that your child is at risk for being affected by thalassemia, there are prenatal tests that you can have to find out if your unborn child is affected by the disease.
Alpha-Thalassemia
Children with alpha-thalassemia trait do not have thalassemia disease. A specific blood test called a hemoglobin electrophoresis is used to screen for alpha-thalassemia trait and can be done in infancy. But often, diagnosis of alpha thalassemia is done only after other conditions are ruled out, after the parents are screened. The disease can be harder to detect in older children and adults.
Kids who have the alpha-thalassemia trait usually have no significant health problems, with the exception of possibly being mildly anemic. The anemia can cause slight fatigue.
The fatigue resulting from alpha-thalassemia trait is often mistaken for an iron deficiency.
Other cases of alpha-thalassemia resemble another form of the disorder, called beta-thalassemia intermedia (see next section). People with this form of alpha-thalassemia may require occasional blood transfusions during times of physical stress, like fevers or other illnesses, or at times when the anemia becomes severe enough to cause symptoms such as fatigue.
The most severe form of the disorder is called alpha-thalassemia major. This type is extremely rare, and women carrying fetuses with this form of thalassemia have a high incidence of miscarriage because the fetuses cannot survive.
Beta-Thalassemia
Beta-thalassemia, the most common form of the disorder seen in the United States, is grouped into three categories: beta-thalassemia minor (trait), intermedia, and major (Cooley's anemia). A person who carries the beta-thalassemia gene has a 25% (1 in 4) chance of having a child with the disease if his or her partner also carries the trait.
Beta-Thalassemia Minor (trait)
Beta-thalassemia minor often goes undiagnosed because kids with the condition have no real symptoms other than mild anemia. It is often suspected based on routine blood tests such as a complete blood count (CBC) and can be confirmed with a hemoglobin electrophoresis. No treatment is usually needed.
As with alpha-thalassemia trait, the anemia associated with this condition may be misdiagnosed as an iron deficiency.
Beta-Thalassemia Intermedia
Children with beta-thalassemia intermedia have varying effects from the disease - mild anemia might be their only symptom or they might require regular blood transfusions.
The most common complaint is fatigue or shortness of breath. Some children also experience heart palpitations, also due to the anemia, and mild jaundice, which is caused by the destruction of abnormal red blood cells that result from the disease. The liver and spleen may be enlarged, which can feel uncomfortable for a child. Severe anemia can also affect a child's growth.
Another symptom of beta-thalassemia intermedia can be bone abnormalities. Because the bone marrow is working overtime to make more red blood cells to counteract the anemia, children can experience enlargement of their cheek bones, foreheads, and other bones. Gallstones are also a frequent complication of thalassemia because of abnormalities in bile production that involve the liver and the gallbladder.
Some children with beta thalassemia intermedia may require a blood transfusion only occasionally. They will always have anemia, but may not need transfusions except during illness, medical complications, or later on during pregnancy.
Other children with this form of the disease require blood transfusions on a regular basis. In these kids, low or falling hemoglobin levels greatly reduce the blood's ability to carry oxygen to the body, resulting in extreme fatigue, poor growth, and facial abnormalities. Regular transfusions can help alleviate these problems. Sometimes, kids who have this form of the disease have their spleens removed.
Beta-thalassemia intermedia is often diagnosed in the first year of a child's life. Doctors may be prompted to test for it when a child has chronic anemia, or a family history of the condition. As long as it is diagnosed while the child is still doing well and has not experienced any serious complications, the disorder can be successfully treated and managed.
Beta-thalassemia Major
Beta-thalassemia major, which is also called Cooley's anemia, is a severe condition in which regular blood transfusions are necessary for the child to survive.
Although multiple lifelong transfusions save lives, they also cause a serious side effect: an overload of iron in the bodies of thalassemia patients. Over time, people with thalassemia accumulate deposits of iron in their bodies, especially in the liver, heart, and endocrine (hormone-producing) glands. The deposits eventually can affect the normal functioning of the heart, and liver, in addition to delaying growth and sexual maturation.
To minimize iron deposits in the body, people affected by the disease must undergo chelation (iron-removing) therapy for up to 12 hours a day with subcutaneous (under the skin) doses of the iron-binding agent. Researchers are working to develop an iron chelator, which can be given by mouth, but currently, none is available.
Chelation therapy is typically given 5 to 7 days a week and has been proven to prevent liver and heart damage from iron overload, allow for normal growth and sexual development in children with thalassemia, and increase life span. Iron concentrations in the body are monitored every few months. Sometimes liver biopsies are needed to get a more accurate picture of the body's iron load.
There are side effects of the chelation drug, which is called desferrioxamine, which can include visual impairment and hearing loss. Any children who receive chelation therapy are usually screened on a regular basis for such side effects.
Other risks associated with chronic blood transfusions for thalassemia major include blood-borne diseases like hepatitis B and C. Blood banks can usually screen for such infections, in addition to rarer infections such as HIV. In addition, kids who have many transfusons can develop allergic reactions that can prevent further transfusions and cause serious illnesses.
For kids and teens with thalassemia, adolescence can be a difficult time, particularly because of the amount of time required for transfusions and chelation therapy.
Recently, some children have successfully undergone bone marrow transplants to treat thalassemia major; however, this is considered only in cases of severely disabling thalassemia disease. There is considerable risk to bone marrow transplants: the procedure involves the destruction of all of the blood-forming cells in the child's bone marrow and repopulating the marrow space with donor cells that must match perfectly (the closest match is usually from a sibling). The procedure is usually done in children younger than 16 years of age who have no existing evidence of liver scarring or serious liver disease. Results have been highly encouraging so far, with disease-free survival in most patients.
Blood-forming stem cells taken from umbilical cord blood have also been successfully transplanted, and research using this technique is expected to increase. Currently bone marrow treatment is the only known cure for the disease.
Talking to Your Child's Doctor
If you know the thalassemia trait exists in your family, it's important to meet with your child's doctor, particularly if you notice any of the symptoms of thalassemia major - anemia, listlessness, or bone abnormalities - in your child. If you are thinking of having children, particularly if you have any thalassemia in your family, it's a good idea to speak with a genetic counselor to determine your risk of passing on the disease to any future children.
Sepsis
Sepsis is a serious but rare infection that is usually caused by bacteria. It occurs when bacteria, which can originate in a child's lungs, intestines, urinary tract, or gallbladder, make toxins that cause the body's immune system to attack the body's own organs and tissues.
Sepsis can be frightening because if it is untreated, it can lead to serious complications that affect a child's kidneys, lungs, brain, and hearing. But by learning to recognize the symptoms, you can help your child get treatment and fully recover.
Sepsis can affect a person of any age, but it is more prevalent in young infants whose immune systems have not developed enough to fight off overwhelming infections and people whose immune systems are compromised from conditions such as HIV.
If your infant has a rectal temperature of 100.4 degrees Fahrenheit (38 degrees Celsius)
seems lethargic, uninterested in eating, or seems to be having difficulty breathing, it's a good idea to call your child's doctor. In an older child, the symptoms of sepsis may include a fever (an oral temperature at or above 99.5 degrees Fahrenheit [37.5 degrees Celsius]); your child may also seem lethargic, irritable, and may complain that his or her heart feels like it's racing.
If your child's temperature is normal, but you're still concerned, it's a good idea to call the doctor.
What Is Sepsis?
Sepsis occurs when the body's normal reaction to inflammation or a bacterial infection goes into overdrive. With sepsis, the bacteria create a toxin that causes a widespread inflammation of the body's organs and causes rapid changes in a person's body temperature, blood pressure, and dysfunction in the lung and other organs.
Babies under the age of 2 months are more susceptible to sepsis because their immune systems have not yet developed enough to fight off some serious infections. It is also more prevalent in people of all ages whose immune systems are compromised by chronic illnesses and conditions like HIV.
Signs and Symptoms of Sepsis
Sepsis in newborns produces few concrete symptoms, though symptoms can vary widely between from child to child. Frequently, these babies suddenly aren't feeling well or "just don't look right" to their caretakers.
Some of the more common signs or symptoms of sepsis in newborns and young infants include:
disinterest or difficulty in feeding
fever (above 100.4 degrees Fahrenheit [38 degrees Celsius] rectally) or sometimes low, unstable temperatures
irritability or increased crankiness
lethargy (not interacting and listless)
decreased tone (floppiness)
changes in heart rate - either faster than normal (early sepsis) or significantly slower than usual (late sepsis, usually associated with shock)
breathing very quickly or difficulty breathing
periods where the baby seems to stop breathing for more than 10 seconds (apnea)
jaundice
Older children who have sepsis might have a fever (an oral temperature above 99.5 degrees Fahrenheit [37.5 degrees Celsius]), vomit, and complain of feeling like their hearts are racing. A child with sepsis may have started with an infection such as cellulitis that seems to be spreading and getting worse, not better.
What Causes Sepsis?
Bacteria are almost always the cause of sepsis in newborns and infants.
Bacteria such as E. coli, Listeria monocytogenes, Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae type b, Salmonella, and Group B streptococcus (GBS) are the more common culprits in sepsis in newborns and infants younger than 3 months.
Premature babies receiving neonatal intensive care are particularly susceptible to sepsis because their immune systems are even more underdeveloped than other babies, and they typically undergo invasive procedures involving long-term intravenous (IV) lines, multiple catheters, and need to breathe through a tube attached to a ventilator. The incisions a young infant gets for catheters or other tubes can provide a path for bacteria, which normally live on the skin's surface, to get inside the baby's body and cause the infection.
In many cases of sepsis in new babies, bacteria enter the baby's body from the mother during pregnancy, labor, or delivery. Some pregnancy complications that can increase the risk of sepsis for a newborn include:
bleeding
maternal fever
an infection in the uterus or placenta
premature rupture of the amniotic sac (before 37 weeks of gestation)
rupture of the amniotic sac very early in labor (18 hours or more before delivery)
a long, difficult delivery
Some bacteria - GBS in particular - can be acquired by the newborn as the child is being delivered. At least one out of every five pregnant women carries the bacterium for Group B streptococcus in her vagina or rectum, where it can be passed from mother to child during delivery.
Diagnosing and Treating Sepsis
Because symptoms of sepsis can be vague in infants, laboratory tests play a crucial role in confirming or ruling out sepsis. These lab tests may include:
Blood tests (including red and white blood cell counts) and blood cultures may be taken to determine whether bacteria are present in the blood.
Urine is usually collected by inserting a sterile catheter into the baby's bladder through the urethra for a few seconds to remove urine; this will be examined under a microscope and cultured to check for the presence of bacteria.
A lumbar puncture (spinal tap) may be performed, depending on the baby's age and overall appearance. A sample of cerebrospinal fluid will be tested and cultured to determine if the baby has possible meningitis.
X-rays, especially of the chest (to make sure there isn't pneumonia), are sometimes taken.
If the baby has any kind of medical tubes running into his or her body (such as IV tubes, catheters, or shunts), the fluids inside those tubes may be tested for signs of infection as well.
Sepsis, or even suspected cases of sepsis in infants, is treated in the hospital, where doctors can closely watch the infection and administer strong antibiotics intravenously to fight the infection.
Typically, doctors start infants with sepsis on antibiotics right away - even before the diagnosis is confirmed. If more symptoms of sepsis begin to appear, they usually start them on IV fluids to keep them hydrated, blood pressure medication to keep their hearts working properly, and respirators to help them breathe.
Can Sepsis Be Prevented?
Although there's no way to prevent all types of sepsis, some cases can be avoided, namely the transmission of Group B streptococcus bacteria from mother to child during childbirth. Pregnant women can have a simple swab test during the 35th and 37th weeks of pregnancy and again just before the birth to determine if they carry the GBS bacteria.
If a woman tests positive for GBS, she can receive intravenous antibiotics during labor.
Women are at higher risk of carrying GBS if they have a fever during labor, if the amniotic sac ruptures prematurely, if they have prolonged labor, or if they had other children with sepsis or other diseases triggered by GBS, such as pneumonia or meningitis. A woman with one of these risk factors can receive intravenous antibiotics to lower her risk of transmitting the bacteria to her child.
Immunizations routinely given to infants today include vaccinations against certain strains of pneumococcus and Haemophilus influenzae type b that can cause sepsis or occult bacteremia, an infection of the blood.
When to Call Your Child's Doctor
Because the symptoms of sepsis can be very difficult to identify in newborns and young infants, it's a good idea to call your child's doctor or seek emergency medical care if your baby shows any of the following symptoms:
difficulty or continued disinterest in feeding
fever (100.4 degrees Fahrenheit [38 degrees Celsius] and above rectal temperature) in newborns and young infants
labored or unusual breathing
change in skin color (paler than usual or mildly bluish)
listlessness or lethargy
change in the sound of the baby's cry or excessive crying
change in baby's muscle tone - either seeming too stiff or especially floppy
a slower or faster heart rate than usual
bulging or fullness of the "soft spot" on the baby's head
any type of behavior or appearance that concerns you
These signs and symptoms don't necessarily mean your baby has sepsis, but infants who are younger than 3 months should be checked out immediately to ensure that nothing else is wrong.
Thalassemias is the name for the group of genetic blood diseases which vary widely in severity.
As frightening as thalassemias can be, the outlook is encouraging. In the past 20 years, new therapies have greatly improved the quality of life and life expectancy in kids who are diagnosed with this disease.
What Is Thalassemia?
Thalassemia is a genetic disorder that involves the decreased and defective production of hemoglobin, a molecule that's found inside all red blood cells and is necessary to transport oxygen throughout the body.
Hemoglobin contains two different kinds of protein chains named alpha and beta chains. Any deficiency in these chains causes abnormalities in the formation, size, and shape of red blood cells.
There are two types of thalassemia: alpha-thalassemia and beta-thalassemia. Their names describe which part of the hemoglobin molecule that is effected, the alpha or the beta chain.
Thalassemia can cause ineffective production of red blood cells, and the destruction of red blood cells. As a result, people with thalassemia often have a reduced number of red blood cells in the bloodstream, a condition called anemia, which can affect the transportation of oxygen to the body tissues that need it. In addition, thalassemia can cause red blood cells to be smaller than normal, or the amount of hemoglobin in the red blood cells to be below normal levels.
Kids who have with different forms of thalassemia have different kinds of health problems resulting from the disorder. Some children only have mild anemia with little or no effects, while others require frequent serious medical treatment.
What Causes Thalassemia?
Thalassemia is always inherited, passed on from parents to children through their genes. A child cannot develop the disease unless both parents carry the thalassemia gene.
If only one parent passes the gene for thalassemia on to the child, then the child is said to have thalassemia trait. Thalassemia trait will not develop into the full-blown disease, and no medical treatment is necessary. Many families have thalassemia carriers, but the trait often goes undiagnosed because the trait produces no or few symptoms. Frequently, thalassemia is not diagnosed in a family until a baby is born with the disease. So if someone in your family carries the gene, it's a good idea to have genetic counseling when you're thinking of having children.
At one time it was believed that the disease affected only people of Italian or Greek descent. It is now known that in addition to people living in areas on the Mediterranean Sea (Italy, Greece, and Turkey), many people with thalassemia also come from or are descended from Africa, Malaysia, China, and many parts of Southeast Asia.
Because of a recent pattern of migration from Southeast Asia, there has been an increase in the past decade of thalassemia in North America. Testing for thalassemia is generally recommended for anyone from Southeast Asia with unexplained anemia. If your healthcare providers determine that your child is at risk for being affected by thalassemia, there are prenatal tests that you can have to find out if your unborn child is affected by the disease.
Alpha-Thalassemia
Children with alpha-thalassemia trait do not have thalassemia disease. A specific blood test called a hemoglobin electrophoresis is used to screen for alpha-thalassemia trait and can be done in infancy. But often, diagnosis of alpha thalassemia is done only after other conditions are ruled out, after the parents are screened. The disease can be harder to detect in older children and adults.
Kids who have the alpha-thalassemia trait usually have no significant health problems, with the exception of possibly being mildly anemic. The anemia can cause slight fatigue.
The fatigue resulting from alpha-thalassemia trait is often mistaken for an iron deficiency.
Other cases of alpha-thalassemia resemble another form of the disorder, called beta-thalassemia intermedia (see next section). People with this form of alpha-thalassemia may require occasional blood transfusions during times of physical stress, like fevers or other illnesses, or at times when the anemia becomes severe enough to cause symptoms such as fatigue.
The most severe form of the disorder is called alpha-thalassemia major. This type is extremely rare, and women carrying fetuses with this form of thalassemia have a high incidence of miscarriage because the fetuses cannot survive.
Beta-Thalassemia
Beta-thalassemia, the most common form of the disorder seen in the United States, is grouped into three categories: beta-thalassemia minor (trait), intermedia, and major (Cooley's anemia). A person who carries the beta-thalassemia gene has a 25% (1 in 4) chance of having a child with the disease if his or her partner also carries the trait.
Beta-Thalassemia Minor (trait)
Beta-thalassemia minor often goes undiagnosed because kids with the condition have no real symptoms other than mild anemia. It is often suspected based on routine blood tests such as a complete blood count (CBC) and can be confirmed with a hemoglobin electrophoresis. No treatment is usually needed.
As with alpha-thalassemia trait, the anemia associated with this condition may be misdiagnosed as an iron deficiency.
Beta-Thalassemia Intermedia
Children with beta-thalassemia intermedia have varying effects from the disease - mild anemia might be their only symptom or they might require regular blood transfusions.
The most common complaint is fatigue or shortness of breath. Some children also experience heart palpitations, also due to the anemia, and mild jaundice, which is caused by the destruction of abnormal red blood cells that result from the disease. The liver and spleen may be enlarged, which can feel uncomfortable for a child. Severe anemia can also affect a child's growth.
Another symptom of beta-thalassemia intermedia can be bone abnormalities. Because the bone marrow is working overtime to make more red blood cells to counteract the anemia, children can experience enlargement of their cheek bones, foreheads, and other bones. Gallstones are also a frequent complication of thalassemia because of abnormalities in bile production that involve the liver and the gallbladder.
Some children with beta thalassemia intermedia may require a blood transfusion only occasionally. They will always have anemia, but may not need transfusions except during illness, medical complications, or later on during pregnancy.
Other children with this form of the disease require blood transfusions on a regular basis. In these kids, low or falling hemoglobin levels greatly reduce the blood's ability to carry oxygen to the body, resulting in extreme fatigue, poor growth, and facial abnormalities. Regular transfusions can help alleviate these problems. Sometimes, kids who have this form of the disease have their spleens removed.
Beta-thalassemia intermedia is often diagnosed in the first year of a child's life. Doctors may be prompted to test for it when a child has chronic anemia, or a family history of the condition. As long as it is diagnosed while the child is still doing well and has not experienced any serious complications, the disorder can be successfully treated and managed.
Beta-thalassemia Major
Beta-thalassemia major, which is also called Cooley's anemia, is a severe condition in which regular blood transfusions are necessary for the child to survive.
Although multiple lifelong transfusions save lives, they also cause a serious side effect: an overload of iron in the bodies of thalassemia patients. Over time, people with thalassemia accumulate deposits of iron in their bodies, especially in the liver, heart, and endocrine (hormone-producing) glands. The deposits eventually can affect the normal functioning of the heart, and liver, in addition to delaying growth and sexual maturation.
To minimize iron deposits in the body, people affected by the disease must undergo chelation (iron-removing) therapy for up to 12 hours a day with subcutaneous (under the skin) doses of the iron-binding agent. Researchers are working to develop an iron chelator, which can be given by mouth, but currently, none is available.
Chelation therapy is typically given 5 to 7 days a week and has been proven to prevent liver and heart damage from iron overload, allow for normal growth and sexual development in children with thalassemia, and increase life span. Iron concentrations in the body are monitored every few months. Sometimes liver biopsies are needed to get a more accurate picture of the body's iron load.
There are side effects of the chelation drug, which is called desferrioxamine, which can include visual impairment and hearing loss. Any children who receive chelation therapy are usually screened on a regular basis for such side effects.
Other risks associated with chronic blood transfusions for thalassemia major include blood-borne diseases like hepatitis B and C. Blood banks can usually screen for such infections, in addition to rarer infections such as HIV. In addition, kids who have many transfusons can develop allergic reactions that can prevent further transfusions and cause serious illnesses.
For kids and teens with thalassemia, adolescence can be a difficult time, particularly because of the amount of time required for transfusions and chelation therapy.
Recently, some children have successfully undergone bone marrow transplants to treat thalassemia major; however, this is considered only in cases of severely disabling thalassemia disease. There is considerable risk to bone marrow transplants: the procedure involves the destruction of all of the blood-forming cells in the child's bone marrow and repopulating the marrow space with donor cells that must match perfectly (the closest match is usually from a sibling). The procedure is usually done in children younger than 16 years of age who have no existing evidence of liver scarring or serious liver disease. Results have been highly encouraging so far, with disease-free survival in most patients.
Blood-forming stem cells taken from umbilical cord blood have also been successfully transplanted, and research using this technique is expected to increase. Currently bone marrow treatment is the only known cure for the disease.
Talking to Your Child's Doctor
If you know the thalassemia trait exists in your family, it's important to meet with your child's doctor, particularly if you notice any of the symptoms of thalassemia major - anemia, listlessness, or bone abnormalities - in your child. If you are thinking of having children, particularly if you have any thalassemia in your family, it's a good idea to speak with a genetic counselor to determine your risk of passing on the disease to any future children.
Sepsis
Sepsis is a serious but rare infection that is usually caused by bacteria. It occurs when bacteria, which can originate in a child's lungs, intestines, urinary tract, or gallbladder, make toxins that cause the body's immune system to attack the body's own organs and tissues.
Sepsis can be frightening because if it is untreated, it can lead to serious complications that affect a child's kidneys, lungs, brain, and hearing. But by learning to recognize the symptoms, you can help your child get treatment and fully recover.
Sepsis can affect a person of any age, but it is more prevalent in young infants whose immune systems have not developed enough to fight off overwhelming infections and people whose immune systems are compromised from conditions such as HIV.
If your infant has a rectal temperature of 100.4 degrees Fahrenheit (38 degrees Celsius)
seems lethargic, uninterested in eating, or seems to be having difficulty breathing, it's a good idea to call your child's doctor. In an older child, the symptoms of sepsis may include a fever (an oral temperature at or above 99.5 degrees Fahrenheit [37.5 degrees Celsius]); your child may also seem lethargic, irritable, and may complain that his or her heart feels like it's racing.
If your child's temperature is normal, but you're still concerned, it's a good idea to call the doctor.
What Is Sepsis?
Sepsis occurs when the body's normal reaction to inflammation or a bacterial infection goes into overdrive. With sepsis, the bacteria create a toxin that causes a widespread inflammation of the body's organs and causes rapid changes in a person's body temperature, blood pressure, and dysfunction in the lung and other organs.
Babies under the age of 2 months are more susceptible to sepsis because their immune systems have not yet developed enough to fight off some serious infections. It is also more prevalent in people of all ages whose immune systems are compromised by chronic illnesses and conditions like HIV.
Signs and Symptoms of Sepsis
Sepsis in newborns produces few concrete symptoms, though symptoms can vary widely between from child to child. Frequently, these babies suddenly aren't feeling well or "just don't look right" to their caretakers.
Some of the more common signs or symptoms of sepsis in newborns and young infants include:
disinterest or difficulty in feeding
fever (above 100.4 degrees Fahrenheit [38 degrees Celsius] rectally) or sometimes low, unstable temperatures
irritability or increased crankiness
lethargy (not interacting and listless)
decreased tone (floppiness)
changes in heart rate - either faster than normal (early sepsis) or significantly slower than usual (late sepsis, usually associated with shock)
breathing very quickly or difficulty breathing
periods where the baby seems to stop breathing for more than 10 seconds (apnea)
jaundice
Older children who have sepsis might have a fever (an oral temperature above 99.5 degrees Fahrenheit [37.5 degrees Celsius]), vomit, and complain of feeling like their hearts are racing. A child with sepsis may have started with an infection such as cellulitis that seems to be spreading and getting worse, not better.
What Causes Sepsis?
Bacteria are almost always the cause of sepsis in newborns and infants.
Bacteria such as E. coli, Listeria monocytogenes, Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae type b, Salmonella, and Group B streptococcus (GBS) are the more common culprits in sepsis in newborns and infants younger than 3 months.
Premature babies receiving neonatal intensive care are particularly susceptible to sepsis because their immune systems are even more underdeveloped than other babies, and they typically undergo invasive procedures involving long-term intravenous (IV) lines, multiple catheters, and need to breathe through a tube attached to a ventilator. The incisions a young infant gets for catheters or other tubes can provide a path for bacteria, which normally live on the skin's surface, to get inside the baby's body and cause the infection.
In many cases of sepsis in new babies, bacteria enter the baby's body from the mother during pregnancy, labor, or delivery. Some pregnancy complications that can increase the risk of sepsis for a newborn include:
bleeding
maternal fever
an infection in the uterus or placenta
premature rupture of the amniotic sac (before 37 weeks of gestation)
rupture of the amniotic sac very early in labor (18 hours or more before delivery)
a long, difficult delivery
Some bacteria - GBS in particular - can be acquired by the newborn as the child is being delivered. At least one out of every five pregnant women carries the bacterium for Group B streptococcus in her vagina or rectum, where it can be passed from mother to child during delivery.
Diagnosing and Treating Sepsis
Because symptoms of sepsis can be vague in infants, laboratory tests play a crucial role in confirming or ruling out sepsis. These lab tests may include:
Blood tests (including red and white blood cell counts) and blood cultures may be taken to determine whether bacteria are present in the blood.
Urine is usually collected by inserting a sterile catheter into the baby's bladder through the urethra for a few seconds to remove urine; this will be examined under a microscope and cultured to check for the presence of bacteria.
A lumbar puncture (spinal tap) may be performed, depending on the baby's age and overall appearance. A sample of cerebrospinal fluid will be tested and cultured to determine if the baby has possible meningitis.
X-rays, especially of the chest (to make sure there isn't pneumonia), are sometimes taken.
If the baby has any kind of medical tubes running into his or her body (such as IV tubes, catheters, or shunts), the fluids inside those tubes may be tested for signs of infection as well.
Sepsis, or even suspected cases of sepsis in infants, is treated in the hospital, where doctors can closely watch the infection and administer strong antibiotics intravenously to fight the infection.
Typically, doctors start infants with sepsis on antibiotics right away - even before the diagnosis is confirmed. If more symptoms of sepsis begin to appear, they usually start them on IV fluids to keep them hydrated, blood pressure medication to keep their hearts working properly, and respirators to help them breathe.
Can Sepsis Be Prevented?
Although there's no way to prevent all types of sepsis, some cases can be avoided, namely the transmission of Group B streptococcus bacteria from mother to child during childbirth. Pregnant women can have a simple swab test during the 35th and 37th weeks of pregnancy and again just before the birth to determine if they carry the GBS bacteria.
If a woman tests positive for GBS, she can receive intravenous antibiotics during labor.
Women are at higher risk of carrying GBS if they have a fever during labor, if the amniotic sac ruptures prematurely, if they have prolonged labor, or if they had other children with sepsis or other diseases triggered by GBS, such as pneumonia or meningitis. A woman with one of these risk factors can receive intravenous antibiotics to lower her risk of transmitting the bacteria to her child.
Immunizations routinely given to infants today include vaccinations against certain strains of pneumococcus and Haemophilus influenzae type b that can cause sepsis or occult bacteremia, an infection of the blood.
When to Call Your Child's Doctor
Because the symptoms of sepsis can be very difficult to identify in newborns and young infants, it's a good idea to call your child's doctor or seek emergency medical care if your baby shows any of the following symptoms:
difficulty or continued disinterest in feeding
fever (100.4 degrees Fahrenheit [38 degrees Celsius] and above rectal temperature) in newborns and young infants
labored or unusual breathing
change in skin color (paler than usual or mildly bluish)
listlessness or lethargy
change in the sound of the baby's cry or excessive crying
change in baby's muscle tone - either seeming too stiff or especially floppy
a slower or faster heart rate than usual
bulging or fullness of the "soft spot" on the baby's head
any type of behavior or appearance that concerns you
These signs and symptoms don't necessarily mean your baby has sepsis, but infants who are younger than 3 months should be checked out immediately to ensure that nothing else is wrong.
Friday, September 23, 2005
Health Headlines - September 23
3 Baby Deaths Show Staph Germ Is Strengthening: Report
A baby and two toddlers in the Chicago area have died from a superbug they caught in the community, not in hospital, which is where the germ is usually found, case reports released Thursday reveal.
The cases show that the staph germ, known as methicillin-resistant staphylococcus aureus, or MRSA, has become even more dangerous by acquiring the ability to cause a deadly illness similar to toxic shock syndrome, the Associated Press reported.
In the cases, reported in Thursday's New England Journal of Medicine, the three children who died were otherwise healthy before they were separately admitted to a Chicago hospital with pneumonia-like symptoms between 2000 and 2004. The babies, a 9-month-old girl, a 15-month-old girl, and a 17-month-old boy died within a week of being hospitalized. Autopsies showed they suffered from shock and bleeding in the adrenal gland. The infections were caused by MRSA, which is usually not associated with the syndrome. Doctors believe the children probably inhaled the germ, the AP
Health officials do not yet know how the staph infection causes this new syndrome, but it appears to be rare, according to Dr. Clifford McDonald, an epidemiologist with the Centers for Disease Control and Prevention. However, doctors should be on the lookout for shock-like cases caused by MRSA, said Dr. Robert Daum, a pediatrician at the University of Chicago who co-authored the study.
In April, the journal had reported strong signs of the staph infection moving out of hospitals into communities.
FDA Gives Conditional Approval to 2nd Silicone Breast Implant
The U.S. Food and Drug Administration said Wednesday that it has granted a second manufacturer of silicone gel-filled breast implants a "conditional approval," taking the company a step closer to returning the controversial implants to the market, the Associated Press reported.
The FDA told Inamed Corp., of Santa Barbara, Calif., that its implants can be approved under certain conditions, but the agency did not spell out those conditions.
In July, the agency gave a similar, conditional approval to manufacturer Mentor Corp., also of Santa Barbara, after an FDA advisory panel voted to recommend approval of the company's application to sell the implants, the AP said.
But the panel at the time recommended against Inamed's implants, citing safety concerns. The FDA said Wednesday that Inamed has subsequently provided additional information to address those concerns.
Silicone gel implants went on sale in 1962 in the United States. Thirty years later, the FDA banned all but those used for breast cancer reconstruction, amid fears that leaks might be responsible for autoimmune diseases and even cancer. Other problems included the fact that many women needed repeat operations to deal with painful scar tissue.
By 1998, more than 170,000 lawsuits had been filed against implant manufacturers by women claiming their silicone implants had caused immune system disorders and chronic diseases such as rheumatoid arthritis and systemic lupus. Four companies paid out millions of dollars in settlements to the women, and one of them, Dow Corning, filed for bankruptcy to pay $3.2 billion to settle its claims.
However, studies by the Mayo Clinic, Harvard Medical School and the Institute of Medicine (IOM) panel from the National Academy of Sciences subsequently found no evidence that leaked silicone from gel implants caused systemic disease.
Proponents of silicone implants say they look and feel more natural than saline implants.
FDA Rejects Liquid Cox-2 Painkiller
Pfizer Inc.'s application for an injectable liquid form of a cox-2 painkiller was rejected by the U.S. Food and Drug Administration, the Associated Press reported.
The FDA issued a "non-approvable" letter for the drug parecoxib sodium, which is marketed as Dynastat in the European Union and other parts of the world. The reasons behind the refusal were not disclosed, the AP reported.
Pfizer said it plans to meet with the FDA to discuss the rejection of the drug. The company contends that Dynastat, the only injectable cox-2 inhibitor, reduces the need to use opioids to control post-surgical pain.
Cox-2 inhibitors have been linked to increased risk of heart problems. Vioxx and Bextra have been removed from the market, and Celebrex now contains a warning label.
This is the second recent FDA rejection of a Pfizer application. Less than a week ago, the agency denied a Pfizer application for an osteoporosis drug, the AP reported.
Personalized Drug Treatment Still Years Away: Report
Despite much hype, individually tailored drug treatments based on a person's genes are still at least 15 to 20 years away, says a report by the Royal Society in Great Britain.
"Personalized medicines show promise but they have undoubtedly been over-hyped. With the human genome sequenced, some people are expecting personalized medicines within a few years, but the reality is still many years away," noted Royal Society working group chairman Sir David Weatherall.
"There are some examples around today, but the complex multiple causes of diseases mean it will be at least 15 to 20 years before a patient's genetic make-up is a major factor in determining which drugs they are prescribed," he said.
The report said more funding and research are required to further the development of individually tailored drugs, BBC News reported.
Health Tip: Quitting Smoking
Ex-smokers will tell you that quitting was one of the hardest things they've ever done. The physical and psychological withdrawal can be intense.
If you're thinking of "butting out," the U.S. Surgeon General offers these tips to help you handle the cravings:
Drink lots of liquids, especially water.
Avoid sugar and fatty foods, and don't skip meals.
Exercise regularly and moderately.
Get more sleep.
Take deep breaths when cravings hit.
Change your habits. For example, eat breakfast in a different place, or take a different route to work.
Do something to reduce your stress. Take a hot bath, read a book, or exercise.
Health Tip: Before You Start an Aspirin Regimen
Before you start a daily dose of aspirin to lower your risk of a heart attack or stroke, you should speak to your doctor, advises the U.S. Food and Drug Administration.
While aspirin can help prevent a heart attack or clot-related stroke by lowering the clotting action of the blood's platelets, it can also cause unwanted side effects. These include stomach bleeding, bleeding in the brain, and kidney failure.
Aspirin can also mix badly with other medicines, vitamins and herbal or dietary supplements.
If your doctor has recommended you take a daily dose of aspirin, discuss any potentially dangerous side effects first.
A baby and two toddlers in the Chicago area have died from a superbug they caught in the community, not in hospital, which is where the germ is usually found, case reports released Thursday reveal.
The cases show that the staph germ, known as methicillin-resistant staphylococcus aureus, or MRSA, has become even more dangerous by acquiring the ability to cause a deadly illness similar to toxic shock syndrome, the Associated Press reported.
In the cases, reported in Thursday's New England Journal of Medicine, the three children who died were otherwise healthy before they were separately admitted to a Chicago hospital with pneumonia-like symptoms between 2000 and 2004. The babies, a 9-month-old girl, a 15-month-old girl, and a 17-month-old boy died within a week of being hospitalized. Autopsies showed they suffered from shock and bleeding in the adrenal gland. The infections were caused by MRSA, which is usually not associated with the syndrome. Doctors believe the children probably inhaled the germ, the AP
Health officials do not yet know how the staph infection causes this new syndrome, but it appears to be rare, according to Dr. Clifford McDonald, an epidemiologist with the Centers for Disease Control and Prevention. However, doctors should be on the lookout for shock-like cases caused by MRSA, said Dr. Robert Daum, a pediatrician at the University of Chicago who co-authored the study.
In April, the journal had reported strong signs of the staph infection moving out of hospitals into communities.
FDA Gives Conditional Approval to 2nd Silicone Breast Implant
The U.S. Food and Drug Administration said Wednesday that it has granted a second manufacturer of silicone gel-filled breast implants a "conditional approval," taking the company a step closer to returning the controversial implants to the market, the Associated Press reported.
The FDA told Inamed Corp., of Santa Barbara, Calif., that its implants can be approved under certain conditions, but the agency did not spell out those conditions.
In July, the agency gave a similar, conditional approval to manufacturer Mentor Corp., also of Santa Barbara, after an FDA advisory panel voted to recommend approval of the company's application to sell the implants, the AP said.
But the panel at the time recommended against Inamed's implants, citing safety concerns. The FDA said Wednesday that Inamed has subsequently provided additional information to address those concerns.
Silicone gel implants went on sale in 1962 in the United States. Thirty years later, the FDA banned all but those used for breast cancer reconstruction, amid fears that leaks might be responsible for autoimmune diseases and even cancer. Other problems included the fact that many women needed repeat operations to deal with painful scar tissue.
By 1998, more than 170,000 lawsuits had been filed against implant manufacturers by women claiming their silicone implants had caused immune system disorders and chronic diseases such as rheumatoid arthritis and systemic lupus. Four companies paid out millions of dollars in settlements to the women, and one of them, Dow Corning, filed for bankruptcy to pay $3.2 billion to settle its claims.
However, studies by the Mayo Clinic, Harvard Medical School and the Institute of Medicine (IOM) panel from the National Academy of Sciences subsequently found no evidence that leaked silicone from gel implants caused systemic disease.
Proponents of silicone implants say they look and feel more natural than saline implants.
FDA Rejects Liquid Cox-2 Painkiller
Pfizer Inc.'s application for an injectable liquid form of a cox-2 painkiller was rejected by the U.S. Food and Drug Administration, the Associated Press reported.
The FDA issued a "non-approvable" letter for the drug parecoxib sodium, which is marketed as Dynastat in the European Union and other parts of the world. The reasons behind the refusal were not disclosed, the AP reported.
Pfizer said it plans to meet with the FDA to discuss the rejection of the drug. The company contends that Dynastat, the only injectable cox-2 inhibitor, reduces the need to use opioids to control post-surgical pain.
Cox-2 inhibitors have been linked to increased risk of heart problems. Vioxx and Bextra have been removed from the market, and Celebrex now contains a warning label.
This is the second recent FDA rejection of a Pfizer application. Less than a week ago, the agency denied a Pfizer application for an osteoporosis drug, the AP reported.
Personalized Drug Treatment Still Years Away: Report
Despite much hype, individually tailored drug treatments based on a person's genes are still at least 15 to 20 years away, says a report by the Royal Society in Great Britain.
"Personalized medicines show promise but they have undoubtedly been over-hyped. With the human genome sequenced, some people are expecting personalized medicines within a few years, but the reality is still many years away," noted Royal Society working group chairman Sir David Weatherall.
"There are some examples around today, but the complex multiple causes of diseases mean it will be at least 15 to 20 years before a patient's genetic make-up is a major factor in determining which drugs they are prescribed," he said.
The report said more funding and research are required to further the development of individually tailored drugs, BBC News reported.
Health Tip: Quitting Smoking
Ex-smokers will tell you that quitting was one of the hardest things they've ever done. The physical and psychological withdrawal can be intense.
If you're thinking of "butting out," the U.S. Surgeon General offers these tips to help you handle the cravings:
Drink lots of liquids, especially water.
Avoid sugar and fatty foods, and don't skip meals.
Exercise regularly and moderately.
Get more sleep.
Take deep breaths when cravings hit.
Change your habits. For example, eat breakfast in a different place, or take a different route to work.
Do something to reduce your stress. Take a hot bath, read a book, or exercise.
Health Tip: Before You Start an Aspirin Regimen
Before you start a daily dose of aspirin to lower your risk of a heart attack or stroke, you should speak to your doctor, advises the U.S. Food and Drug Administration.
While aspirin can help prevent a heart attack or clot-related stroke by lowering the clotting action of the blood's platelets, it can also cause unwanted side effects. These include stomach bleeding, bleeding in the brain, and kidney failure.
Aspirin can also mix badly with other medicines, vitamins and herbal or dietary supplements.
If your doctor has recommended you take a daily dose of aspirin, discuss any potentially dangerous side effects first.
Thursday, September 22, 2005
Health Headlines - September 22
Green Tea Compound Stops Alzheimer's in Mice
An ingredient in green tea has prevented Alzheimer's disease-like brain damage in mice, researchers report.
The compound, called epigallocatechin-3-gallate (EGCG), decreased production of the protein beta-amyloid, which accumulates in the brains of Alzheimer's patients and causes nerve damage and memory loss.
"The findings suggest that a concentrated component of green tea can decrease brain beta-amyloid plaque formation," senior researcher Dr. Jun Tan, director of the Neuroimmunology Laboratory at the the University of South Florida's Silver Child Development Center, said in a prepared statement.
Reporting in the Sept. 21 issue of the Journal of Neuroscience, the research team worked with mice genetically programmed to develop a disease mimicking human Alzheimer's.
The mice received daily injections of EGCG for several months and showed as much as a 54 percent reduction in the formation of brain-clogging beta-amyloid plaques. It appears that EGCG prevents the initial process that leads to beta-amyloid formation in brain cells, the researchers said.
"If beta-amyloid pathology in this Alzheimer's mouse model is representative of Alzheimer's disease pathology in humans, EGCG dietary supplementation may be effective in preventing and treating the disease," Tan said.
The researchers will next study whether multiple oral doses of EGCG improve memory loss in mice with Alzheimer's.
"If those studies show clear cognitive benefits, we believe clinical trials of EGCG to treat Alzheimer's disease would be warranted," Tan said.
Courage and Caring Amid Katrina's Chaos
Of all the surreal scenes playing out across New Orleans in the aftermath of Hurricane Katrina, this may have been one of the strangest.
As the New Orleans flood waters rose, Dr. Joseph Guarisco, chairman of emergency medicine at the city's Ochsner Clinic Foundation, looked out the center's windows and saw a succession of people perched on boats, rafts and even garbage cans floating by.
Then, finally, a city bus sped through the water. It did not pass the hospital and continue west with the stream but, instead, sped up the ambulance ramp and screeched to a halt. At least there was a dry place to stop: Ochsner is above sea level.
The bus, it turned out, held paraplegics who had been carried down eight flights of stairs at another hospital. The city bus had been commandeered by the paramedics and had been turned away by every shelter and hospital between Ochsner and downtown, a distance of about five miles.
"I'm turning the bus off, parking it and leaving," the paramedic, who was armed, stated.
Guarisco tried to reason with the paramedic: The paraplegics didn't have any acute medical problems, so they really needed to be at a shelter, not a hospital. The hospital needed to be ready for medical emergencies. But the paramedic prepared to leave, so Guarisco summoned Ochsner security (also armed) and, finally, the hospital's CEO.
"The infrastructure of the city was falling apart, police were abandoning their positions, city bus drivers were abandoning running buses. The city's flooding, and here we have paraplegics inside a bus and there's an armed standoff between paramedics and our own security," Guarisco said. "It was right out of a scene about the end of the world."
Ochsner staff finally convinced the paramedic to return the paraplegics to the last shelter they had visited.
The scene was perhaps not too much stranger than other scenes playing out all over New Orleans and, indeed, throughout the Gulf Coast after Katrina unleashed her fury at the end of August.
At the heart of so many of those stories, men and women trained in emergency care used whatever resources were at hand to help others struggling against chaos, confusion and death.
Chapels and operating rooms were turned into makeshift morgues, corpses floated in nursing homes and Federal Emergency Management Agency (FEMA) officials commandeered transportation away from hospitals and nursing homes, according to news reports.
Some patients waited up to 12 hours in stairwells waiting to be airlifted, only to be told it wasn't going to happen that day. There were reports of one hospital evacuating its staff before sick infants. Some 90 patients died in area hospitals, the news reports found.
At the New Orleans International Airport, Concourse D became the initial triage and treatment center for thousand of evacuees from nursing homes, hospitals, private homes, civic centers and the Superdome.
By the time Dr. Russell Bieniek arrived from Erie, Pa., as part of a disaster medical assistance team, the overflow had taken over the rest of that floor and the floor below it.
"It was wall-to-wall people waiting for care and transport," said Bieniek, who is medical director of the emergency department at St. Vincent Health Center in Erie. On the busiest day, about 12,000 people came through.
While many patients simply required wound and other minor care, others were critical.
"Most of the evacuees had not had any medical care in four or five days. This meant no dialysis, blood pressure meds, cardiac meds, seizure meds, insulin," Bieniek. "We had a man having an acute heart attack, several patients seizing, a woman nearing cardiac arrest from high potassium because she missed her dialysis, and many people with sugars out of control from not having any insulin where they were."
For several days, Bieniek slept in the baggage claim area and took showers in a trailer provided by the forestry service and parked between C and D concourses. The number of patients being treated at the airport had dwindled to by the end of the first week of September as patients were moved elsewhere.
In the parking lot of the Houston Astrodome, where thousands huddled in the weeks after the storm, doctors waiting to treat patients arriving by bus saw many of the same issues: chronic diseases gone awry because patients had no access to medication.
Several people were admitted to hospital with diabetic ketoacidosis -- a dangerously high level of ketones, or acids, that build up in the blood and can lead to diabetic coma or death, said Dr. Clinton White, a professor of internal medicine at Baylor College of Medicine and chief of infectious disease at Ben Taub General Hospital, both in Houston.
One person appears to have died of a heart attack because his blood pressure had skyrocketed, said White, who is also a counselor with the American Society of Tropical Medicine & Hygiene.
During that first chaotic weekend in September, medical staff were suddenly faced with an outbreak of diarrhea in the Astrodome. "Hundreds of people were getting sick," White said.
Medical personnel blocked off one area of the arena to isolate people while labs ran tests for free. The culprit turned out to be norovirus, the same germ responsible for many illnesses aboard cruise ships.
The problem was that people in the Astrodome and adjacent Astro Arena were using alcohol disinfectant, which doesn't work well for this particular organism. White had more sinks put in so people could wash with soap and water.
Dr. Hilarie Cranmer was driving to Boston's Logan Airport, preparing to fly to France to speak about her experiences tending victims of the Asian tsunami, when her cell phone rang.
It was the Harvard Humanitarian Institute asking her to fly to Louisiana to help the Red Cross coordinate disaster efforts. She turned the car around and repacked for Baton Rouge.
The devastation, especially in Mississippi, looked a lot like that from the tsunami, Cranmer recalled. And, again, thousands upon thousands of people were displaced. Cranmer was charged with helping to coordinate with the various shelters, making sure they had what they needed.
This proved more difficult than anticipated.
"One of the hardest things was to actually find out where the shelters were because the communications were down," Cranmer said. "We knew there were shelters out there, but we couldn't know what they needed because we couldn't get through." Eventually, they did, and made sure that basic public health standards were being met, things like separating trash from food and cleaning up overflowing toilets.
The Ochsner emergency room saw just a handful of patients during the storm. Once the water started rising, however, they saw people stranded, starved, dehydrated and/or elderly wandering out of the city. "A lot of people were without basic resources of food, water and medication," Guarisco said. "There was a tremendous amount of despair and helplessness. It was truly as if someone had dropped a bomb in the middle of the city."
That stream of desperate individuals included even fellow rescue workers injured in accidents.
Still, as yet another storm -- Hurricane Rita -- loomed Tuesday, Guarisco said Ochsner's emergency department has gotten "back to regular business," ready to face what comes.
At least for now.
Health Tip: Caring for Your Skin
If you're in your 20s or 30s and value your youthful appearance, now's the time to begin a good skin care program. It may help you avoid cosmetic surgery down the road, according to the Facial Plastic Surgery Center at Saint Louis University.
Here are some tips:
Get enough sleep.
Eat healthy.
Limit your caffeine consumption.
Use sunscreen every day.
Wear sunglasses to avoid squinting.
Don't go to tanning salons.
Establish a nighttime skin care ritual.
Use the right skin care products.
Don't smoke.
Consider anti-wrinkle creams.
Health Tip: Prevent Colon Cancer
Colorectal cancer is the fourth most common cancer in the United States with about 135,000 new cases diagnosed each year, according to Duke University Medical Center.
Here are some ways to minimize your risk of developing colorectal cancer:
Follow a healthful diet.
Exercise regularly.
After age 40, start a screening program that includes an annual digital rectal exam and a stool-sample test. After age 50, get a colonoscopy every five to 10 years.
If there's a family history of colorectal cancer, talk to your doctor about starting a more rigorous screening program.
Be alert for symptoms including blood in the stool, a change in bowel habits, and abdominal pain.
An ingredient in green tea has prevented Alzheimer's disease-like brain damage in mice, researchers report.
The compound, called epigallocatechin-3-gallate (EGCG), decreased production of the protein beta-amyloid, which accumulates in the brains of Alzheimer's patients and causes nerve damage and memory loss.
"The findings suggest that a concentrated component of green tea can decrease brain beta-amyloid plaque formation," senior researcher Dr. Jun Tan, director of the Neuroimmunology Laboratory at the the University of South Florida's Silver Child Development Center, said in a prepared statement.
Reporting in the Sept. 21 issue of the Journal of Neuroscience, the research team worked with mice genetically programmed to develop a disease mimicking human Alzheimer's.
The mice received daily injections of EGCG for several months and showed as much as a 54 percent reduction in the formation of brain-clogging beta-amyloid plaques. It appears that EGCG prevents the initial process that leads to beta-amyloid formation in brain cells, the researchers said.
"If beta-amyloid pathology in this Alzheimer's mouse model is representative of Alzheimer's disease pathology in humans, EGCG dietary supplementation may be effective in preventing and treating the disease," Tan said.
The researchers will next study whether multiple oral doses of EGCG improve memory loss in mice with Alzheimer's.
"If those studies show clear cognitive benefits, we believe clinical trials of EGCG to treat Alzheimer's disease would be warranted," Tan said.
Courage and Caring Amid Katrina's Chaos
Of all the surreal scenes playing out across New Orleans in the aftermath of Hurricane Katrina, this may have been one of the strangest.
As the New Orleans flood waters rose, Dr. Joseph Guarisco, chairman of emergency medicine at the city's Ochsner Clinic Foundation, looked out the center's windows and saw a succession of people perched on boats, rafts and even garbage cans floating by.
Then, finally, a city bus sped through the water. It did not pass the hospital and continue west with the stream but, instead, sped up the ambulance ramp and screeched to a halt. At least there was a dry place to stop: Ochsner is above sea level.
The bus, it turned out, held paraplegics who had been carried down eight flights of stairs at another hospital. The city bus had been commandeered by the paramedics and had been turned away by every shelter and hospital between Ochsner and downtown, a distance of about five miles.
"I'm turning the bus off, parking it and leaving," the paramedic, who was armed, stated.
Guarisco tried to reason with the paramedic: The paraplegics didn't have any acute medical problems, so they really needed to be at a shelter, not a hospital. The hospital needed to be ready for medical emergencies. But the paramedic prepared to leave, so Guarisco summoned Ochsner security (also armed) and, finally, the hospital's CEO.
"The infrastructure of the city was falling apart, police were abandoning their positions, city bus drivers were abandoning running buses. The city's flooding, and here we have paraplegics inside a bus and there's an armed standoff between paramedics and our own security," Guarisco said. "It was right out of a scene about the end of the world."
Ochsner staff finally convinced the paramedic to return the paraplegics to the last shelter they had visited.
The scene was perhaps not too much stranger than other scenes playing out all over New Orleans and, indeed, throughout the Gulf Coast after Katrina unleashed her fury at the end of August.
At the heart of so many of those stories, men and women trained in emergency care used whatever resources were at hand to help others struggling against chaos, confusion and death.
Chapels and operating rooms were turned into makeshift morgues, corpses floated in nursing homes and Federal Emergency Management Agency (FEMA) officials commandeered transportation away from hospitals and nursing homes, according to news reports.
Some patients waited up to 12 hours in stairwells waiting to be airlifted, only to be told it wasn't going to happen that day. There were reports of one hospital evacuating its staff before sick infants. Some 90 patients died in area hospitals, the news reports found.
At the New Orleans International Airport, Concourse D became the initial triage and treatment center for thousand of evacuees from nursing homes, hospitals, private homes, civic centers and the Superdome.
By the time Dr. Russell Bieniek arrived from Erie, Pa., as part of a disaster medical assistance team, the overflow had taken over the rest of that floor and the floor below it.
"It was wall-to-wall people waiting for care and transport," said Bieniek, who is medical director of the emergency department at St. Vincent Health Center in Erie. On the busiest day, about 12,000 people came through.
While many patients simply required wound and other minor care, others were critical.
"Most of the evacuees had not had any medical care in four or five days. This meant no dialysis, blood pressure meds, cardiac meds, seizure meds, insulin," Bieniek. "We had a man having an acute heart attack, several patients seizing, a woman nearing cardiac arrest from high potassium because she missed her dialysis, and many people with sugars out of control from not having any insulin where they were."
For several days, Bieniek slept in the baggage claim area and took showers in a trailer provided by the forestry service and parked between C and D concourses. The number of patients being treated at the airport had dwindled to by the end of the first week of September as patients were moved elsewhere.
In the parking lot of the Houston Astrodome, where thousands huddled in the weeks after the storm, doctors waiting to treat patients arriving by bus saw many of the same issues: chronic diseases gone awry because patients had no access to medication.
Several people were admitted to hospital with diabetic ketoacidosis -- a dangerously high level of ketones, or acids, that build up in the blood and can lead to diabetic coma or death, said Dr. Clinton White, a professor of internal medicine at Baylor College of Medicine and chief of infectious disease at Ben Taub General Hospital, both in Houston.
One person appears to have died of a heart attack because his blood pressure had skyrocketed, said White, who is also a counselor with the American Society of Tropical Medicine & Hygiene.
During that first chaotic weekend in September, medical staff were suddenly faced with an outbreak of diarrhea in the Astrodome. "Hundreds of people were getting sick," White said.
Medical personnel blocked off one area of the arena to isolate people while labs ran tests for free. The culprit turned out to be norovirus, the same germ responsible for many illnesses aboard cruise ships.
The problem was that people in the Astrodome and adjacent Astro Arena were using alcohol disinfectant, which doesn't work well for this particular organism. White had more sinks put in so people could wash with soap and water.
Dr. Hilarie Cranmer was driving to Boston's Logan Airport, preparing to fly to France to speak about her experiences tending victims of the Asian tsunami, when her cell phone rang.
It was the Harvard Humanitarian Institute asking her to fly to Louisiana to help the Red Cross coordinate disaster efforts. She turned the car around and repacked for Baton Rouge.
The devastation, especially in Mississippi, looked a lot like that from the tsunami, Cranmer recalled. And, again, thousands upon thousands of people were displaced. Cranmer was charged with helping to coordinate with the various shelters, making sure they had what they needed.
This proved more difficult than anticipated.
"One of the hardest things was to actually find out where the shelters were because the communications were down," Cranmer said. "We knew there were shelters out there, but we couldn't know what they needed because we couldn't get through." Eventually, they did, and made sure that basic public health standards were being met, things like separating trash from food and cleaning up overflowing toilets.
The Ochsner emergency room saw just a handful of patients during the storm. Once the water started rising, however, they saw people stranded, starved, dehydrated and/or elderly wandering out of the city. "A lot of people were without basic resources of food, water and medication," Guarisco said. "There was a tremendous amount of despair and helplessness. It was truly as if someone had dropped a bomb in the middle of the city."
That stream of desperate individuals included even fellow rescue workers injured in accidents.
Still, as yet another storm -- Hurricane Rita -- loomed Tuesday, Guarisco said Ochsner's emergency department has gotten "back to regular business," ready to face what comes.
At least for now.
Health Tip: Caring for Your Skin
If you're in your 20s or 30s and value your youthful appearance, now's the time to begin a good skin care program. It may help you avoid cosmetic surgery down the road, according to the Facial Plastic Surgery Center at Saint Louis University.
Here are some tips:
Get enough sleep.
Eat healthy.
Limit your caffeine consumption.
Use sunscreen every day.
Wear sunglasses to avoid squinting.
Don't go to tanning salons.
Establish a nighttime skin care ritual.
Use the right skin care products.
Don't smoke.
Consider anti-wrinkle creams.
Health Tip: Prevent Colon Cancer
Colorectal cancer is the fourth most common cancer in the United States with about 135,000 new cases diagnosed each year, according to Duke University Medical Center.
Here are some ways to minimize your risk of developing colorectal cancer:
Follow a healthful diet.
Exercise regularly.
After age 40, start a screening program that includes an annual digital rectal exam and a stool-sample test. After age 50, get a colonoscopy every five to 10 years.
If there's a family history of colorectal cancer, talk to your doctor about starting a more rigorous screening program.
Be alert for symptoms including blood in the stool, a change in bowel habits, and abdominal pain.
Wednesday, September 21, 2005
Health Headlines - September 21
Staying Fit May Fight Joint Pain
You can't run away from pain -- or can you? A new study of older runners suggests that staying active keeps joint pain at bay.
The 14-year study of 866 people (492 runners and 374 controls) concluded that those who got regular exercise experienced 25 percent less joint and muscle pain as they aged compared to less-active people.
According to the Stanford University researchers, the study participants were, on average, in their mid-60s at the start of the study. Each year, the participants filled out a questionnaire on their health status, exercise habits and injury history. The physically active group spent between 6 and 35 hours exercising each week over the course of the study. In contrast, those in the control group were closer to the classic "couch potato."
"Exercise was associated with a substantial and significant reduction in pain even ... despite the fact that fractures, a significant predictor of pain, were slightly more common among runners," the study authors wrote in the journal Arthritis Research & Therapy.
Further research is needed in order to better understand how exercise affects musculoskeletal pain in older people, the researchers said.
Health Tip: Tanning Lamps Can Harm Your Skin
The ultraviolet rays from tanning lamps can be as hazardous to your health as UV rays from the sun.
So if you frequent tanning salons, Health Canada suggests you minimize your risk by:
Reading the warning labels on sunlamps or tanning beds and following the directions closely.
Always wearing safety eyewear.
Having the salon operator recommend an optimal session length based on your skin's sensitivity.
Allowing at least 48 hours between sessions.
Making sure there's a physical barrier, such as a clear sheet of acrylic, between you and the tanning lamp.
Limiting the total number of tanning sessions per year.
Health Tip: Treating Ringworm
Scaly, ring-shaped, pink patches on the skin or scalp may indicate ringworm, a contagious fungal infection.
Children's Healthcare of Atlanta offers these treatment tips:
Check with your doctor before applying treatment. Other skin problems can mimic ringworm.
Apply an anti-fungal cream to the rash and one inch beyond the edge of the rash.
Keep using the cream for one week after the rash has gone.
Avoid scratching the area.
You can't run away from pain -- or can you? A new study of older runners suggests that staying active keeps joint pain at bay.
The 14-year study of 866 people (492 runners and 374 controls) concluded that those who got regular exercise experienced 25 percent less joint and muscle pain as they aged compared to less-active people.
According to the Stanford University researchers, the study participants were, on average, in their mid-60s at the start of the study. Each year, the participants filled out a questionnaire on their health status, exercise habits and injury history. The physically active group spent between 6 and 35 hours exercising each week over the course of the study. In contrast, those in the control group were closer to the classic "couch potato."
"Exercise was associated with a substantial and significant reduction in pain even ... despite the fact that fractures, a significant predictor of pain, were slightly more common among runners," the study authors wrote in the journal Arthritis Research & Therapy.
Further research is needed in order to better understand how exercise affects musculoskeletal pain in older people, the researchers said.
Health Tip: Tanning Lamps Can Harm Your Skin
The ultraviolet rays from tanning lamps can be as hazardous to your health as UV rays from the sun.
So if you frequent tanning salons, Health Canada suggests you minimize your risk by:
Reading the warning labels on sunlamps or tanning beds and following the directions closely.
Always wearing safety eyewear.
Having the salon operator recommend an optimal session length based on your skin's sensitivity.
Allowing at least 48 hours between sessions.
Making sure there's a physical barrier, such as a clear sheet of acrylic, between you and the tanning lamp.
Limiting the total number of tanning sessions per year.
Health Tip: Treating Ringworm
Scaly, ring-shaped, pink patches on the skin or scalp may indicate ringworm, a contagious fungal infection.
Children's Healthcare of Atlanta offers these treatment tips:
Check with your doctor before applying treatment. Other skin problems can mimic ringworm.
Apply an anti-fungal cream to the rash and one inch beyond the edge of the rash.
Keep using the cream for one week after the rash has gone.
Avoid scratching the area.
Tuesday, September 20, 2005
Health Headlines - September 20
Moms' View on Family Meal Influences Kids' Weight
Moms concerned about keeping their kids fit and trim may want to encourage an increasingly threatened institution: the healthy family meal.
That's true even if the family's goals of eating together each day falls short occasionally, according to a study published in a recent issue of the journal Obesity Research.
Eating together as a family has long been recommended by nutrition experts.
"I certainly recommend people eat together at least a few times a week," said Lola O'Rourke, a Seattle dietitian and spokeswoman for the American Dietetic Association. Doing so helps parents teach kids healthy eating habits, she said, and also gives them some control over what their children eat.
The family meal may be more important than ever, experts say, especially in the wake of a government study released earlier this month that found high-calorie, low-nutrient junk food readily available in nine out of 10 U.S. schools.
In their study on family dinners, Dr. Abdullah A. Mamun, of the University of Queensland in Brisbane, Australia, and colleagues evaluated data on nearly 3,800 children, half girls and half boys, following them from birth to age 14.
They found the prevalence of overweight at age 14 was 24.1 percent for the boys and 27.1 percent for the girls.
They also looked at whether or not families ate together regularly, and quizzed mothers on their attitudes towards the family meal.
While 79 percent of the mothers said their family ate together at least once a day, only 43 percent said they felt it was important to eat together, the Australian team found.
Then the researchers focused on the children of mothers who didn't say it was important to eat together. According to the study, those children were 30 percent more likely to be overweight by age 14 compared with kids born to moms who valued the family meal.
The researchers found no association between the mothers' report of how often the family actually did eat together and the chances of the teen being overweight by age 14, however.
So why might a mother's attitude to family meals matter, even when her family often fails to get together for lunch or dinner? Researchers speculate that maternal attitudes towards the importance of family meals may reflect a broader respect for good nutrition. This might extend to practices such as keeping healthy foods in the house or limiting the amount of times their children can eat "junk food."
That interpretation makes sense to O'Rourke. "You would think people who are more concerned about family meals are also probably more concerned about nutrition," she said.
Mothers who encourage family dinners may also be providing more emotional support to their teens, she said, or building self-confidence in them so they are less likely to turn to food for stress-relief.
"In the past we have seen [in research] that a higher incidence of family meals is associated with a better nutrient intake, healthier meals," she said.
Eating together as a family, at least a few times a week, gives everyone a chance to connect, she said, and "parents have more influence in terms of what is being put on the table."
Parents can also take the opportunity to discuss healthy eating habits and set guidelines for eating at school, where junk food is common. A study released in early September by the Government Accountability Office, the investigative arm of Congress, found that nine out of 10 schools have candy, soda, pizza and other snacks readily available, and that schools are one of the largest sources for unhealthy food for today's children.
In the sample, the GAO surveyed 656 schools, with 51 percent of the principals responding. Vending machines were available in nearly all high schools and middle schools but less than half of elementary schools. Junk food has become more common in middle schools in the past five years, the survey found. And the investigators found that vending machine foods and "junk foods" offered in a-la-carte lines in school cafeterias are crowding out healthier choices.
The result? Obesity among children and teens has more than doubled in the past three decades, according to experts at the Institute of Medicine.
Parents can set guidelines for making good choices at school, however.
"Don't tell them they absolutely can't have pizza or whatever it is [they want to eat]," O'Rourke said. "Saying no you can't have it at all will backfire." Rather, she suggested, ask them to limit foods such as pizza to once a week or so at school.
Another good idea, O'Rourke said, is to "create these foods at home in healthier versions, such as pizza with less cheese, using whole wheat crust and more veggies as toppings."
Health Tip: Prevent Eating Disorders
The causes of eating disorders, such as anorexia nervosa and bulimia, are often multi-faceted, which can make the conditions difficult to treat.
The best cure is prevention, says the U.S. Naval Hospital in Camp Pendleton, Cal. Here are five ways to help combat eating disorders:
Talk to your kids about natural differences in body shapes and sizes.
Avoid negative attitudes or conversations about weight.
Don't discourage activities, such as swimming or dancing, just because they draw attention to weight or body shape.
Talk to your kids about the misguided way in which appearance is linked to success.
Be a good role model by eating nutritious meals and exercising regularly.
Health Tip: Before You Have Lasik Surgery
Before you sign up for the vision-correcting procedure known as Lasik, make sure you have both the short view and the long view of how your vision will be affected.
The American Academy of Ophthalmology offers the following information:
Lasik may not give you perfect vision. Seven of 10 patients achieve 20/20 vision, but 20/20 doesn't always mean perfect vision.
If you have Lasik to correct your distance vision, you'll still need reading glasses around age 45.
The procedure is too new to know if there are any long-term ill effects beyond five years of surgery.
Lasik can't be reversed.
Most insurance doesn't cover the surgery.
Moms concerned about keeping their kids fit and trim may want to encourage an increasingly threatened institution: the healthy family meal.
That's true even if the family's goals of eating together each day falls short occasionally, according to a study published in a recent issue of the journal Obesity Research.
Eating together as a family has long been recommended by nutrition experts.
"I certainly recommend people eat together at least a few times a week," said Lola O'Rourke, a Seattle dietitian and spokeswoman for the American Dietetic Association. Doing so helps parents teach kids healthy eating habits, she said, and also gives them some control over what their children eat.
The family meal may be more important than ever, experts say, especially in the wake of a government study released earlier this month that found high-calorie, low-nutrient junk food readily available in nine out of 10 U.S. schools.
In their study on family dinners, Dr. Abdullah A. Mamun, of the University of Queensland in Brisbane, Australia, and colleagues evaluated data on nearly 3,800 children, half girls and half boys, following them from birth to age 14.
They found the prevalence of overweight at age 14 was 24.1 percent for the boys and 27.1 percent for the girls.
They also looked at whether or not families ate together regularly, and quizzed mothers on their attitudes towards the family meal.
While 79 percent of the mothers said their family ate together at least once a day, only 43 percent said they felt it was important to eat together, the Australian team found.
Then the researchers focused on the children of mothers who didn't say it was important to eat together. According to the study, those children were 30 percent more likely to be overweight by age 14 compared with kids born to moms who valued the family meal.
The researchers found no association between the mothers' report of how often the family actually did eat together and the chances of the teen being overweight by age 14, however.
So why might a mother's attitude to family meals matter, even when her family often fails to get together for lunch or dinner? Researchers speculate that maternal attitudes towards the importance of family meals may reflect a broader respect for good nutrition. This might extend to practices such as keeping healthy foods in the house or limiting the amount of times their children can eat "junk food."
That interpretation makes sense to O'Rourke. "You would think people who are more concerned about family meals are also probably more concerned about nutrition," she said.
Mothers who encourage family dinners may also be providing more emotional support to their teens, she said, or building self-confidence in them so they are less likely to turn to food for stress-relief.
"In the past we have seen [in research] that a higher incidence of family meals is associated with a better nutrient intake, healthier meals," she said.
Eating together as a family, at least a few times a week, gives everyone a chance to connect, she said, and "parents have more influence in terms of what is being put on the table."
Parents can also take the opportunity to discuss healthy eating habits and set guidelines for eating at school, where junk food is common. A study released in early September by the Government Accountability Office, the investigative arm of Congress, found that nine out of 10 schools have candy, soda, pizza and other snacks readily available, and that schools are one of the largest sources for unhealthy food for today's children.
In the sample, the GAO surveyed 656 schools, with 51 percent of the principals responding. Vending machines were available in nearly all high schools and middle schools but less than half of elementary schools. Junk food has become more common in middle schools in the past five years, the survey found. And the investigators found that vending machine foods and "junk foods" offered in a-la-carte lines in school cafeterias are crowding out healthier choices.
The result? Obesity among children and teens has more than doubled in the past three decades, according to experts at the Institute of Medicine.
Parents can set guidelines for making good choices at school, however.
"Don't tell them they absolutely can't have pizza or whatever it is [they want to eat]," O'Rourke said. "Saying no you can't have it at all will backfire." Rather, she suggested, ask them to limit foods such as pizza to once a week or so at school.
Another good idea, O'Rourke said, is to "create these foods at home in healthier versions, such as pizza with less cheese, using whole wheat crust and more veggies as toppings."
Health Tip: Prevent Eating Disorders
The causes of eating disorders, such as anorexia nervosa and bulimia, are often multi-faceted, which can make the conditions difficult to treat.
The best cure is prevention, says the U.S. Naval Hospital in Camp Pendleton, Cal. Here are five ways to help combat eating disorders:
Talk to your kids about natural differences in body shapes and sizes.
Avoid negative attitudes or conversations about weight.
Don't discourage activities, such as swimming or dancing, just because they draw attention to weight or body shape.
Talk to your kids about the misguided way in which appearance is linked to success.
Be a good role model by eating nutritious meals and exercising regularly.
Health Tip: Before You Have Lasik Surgery
Before you sign up for the vision-correcting procedure known as Lasik, make sure you have both the short view and the long view of how your vision will be affected.
The American Academy of Ophthalmology offers the following information:
Lasik may not give you perfect vision. Seven of 10 patients achieve 20/20 vision, but 20/20 doesn't always mean perfect vision.
If you have Lasik to correct your distance vision, you'll still need reading glasses around age 45.
The procedure is too new to know if there are any long-term ill effects beyond five years of surgery.
Lasik can't be reversed.
Most insurance doesn't cover the surgery.
Monday, September 19, 2005
Health Headlines - September 19
Medicare Premiums Raised Again
Seniors face yet another increase in their health-care costs, thanks to the federal government.
The New York Times reported Saturday that basic Medicare premiums will go up again; this time the hike will be 13 percent, to $88.50 a month. Increased use of doctor's services is behind the latest increase, the Times reported.
Many beneficiaries will have to pay an additional premium for the much-touted new prescription drug benefit program, set to start Jan. 1, which should average $32 a month. The combined premiums will now average $120 a month, the Times reported.
Medicare premiums are typically deducted from monthly Social Security checks, which currently average $955 a month for retirees, the Times said. Medicare provides medical coverage to 42 million people who are older or disabled.
The basic Medicare premium has gone up by nearly $30 a month, or 51 percent, from 2003 to 2006, Kirsten A. Sloan, a health policy analyst at AARP, told the Times.
Cleveland Clinic Doctor to Attempt First Face Transplant
A Cleveland Clinic doctor will soon try a radical surgery that has never been performed before when she attempts a face transplant, the Associated Press reported Saturday.
Seven women and five men will travel to the Cleveland Clinic in the coming weeks to be examined by Dr. Maria Siemionow, according to the AP. The surgeon will study their facial features and ask them what they hope to gain by such a drastic procedure. They will be warned about the dangers and requirements: At worst, the transplant could be rejected and their new face could literally slough off; even in the best instance, they will have to take powerful immunosuppressant drugs for their rest of their lives, which could damage their kidneys and leave them susceptible to cancer.
Dr. Siemionow told the AP she hopes to one day be able to give people disfigured by burns or accidents a chance at a new life. Even the best current treatments still leave scar tissue that doesn't look or move like skin, according to the AP.
The planned procedure is not without controversy; concerns over the risks recently led hospitals in England and France to scrap plans for face transplants, the AP reported, and it took Dr. Siemionow's transplant team more than a year to secure the blessing of the clinic's institutional review board.
New Orleans Sludge Still Contaminated With Bacteria, Oil
Initial tests conducted on sediments taken after floodwaters receded in New Orleans show high amounts of E. coli bacteria and oil runoff from fuel and chemical plants, the U.S. Environmental Protection Agency said Friday.
E. coli indicates there is fecal bacteria in the water and exposed sediment, and contact with both should be avoided, Marcus Peacock, the EPA's deputy administrator, told reporters Friday at a news conference, the agency's second this week. He said 18 sediment samples taken on Sept. 10 represented the start of "extensive" testing, the Bloomberg news service reported.
And flooded parts of New Orleans, which was 80 percent under water after Hurricane Katrina, include more than 60 chemical plants, oil refineries, and petroleum storage facilities, Bloomberg said.
The Coast Guard said Thursday that Hurricane Katrina may have spilled more than 7 million gallons of oil, about two-thirds of what was released in the Exxon Valdez accident in 1989, according to the Associated Press.
Contact with fuel oils can lead to skin and eye irritation, increased blood pressure, and headache, Bloomberg said.
Officials told Bloomberg that the full extent of the contamination probably won't be known until the city is completely pumped out, which they say could take until mid-October.
Defibrillator Problems on the Rise: FDA Study
Malfunctions in implanted heart devices called defibrillators were increasing even before a huge recall this summer by Guidant Corp., according to a joint study released Friday by the U.S. Food and Drug Administration and Harvard University.
Defibrillators shock awkwardly beating hearts back into a normal rhythm. About 20 of every 1,000 devices malfunction, the researchers found. Those defects led to 31 deaths between 1990 and 2002, although that was a fraction of the more than 400,000 devices implanted during the span, the Associated Press reported.
Nonetheless, the study "points out the need for our agency to improve the way it regulates these products, and we're doing just that," Dr. Daniel Schultz, chief of the FDA's medical devices unit, told the AP.
The research was presented Friday at a daylong meeting of the Heart Rhythm Society in Washington, D.C., to discuss recent safety problems with defibrillators and other implanted cardiac devices, including pacemakers.
The study's leader, Dr. William Maisel of Harvard, found that from 1990 to 2002, 2.25 million pacemakers and 416,000 cardiac defibrillators were implanted in the United States. More than 17,000 of the devices had to be removed later due to malfunctions, the AP reported.
Equally troubling, 50 percent of the defibrillator malfunctions between 1990 and 2002 occurred within the last three years of that time period, the researchers said.
Guidant, and two other makers -- Medtronic and St. Jude Medical -- have recalled or issued warnings about more than 200,000 defibrillators since January, the wire service said. Guidant recently conceded that it waited three years before telling doctors and patients about an electrical defect in one of its models. The defect has been linked to two deaths, the AP reported.
Aspirin at Night May Lower Blood Pressure
Not only may daily aspirin prevent a heart attack, it could also lower blood pressure -- especially if taken at night, researchers have found.
Scientists from Spain, writing in the Sept. 20 issue of the Journal of the American College of Cardiology, said they randomly divided patients with mild hypertension into three groups: those who took aspirin in the morning, those who took it before bed, and those who didn't take aspirin at all.
After three months, blood pressure rose slightly among those who took aspirin in the morning, but fell in the group that took it at night. The group that didn't take aspirin at all saw only a very slight decline in blood pressure that wasn't statistically significant, the researchers at the University of Vigo said.
The authors and other experts said the results would have to be confirmed in future studies.
"Given the widespread use of aspirin, the prevalence of hypertension, and the ease in altering the time of aspirin administration, these results should be widely disseminated," Dr. Joseph Messer, from Rush University Medical Center in Chicago, said in a prepared statement from the American College of Cardiology. Messer wasn't directly connected to the research, the statement said.
'Second disaster' may follow Katrina: doctors
Doctors are bracing themselves for what they call a "second disaster" as New Orleans-area residents return to their devastated city.
While environmentalists warn of the long-term danger to health from possibly polluted floodwaters, and rumors of disease swirl, front-line emergency doctors say the actual health danger will come from accidents.
"The second wave of disaster is when you welcome the people back and the infrastructure of the city is not in place," said Dr. Peter Deblieux, an emergency room doctor at downtown New Orleans' Charity Hospital.
Officials in New Orleans and surrounding Jefferson Parish began allowing residents to return over the weekend and say everyone can come back by mid-week. But residents whose homes were not completely destroyed will confront fallen trees, wrecked roofs and streets full of nails.
Someone will have to clean it up.
"We will see the chainsaw people -- lacerations of the left thigh, lacerations of the left forearm," Deblieux said in an interview. "There will be people falling off the scaffolding."
Public health experts concur. After Hurricane Charley hit Florida in 2004, 77 percent of the deaths blamed on the hurricane were classified as unintentional injury.
Deblieux is concerned about plans to allow more than 180,000 people to return to New Orleans with only four area hospitals up and running, and only one of those in New Orleans proper.
Charity, the city's free public hospital, remains closed, its electricity panels destroyed by flooding. "Where will people get treatment?" asked Deblieux.
Some areas will continue to lack electricity and clean drinking water.
Coast Guard Vice Adm. Thad Allen, who heads the federal recovery effort, voiced similar concerns. He noted that hurricane season is not over.
"If you bring significant amounts of people into New Orleans, you need an evacuation plan on how you're going to do that," he told CNN on Sunday.
INVISIBLE DANGERS
The U.S. Centers for Disease Control and Prevention is launching an education effort to caution people about the danger of carbon monoxide poisoning if they use generators.
While some areas have uncontaminated water, 90 percent of the population does not, the CDC said on Saturday.
"It is contaminated with human and animal waste. But there isn't this sort of toxic soup out there," said Dr. Tom Clark, an infectious disease specialist at the CDC.
The CDC and Environmental Protection Agency are both telling people to wash off mud or dirt as soon as possible and to avoid getting flood water on themselves.
There are heavy metals and oil products such as diesel fuel in the water -- but not huge amounts. And as the mud dries, some compounds, especially metals such as lead and arsenic, will remain in the dirt.
There has been some diarrhea but no epidemics and despite fears, evacuees are not spreading diseases widely. And if people are careful, the contaminated tap water should not pose any great threat, the CDC said.
"E. coli in general are normal flora of the gastrointestinal tracts of people and animals," Clark said.
Some are toxic -- such as the E. coli 0157 strain that can cause deadly food poisoning, especially in children.
The E. coli being measured in city water is not in itself especially harmful but rather means the water is contaminated. And that does not necessarily mean unusual diseases.
"A lot of the time what you see (after a disaster like this) is an increase of what was already there before," Clark said.
Seniors face yet another increase in their health-care costs, thanks to the federal government.
The New York Times reported Saturday that basic Medicare premiums will go up again; this time the hike will be 13 percent, to $88.50 a month. Increased use of doctor's services is behind the latest increase, the Times reported.
Many beneficiaries will have to pay an additional premium for the much-touted new prescription drug benefit program, set to start Jan. 1, which should average $32 a month. The combined premiums will now average $120 a month, the Times reported.
Medicare premiums are typically deducted from monthly Social Security checks, which currently average $955 a month for retirees, the Times said. Medicare provides medical coverage to 42 million people who are older or disabled.
The basic Medicare premium has gone up by nearly $30 a month, or 51 percent, from 2003 to 2006, Kirsten A. Sloan, a health policy analyst at AARP, told the Times.
Cleveland Clinic Doctor to Attempt First Face Transplant
A Cleveland Clinic doctor will soon try a radical surgery that has never been performed before when she attempts a face transplant, the Associated Press reported Saturday.
Seven women and five men will travel to the Cleveland Clinic in the coming weeks to be examined by Dr. Maria Siemionow, according to the AP. The surgeon will study their facial features and ask them what they hope to gain by such a drastic procedure. They will be warned about the dangers and requirements: At worst, the transplant could be rejected and their new face could literally slough off; even in the best instance, they will have to take powerful immunosuppressant drugs for their rest of their lives, which could damage their kidneys and leave them susceptible to cancer.
Dr. Siemionow told the AP she hopes to one day be able to give people disfigured by burns or accidents a chance at a new life. Even the best current treatments still leave scar tissue that doesn't look or move like skin, according to the AP.
The planned procedure is not without controversy; concerns over the risks recently led hospitals in England and France to scrap plans for face transplants, the AP reported, and it took Dr. Siemionow's transplant team more than a year to secure the blessing of the clinic's institutional review board.
New Orleans Sludge Still Contaminated With Bacteria, Oil
Initial tests conducted on sediments taken after floodwaters receded in New Orleans show high amounts of E. coli bacteria and oil runoff from fuel and chemical plants, the U.S. Environmental Protection Agency said Friday.
E. coli indicates there is fecal bacteria in the water and exposed sediment, and contact with both should be avoided, Marcus Peacock, the EPA's deputy administrator, told reporters Friday at a news conference, the agency's second this week. He said 18 sediment samples taken on Sept. 10 represented the start of "extensive" testing, the Bloomberg news service reported.
And flooded parts of New Orleans, which was 80 percent under water after Hurricane Katrina, include more than 60 chemical plants, oil refineries, and petroleum storage facilities, Bloomberg said.
The Coast Guard said Thursday that Hurricane Katrina may have spilled more than 7 million gallons of oil, about two-thirds of what was released in the Exxon Valdez accident in 1989, according to the Associated Press.
Contact with fuel oils can lead to skin and eye irritation, increased blood pressure, and headache, Bloomberg said.
Officials told Bloomberg that the full extent of the contamination probably won't be known until the city is completely pumped out, which they say could take until mid-October.
Defibrillator Problems on the Rise: FDA Study
Malfunctions in implanted heart devices called defibrillators were increasing even before a huge recall this summer by Guidant Corp., according to a joint study released Friday by the U.S. Food and Drug Administration and Harvard University.
Defibrillators shock awkwardly beating hearts back into a normal rhythm. About 20 of every 1,000 devices malfunction, the researchers found. Those defects led to 31 deaths between 1990 and 2002, although that was a fraction of the more than 400,000 devices implanted during the span, the Associated Press reported.
Nonetheless, the study "points out the need for our agency to improve the way it regulates these products, and we're doing just that," Dr. Daniel Schultz, chief of the FDA's medical devices unit, told the AP.
The research was presented Friday at a daylong meeting of the Heart Rhythm Society in Washington, D.C., to discuss recent safety problems with defibrillators and other implanted cardiac devices, including pacemakers.
The study's leader, Dr. William Maisel of Harvard, found that from 1990 to 2002, 2.25 million pacemakers and 416,000 cardiac defibrillators were implanted in the United States. More than 17,000 of the devices had to be removed later due to malfunctions, the AP reported.
Equally troubling, 50 percent of the defibrillator malfunctions between 1990 and 2002 occurred within the last three years of that time period, the researchers said.
Guidant, and two other makers -- Medtronic and St. Jude Medical -- have recalled or issued warnings about more than 200,000 defibrillators since January, the wire service said. Guidant recently conceded that it waited three years before telling doctors and patients about an electrical defect in one of its models. The defect has been linked to two deaths, the AP reported.
Aspirin at Night May Lower Blood Pressure
Not only may daily aspirin prevent a heart attack, it could also lower blood pressure -- especially if taken at night, researchers have found.
Scientists from Spain, writing in the Sept. 20 issue of the Journal of the American College of Cardiology, said they randomly divided patients with mild hypertension into three groups: those who took aspirin in the morning, those who took it before bed, and those who didn't take aspirin at all.
After three months, blood pressure rose slightly among those who took aspirin in the morning, but fell in the group that took it at night. The group that didn't take aspirin at all saw only a very slight decline in blood pressure that wasn't statistically significant, the researchers at the University of Vigo said.
The authors and other experts said the results would have to be confirmed in future studies.
"Given the widespread use of aspirin, the prevalence of hypertension, and the ease in altering the time of aspirin administration, these results should be widely disseminated," Dr. Joseph Messer, from Rush University Medical Center in Chicago, said in a prepared statement from the American College of Cardiology. Messer wasn't directly connected to the research, the statement said.
'Second disaster' may follow Katrina: doctors
Doctors are bracing themselves for what they call a "second disaster" as New Orleans-area residents return to their devastated city.
While environmentalists warn of the long-term danger to health from possibly polluted floodwaters, and rumors of disease swirl, front-line emergency doctors say the actual health danger will come from accidents.
"The second wave of disaster is when you welcome the people back and the infrastructure of the city is not in place," said Dr. Peter Deblieux, an emergency room doctor at downtown New Orleans' Charity Hospital.
Officials in New Orleans and surrounding Jefferson Parish began allowing residents to return over the weekend and say everyone can come back by mid-week. But residents whose homes were not completely destroyed will confront fallen trees, wrecked roofs and streets full of nails.
Someone will have to clean it up.
"We will see the chainsaw people -- lacerations of the left thigh, lacerations of the left forearm," Deblieux said in an interview. "There will be people falling off the scaffolding."
Public health experts concur. After Hurricane Charley hit Florida in 2004, 77 percent of the deaths blamed on the hurricane were classified as unintentional injury.
Deblieux is concerned about plans to allow more than 180,000 people to return to New Orleans with only four area hospitals up and running, and only one of those in New Orleans proper.
Charity, the city's free public hospital, remains closed, its electricity panels destroyed by flooding. "Where will people get treatment?" asked Deblieux.
Some areas will continue to lack electricity and clean drinking water.
Coast Guard Vice Adm. Thad Allen, who heads the federal recovery effort, voiced similar concerns. He noted that hurricane season is not over.
"If you bring significant amounts of people into New Orleans, you need an evacuation plan on how you're going to do that," he told CNN on Sunday.
INVISIBLE DANGERS
The U.S. Centers for Disease Control and Prevention is launching an education effort to caution people about the danger of carbon monoxide poisoning if they use generators.
While some areas have uncontaminated water, 90 percent of the population does not, the CDC said on Saturday.
"It is contaminated with human and animal waste. But there isn't this sort of toxic soup out there," said Dr. Tom Clark, an infectious disease specialist at the CDC.
The CDC and Environmental Protection Agency are both telling people to wash off mud or dirt as soon as possible and to avoid getting flood water on themselves.
There are heavy metals and oil products such as diesel fuel in the water -- but not huge amounts. And as the mud dries, some compounds, especially metals such as lead and arsenic, will remain in the dirt.
There has been some diarrhea but no epidemics and despite fears, evacuees are not spreading diseases widely. And if people are careful, the contaminated tap water should not pose any great threat, the CDC said.
"E. coli in general are normal flora of the gastrointestinal tracts of people and animals," Clark said.
Some are toxic -- such as the E. coli 0157 strain that can cause deadly food poisoning, especially in children.
The E. coli being measured in city water is not in itself especially harmful but rather means the water is contaminated. And that does not necessarily mean unusual diseases.
"A lot of the time what you see (after a disaster like this) is an increase of what was already there before," Clark said.
Sunday, September 18, 2005
Health Headlines - September 18
Medicare Premiums Raised Again
Seniors face yet another increase in their health-care costs, thanks to the federal government.
The New York Times reported Saturday that basic Medicare premiums will go up again; this time the hike will be 13 percent, to $88.50 a month. Increased use of doctor's services is behind the latest increase, the Times reported.
Many beneficiaries will have to pay an additional premium for the much-touted new prescription drug benefit program, set to start Jan. 1, which should average $32 a month. The combined premiums will now average $120 a month, the Times reported.
Medicare premiums are typically deducted from monthly Social Security checks, which currently average $955 a month for retirees, the Times said. Medicare provides medical coverage to 42 million people who are older or disabled.
The basic Medicare premium has gone up by nearly $30 a month, or 51 percent, from 2003 to 2006, Kirsten A. Sloan, a health policy analyst at AARP, told the Times.
New Orleans Sludge Still Contaminated With Bacteria, Oil
Initial tests conducted on sediments taken after floodwaters receded in New Orleans show high amounts of E. coli bacteria and oil runoff from fuel and chemical plants, the U.S. Environmental Protection Agency said Friday.
E. coli indicates there is fecal bacteria in the water and exposed sediment, and contact with both should be avoided, Marcus Peacock, the EPA's deputy administrator, told reporters Friday at a news conference, the agency's second this week. He said 18 sediment samples taken on Sept. 10 represented the start of "extensive" testing, the Bloomberg news service reported.
And flooded parts of New Orleans, which was 80 percent under water after Hurricane Katrina, include more than 60 chemical plants, oil refineries, and petroleum storage facilities, Bloomberg said.
The Coast Guard said Thursday that Hurricane Katrina may have spilled more than 7 million gallons of oil, about two-thirds of what was released in the Exxon Valdez accident in 1989, according to the Associated Press.
Contact with fuel oils can lead to skin and eye irritation, increased blood pressure, and headache, Bloomberg said.
Officials told Bloomberg that the full extent of the contamination probably won't be known until the city is completely pumped out, which they say could take until mid-October.
Defibrillator Problems on the Rise: FDA Study
Malfunctions in implanted heart devices called defibrillators were increasing even before a huge recall this summer by Guidant Corp., according to a joint study released Friday by the U.S. Food and Drug Administration and Harvard University.
Defibrillators shock awkwardly beating hearts back into a normal rhythm. About 20 of every 1,000 devices malfunction, the researchers found. Those defects led to 31 deaths between 1990 and 2002, although that was a fraction of the more than 400,000 devices implanted during the span, the Associated Press reported.
Nonetheless, the study "points out the need for our agency to improve the way it regulates these products, and we're doing just that," Dr. Daniel Schultz, chief of the FDA's medical devices unit, told the AP.
The research was presented Friday at a daylong meeting of the Heart Rhythm Society in Washington, D.C., to discuss recent safety problems with defibrillators and other implanted cardiac devices, including pacemakers.
The study's leader, Dr. William Maisel of Harvard, found that from 1990 to 2002, 2.25 million pacemakers and 416,000 cardiac defibrillators were implanted in the United States. More than 17,000 of the devices had to be removed later due to malfunctions, the AP reported.
Equally troubling, 50 percent of the defibrillator malfunctions between 1990 and 2002 occurred within the last three years of that time period, the researchers said.
Guidant, and two other makers -- Medtronic and St. Jude Medical -- have recalled or issued warnings about more than 200,000 defibrillators since January, the wire service said. Guidant recently conceded that it waited three years before telling doctors and patients about an electrical defect in one of its models. The defect has been linked to two deaths, the AP reported.
Aspirin at Night May Lower Blood Pressure
Not only may daily aspirin prevent a heart attack, it could also lower blood pressure -- especially if taken at night, researchers have found.
Scientists from Spain, writing in the Sept. 20 issue of the Journal of the American College of Cardiology, said they randomly divided patients with mild hypertension into three groups: those who took aspirin in the morning, those who took it before bed, and those who didn't take aspirin at all.
After three months, blood pressure rose slightly among those who took aspirin in the morning, but fell in the group that took it at night. The group that didn't take aspirin at all saw only a very slight decline in blood pressure that wasn't statistically significant, the researchers at the University of Vigo said.
The authors and other experts said the results would have to be confirmed in future studies.
"Given the widespread use of aspirin, the prevalence of hypertension, and the ease in altering the time of aspirin administration, these results should be widely disseminated," Dr. Joseph Messer, from Rush University Medical Center in Chicago, said in a prepared statement from the American College of Cardiology. Messer wasn't directly connected to the research, the statement said.
Lipitor, Celebrex Lead Price Increases, U.S. Reports
The cholesterol-lowering medicine Lipitor and the pain drug Celebrex had the most impact on a 25 percent overall increase in U.S. retail drug prices from 2000 to 2004, says a federal government report.
The Government Accountability Office report said that the price of a 30-day supply of 96 drugs used by older people increased by 24.5 percent from January 2000 to December 2004, the Kansas City Star reported.
The study found that 20 of the 96 drugs accounted for nearly two-thirds of that increase. Of those 20 drugs, 19 were name-brand drugs and one was a generic drug.
"The drug with the largest effect on the price index was Lipitor 10 mg, which accounted for 6.6 percent of the total increase," the report noted. Celebrex had the second greatest impact on drug prices. Both are made by Pfizer Inc.
The other drugs in the top five were: blood thinner Plavix, made by Sanofi-Aventis SA and Bristol-Myers Squibb Co.'; the ulcer drug Prevacid, made by Abbott Laboratories and Takeda Pharmaceutical Co. Ltd.; and Pfizer's Lipitor 20 mg.
Science Finds Key to Autumn's Splendor
Autumn's joyous pageant of red, yellow and gold relies on a single protein, new research reveals.
The protein -- with the less-than-poetic name of FtsH6 -- degrades a second compound that spends most of the year holding tight to the green chlorophyll in leaves. As this compound (called LHCII) slips away, hidden pigments of red and yellow are revealed, explain researchers at Umea Plant Science Center in Sweden.
While LCHII is incredibly small, it is also one of the most abundant plant membrane proteins on earth, and each leaf or blade of grass is so full of the compound that the planet's forests appear as swaths of green from space.
But in temperate climes, deciduous leaves lose that green as the days turn shorter.
The Swedish researchers, in conjunction with a Polish scientist, sought to identify exactly which type of protein-degrading protease molecule breaks down LHCII and causes plants to turn color in autumn.
Reporting in a recent issue of the Proceedings of the National Academy of Sciences, the researchers started on the assumption the molecule belonged to the family of so-called FtsH proteases. They then used genetically modified plants in which various FtsH proteases had already been removed to conduct their study.
One plant variation lacking a key protease, FtsH6, was largely unable to break down LCHII. That suggests FtsH6 is crucial to seasonal chlorophyll removal, the researchers say.
All is not lost in this seasonal cycle, however: Proteins in dying leaves contain important amino acids that trees and other plants recycle, the researchers say. These amino acids are stored all winter in the tree's trunk, branches, roots and stems until next year -- when they are used to help grow new leaves in the spring.
Seniors face yet another increase in their health-care costs, thanks to the federal government.
The New York Times reported Saturday that basic Medicare premiums will go up again; this time the hike will be 13 percent, to $88.50 a month. Increased use of doctor's services is behind the latest increase, the Times reported.
Many beneficiaries will have to pay an additional premium for the much-touted new prescription drug benefit program, set to start Jan. 1, which should average $32 a month. The combined premiums will now average $120 a month, the Times reported.
Medicare premiums are typically deducted from monthly Social Security checks, which currently average $955 a month for retirees, the Times said. Medicare provides medical coverage to 42 million people who are older or disabled.
The basic Medicare premium has gone up by nearly $30 a month, or 51 percent, from 2003 to 2006, Kirsten A. Sloan, a health policy analyst at AARP, told the Times.
New Orleans Sludge Still Contaminated With Bacteria, Oil
Initial tests conducted on sediments taken after floodwaters receded in New Orleans show high amounts of E. coli bacteria and oil runoff from fuel and chemical plants, the U.S. Environmental Protection Agency said Friday.
E. coli indicates there is fecal bacteria in the water and exposed sediment, and contact with both should be avoided, Marcus Peacock, the EPA's deputy administrator, told reporters Friday at a news conference, the agency's second this week. He said 18 sediment samples taken on Sept. 10 represented the start of "extensive" testing, the Bloomberg news service reported.
And flooded parts of New Orleans, which was 80 percent under water after Hurricane Katrina, include more than 60 chemical plants, oil refineries, and petroleum storage facilities, Bloomberg said.
The Coast Guard said Thursday that Hurricane Katrina may have spilled more than 7 million gallons of oil, about two-thirds of what was released in the Exxon Valdez accident in 1989, according to the Associated Press.
Contact with fuel oils can lead to skin and eye irritation, increased blood pressure, and headache, Bloomberg said.
Officials told Bloomberg that the full extent of the contamination probably won't be known until the city is completely pumped out, which they say could take until mid-October.
Defibrillator Problems on the Rise: FDA Study
Malfunctions in implanted heart devices called defibrillators were increasing even before a huge recall this summer by Guidant Corp., according to a joint study released Friday by the U.S. Food and Drug Administration and Harvard University.
Defibrillators shock awkwardly beating hearts back into a normal rhythm. About 20 of every 1,000 devices malfunction, the researchers found. Those defects led to 31 deaths between 1990 and 2002, although that was a fraction of the more than 400,000 devices implanted during the span, the Associated Press reported.
Nonetheless, the study "points out the need for our agency to improve the way it regulates these products, and we're doing just that," Dr. Daniel Schultz, chief of the FDA's medical devices unit, told the AP.
The research was presented Friday at a daylong meeting of the Heart Rhythm Society in Washington, D.C., to discuss recent safety problems with defibrillators and other implanted cardiac devices, including pacemakers.
The study's leader, Dr. William Maisel of Harvard, found that from 1990 to 2002, 2.25 million pacemakers and 416,000 cardiac defibrillators were implanted in the United States. More than 17,000 of the devices had to be removed later due to malfunctions, the AP reported.
Equally troubling, 50 percent of the defibrillator malfunctions between 1990 and 2002 occurred within the last three years of that time period, the researchers said.
Guidant, and two other makers -- Medtronic and St. Jude Medical -- have recalled or issued warnings about more than 200,000 defibrillators since January, the wire service said. Guidant recently conceded that it waited three years before telling doctors and patients about an electrical defect in one of its models. The defect has been linked to two deaths, the AP reported.
Aspirin at Night May Lower Blood Pressure
Not only may daily aspirin prevent a heart attack, it could also lower blood pressure -- especially if taken at night, researchers have found.
Scientists from Spain, writing in the Sept. 20 issue of the Journal of the American College of Cardiology, said they randomly divided patients with mild hypertension into three groups: those who took aspirin in the morning, those who took it before bed, and those who didn't take aspirin at all.
After three months, blood pressure rose slightly among those who took aspirin in the morning, but fell in the group that took it at night. The group that didn't take aspirin at all saw only a very slight decline in blood pressure that wasn't statistically significant, the researchers at the University of Vigo said.
The authors and other experts said the results would have to be confirmed in future studies.
"Given the widespread use of aspirin, the prevalence of hypertension, and the ease in altering the time of aspirin administration, these results should be widely disseminated," Dr. Joseph Messer, from Rush University Medical Center in Chicago, said in a prepared statement from the American College of Cardiology. Messer wasn't directly connected to the research, the statement said.
Lipitor, Celebrex Lead Price Increases, U.S. Reports
The cholesterol-lowering medicine Lipitor and the pain drug Celebrex had the most impact on a 25 percent overall increase in U.S. retail drug prices from 2000 to 2004, says a federal government report.
The Government Accountability Office report said that the price of a 30-day supply of 96 drugs used by older people increased by 24.5 percent from January 2000 to December 2004, the Kansas City Star reported.
The study found that 20 of the 96 drugs accounted for nearly two-thirds of that increase. Of those 20 drugs, 19 were name-brand drugs and one was a generic drug.
"The drug with the largest effect on the price index was Lipitor 10 mg, which accounted for 6.6 percent of the total increase," the report noted. Celebrex had the second greatest impact on drug prices. Both are made by Pfizer Inc.
The other drugs in the top five were: blood thinner Plavix, made by Sanofi-Aventis SA and Bristol-Myers Squibb Co.'; the ulcer drug Prevacid, made by Abbott Laboratories and Takeda Pharmaceutical Co. Ltd.; and Pfizer's Lipitor 20 mg.
Science Finds Key to Autumn's Splendor
Autumn's joyous pageant of red, yellow and gold relies on a single protein, new research reveals.
The protein -- with the less-than-poetic name of FtsH6 -- degrades a second compound that spends most of the year holding tight to the green chlorophyll in leaves. As this compound (called LHCII) slips away, hidden pigments of red and yellow are revealed, explain researchers at Umea Plant Science Center in Sweden.
While LCHII is incredibly small, it is also one of the most abundant plant membrane proteins on earth, and each leaf or blade of grass is so full of the compound that the planet's forests appear as swaths of green from space.
But in temperate climes, deciduous leaves lose that green as the days turn shorter.
The Swedish researchers, in conjunction with a Polish scientist, sought to identify exactly which type of protein-degrading protease molecule breaks down LHCII and causes plants to turn color in autumn.
Reporting in a recent issue of the Proceedings of the National Academy of Sciences, the researchers started on the assumption the molecule belonged to the family of so-called FtsH proteases. They then used genetically modified plants in which various FtsH proteases had already been removed to conduct their study.
One plant variation lacking a key protease, FtsH6, was largely unable to break down LCHII. That suggests FtsH6 is crucial to seasonal chlorophyll removal, the researchers say.
All is not lost in this seasonal cycle, however: Proteins in dying leaves contain important amino acids that trees and other plants recycle, the researchers say. These amino acids are stored all winter in the tree's trunk, branches, roots and stems until next year -- when they are used to help grow new leaves in the spring.
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