Exercise and the Flu

Regular exercise may help ward off colds and flu.
The CNN (11/1, Gardner) "The Chart" blog reported, "Working out regularly helps ward off colds and flu," according to a study published online Nov. 1 in the British Journal of Sports Medicine.
HealthDay (11/1, Reinberg) reported that after collecting "data on 1,002 men and women from ages 18 to 85," investigators "tracked the number of upper respiratory tract infections the participants suffered" over 12 weeks during the fall and winter of 2008. Study participants also "reported how much and what kinds of aerobic exercise they did weekly."
The study authors found that "people who were physically fit and who engaged in exercise five or more days per week were about half as likely to suffer cold symptoms compared to participants who reported less physical activity," WebMD (11/1, Hendrick) reported. "What is more, researchers say the severity of symptoms fell by 41% among those who felt fittest and by 31% among the most physically active."
According to MedPage Today (11/1, Neale), "In addition to the number of days spent with an upper respiratory tract infection, the severity and symptomatology of such infections was reduced as well, by 32% to 41% between the high versus low aerobic activity and physical fitness.

Peanuts and Children

Children whose mothers ate peanut products during pregnancy more likely to test positive for peanut allergies.
The CNN (11/1, Landau) "The Chart" blog reported, "A new study in the Journal of Allergy and Clinical Immunology finds that children whose mothers ate peanut products during pregnancy were more likely to test positive for peanut allergies." Researchers at the Mount Sinai School of Medicine were quick to point out, however, that such children may not "actually show allergic symptoms, since the test does not indicate the strength of reaction." What's more, "most of the children in the study have not yet ingested peanuts, so it's not known what whether they actually have negative reactions to peanut-containing foods."
Still, investigators "found that among 503 infants who showed signs of milk and egg allergies aged three to 15 months, those whose mothers ate peanuts more than twice a week while they were pregnant had higher levels of antibodies to peanuts than those whose mothers ate peanuts less often," the Time (11/1, Park) "Healthland" blog reported.
Specifically, "the blood test measured levels of a protein known as IgE, which are elevated in people with peanut allergies," WebMD (11/1, Boyles) reported. But, again, "not everyone with high IgE levels is allergic." Nevertheless, the study authors concluded that "maternal consumption of peanuts during pregnancy was strongly predictive for this sensitivity." HealthDay (11/1, Preidt) also covered the study

Depression in Adolescents

Depression may recur in nearly half of treated adolescents.
The New York Times (11/2, D5, Belluck) reports, "About half of adolescents who recovered from major depression became depressed again within five years, regardless of what treatment or therapy they received to get over their initial depression," according to a study published online Nov. 1 in the Archives of General Psychiatry. What's more, the study "found that girls were more likely to have another major depression, which surprised researchers because, as adults, women have not been considered more likely to have a recurrence than men."
In their study of 196 teens, researchers from "Duke University Medical School, found that adolescents treated with fluoxetine (Prozac) alone, cognitive behavior therapy alone, or a combination of the two experienced the same recurrence rate as those treated with placebo in a five year follow up study, " the Time (11/1, Park) "Healthland" blog reported. "The teens showed a high rate of response to all of the treatments in the first few years, with 96% of them recovering from their initial depressive episode three and a half years later." However, "46% of those who recovered experienced another round of depression within two more years."
HealthDay (11/1, Gardner) reported, "Girls were more likely to suffer depression again than boys (about 58 percent versus 33 percent, respectively), as were teens with an anxiety disorder." Lead study author John Curry, PhD, theorized that, because girls "'have more anxiety...that might be the factor, because anxiety disorders also predicted recurrence. And it's generally true that girls have more anxiety disorders than boys,' Curry said."
In fact, overall, "teens who also had an anxiety disorder also had a higher risk of depression relapse (62% of those with an anxiety disorder had a relapse vs. 42% of those without)," WebMD (11/1, Warner) reported.
Children's mood, learning problems may be attributable to late night use of electronic media. USA Today (11/2, Szabo, Marcus) reports, "More than half of children who use electronic media before bedtime may have mood or learning problems during the day." In fact, "young people who used the most bedtime media -- from cellphones to video games -- were more likely to have attention-deficit hyperactivity disorder, anxiety, depression, and learning problems during the day," researchers at the JFK Medical Center Sleep Laboratory explained.

Binge Drinking and Heart Disease

Binge drinking may increase risk for heart attack, heart disease.
Bloomberg News (11/24, von Schaper) reports, "The French habit of drinking wine almost daily is less taxing to the heart than the Irish custom of downing an equivalent amount of beer on one or two nights a week," according to a study published Nov. 23 in the British Medical Journal. "Middle-aged men in Belfast had almost double the risk of developing heart disease, compared with French drinkers who spread their consumption over a week." Bloomberg News notes that the study "bolsters the findings of previous studies suggesting a link between ischemic heart disease...and drinking patterns."
WebMD (11/23, Hendrick) reported that after examining the "alcohol drinking patterns of 9,758 men in France and Belfast over a 10-year period," researchers found that "men who binge drink have nearly twice the risk of heart attack or death from heart disease than regular drinkers over a 10-year period." For study purposes, "binge drinking was defined as excessive alcohol consumption, or the equivalent of four or five drinks in a short period of time such as a weekend day."
HeartWire (11/23, Nainggolan) reported that an accompanying editorial noted, "Middle-aged men should be made aware that if they are irregular heavy drinkers, the possible cardioprotective properties of alcohol consumption may not apply to them, and in contrast they may be putting themselves at increased risk of having a heart attack."
Alcohol-related problems send nearly 1,000 college-age students to EDs each year. The Boston Globe (11/23, Johnson) "White Coat Notes" blog reported, "Alcoholic drinks that contain caffeine are banned from store shelves in Massachusetts, but new data shows that even before concerns about Four Loko amped up, alcohol-related problems sent nearly 1,000 college-age students to the emergency room each year." According to investigators with the Boston Public Health Commission, the "largest number of alcohol-related visits were by 18- and 19-year-olds. The number of visits was highest from September to November, early in the school year, and least common during the summer."
Analysis: Children can benefit from weight training.
The New York Times (11/24, Reynolds) "Well" blog reports that in a "Pediatrics review, researchers with the Institute of Training Science and Sports Informatics in Cologne, Germany, analyzed 60 years' worth of studies of kids and weightlifting. The studies covered boys and girls from age 6 to 18." The investigators "found that, almost without exception, children and adolescents benefited from weight training. They grew stronger." Meanwhile, "older kids, particularly teenagers, tended to add more strength than younger ones, as would be expected, but the difference was not enormous."

Best Glycemic Control Exercise

Combination of aerobic, resistance training may provide better glycemic control.
The AP (11/24) reports that, according to a study published in the Nov. 24 issue of the Journal of the American Medical Association, "people with diabetes should mix aerobics with weight training to get the best results in lowering blood sugar." What's more, "the combination worked best for weight loss too, compared to aerobics or weight training alone."
"The study participants were made up of 262 sedentary men and women who had type 2 diabetes and hemoglobin A1C levels of at least 6.5%," the Los Angeles Times (11/23, Stein) "Booster Shots" blog reported. "The men and women, average age about 56, were divided into three groups for the nine-month study: one that did resistance training, one that did aerobic training, one that did both, and a control group that did not do any exercise." Participants "in the exercise groups worked out for about 140 minutes per week."
HealthDay (11/23, Gordon) reported, "At the end of the study, the combination group had lowered their HbA1C levels by 0.34 percent compared to the control group, while the aerobic group went down 0.24 percent and the resistance-only group went down 0.16 percent." But, "the only change that was considered statistically significant, according to the study, was the combination group's change."
WebMD (11/23, Warner) pointed out that "fewer of the people in the combination exercise group needed to increase the amount of medications they required to control their disease, compared with the other groups." In fact, "39% of non-exercisers had to increase these medications, compared with 32% in the resistance training group, 22% in the aerobic exercise group, and 18% in the combination group."
According to MedPage Today (11/23, Neale), an accompanying editorial noted "that, given a specific amount of time to invest in exercise, it is more beneficial to devote some time to each form of exercise rather than devoting all the time to just one form of exercise." The Wall Street Journal (11/24, Dooren, subscription required) also covers the story.

New Pill to Reduce HIV Risk

Study finds daily pill lowers risk of HIV infection.
ABC World News (11/23, story 5, 1:25, Sawyer) reported "a major announcement in the fight against AIDS. A drug" now "has doctors everywhere using the word breakthrough." The CBS Evening News (11/23, story 5, 0:25, Couric) reported, "A new study finds Truvada [emtricitabine and tenofovir disoproxil fumarate], a pill that treats HIV infection, can also prevent the virus from spreading. Researchers say giving Truvada to high-risk men along with counseling and condom use reduced their risk of getting HIV by an average of 44%." NBC Nightly News (11/23, story 8, 0:35, Williams) reported, "Experts say the finding could lead to wider use of the drug for high-risk patients but they emphasize one important thing. It's not a reason for anyone to abandon standard HIV prevention measures."
On its front page, the New York Times (11/24, A1, McNeil) reports, "In the study, published Tuesday by the New England Journal of Medicine, researchers found that the men taking Truvada, a common combination of two antiretroviral drugs, were 44 percent less likely to get infected with the virus that causes AIDS than an equal number taking a placebo." The "results are the best news in the AIDS field in years, even better than this summer's revelation that a vaginal microbicide protected 39 percent of all the women testing it and 54 percent of those who used it faithfully."
According to the Time (11/23, Park) "Healthland" blog, "Fauci is particularly encouraged by the data, since a closer look at the difference in HIV infection rates among those taking medications suggests that any exposure to the potent anti-HIV drugs can be effective in thwarting infection." For example, "among those in the drug arm, the volunteers who showed any measurable level of medication, no matter how faithfully they were popping their daily pills, had a 13-fold lower rate of HIV infection than those who showed no measurable level of drug in their system." Fauci added "that more research will be needed to assess the effectiveness of the drugs in preventing infection among women, as well as heterosexual men."
The AP (11/24) also quotes Fauci, who said, "'This is an exciting finding...but is only one study in one specific study population,' so its impact on others is unknown."
The Boston Globe (11/24, A1, Cooney) reports on its front page, "Researchers had feared the pills might give a false sense of security and make men less likely to use condoms or to limit their partners, but the opposite happened -- risky sex declined."
The Washington Post (11/24, Brown) reports that the study "adds to a growing menu of strategies for preventing infection in ways other than by urging people to change their behavior. While globally the AIDS epidemic is starting to ebb, gay men remain a risk group in which rates of infection are growing in both rich countries and the developing world." The Wall Street Journal (11/24, McKay, Marcus, subscription required), Bloomberg News (11/24, Bennett, Waters), HealthDay (11/23, Gardner), WebMD (11/23, DeNoon), the San Francisco Chronicle (11/24, A1, Allday), Medscape (11/23, Lowes), ABC News (11/23), the Los Angeles Times (11/23, Maugh) "Booster Shots" blog, the CNN (11/23, Young) "The Chart" blog, and the NPR (11/23, Fulton) "Shots" blog also covered the story.
UNAIDS report says global AIDS epidemic slowing. USA Today (11/24, Sternberg) reports, "The global AIDS epidemic has taken a turn for the better with fewer new infections than a decade ago, but overall progress is slow and much work lies ahead, the United Nation's leading AIDS agency reported Tuesday." A "new report by UNAIDS says that 2.6 million people became infected with HIV, the AIDS virus, in 2009, about 20% fewer new infections than 1999 when the epidemic was at its peak." The report "comes a day after researchers reported that a daily dose of a widely available HIV drug, Truvada [emtricitabine and tenofovir disoproxil fumarate], can prevent infections in gay and bisexual men."
Gilead asks FDA to approve HIV single pill treatment combination. The AP (11/24) reports, "Drugmaker Gilead Sciences Inc. said Tuesday it asked the Food and Drug Administration to approve a single pill combination of its HIV treatment Truvada and Tibotec Pharmaceuticals' rilpivirine."

Marijuana and Brain Development

Study says smoking marijuana may have long-lasting effects on brain development.
USA Today (11/20, Marcus) reported, "Teenagers respond differently to drugs than adults, and early use may lead to long-lasting effects on brain development, according to new research." Staci Gruber, of Harvard Medical School, presented the study "at the Society for Neuroscience meeting, in San Diego last week," noting "people who start using marijuana at a young age have more cognitive shortfalls." Gruber "evaluated 29 non-smokers and 35 chronic marijuana smokers," and said she found that "while the smokers performed tasks quickly, they did not learn from their errors when corrected -- a hallmark that the part of the brain that governs executive function is impaired." Notably, "functional magnetic resonance imaging (fMRI) backed that up." Data from the National Institute on Drug Abuse show that "marijuana is the most commonly used illegal drug in the US with 25.8 million Americans ages 12 and older reporting at least one instance of abuse in 2008."

Tele Medicine

Use of telemedicine growing.
American Medical News (11/22, Krupa) reports, "Nationwide, telemedicine increasingly is being used to bridge gaps in access to care in rural and other medically underserved communities that have a hard time recruiting physicians." For instance, "140 of 153 VA hospitals nationwide have telemedicine capabilities," and "such consults reduce patient transfers, allow local doctors to respond more quickly to their patients' needs, and save patients time and money by eliminating the need to take off work or school to travel long distances for care." Notably, CMS "is making changes to promote telemedicine. In June, the agency proposed new policies that would make it easier for hospital officials to credential physicians who provide telemedicine services at their facilities," and next year, "CMS will expand Medicaid coverage for remote services, including disease management training for patients with diabetes or kidney disease."

Darvocet Dilemma

Propoxyphene, acetaminophen and propoxyphene painkillers pulled from market over heart risks after FDA recommendation.
The Los Angeles Times (11/19, Zajac) reported, "The maker of Darvon [propoxyphene] and Darvocet [acetaminophen and propoxyphene] announced Friday that it will stop marketing the widely used painkillers in the US because of a new study linking the active ingredient in the drugs to serious and sometimes fatal heart rhythm abnormalities." Xanodyne Pharmaceuticals Inc. "agreed to the ban at the request of the Food and Drug Administration, which also asked makers of generic versions of the drugs' core compound, known as propoxyphene, to stop selling it in the US."
Bloomberg News (11/19, Peterson) reported Xanodyne "will withdraw Darvon and Darvocet, a product that combines Darvon's active ingredient with acetaminophen." The FDA "requested the move after evaluating study data, and asked makers of generic versions to take them off the market as well." Xanodyne's "new clinical research, combined with new epidemiological data, led the FDA to conclude that propoxyphene's benefits no longer outweigh its risks, said John Jenkins, director of the agency's Office of New Drugs."
The AP (11/19) reported, "Britain and the European Union decided to ban Darvon in 2005 and 2009, respectively, due to a long trend of suicides and accidental overdoses." The FDA said it "decided to take action based on a recent study showing Darvon interferes with the electrical activity of the heart, causing irregular heart rhythms that can be fatal. Xanodyne conducted the study last year at the government's request."
The Washington Post (11/19, Stein) reported, "The FDA has received two requests to remove the drug from the market since 1978 but had previously determined the benefits outweighed the risks." Consumer advocates "welcomed the announcement but sharply criticized the agency for failing to act sooner." The New York Times (11/19) "Prescriptions" blog, the Wall Street Journal (11/20, Dooren, subscription required), HeartWire (11/22), and the CNN (11/19) "The Chart" blog also reported the story.

New Weight Loss Drug

FDA panel recommends approval for naltrexone and bupropion weight-loss drug.
ABC World News (12/7, story 6, 0:20, Sawyer) reported, "Big news on a diet drug tonight. After two drugs were rejected recently, a panel of advisers today recommended the FDA approve a pill called Contrave (naltrexone and bupropion), which is both an anti-depressant and acts to block addictive behavior."
The Los Angeles Times (12/8, Healy) reports, "An advisory panel to the Food and Drug Administration set aside lingering concerns about the safety and marginal effectiveness of the latest weight-loss drug to come before it, voting 13 to 7 on Tuesday to recommend the approval of Contrave, a combination of two medications available since the mid-1980s." The "vote made Contrave the first of three weight-loss drugs reviewed by the FDA panel in 2010 to win favor." In four different "clinical trials presented to the panel at Tuesday's meeting outside Washington, Contrave was found to have helped obese subjects lose more weight than a dummy pill."
Bloomberg News (12/8, Larkin) reports Orexigen Therapeutics Inc. and partner Takeda Pharmaceutical Co. "avoided safety concerns that delayed competing products from Arena Pharmaceuticals Inc. and Vivus Inc. in October." The FDA "hasn't approved a prescription diet pill since 1999 for the almost two-thirds of US adults who struggle with their weight."
The AP (12/8) reports, "Experts had voiced safety concerns on the drug, but determined the benefits outweigh the risks." FDA scientists "are concerned over Contrave's effects on the heart, an issue that has weighed heavy on potential weight loss drugs." The complaints "focused on the company's lack of elderly patients with a history of heart disease in clinical trials. That lack of data made it difficult to determine the drug's safety in patients at risk for heart attack and stroke."
The San Diego Union-Tribune (12/8, Calbreath) adds, "Contrave is no silver bullet against obesity. Clinical studies show that most users can only expect a weight loss of 5 percent to 10 percent, with even higher losses achieved with diet and exercise." Many "experts on obesity said that even a 5 to 10 percent weight loss is a significant first step in combating obesity." The Wall Street Journal (12/8, Dooren, subscription required), the New York Times (12/8) "Prescriptions" blog, and the Washington Post (12/8, Stein) "The Checkup" blog also report the story.

Food Allergy Guidelines

Newly released guidelines aim to standardize diagnosis, management of food allergy.
On the front of its Personal Journal section, the Wall Street Journal (12/7, D1, Beck, subscription required) reports in "Health Journal" that at present, pulmonologists, emergency physicians, dermatologists, gastroenterologists, pediatricians, and allergists diagnose and manage food allergies in a wide variety of ways. What's more, some tests on the market have not been scientifically validated, while the results of others are often misinterpreted. Such realities make it difficult to gauge the number of Americans suffering from food allergies.
In fact, there are "wildly divergent estimates of food allergies that range from 1% to 10% of the US population," the Los Angeles Times (12/7, Roan) reports. "Most likely, about 3% to 4% of Americans have some type of food allergy, although the prevalence appears to be increasing for unknown reasons, said Dr. Hugh A. Sampson, a professor of pediatrics at Mount Sinai School of Medicine in New York and past president of the American Academy of Allergy, Asthma & Immunology." In other words, "as many as 50% to 90% of people with presumed food allergies do not in fact have them, medical research suggests."
Now, however, newly released guidelines may eventually get "everyone on the same page when it comes to diagnosing and treating food allergies," the Washington Post (12/6, Huget) "The Checkup" blog reported. "An expert panel working with the National Institute of Allergy and Infectious Diseases (NIAID) compiled the comprehensive guide published...in the Journal of Allergy and Clinical Immunology." Again, the "goal was to provide healthcare professionals, whether they be allergy specialists, ED personnel, or general practitioners, up-to-date, science-based information about managing food allergies."
Altogether, "43 recommendations" were released, HealthDay (12/6, Reinberg) reported. "One thing the guidelines try to do is delineate which tests can distinguish between a food sensitivity and a full-blown food allergy, Sampson noted." Yet, the "two most common tests done to diagnose a food allergy -- the skin prick and measuring the level of antigens in a person's blood -- only spot sensitivity to a particular food, not whether there will be a reaction to eating the food. To determine whether the results of these two tests indicate a true allergy, other tests and a food challenge are often needed."
For those who are eventually diagnosed and react to a specific foodstuff, the "recommended therapy for anaphylaxis is described in the guidelines," Medscape (12/6, Hitt) reported. "Dr. Sampson stressed that 'epinephrine is the first choice for the treatment of anaphylaxis and many of the other drugs, such as antihistamines, corticosteroids, and such, are secondary medications.'"
Investigators also pointed out that "food elimination diets -- taking away one or a few specific foods to see if the reaction disappears -- may help," WebMD (12/6, Doheny) reported. "Oral food challenges -- exposing the person to the suspected food under medical supervision -- are thought to be helpful." As for prevention, "some pregnant women may hope restricting their diets during pregnancy or during breastfeeding may help their children avoid allergies," but the "experts disagree and don't recommend this." They fail to endorse "soy formula as a strategy for preventing the development of allergies," as well.
Notably, MedPage Today (12/6, Neale) reported, the recommendations "are meant to be easily understood and implemented by clinicians in varied specialties, according to Matthew Fenton, PhD, of the NIAID's Division of Allergy, Immunology, and Transplantation." He added, "We were very specifically looking to generate a document that was not written by allergists for allergists."
Dr. Fenton also explained that the "agency is now working on a summary for consumers," the CNN (12/7, Young) "The Chart" blog reported. "It's important for patients and their families to understand that the symptoms of food allergy can mimic several other very legitimate diseases such as food intolerance and gastrointestinal problems. It is important for them to work with their doctors so they can identify the true root cause of the health affect caused by food." The Wall Street Journal (12/6, Hobson, subscription required) "Health Blog" also covered the story.

Screening for Depression

Many primary-care physicians now screening patients for depression.
On the front of its Personal Journal section, the Wall Street Journal (12/7, D1, Landro, subscription required) reports in "The Informed Patient" that many primary-care physicians are now routinely screening patients for depression using specially designed questionnaires, such as the Patient Health Questionnaire 9 (PHQ-9) for that purpose. Such screening may help improve treatment rates. In 2009, the Substance Abuse and Mental Health Services Administration found that fewer than 38% of US adults with a mental illness got any sort of treatment at all. The article goes on to explain how depression often goes hand-in-hand with physical problems, such as obesity, diabetes, or heart disease.
Mindfulness therapy may be as effective as antidepressants in protecting against depression relapse. The CNN (12/6, Landau) "The Chart" blog reported, "A new study published [in] the Archives of General Psychiatry finds that depression patients in remission who underwent mindfulness therapy did as well as those who took an antidepressant, and better than those who took a placebo." In other words, "that means that mindfulness therapy was as effective as antidepressants in protecting against a relapse of depression." The blog entry explained that "mindfulness generally refers to the concept of being present and in the moment."

Asprin to Prevent Cancer

Aspirin may be more effective at preventing cancer deaths than previously thought.
NBC Nightly News (12/6, story 7, 2:20, Williams) reported, "In the advertisements for aspirin, on this and other broadcasts, they for years have called it a wonder drug, and a good many doctors believe it is something of a wonder." What's more, "millions of people take a half aspirin every day, for example, for heart health." Now, a newly published paper in The Lancet indicates that "aspirin may be much more effective than anyone knew at helping prevent cancer deaths."
The "stunning finding came while researchers were studying 25,000 people taking daily aspirin to prevent heart disease," ABC World News (12/6, story 3, 2:15, Sawyer) reported. "It turns out aspirin was doing something else, reducing the death rate from cancer as well." In fact, "in the trials where people have taken aspirin four, five, six, seven years on average, the risk of dying of cancer was reduced by about 25%."
So, asked the CBS Evening News (12/6, story 5, 2:00, Smith), "Should everyone take low-dose aspirin? Today the American Cancer Society said no and that 'it would be premature to recommend people start taking aspirin specifically to prevent cancer,'" considering that "even low dose aspirin can lead to dangerous internal bleeding. Still, evidence that it might help fight cancer is intriguing for doctors."
Researchers at Oxford reached that conclusion after examining "the cancer death rates of 25,570 patients who had participated in eight different randomized controlled trials of aspirin that ended up to 20 years earlier," the New York Times (12/7, A16, Rabin) reports. "Participants who had been assigned to the aspirin arms of the studies were 20 percent less likely after 20 years to have died of solid tumor cancers than those who had been in the comparison group taking dummy pills during the clinical trials, and their risk of gastrointestinal cancer death was 35 percent lower. The risk of lung cancer death was 30 percent lower, the risk of colorectal cancer death was 40 percent lower, and the risk of esophageal cancer death was 60 percent lower."
Only "one-third of people in the analysis were women -- not enough to calculate any estimates for breast cancer," the AP (12/7) points out. And, "there appeared to be no benefit to taking more than 75 milligrams daily -- roughly the amount in a European dose of baby aspirin and a bit less than the baby aspirin dose in the US."
In addition, "aspirin was not found to [significantly] influence the risk of death from pancreatic, prostate, bladder, kidney, brain, or blood cancers," the Los Angeles Times (12/7, Maugh) reports. Yet, lead investigator Dr. Peter M. "Rothwell noted that most of the subjects stopped taking aspirin at the end of the study -- or, alternatively, many in the control group began taking it -- potentially confusing the results." He added that "'it's likely that if people had carried on taking aspirin,' the benefit would have been greater."

iPod Health Apps

Mobile health apps being used increasingly.
The Baltimore Sun (12/4, Sentementes) reported, "One of the current buzzwords in healthcare technology is 'mHealth,' for mobile health. At its simplest, the concept encompasses regular text messages to pregnant mothers charting the baby's growth." Yet, "boosters envision more complex applications that would integrate medical devices, wireless networks and mobile phones to reach large segments of the population and help them manage their health and ailments." Already, "Rockville-based CTIS, Inc...is working with Walter Reed Army Medical Center to design an app called 'mWarrior' for soldiers suffering from post-traumatic stress disorder to use on smart phones," while "Baltimore-based WellDoc has devised an application that allows users to wirelessly connect blood glucose meters to their cell phones."

Mammogram Controversy

Annual mammograms may reduce mastectomy risk for women in their 40s.
The Los Angeles Times (12/3, Forgione) "Booster Shots" blog reported, "For women in their 40s, a new study suggests that annual mammograms may reduce the risk of having a mastectomy." The subject has generated considerable "controversy over the past few years," with the US Preventive Services Task Force and the American Cancer Society making their separate recommendations. This latest recommendation is based on "a British study of 971 women between 40 and 50 years old who had been diagnosed with breast cancer."
Investigators eventually discovered "that among the women who had a mammogram in the preceding year, only 22% needed a mastectomy, compared with 52% who had mammographies done more than a year before," MedPage Today (12/3, Fiore) reported. "Women who'd been screened in the preceding year also had smaller tumors -- 17.8 mm, on average, compared with 24 mm for those who'd had mammography more than a year before and 29 mm for those who'd never had one. They also had less multifocal disease -- 12% versus 36% for those never screened (P=0.003) -- and less high-grade disease (31% versus 46%, P=0.03)."
Anger lingers over mammogram recommendations. CNN (12/3, Landau) reported, "If you're a woman in your 40s, you probably remember how checking the health of your breasts became a point of national contention last year." Many "fought back...when the United States Preventive Services Task Force recommended that women with average breast cancer risk begin biannual mammograms at 50." The "American Cancer Society, the American College of Radiology...and other organizations have continued to support women getting yearly mammograms from 40 onward," and recent research "has continued to suggest that women in their 40s need annual mammograms." Although "the situation has calmed down," many remain angry about the revised recommendations.

Healthy Diet to Avoid Cancer

British researcher discusses value of fruits and vegetables to ward off cancer.
The Los Angeles Times (12/2, Stobart) "Booster Shots" blog reported, "Health writers in the Guardian and Telegraph homed in on the British Journal of Cancer this week, which published summarized findings of a decade-long research project investigating the value of a wide-ranging fruit and vegetable diet in warding off cancer." The blog entry noted that "initial studies in the 1990s claimed that a limited number of case-controlled studies showed that those with a low intake of fruit and vegetables were at greater risk of developing cancer." However, "more specific studies from 1997 to 2007, including research from the American Institute for Cancer Research, concluded that larger intakes of fruit and vegetables offered no greater protection."

Exercise and Alzheimers

Researchers explain why exercise may help reduce risk for Alzheimer's.
The Milwaukee Journal Sentinel (12/2, Fauber) "Health& Science Today" blog reported that in a study published online Dec. 2 in the journal Circulation Research, scientists from the Mayo Clinic have explained "why exercise may help reduce the risk of Alzheimer's disease." By "using endothelial cells from tiny blood vessels from the human brain, the researchers chemically inhibited the production of an enzyme needed to produce nitric oxide."
HealthDay (12/2, Preidt) reported that "endothelial dysfunction increases production of proteins that provide the raw material for the amyloid plaques seen in the brains of people with Alzheimer's disease." The study's senior author explained that exercise stimulates "the endothelium to produce more nitric oxide. What we have identified in this paper may help explain the reported (cognitive) benefit of exercise."

High Risk Behaviour and Infidelity

Genes associated with sensation-seeking behaviors may also be associated with sexual promiscuity, infidelity.
According to the Time (12/2, Kluger) "Healthland" blog, "infidelity -- and, for that matter, any act of fleeting, uncommitted sex -- always has an element of risk about it." In order "to determine just what might distinguish people who are thrilled by sexual risk from people who recoil from it," researchers from Binghamton University started their search by looking at the "DRD4 gene, which helps regulate dopamine receptors." The scientific community is well aware that that the "DRD4 gene is involved in thrill-seeking behaviors such as gambling and drinking, and" lead study author Justin "Garcia suspected it might play a role in high-wire sex too."
Investigators then "interviewed 181 young adults, asked them about their sexual behavior and relationships, and took samples of their DNA," WebMD (12/2, Woznicki) reported. They eventually discovered that "people with a genetic variation of DRD4 called 7R+ were more likely to commit infidelity or be promiscuous; 50% of people with 7R+ reported being unfaithful, compared with 22% of people who did not have this genetic variation." According to the paper in PLoS ONE, "gender did not play a role in genetic variation; 23% of women and 26% of men in the group were found to have the 7R+ genetic variation."

Medication Compliance

Boston Globe: Physicians should help patients maintain medication regimens.
The Boston Globe (12/3) editorializes, "Patients who don't take their medications are a well-documented problem in medicine. If doctors are to spot patients who might stop complying with prescriptions, it's vital to have a fuller understanding of why and how it happens." A new study "in the Annals of Internal Medicine, by researchers at Brigham and Women's Hospital and Harvard Medical School, shines the spotlight on another contributor: Patients not picking up prescriptions that have already been filled." And "not surprisingly, prescriptions with $40 to $50 co-pays were the most likely to be abandoned." The Globe concludes, "Doctors are unlikely to know their patients' co-pays for drugs, but taking the time to talk about drug costs would help them identify those who might never pick up their prescriptions," which could cut costs and save lives.

Snoring Health Risks

People who snore, have trouble falling asleep may have increased risk of metabolic syndrome.
Bloomberg News (12/1, Lopatto) reports that, according to a study published in the journal Sleep, "people who snore, have trouble falling asleep, or who wake up in the morning feeling fatigued have an increased risk of developing conditions tied to diabetes and heart disease." In a study of 812 people, researchers found that "adults who reported frequent loud snoring had twice the risk of developing metabolic syndrome -- conditions that include obesity, high blood pressure, and diabetes -- during a three-year follow-up period, compared with quieter sleepers." What's more, "the risk jumped 80 percent in people who had difficulty falling asleep and 70 percent in those who said their sleep wasn't refreshing."

Autism Genetic Update

Autism associated with defects in mitochondria.
The Los Angeles Times (11/30, Maugh) "Booster Shots" blog reported that, according to a study published in the Dec. 1 issue of the Journal of the American Medical Association, children with autism may "have a high incidence of defects in mitochondria, the 'powerhouses' of cells." For the study, researchers from the University of California-Davis "enlisted 10 autistic children, ages two to five...and 10 healthy children of the same age." They found that "one of the 10 autistic children had a full-blown mitochondrial respiratory disease -- a much higher rate than is seen in the normal population -- and that more than half of them had some problems with their mitochondria."
"Mitochondrial dysfunction been implicated in neurological conditions ranging from Parkinson's and Alzheimer's disease to schizophrenia and bipolar disorder," HealthDay (11/30, Goodwin) pointed out, noting that "there are many unknowns, including how mitochondrial dysfunction in brain cells might alter brain function in a way that leads to some of the symptoms of autism, including communication and social difficulties." The study authors "also don't know when the mitochondrial dysfunction starts -- in the womb, in infancy or later, and how that might impact the onset of autism or what other environmental or genetic factors may also contribute."
Nevertheless, WebMD (11/30, Boyles) reported, "based on their findings and those of earlier studies, the researchers concluded that the incidence of mitochondrial disease may be 550 to 770 times higher in autistic children than in the general population." MedPage Today (11/30, Neale) also covers the story.

Childrens OTC Medication Dosing

Dosing instructions for OTC medicines for children confusing, hard to follow.
The Los Angeles Times (12/1, Roan) reports that, according to a study published online Nov. 30 in the Journal of the American Medical Association, "many over-the-counter, liquid medications meant for children contain dosing instructions and measuring cups or droppers that rarely match each other and could confuse even the most careful parent or caretaker." As a result, "this could easily lead to under- or over-dosing, with potentially dangerous consequences, researchers said."
"Twenty-six percent of products had no dispensers, such as a cup or medicine dropper, forcing parents to measure out doses themselves," USA Today (12/1, Szabo) reports. "But even products with dispensers had problems." For example, "label instructions on 99% of these products conflicted with markings on the dispensing cup or dropper."
Bloomberg News (12/1, Cortez) reports that last year, the Food and Drug Administration issued voluntary industry "guidelines (pdf) for the labels on nonprescription liquid children's medicines and measuring devices...after numerous overdoses were attributed to confusing labels." The results of this new study, which was conducted by "Shonna Yin, a pediatrician at the New York University School of Medicine and Bellevue Hospital Center," may now "be used to evaluate how well companies that make over-the-counter children's medicines improve their products, the researchers said."
The Columbus Dispatch (12/1, Crane) reports that in an accompanying editorial suggested that "uniform use of milliliters as a measurement would help reduce errors and ensure that parents don't get confused or reach for a spoon when given directions based on teaspoons."

Prostate Cancer Update

Active surveillance for low-risk prostate cancer may provide better QoL.
The Los Angeles Times (11/30, Kaplan) "Booster Shots" blog reported, "Last year, about 192,000 American men were diagnosed with prostate cancer," and "for 16% to 40% of them, the disease is deemed to be so low-risk that no immediate medical intervention is necessary. Instead, they can undergo 'active surveillance.'" Now, new research reveals that "too many men are passing up a good thing."
The study detailed in the Journal of the American Medical Association "'isn't designed to tell people what is best," Harvard Medical School's Julia Hayes told Bloomberg News (12/1, Ostrow). "It is designed on an individual level to provide a starting point for discussion between the physician and the patient," she added. "Sixty percent of men who are screened and diagnosed are over-treated," yet, "those men would be reasonable candidates for active surveillance if they and their doctor are comfortable with that approach."
Before reaching those conclusions, "Hayes and colleagues developed a model to look at the quality-of-life benefits and risks associated with active surveillance, internal radiation therapy (brachytherapy), intensity-modulated radiation therapy (IMRT), or radical prostatectomy in a hypothetical group of men aged 65 who were diagnosed with localized, low-risk prostate cancer," WebMD (11/30, Mann) reported. "Men aged 65 with low-risk prostate cancer who chose active surveillance (with IMRT if the cancer progressed) scored highest in terms of quality-adjusted life expectancy (QALE)." In fact, "this strategy produces 11.07 quality-adjusted life-years (QALY)."
In comparison, "brachytherapy produced a 10.57 QALYs rating, followed by IMRT at 10.51 QALYs, and surgery to remove the prostate at 10.23 QALYs," HealthDay (11/30, Gardner) reported. "QALYs are a measure often used by scientists to indicate 'the number of good quality years of life left,' explained" an expert not involved in the study, "and therein lie some of the complexities of translating these findings into the real world of real men." In other words, said Duke University Medical Center's Dr. Stephen Freedland, "it depends on your definition of 'good.'"
The authors of an accompanying editorial pointed out, "as did the authors of the paper, that individual patient preferences still play a central role in the decision, particularly for those for whom anxiety caused by active surveillance would result in a relatively low quality of life," MedPage Today (11/30, Phend) reported. The study authors also "noted that they had been conservative in modeling, potentially exaggerating the uncertainty in the results. But, despite the 'substantial uncertainty surrounding this clinical question, active surveillance appears to be a reasonable alternative to initial treatment,' they concluded." The Wall Street Journal (11/30, Hobson, subscription required) "Health Blog" also covered that study.
Men with long index fingers may be less likely to develop prostate cancer. Bloomberg News (12/1, Fourcade) reports, "Men with long index fingers are at lower risk of prostate cancer," according to a paper in the British Journal of Cancer. "Scientists in the UK who compared the hands of 1,500 prostate cancer patients and 3,000 healthy men found that those whose index was longer than their ring finger were 33 percent less likely to develop the potentially fatal disease." Investigators pointed out that "finger length is set before birth, influenced by the level of sex hormones babies are exposed to in the womb." And, a "longer index finger points to less testosterone, which may protect against cancer later in life, they said."
Prostate gland swelling after seed insertion may prompt migration. MedWire (11/30, Guy) reported "that seed migration after prostate cancer treatment with brachytherapy (BRT) is common, and may be caused by the swelling of the prostate gland after seed insertion," according to a paper in the Japanese Journal of Clinical Oncology. "Among the 62 BRT patients in the study, 69.4% had experienced seed migration 30 days after the seeds were implanted," researchers at the National Center for Global Health and Medicine explained. "They add that the percentage of prostate swelling differed significantly between the pre-BRT monitoring scans and initial post-BRT scans."

Best Diet Advice

Study finds benefits of high protein, low carb diet for keeping weight off.
The AP (11/29) reports, "More turkey, less white bread and mashed potatoes. Just in time for holiday feasting, a large study found that diets higher in protein and lower in carbohydrates can help overweight adults who managed to drop some weight keep it off." European researchers "led by Denmark's University of Copenhagen" write in a study in Thursday's New England Journal of Medicine that "diets rich in lean meats, poultry and beans, and low in starchy carbs appear 'to be the ideal for the prevention of weight regain.'"
MedPage Today (11/24, Walsh) reported that among participants "who completed an eight-week, low-calorie weight loss phase and then entered a maintenance phase in which they consumed diets with variations in protein content and glycemic index, weight regain was 0.93 kg higher, a statistically significant difference, in those on low-protein diets compared with those on high-protein diets (95% CI 0.31 to 1.55, P=0.003)." Weight "regain also was higher by 0.95 kg (95% CI 0.33 to 1.57, P=0.003) in participants who consumed a diet with a high glycemic index, according to Thomas Meinert Larsen, PhD, from the University of Copenhagen, and colleagues."
HealthDay (11/24, Doheny) reported that "with his colleagues, Larsen evaluated 938 adults with an average body-mass index (BMI) of 34, which is considered obese. In all, 773 completed the initial weight-loss phase and then were assigned to one of five different maintenance plans." Those "on the low-GI diet had an average weight regain of 2 pounds less than those on the high-GI diet."
HeartWire (11/25, Wood) reported Dr. Larsen said "whether that ability to maintain a healthy weight-or the means used to attain it-have implications for the heart remains to be seen." Larsen said, "So far we have looked at body-weight maintenance: whether that translates into a lowered cardiovascular risk, this is of course too preliminary to say."
The Boston Globe (11/29, Cooney) reports after "six months, people who followed the high-protein, low glycemic index diet were more likely to keep their weight stable or continue to lose weight than the people who ate a low-protein, high glycemic index diet. The difference between the groups averaged about five pounds." Perhaps "equally important, only a quarter of the people in the high-protein, low glycemic index group dropped out of the study compared with a third of those in the low-protein, high glycemic index group."
Glycemic index remains opaque concept for consumers. The Los Angeles Times (11/29, Roan) reports diet researchers "reported Thursday that a high-protein, low-glycemic-index diet may work best for maintaining a weight loss," but "they concede that many people may not understand just how to achieve such a diet." While it's "easier to understand which foods are high in protein -- eggs, turkey and dairy products -- knowing the glycemic index (GI) of foods can be trickier. Moreover, just because a food is low on the glycemic index doesn't mean it's more healthful, said the authors of the Diogenes study, published Thursday in the New England Journal of Medicine."

Second Hand Smoke Stats

Secondhand smoke sickens millions, kills more than 600,000 people worldwide each year.
USA Today (11/27, Szabo) reported, "Secondhand smoke sickens millions and kills more than 600,000 people worldwide each year, including more than 165,000 children under 5, according to the first report to estimate the worldwide burden of disease and death from tobacco." After looking at data collected from 192 countries, investigators with the World Health Organization "found more than half of the deaths are from heart disease, followed by deaths from cancer, lung infections, asthma and other ailments." The team also noted that "more than two-thirds of the children's deaths are in Africa and Asia, where they have less access to important public health services, such as vaccines, and less advanced medical care."
And the "mix of infectious diseases and secondhand smoke is a deadly combination," lead investigator Armando Peruga told the AP (11/29). The researchers also pointed out in their Lancet paper that "secondhand smoke had its biggest impact on women, killing about 281,000. In many parts of the world, women are at least 50 percent more likely to be exposed to secondhand smoke than men.
According to the CNN (11/26, Falco) "The Chart" blog, "researchers believe more needs to be done to create complete smoke-free indoor environments at work, in public places and on public transportation." Specifically, "educating and empowering women can make a big difference is protecting children and non-smoking adults from the deadly effects of secondhand smoke." Bloomberg News (11/26, von Schaper) also covered the study.

High Deductible Health Plans

Costs forcing more Americans to select high-deductible health plans.
NBC Nightly News (11/28, story 5, 2:20, Morales) reported, "This is the time of year when millions of Americans are asked to make their annual choices for health insurance. With the cost of healthcare skyrocketing, more and more people are forced to accept deductibles so high they end up paying most of the medical bills themselves." NBC (Costello) discussed a family whose deductible is $7000, with the result that "every doctor visit, every antibiotic every trip to the ER is out of pocket." Costello added, "To contain costs companies are increasingly only offering healthcare plans with sky high deductibles. This year, 18 million Americans are enrolled in high deductible plans compared with 13 million last year. Yet, insured Americans are also going to the doctor less, getting fewer tests and filling fewer prescriptions than a year ago."

Parent Stress = Kid Stress

Study says parents' stress can take a toll on their kids.
The Los Angeles Times (11/11, Forgione) "Booster Shots" blog reported, "Parents' stress can take a toll on their kids. Ask children, not Mom and Dad, how they are affected by their parents' stress." According to a "survey reported by the American Psychological Assn., children who say their parents are stressed out also say they feel that way. Some said it made them feel sad, worried or frustrated - feelings parents seem to be unaware of, according to the survey."
Yoga may beat walking in helping reduce anxiety, elevate mood. The Los Angeles Times (11/11, Stein) "Booster Shots" blog reported that people who practice yoga may show "greater improvements in mood and anxiety," according to a study published in the Journal of Alternative and Complementary Medicine. Researchers arrived at this conclusion after randomizing "19 people to an Iyengar yoga program and 15 to a metabolically matched regular walking regimen" for one hour three times weekly for 12 weeks, then having participants undergo "magnetic resonance spectroscopy scans to measure levels of the brain chemical gamma-Aminobutyric acid (GABA), a neurotransmitter that quiets brain activity, reducing anxiety, and producing a state of calm."

Concentration and Happiness Linked

Study suggests lack of concentration may make people unhappy.
The Boston Globe (11/12) reports, "Research by Harvard researchers, which used the iPhone to periodically interrupt 2,250 people's lives, found that about half the time, people's minds are wandering. Most strikingly, they found that overall, people whose minds are wandering are less happy than those focused on the task at hand."
The study, reported in this weeks' issue of the journal Science, analyzed the data in the US "to find out how happy" the volunteers were, "what they were doing and whether they were thinking about their current activity or something else, and whether that something else was pleasant, neutral or unpleasant," the Washington Post (11/12, Stein) "The Checkup" blog reports. "On average, the volunteers," aged 18 to 88, "reported that their minds wandered 46.9 percent of the time and no less than 30 percent of the time during every activity except sex, the researchers reported. People reported being happiest when they were engaging in sex, exercise and conversation," the Post notes.
"People were more unhappy when their mind wandered to neutral or unpleasant thoughts," Bloomberg News (11/12, Lopatto) reports. Study author Matthew Killingsworth, "a doctoral candidate in psychology at Harvard University, in Cambridge, Massachusetts," said that "by analyzing the data over time, the researchers discovered that people didn't merely fantasize when they were unhappy; instead, wandering minds led to unhappiness."
The CNN (11/11, Landau) "The Chart" blog, the Los Angeles Times (11/11, Roan) "Booster Shots" blog reports, and the Time (11/11, Szalavitz ) "Healthland" blog also covered the story.

Asthma and Social Networking

Social networking site could exacerbate asthma, physicians warn.
The AP (11/19) reports, "Italian doctors warn that Facebook could trigger an attack in some susceptible users," according to a paper published Nov. 20 in The Lancet. They found that one patient, a "man, had been taking two inhaled steroid drugs several times a day to control his asthma. But when his girlfriend dumped him -- and worse, unfriended him on Facebook -- his condition deteriorated."
According to "The Body Odd" blog hosted by MSNBC.com (11/198, Dahl), "Somehow," explained Dr. Neil L. Kao, an allergist located in South Carolina, "when the mind is under pressure or stress, some people are prone toward asthma attacks; these are people who really are susceptible to stress." Kao "didn't treat this particular young man, but he sees many patients whose asthma is caused by stress-outs about school, sports or social situations, which is what might be happening to this young man."
Thus, the study authors "say the case could be a useful tip for doctors who want to explore mystery cases of wheezing and breathlessness among young patients," AFP (11/19) reports. "Considering the high prevalence of asthma, especially among young people, we suggest that this type of trigger be considered in the assessment of asthma exacerbations." The Los Angeles Times (11/18, Kaplan) "Booster Shots" blog, HealthDay (11/18, Preidt) and WebMD (11/18, Woznicki) also covered the story.