Student Anxiety

Study: Students who write about anxieties perform better on tests.
ABC World News (1/13, story 8, 0:20, Sawyer) reported, "And, what if you could cure your fears by writing them down? A new study found if students spend ten minutes listing their fears before a big exam, their scores increase 5% over time. Fearful students who do nothing saw their scores drop 12%. Doctors think writing down your fears makes them less mysterious, so your brain is less distracted."
The Los Angeles Times (1/14, Khan) reports University of Chicago researchers "performed a series of experiments to test their hypothesis." Initially, "they asked 20 college students to take a math test just to get a base-line score, and simply told them to do their best. Next, to raise the stakes, they told the students that they could receive a monetary award if they got a good grade." The Times says that "before beginning the main test, the researchers asked one group of students to spend 10 minutes writing down their feelings about the test, and the other group sat quietly for that time. Everyone then took the same exam." Notably, they "found that students who sat quietly did 12% worse than they had on the pre-test, and the ones who wrote about their anxieties improved their scores by 5%."
The Time (1/13, Park) "Healthland" blog reported the researchers speculate that "the benefits of writing" could be "related to the fact that when you worry, anxious thoughts occupy the working memory of the brain, thus crowding out other thoughts or knowledge relevant to the pressure-packed task at hand. Writing about the fear provides an outlet for these nerve-wracking thoughts, freeing up the working memory to concentrate on other things." The study was published in the journal Science. The Chicago Tribune (1/14, Malone) covers the story, as did the CNN (1/13, Landau) "The Chart" blog.

ER Crowd Tips

Physicians offer several tips meant to help patients better navigate EDs.
In a series dedicated to empowering patients, CNN (1/14, Rice) recounts the case of an infant whose worsening prognosis was attributed to -- by her parents -- the fact that she spent "nearly five hours...waiting in the emergency department." The case is surely not unique, considering that, "according to a 2009 report from the Government Accountability Office, emergency department wait times continue to increase." Comparing an ED to a restaurant in which some patrons stay longer than expected, ACEP President Dr. Sandra Schneider "says the backups occur as emergency departments struggle to find beds for admitted patients." With that in mind, ED physicians offered several tips to help patients "both before and after" they're arrival.
EDs trying new approaches to ease crowding. Kaiser Health News (1/14, Kenen) reports that Ochsner Medical Center "is one of a growing number of emergency departments trying new approaches to ease crowding. Those efforts "have ranged from high-tech options such as smart phone programs that let patients compare waiting times at local hospitals to something as mundane as staggering nursing shifts to better match patient traffic." But a number of hospitals like Ochsner "are looking at more fundamental routines, shaking up and re-engineering their procedures." For example, the center "created an emergency department protocol called 'QTrack'" in which the "sickest patients still go back immediately to the emergency department's traditional beds, but [some] patients...go quickly into separate treatment areas with a nice comfortable recliner or to a procedure room for stitches or a cast."
Emergency departments experience increase in patients, obstacles during snowstorms. CNN (1/13, Park) reported, "During snowstorms, people with chronic health issues such as end-stage renal disease have nowhere else to go for help, because their dialysis centers are closed." What's more, "'if you can't get to the pharmacy and it's a critical life-sustaining medication, the emergency department is your only bet,' said Dr. Leigh Vinocur, a spokeswoman for the American College of Emergency Physicians." Indeed, the "wait...may not be longer than usual, because people with less pressing health needs opt to stay home," but EDs "can face issues of crowding as discharged patients can't leave because they have no safe way of getting home" and "the homeless who are unable to find shelter come to hospitals with cold-related issues such as hypothermia." But "for emergency responders, the biggest obstacle is navigating through the maze of ice slicks and car accidents."

Tylenol in Drugs

FDA to limit amount of acetaminophen in prescription painkillers.
ABC World News (1/13, story 4, 1:50, Sawyer) reported, "The FDA launched a major crackdown [on Thursday] against the overuse of one of the most popular painkillers on the market, acetaminophen."
Bloomberg News (1/14, Larkin) reports, "Prescription pain pills may contain no more than 325 milligrams of acetaminophen as of Jan. 14, 2014, the Food and Drug Administration said." The medicines "also will carry a boxed warning on liver risks." The FDA said the "most common acetaminophen dose for prescription and over-the-counter drugs is 500 milligrams."
The AP (1/14, Perronne) reports that FDA officials said "the labeling on prescription drugs often does not make it clear that they contain acetaminophen, instead using abbreviations for the ingredient like 'APAP.'"
The New York Times (1/14, Harris) reports that Federal drug regulators "have tried for decades to cut down on acetaminophen's toll, but little changed until June 2009, when the FDA's panel of experts voted by a bare majority to call for a ban on drugs that combine acetaminophen with narcotics."
The Washington Post (1/14, Stein) reports the FDA's Sandra Kweder said, "The FDA is taking this action to make prescription combination pain medications containing acetaminophen safer for patients to use. ... Overdose from prescription combination products containing acetaminophen account for nearly half of all cases of acetaminophen-related liver failure in the United States, many of which result in liver transplant or death."

Ear Infection Update

Antibiotics may help ease children's ear infections.
The Los Angeles Times (1/13, Maugh) reports, "The medical consensus on whether to give antibiotics to young children with ear infections has been swinging from one extreme to the other as conflicting clinical trials have pushed pediatricians first toward widespread use of the drugs, then toward a 'watch and wait' approach in which most infections seem to clear up on their own." Now, however, "two new trials reported Wednesday in the New England Journal of Medicine are nudging the pendulum back toward treatment of the infections, especially for the youngest children." They indicate that "the use of antibiotics in infants and toddlers under the age of two is only modestly effective and reduces the duration of symptoms by only a small amount, but it prevents relapses and progression of the disease."
Bloomberg News (1/13, Ostrow) emphasizes the importance of the new research, since "three of four children will have at least one ear infection by the time they turn three years old, according to the US National Institutes of Health." NIH defines "an ear infection [as] an inflammation of the middle ear, which occurs when fluid builds up behind the eardrum," and "is usually caused by bacteria."
The Washington Post (1/12, Huget) "The Checkup" blog reported that both studies "show that antibiotics are more effective than placebos in relieving ear-infection symptoms such as fever, poor appetite, decreased activity and irritability, and suggested that their benefits warrant their being administered early on, regardless of the seeming severity of a child's symptoms." The studies also noted, however, that "the use of antibiotics must be weighed against the risk of antimicrobial resistance, to which prescriptions for childhood maladies, such as ear infections, are thought to contribute mightily, and against antibiotics' side effects, which can include diarrhea and eczema."
The NPR (1/13, Knox) "Shots" blog reported that both studies "come down firmly on the side of early antibiotic therapy for kids under age two or three," finding that these children "get over painful ear infections faster, and have less severe symptoms, if they get prompt treatment with Augmentin [amoxicillin clavulanate], an inexpensive antibiotic often used to treat respiratory infections." Nevertheless, the "study authors and other experts say doctors should be sure the child really is suffering from an ear infection before writing that prescription."
HealthDay (1/12, Salamon) reported that in the first study, "291 children between the ages of six months and 23 months old with certain ear infections -- as defined by the presence of a bulging eardrum and parental observations, among other symptoms -- were split into groups receiving antibiotics or placebos for 10 days." Researchers found that "among those who received amoxicillin-clavulanate, 35 percent had initial resolution of symptoms by day two; 61 percent by day four; and 80 percent by day seven. In contrast, of those on placebo, 28 percent had initial resolution of symptoms by day two, 54 percent by day four and 74 percent by day seven," investigators found.
According to WebMD (1/12, DeNoon), in the second study, researchers followed "319 children aged six to 35 months with acute otitis media," half of whom were randomized to placebos and the other "half were treated with a seven-day course of Augmentin." The investigators discovered that "only 18.6% of the children treated with antibiotics got worse or failed to improve, compared with 44.9% of the children in the placebo group."
MedPage Today (1/12, Bankhead) reported, "Collectively, the two studies provided a clear answer to an unresolved clinical question, Jerome Klein, MD, of Boston University Medical Center, wrote in an accompanying editorial." Klein wrote, "More young children with a certain diagnosis of acute otitis media recover more quickly when they are treated with an appropriate antimicrobial agent." Medscape (1/12, Barclay, subscription required) also covered the story.

Don't Sit!

Taking small breaks from sitting may help heart, metabolic health.
Bloomberg News (1/12, von Schaper) reports that "taking small breaks from sitting down such as standing for phone calls or walking to see colleagues may trim office workers' waistlines and help their heart and metabolic health," according to a study published in the European Heart Journal. Investigators "drew on data from almost 4,800 volunteers outfitted with devices that tracked their activity for seven days as part of the U.S. National Health and Nutrition Examination Survey." The researchers found that "the more breaks people took, the smaller their waists and the lower the levels of a blood marker linked to inflammation."

Shingles Vaccine Update

Shingles vaccine may reduce risk of outbreaks by 55%.
The Los Angeles Times (1/12, Maugh) reports that a study published Jan. 12 in the Journal of the American Medical Association involving "more than 300,000 elderly patients showed that the underutilized herpes zoster vaccine reduced the incidence of painful shingles outbreaks by 55%, even in the oldest populations." Shingles, "a painful rash brought on by the varicella zoster virus," may precipitate painful post-herpetic neuralgia and may also "cause vision loss if it spreads to the eyes." There is no cure for the condition, which is precipitated by the same virus that causes chickenpox.
USA Today (1/12, Lloyd) reports, "Everyone over 60 should be vaccinated against shingles, the Centers for Disease Control and Prevention recommends." The study, which was co-written by researchers from the CDC and Kaiser Permanente, pointed out that "nearly one out of three people in the USA will develop shingles, a painful and potentially serious condition also known as herpes zoster." Despite that fact, "only 10% of those 60 and older -- the group most at risk for shingles -- got the vaccine (Zostavax) in 2009." USA Today explains that some insurance and Medicare plans do not cover the cost of the vaccine, which ranges in price from $150 to $300. This might be one reason why the vaccine is underutilized.
Bloomberg News (1/12, Ostrow) reports that after comparing "75,761 members of Kaiser Permanente who received Zostavax with 227,283 unvaccinated members," researchers "found that one episode of shingles would be averted for every 71 people who receive the vaccine." Based on the study's findings and the fact that the incidence of shingles will increase as baby boomers age, family-practice physician Juanita Watts, of Kaiser Permanente's office in Glendale, CA, "said anyone 60 and older, including people who've had shingles before, can get the vaccine as long as they don't suffer from an illness that affects their immune system."
WebMD (1/11, Doheny), HealthDay (1/11, Gardner), MedPage Today (1/11, Phend), and Medscape (1/11, Jeffrey, subscription required) all covered the story.

NSAID Safety Update

Certain NSAID painkillers associated with increased risk for heart attack and stroke.
Bloomberg News (1/12, Hallam) reports, "Commonly prescribed medicines that ease pain by fighting inflammation have been linked to increased risk heart attack and stroke," according to an analysis published online Jan. 11 in the British Medical Journal.
The CNN (1/11, Landau) "The Chart" blog reported, "Supporting previous research on the subject, a large meta-analysis of 31 studies has found significant risks of cardiovascular events in people who take prescription-strength nonsteroidal anti-inflammatory drugs (NSAIDs)." The blog entry noted, "The analysis spanned studies including a total of more than 116,000 patients. Scientists looked at trials that had compared NSAIDs with other NSAIDs or placebo."
According to HealthDay (1/11, Reinberg), "Compared with patients taking placebo, those taking rofecoxib and lumiracoxib had twice the risk of heart attack, and those taking ibuprofen had more than three times the risk of stroke." Interestingly, "the highest risks for cardiac death were associated with etoricoxib and diclofenac, where the risk was around four times greater than for placebo, the researchers found." The least harmful medicine appeared to be naproxen, the study found.

Long Term Health Costs

Study examines rising cost of long-term care.
The Boston Globe (1/12, Costa) reports, "A recent study by MetLife indicates that the cost of long term care continues to rise much faster than the general rate of inflation. The study found that the average daily rate in 2010 for a private room in a nursing home was $229 or over $83,500 per year. That represents an increase of 4.6 percent versus the 2009 figure of $219 per day." Notably, "the average cost of a semi-private room is now $205 per day or almost $75,000. That represents an increase of 3.5 percent from the 2009 cost of $198 per day. And what about the cost of a stay in an assisted living facility? Those rates increased 5.2 percent from 2009 to 2010 and the average monthly rate is now $3,293." However, "in one piece of good news, the cost for in-home health care assistant remained constant at $21 per hour."

Health Package

Sam's Club to begin selling "personalized health" package.
CNNMoney (1/12, Kavilanz) reports, "Beginning this month, Sam's Club shoppers stocking up on milk, detergent and toilet paper, can now also throw a basic health service package into their shopping cart. The package, which will cost $99, is called 'The Prevention Plan' and is offered by U.S. Preventive Medicine." Notably, the "plan isn't health insurance, said Christopher Fey, CEO of US Preventive Medicine," but "more of a personalized health program that gives buyers access to the basic tools they need to evaluate their health."

Fevers in Children

Physician points out fever in kids is positive evidence of an active immune system.
In the New York Times (1/11, D5) "18 and Under" column, Perri Klass, MD, discusses how some parents are downright phobic about fevers in their children. "Fever does not harm the brain or the body, though it does increase the need for fluids. And even untreated, fevers rarely rise higher than 104 or 105 degrees," Klass reassures her readers. "In general, in older children who do not look very distressed, fever is positive evidence of an active immune system, revved up and helping an array of immunological processes work more effectively." Meanwhile, Dr. Barton D. Schmitt, who in 1980 authored an article about parental fever phobia, pointed out that physicians too may be just as concerned about a child's fever as parents and may be contributing to the problem of parental misconceptions about children's fevers.

New Psychiatric Treatments

New technologies stimulate brain to treat psychiatric conditions.
The Wall Street Journal (1/11, D3, Beck, subscription required) reports in "Health Journal" that new therapies in which the brain is stimulated by magnets, infrared waves, electricity, or ultrasound are showing promise in treating intractable depression and may even help treat other conditions, such as panic disorder, obsessive-compulsive disorder, and even addictions. Now, some companies are even beginning to market battery-operated brain-stimulation devices that can be used at home for the treatment of depression or insomnia. The column also pointed out that the Food and Drug Administration will conduct a hearing later this month on electroconvulsive therapy (ECT), which the agency had grandfathered in as a treatment for depression in 1976 without extensive clinical trial data. Some critics of ECT say that it may leave patients with cognitive problems or dementia.

Heart Attacks and Computer Screens

Screen time may be linked to increased heart risks.
The Los Angeles Times (1/10, Roan) "Booster Shots" blog reported that "heart disease risks rise dramatically among people who spend two or more hours a day sitting in front of a computer screen, television or video-game box," according to a study published in the Journal of the American College of Cardiology. Investigators "examined data from 4,512 adults. Screen time was defined as TV or DVD watching, video gaming and leisure-time computer use."
HealthDay (1/10, Reinberg) reported that "during 4.3 years of follow-up, 325 of these people died and 215 had a cardiovascular event."
MedPage Today (1/10, Neale) reported that the researchers "found those who spent at least four hours of screen time each day were more than twice as likely as those with less than two hours of screen time to suffer a cardiovascular event." The investigators also found that "people with the most screen time also had an increased risk of death during an average of four years of follow-up." HeartWire (1/10, Nainggolan) also covered the story.

Prescription Reminders

New technology aims to help patients with prescription reminders.
The Los Angeles Times (1/11, Dance) reports on "new devices to help people take their meds on time and improve the results coming out of clinical trials for new drugs." The new pills "will report back to a recorder or smart phone exactly what kind and how much medicine has gone down the hatch and landed in the stomach. Someday they may also report on heart rate and other bodily data." The "next generation of pills is all about compliance, as it's termed in doctor-speak -- the tendency of patients to follow their doctors' instructions (or not)."
Another Los Angeles Times (1/11, Dance) story reports that "in addition to dreaming up higher-tech pills, scientists are also working on drug delivery approaches that don't go the oral route." Instead, "patients must receive the medicine as injections or infusions so it directly enters the bloodstream." Researchers are hoping "to replace the uncomfortable, time-consuming needle-based treatments with drug pumps that are easier and less painful for patients to use."
Three technologies caregivers want discussed. The Wall Street Journal (1/10, Hobson, subscription required) "Health Blog" reported that a new survey released last week revealed the three technologies that caregivers want the most. These include having the ability to keep tabs on personal health records, a system to help coordinate caregiving, and a system that would help ensure that patients take medication appropriately, and provide alerts when the proper dose is not taken. The majority of respondents said that they would purchase these technologies despite cost or privacy concerns.

Universal Flu Vaccine

Scientists say they are closer to creating universal flu vaccine.
The Atlanta Journal-Constitution (1/11, Williams) reports that after studying patients in Atlanta who were "infected by the 2009 H1N1 pandemic flu," scientists now say they are "one step closer to creating a universal flu vaccine." According to the paper in the Journal of Experimental Medicine, "several individuals infected with the H1N1 virus developed antibodies that protect against a variety of flu strains," a discovery that "could help put an end to the annual race to develop a new vaccine for flu strains that are the most prevalent each year." NIAID director Dr. Anthony Fauci "said he thinks an initial trial of a global vaccine on humans may be just a couple of years away, but it could be several years before such a vaccine actually makes it to store shelves."
HealthDay (1/10, Preidt) reported. "The surprise was that such a very difficult influenza strain, as opposed to the most common strains, could lead us to something so widely applicable," he added.
Delving into study specifics, the Time (1/10, Melnick) "Healthland" blog reported that "Wilson and his team -- which included researchers from Columbia University, Harvard University and the National Institutes of Health (NIH) -- tested 86 antibodies they'd been able to cultivate from nine H1N1 patients and found that five of the antibodies were effective against several strains of flu virus, including all of the H1N1 strains that have appeared over the past decade." And, "in additional tests, some of those same five antibodies protected mice from lethal doses of the 2009 H1N1 influenza or other common lab strains of flu virus."
Current "vaccines target a section of the viral hemagglutinin protein, the so-called globular head, which is highly variable," MedPage Today (1/10, Smith) noted. "But more than half of the antibodies found by the researchers bound to regions in the stalk of the protein, which is thought to be more highly conserved, Wilson said. Interestingly, however, some antibodies found in the study did bind to the head of the protein and even they were broadly neutralizing, suggesting that their binding regions are also highly conserved over time," and "using those highly conserved regions, it might be possible to create a flu vaccine that would protect year after year, he said." The Milwaukee Journal Sentinel (1/10, Johnson) "Health & Science Today" blog also covered the study.

Music and the Brain

Brain-scan study explores music's effects on brain.
The AP (1/10) reports that "people like music for the same reason they like eating or having sex: It makes the brain release a chemical that gives pleasure," according to a study published in the journal Nature Neuroscience. Investigators "described brain-scanning experiments with eight volunteers who were chosen because they reliably felt chills from particular moments in some favorite pieces of music. That characteristic let the experimenters study how the brain handles both anticipation and arrival of a musical rush."
The Los Angeles Times (1/9, Brown) "Booster Shots" blog reported that "PET scans showed increased dopamine release when subjects listened to pleasurable music (as opposed to 'neutral' music). The fMRI results showed the researchers that the increased dopamine activity occurred both during periods of anticipation of hearing the favorite bits of music and during the listening experience itself -- although different parts of the brain were involved."

New Doctors En Route

With $20 million gift, Partners HealthCare launches program to attract physicians to Massachusetts community health centers.
The Boston Globe (1/9, Kowalzcyk) reported, "With a $20 million gift from Robert and Myra Kraft, Partners HealthCare is launching a program to attract doctors and nurses to Massachusetts community health centers, the cornerstone of the push to reduce health costs and care for newly insured patients." The Globe explained, "The gift to Partners HealthCare System Inc. will be used to pay off up to $50,000 of the medical school loans of physicians and nurse practitioners, as well as finance fellowships in targeted specialties and for master's degrees." But, "in return, caregivers must work for two to three years in a health center or other community-based setting to care for needy patients."

Autism Update

Having babies close together may increase younger child's risk for autism.
USA Today (1/10, Szabo) reports that, according to a study published today in the journal Pediatrics, "having babies close together appears to increase the risk of autism...and the more closely babies are spaced, the higher the risk that the younger one will be diagnosed with autism."
The AP (1/10, Johnson) reports, "Children born less than two years after their siblings were considerably more likely to have an autism diagnosis compared to those born after at least three years." Notably, "the effect was found for parents of all ages, decreasing the chance that it was older parents and not the birth spacing behind the higher risk."
The Wall Street Journal (1/10, Dooren, subscription required), the Washington Post (1/10, Huget) "The Checkup" blog, the CNN (1/10, Wade) "The Chart" blog, and the Time (1/10, Park) "Healthland" blog also cover the story.
Op-ed: Women fare better when they delay having children. Author and professor Elizabeth Gregory wrote in a Los Angeles Times (1/9) op-ed, "According to data released in December by the Centers for Disease Control and Prevention, births for 2009 continued the downward trend begun in 2008, and 2010 data indicate more of the same." Gregory added, "Falling birthrates often breed anxiety: Who will do the work; who will pay the Social Security taxes of the future?" yet, "in reality, the declining baby rates -- prompted by the recession, many experts say -- actually bode well for women, their families and the nation." This has helped the decline in teenage births, and "allowed a 'trickle up' of women into policymaking roles in business and government."

Lower Teen Birth Rate

Teen birth rate reaches record low.
The Los Angeles Times (12/22) reports, "Teenagers are giving birth at the lowest rates noted in seven decades of record-keeping, according to government statistics released Tuesday." The CDC's "National Center for Health Statistics report doesn't speculate on why the birthrate has fallen, but two decades of public-health initiatives to curb teenage pregnancy may be paying dividends. Outside experts said the economy, too, could be a factor."
The newly released data also noted "a continued decline in the number of births overall," USA Today (12/22, Jayson) reports. "For women ages 20-24, the birthrate declined by 7% to 96.3 births per 1,000, which represents the largest drop for this age group since 1973; the number of total births decreased 4%." Between 2008 and 2009, the "birthrate and number of births for women in their 30s also declined; the only age group whose birthrate rose was among women ages 40-44."
Still, CDC officials say, the "most striking change was the decline among teens," the AP (12/22) reports. The "birth rate for teenagers fell to 39 births per 1,000 girls, ages 15 through 19," which is "a six percent decline from the previous year, and the lowest since health officials started tracking the rate in 1940." Aside from the "recent recession," the falling rate is also being attributed to a "decline in immigration to the United States," and "some experts credited popular culture as playing a role," saying the "issue of teen pregnancy got a lot of attention through Bristol Palin."
MTV's "'16 and Pregnant' series and Washington's birth control-vs.-abstinence debate" may have also "gotten through to teens," according to the Washington Post (12/22, Stein). "Some data, for example, indicate that use of birth-control pills and other forms of contraception among teen girls is increasing." Researchers were quick to point out, however, that it is too soon to draw any steadfast conclusions, the Wall Street Journal (12/22, A4, Esterl, subscription required) reports. That may occur later when data come in for a more recent year.

Gardasil Indications

FDA approves Gardasil to prevent anal cancer.
The Los Angeles Times (12/22, Healy) reported, "Gardasil (human papillomavirus), the vaccine that can prevent most cases of cervical cancer in girls, has won the FDA's blessing as a vaccine to prevent anal cancer, a rare but growing diagnosis in the United States." The FDA's "approval for Gardasil as an anal cancer vaccine opens the way for the medication's maker, Merck and Co. Inc., to market the vaccine to boys and young men between the ages of nine and 26. ... But physicians are most likely to recommend the vaccine first for boys and young men who are gay but have not yet become sexually active and for young men who may engage in sexual relations with other men."
The Boston Globe (12/22, Kotz) "Daily Dose" blog reported, "Whether this increases uptake of the vaccine in teens and young adults up to age 26 -- for whom the vaccine is approved -- remains to be seen." Approximately "37 percent of teen girls have received one shot and only 18 percent of girls have gotten all three recommended shots, according to a 2009 Centers for Disease Control and Prevention (CDC) survey."
According to Dow Jones Newswire (12/22, Solsman, subscription required), an FDA advisory panel previously approved the new use of the vaccine. MSNBC (12/22, Aleccia), WebMD (12/22, DeNoon), the CNN (12/22, Young) "The Chart" blog, and HealthDay (12/22, Roberts) also covered the story.

Smoking and Pain

Cancer patients who smoke may experience greater pain than nonsmokers.
The CNN (12/22) "The Chart" blog reported that "researchers say there is evidence to suggest that cancer patients who keep smoking experience greater pain than nonsmokers." The study, published in the journal Pain, "also found an 'inverse relationship' between pain and the number of years since quitting."
Report: California has second lowest smoking rate in US. The New York Times (12/26, A22, Lovett) said, "Californians are smoking less than most other Americans. According to a study released last week by the California Department of Public Health, just 13.1 percent of California residents reported smoking last year, compared with 20.6 percent nationally." Notably, "California now has the second-lowest smoking rate in the country, trailing only Utah. The declining rate here reflects a culture that is especially conscious of health and the environment, and it was hailed by state officials as evidence of the success of a strategy to demonize smoking."

Drug Shortages in US

US faces "unprecedented" shortages of certain drugs.
ABC World News (12/22, story 7, 2:45, Stephanopoulos) reported on the "unprecedented shortage of drugs, everything from life extending cancer treatments to medications routinely administered in emergency" departments. Dr. Michael Link, president-elect of the American Society of Clinical Oncology, was shown saying, "This year, a nationwide shortage of over 100 critical medications used for everything from anesthesia to asthma."
ABC News (12/22, Salahi) reported on its website, "Many hospital patients are being turned away for potentially life-saving injection treatments in what may be the largest US hospital drug shortage in over two decades." The majority of "drugs in short supply are known as injectables and include sedation medication such as propofol, the popular blood thinner heparin, and hard-hitting chemotherapy drugs like doxorubicin." Dr. Link said, "I've been in practice more than 30 years and this is the first time I've encountered shortages that may affect patient care." According to the American Society of Health-System Pharmacists, demand for many drugs has only increased.
The CNN (12/22) "The Chart" blog reported that Dr. Richard Schilsky, a spokesman for the American Society for Clinical Oncology and professor of medicine at the University of Chicago, said, "In some cases, it's possible to substitute one [cancer] drug for another, but [in other cases] there are not a great deal of options."

Take Your Medicine

Study finds taking prescription drugs now can save on medical expenses later.
The Los Angeles Times (1/7, Kaplan) "Booster Shots" blog reports that a new study published in Health Affairs "says that people with four common chronic illnesses saved themselves -- and the healthcare system -- big bucks by taking their meds instead of skipping them." Researchers analyzed data on "135,000 patients with congestive heart failure, diabetes, hypertension and high cholesterol." The study, funded by CVS Caremark, "found that people who took their meds made fewer visits to the emergency room and spent fewer days in the hospital." The New York Times (1/7) "Prescriptions" blog also reports the story.

Depression and Bright Light

Bright light therapy may benefit older patients with depression.
The New York Times "Well" blog reported that, according to a study published in the January issue of the Archives of General Psychiatry, bright light therapy, currently used to help patients with seasonal affective disorder, may also benefit older patients with depression. In a study including 89 patients over the age of 60, "compared with a placebo, light therapy improved mood just as well as conventional antidepressant medications." The study's lead author said that bright light therapy "should be considered for major depression because of its benefits, especially the apparent lack of adverse side effects."

Lung Damage and Studded Tires

Studded tires may cause heart, lung damage.
MSNBC (1/7, Nierenberg) reports that "drivers who hit the road in winter with studded tires" could "be harming their hearts and lungs," according to a study published in the journal Chemical Research in Toxicology. Investigators "collected airborne particles generated as studded tires rolled over a road simulator at about 40 miles an hour," then added the particles "to a dish containing human white blood cells." The investigators "found that important chemical markers changed after being exposed to road debris -- higher levels of three proteins known to increase inflammation and lower amounts of seven proteins that can protect against it."

Birth Control Pill Update

Oral contraceptives using 24-day regimen may be better at preventing pregnancy.
The Los Angeles Times (1/6, Roan) "Booster Shots" blog reported that, according to a study published in the January issue of the journal Obstetrics & Gynecology, birth control pills using a "shorter drug-free interval [24 days of active pills followed by four days of inactive pills] combined with pills containing drospirenone, a specific type of progestin that tends to remain in the body longer, are better at preventing pregnancy." Specifically, "the study found that women on a 24-day regimen containing drospirenone had lower failure rates compared with the standard 21-day regimen of pills containing other types of progestins: a 2.1% failure rate after one year of use compared with 3.5% for the other pills and a 4.7% failure rate after three years compared with 6.7%."

People Paying for Tests

Study seeks to determine what people will pay for predictive tests of non-preventable conditions.
The Wall Street Journal (1/6, Hobson, subscription required) "Health Blog" discussed a study published in the journal Health Economics in which researchers from Tufts Medical Center presented a hypothetical question to 1,463 people in which they were asked if they would pay to take a blood test to find out if they were going to develop a disease that would not be possible to prevent, such as Alzheimer's, breast or prostate cancer, or arthritis. While most of the respondents said they would want to be tested and were willing to pay anywhere from $320 to $622, others did not want to be tested at all, even for free. They just did not want to find out they had a disease hanging over their head that they could not prevent.

Human Tears and Behavior

Human tears may be sending chemical signals meant to influence other people's behavior.
On its front page, the New York Times (1/7, A1, Belluck) reports, "When we cry, we may be doing more than expressing emotion." In fact, "our tears, according to striking new research, may be sending chemical signals that influence the behavior of other people." The paper appearing in Science may "begin to explain something that has baffled scientists for generations: Why do humans, unlike seemingly any other species, cry emotional tears?"
According to the Time (1/6, Szalavitz) "Healthland" blog, "fluids similar to tears are used to send chemical signals" among mice. "For example, male mice become more aggressive when exposed to these fluids from other males. In humans, sexual attraction and the menstrual cycle are known to be influenced by odors."
What's more, "emotional tears previously had been shown to be chemically distinct from reflexive, eye-protecting tears," the Los Angeles Times (1/7, Khan) reports. So, "perhaps human tears contained a chemical signal too." With that in mind, researchers in Israel "asked six women to watch triple-hanky chick flicks," and collected their tears, thinking the "tears would trigger feelings of sadness or empathy" among men. Instead, the "50 tear-sniffing men whose testosterone levels were tested experienced a drop averaging 13%," and "sniffers who viewed erotic images before submitting to an MRI showed less activity in the sexual arousal regions of their brains, too."
Notably, the team at the Weizmann Institute of Science "used female tears, because crying is considered more culturally acceptable for women than men," Bloomberg News (1/7, Lopatto) reports. But, the "researchers don't think the signals from tear chemicals are unique to women, they wrote, and they may also occur in crying men and children."
Interestingly, the research "places human tears in a family of fluids that includes urine and anogenital gland secretions," the Washington Post (1/7, Brown) reports. In other words, "what we have found is that human emotional crying may not be so unique after all," explained lead investigator Noam Sobel. "It is a reflection of something common to many, if not all, mammals, which is chemosignaling through lacrimal secretions."
The USA Today (1/6, Vergano) "Science Fair" blog, HealthDay (1/6, Salamon), and WebMD (1/6, Hendrick) also covered the story.

New Rheumatoid Arthritis Drug

Roche wins expanded US approval for rheumatoid arthritis treatment.
Bloomberg News (1/6, Doherty) reports, "Roche Holding AG's Actemra (tocilizumab) medicine won expanded US approval as a treatment for moderate to severe rheumatoid arthritis." Actemra "can be used to inhibit and slow structural joint damage and improve physical function when combined with a standard medicine, methotrexate," Roche said. Actemra "won US clearance last year as a therapy for rheumatoid arthritis patients who haven't been helped by older treatments."

Chickenpox Vaccine Update

Recommended two doses of varicella vaccine appear to be highly effective at preventing infection.
The Boston Globe (1/5, Kotz) "Daily Dose" blog reported that when the chicken pox vaccine "was...in its infancy" some 15 years ago, "many parents" had various concerns that led them to "shun the vaccine in favor of getting their children infected 'naturally' with the varicella virus...going so far as to bring them to parties with other infected kids." Now, Yale researchers have released a paper that is said to detail the "first study to assess the effectiveness of the two-dose vaccine in the general population."
The group began their work by performing "a case-control study of children four years and older," MedPage Today (1/5, Neale) reported. "Each child with confirmed varicella infection was matched by age and pediatric practice with up to two healthy controls" and, according to the paper in the Journal of Infectious Diseases, "from July 2006 to January 2010, the researchers enrolled 71 cases and 140 controls."
Investigators eventually noted that "none of the youngsters who came down with the illness had received the two-dose course of the vaccine, while 93 percent had received one dose and seven percent had not been vaccinated," HealthDay (1/5, Holohan) reported. Next, the team "compared children who received two doses of the vaccine to those who received one dose and found that the effectiveness rates were 98.3 percent and 86 percent, respectively. In other words, 'the odds of developing varicella were 95 percent lower in children who had received two doses of the vaccine compared with those who had received only one,'" the study authors explained, adding that their "findings support the CDC's recommendation for the two-dose regimen."

Cocaine Vaccine?

Newly engineered vaccine may help treat cocaine addiction.
The CNN (1/5, Curley) "The Chart" blog reported, "In 2008, 5.3 million Americans age 12 and older had abused cocaine in any form and 1.1 million had abused crack at least once in the year prior to being surveyed, according to data from the National Institute on Drug Abuse." Now, research coming from the Weill Cornell Medical College may help those battling with the disease of addiction. In fact, the "new vaccine shows promise for producing immunity to cocaine's highly addictive effects," according to the paper in Molecular Therapy.
The scientists "fashioned the vaccine around an infectious agent: namely, specific parts of the adenovirus (a common cold virus) that pose no risk in terms of causing sickness," HealthDay (1/5, Mozes) reported. Next, the "team attached the cold virus agent to a chemical that is structurally similar to cocaine. The result: When injected into mice, the vaccine prompted their immune system to generate a strong antibody response to cocaine, something the immune system normally doesn't do effectively" and "in test tubes these antibodies stopped cocaine in its tracks."
But, "even if the vaccine proves itself in" those studies, "experts on addiction warn that it's not a panacea," the Time (1/5, Kluger) "Healthland" blog pointed out.

Kidney Donor Program

New system of kidney donation proposed.
In an opinion piece in the Wall Street Journal (1/6, A15, subscription required), psychiatrist and kidney transplant recipient Sally Satel, MD, and retired marketing executive Ira Brody propose a system of kidney donation whereby prisoners who are serving at least a five-year sentence may donate kidneys. Recipients would be those patients who are at the top of the transplant waiting list. Prisoners would be given no consideration for parole and would only be compensated in the amount of $40,000 in the form of an annuity for their donation upon completion of their sentences. The annuity funds would come from Medicaid, Medicare, or a private insurer. Satel and Brody claim their proposal would not only save lives, but would also save money, since dialysis costs approximately $72,000 per patient annually, as well as provide some income for prisoners upon release.

New Alzheimers Project

Obama signs National Alzheimer's Project Act into law.
USA Today (1/6, Marcus) reports that on Tuesday, Jan. 4, "President Obama signed the National Alzheimer's Project Act (NAPA) into law." The aim of the new law "is to create a coordinated national strategy that deals with Alzheimer's, a brain-wasting condition projected to leap from 5.3 million cases this year into the double digits by midcentury." Even though "the new law doesn't in itself deliver money for research to find a cure or support services for patients and caregivers grappling with the disease, it will help establish an interagency council that will work with the secretary of Health and Human Services to give a full assessment of what needs to be accomplished to stem the disease." CQ HealthBeat (1/6, subscription required) also covers the story, providing a link to the bill text.

Steve Jobs Analog

"Steve Jobs of biotechnology" hopes to bring DNA sequencing to the masses.
On the front page of its Business Day section, the New York Times (1/5, B1, Pollack) reports that Ion Torrent founder "Jonathan M. Rothberg fancies himself the Steve Jobs of biotechnology," and he "wants to do for DNA sequencing what Mr. Jobs did for computing -- spread it to the masses." The majority of "sequencers cost hundreds of thousands of dollars and are at least the size of small refrigerators," but Ion's new "machine sells for just under $50,000 and is the size of a largish desktop printer." Thus, the "machine could expand the use of DNA sequencing from specialized centers to smaller university and industrial labs, and into hospitals and doctors' offices." But some experts "think Dr. Rothberg is overselling his machine," saying that "like the early Apple II of Mr. Jobs, it is too puny for many tasks, including sequencing the entire genome of a person."

Bullying Victims

Bullying may increase victim's risk for developing psychotic symptoms later in life.
The Los Angeles Times (1/5, Roan) "Booster Shots" blog reported that "bullying by peers can increase the risk of the victim developing psychotic symptoms later in life," an international team of researchers concluded after following 2,232 twin children and their families. "Children who were bullied by peers were more than twice as likely to experience psychotic symptoms at age 12 compared with children who did not suffer similar trauma," according to a paper in the American Journal of Psychiatry. "This risk remained present even when the researchers controlled for other factors that could contribute to mental illness, such as socioeconomic deprivation, IQ and genetic disposition to mental illness."

Baldness Update

Specific genetic defect appears to play important role in male-pattern baldness.
WebMD (1/4, Warner) reported, "A genetic defect in the way hair follicle cells develop may play an important role in male-pattern baldness." There's been speculation that "male-pattern baldness is associated with a significant decrease in hair follicle size, which could be related to a loss of the hair follicle stem or progenitor cells necessary for normal development. To test this theory, researchers" at the University of Pennsylvania "compared the number of these cells in bald and non-bald scalp cell samples from people with AGA [androgenetic alopecia]."
A "complex series of analyses revealed that bald and haired tissue contain equivalent amounts of preserved stem cells, which give rise to progenitor cells," HealthDay (1/4, Mozes) reported. "Bald tissue, however, did not contain the normal amount of progenitor cells, suggesting a malfunction in the normal behavior of hair follicle stem cells." In other words, the "follicles that make hair don't go away completely, but they become miniaturized, to the point where the hair they normally make to replace hair when it naturally falls out becomes microscopic and therefore invisible," according to the paper in the Journal of Clinical Investigation.
"That's good news, says the team, as, 'demonstrated preservation of hair follicle stem cells suggests potential reversibility of this condition,'" the USA Today (1/4, Vergano) "Science Fair" blog reported. "Experiments in mice suggest that progenitor cells grown from stem cells in test tubes may be lead to hair regrowth if applied as a treatment." The Milwaukee Journal Sentinel (1/4, Johnson) "Health & Science Today" blog also covered the story.

Electric Bed Warning

FDA issues warning over potential fire hazard from electric beds.
The AP (1/5) reports, "Federal health regulators have issued a warning to Invacare Corp. for failing to report and address malfunctions with its electric beds, including electronics that allegedly caught on fire causing injury and death." The Food and Drug Administration said "the company has repeatedly failed to document and investigate recurring complaints with its adjustable beds. Between April and July last year, the company received four complaints involving sparks or fires that were reportedly triggered by its beds." Invacare said Tuesday "that the company has assembled a team of quality control specialists to work on the problems."
Bloomberg News (1/5, Peterson) reports, "One complaint alleged that an 11-year-old child died after becoming trapped by an Invacare bed rail. Another patient died after one of the company's beds caught fire, according to the agency." And, "two other patients were taken to the hospital and treated for smoke inhalation and chest pain after the control box of an Invacare bed caught fire, the FDA said." The Wall Street Journal /Dow Jones Newswire (1/5, Dooren, subscription required) also reports the story.

Physician Burnout

Two studies take another look at "physician burnout."
The Los Angeles Times (1/5, Brown) reports, "You might have heard already that surgeons who miss out on sleep make more mistakes in the operating room. Now the editors of Anesthesiology want you to know about another potential patient-safety pitfall: physician burnout." According to one Vanderbilt-penned paper published in the journal, "physicians, and particularly residents (who usually carry larger workloads), were at higher risk of burnout than nurses and other personnel." Meanwhile, researchers at Northwestern "focused on burnout among senior physicians -- chairs of academic anesthesiology departments" -- finding that "about half of the anesthesiologists they surveyed -- 55 doctors in all -- met their criteria for 'high burnout' or 'moderately-high burnout.'"

Homeless Clinic in LA

Article profiles Los Angeles clinic providing free health services to homeless.
The Los Angeles Times (1/5, Helfand) reports on "the nonprofit Venice Family Clinic," which brings "medical services to the homeless in parks, shelters and other places where they congregate on the Westside." The Times adds, "Delivering preventive care, the doctors believe, not only keeps their patients healthier, it also makes financial sense. People who live on the streets are up to five

Walk..Walk..Walk!

Walking speed may help clinicians predict how long their older patients will live.
USA Today (1/5, Fontana) reports that research coming out of the University of Pittsburg indicates that "walking speed" may determine how long and how well older people will live. "The findings can provide doctors with an inexpensive, safe and simple way of measuring performance that can help identify health problems," says lead researcher Stephanie Studenski, "and in many cases lead to treatments that can improve well-being, ward off disabilities and help the elderly maintain independence." Similarly, Evan Hadley, "associate director of geriatrics at the National Institute on Aging," said, "I think it's a very useful tool, and some physicians already use it."
The study authors began their work by analyzing "data from nine different studies, collectively looking at nearly 35,000 adults aged 65 and older," the CNN (1/4, Landau) "The Chart" blog reported. Among other things, they eventually noted that "for a 70-year-old man, the difference between walking 3 mi/hr and 3.5 mi/hr was four years of life on average; for a woman, it's six to seven years." According to the paper in the Journal of the American Medical Association, a "70-year-old man who walks at 2.5 mi/hr would expected to live an average of eight years longer than if he walks at 1 mi/hr; for a woman, that difference is about 10 years."
But in an "editorial accompanying the study, Matteo Cesari of the Universita Campus BioMedico in Rome" wrote that "much more research is needed before doctors routinely start measuring how fast people walk to get an idea of how long they may live," the Washington Post (1/5, Stein) "The Checkup" blog points out.
And, according to one expert who was not involved in the study, "for many elderly folks who walk slowly, hitting the treadmill at the gym to improve their fitness level isn't the solution," the Boston Globe (1/4, Kotz) "Daily Dose" blog reported. "We need to do more to figure out what slows gait speed," explained Dr. Farzaneh Sorond, a "stroke neurologist at Brigham and Women's hospital who studies gait speed" in the elderly. "On the other hand, if you're just starting to slow down a bit and don't have major medical problems, getting that exercise may be the key to a longer life, Sorond contends."
Bloomberg News (1/5, Ostrow), the Los Angeles Times (1/5, Stein) "Booster Shots" blog, the Time (1/4, Park) "Healthland" blog, Medscape (1/4, Barclay, subscription required), MedPage Today (1/4, Neale), HealthDay (1/4, Dotinga), and WebMD (1/4, Stacy) also covered the study.
Physical activity may help improve function, walking speed among adults with knee OA. MedPage Today (1/4, Walsh) reported that, according to a paper in Arthritis & Rheumatism, "increasing physical activity over two years can improve function and even walking speed among adults with osteoarthritis of the knee -- regardless of their level of activity." The "ongoing cohort study of more than 2,500 patients with knee osteoarthritis (knee OA) found that the average gait speed -- an objective measure of functional performance -- was 4 feet/second among patients reporting the lowest quartile of physical activity, compared with 4.2, 4.3, and 4.5 feet/second (P for trend <0.001) among quartiles with increasing activity levels." The team at Northwestern University also pointed out that "this graded relationship between physical activity and walking speed was similar across sex and age groups, and persisted after one year (P<0.001 for all)."

Botox Treatment

Botox injections may benefit some patients suffering from chronic migraine headaches.
The Wall Street Journal (1/4, D4, Landro, subscription required) reports in "Aches & Claims" that some patients who suffer from chronic migraine headaches may benefit from injections of botulinum toxin, which is also used by dermatologists to combat wrinkles. Recently, two large clinical studies encompassing 1,384 patients indicated that Botox (onabotulinumtoxin A) may reduce the number of days patients suffer from migraine headaches. The article also points out that Botox has been approved by the Food and Drug Administration this past fall as a treatment for patients with chronic migraine. Chronic migraine is defined as a condition in which headaches affect patients for at least 15 days a month for a period of four or more hours daily. The injections don't help all patients with chronic migraine, however, and they are expensive and not always covered by health insurance.

Tonsillectomy Guidelines

New clinical guidelines on tonsillectomies in children published.
The CNN (1/3, Caruso) "The Chart" blog reported that, according to Richard M. Rosenfeld, MD, MPH, of SUNY Downstate Medical Center, "over half a million tonsillectomies are done every year in the United States."
Dr. Rosenfeld also pointed out that the "associated morbidity, and the availability of hundreds of randomized clinical trials evaluating associated interventions create a pressing need for evidence-based guidance to aid clinicians," Medscape (1/3, Barclay, subscription required) reported. Therefore, he helped author a new guideline that "offers evidence-based recommendations on identifying children who are the best candidates for tonsillectomy, and on preoperative, intraoperative, and postoperative care and management." The guideline, published in Otolaryngology–Head and Neck Surgery, includes other objectives as well, including "improving counseling and education for families, describing management options for patients with modifying factors, reducing inappropriate or unnecessary variations in care, and discussing the significant public health implications of tonsillectomy."
Notably, the "guidelines update a set of clinical indicators for tonsillectomies published in 2000 by the American Academy of Otolaryngology, which suggested that doctors could consider taking out the tonsils if a child had at least three cases of swollen and infected tonsils in a year," WebMD (1/3, Goodman) reported. "The new guideline, however, says that kids should have at least seven episodes of throat infection, such as tonsillitis or strep throat in a year, or at least five episodes each year for two years, or three episodes annually for three years, before they become candidates for surgery, and that those infections should be documented by a doctor, rather than just reported by parents." According to experts, "the idea...was to reserve surgery only for the most severely affected, because the surgery can rarely have serious complications including infections and serious bleeding."