Screening adults for diabetes could result in significant cost-savings for health care systems compared to the costs of not screening individuals at all.

Emory University researchers will present the findings of their diabetes screening cost analysis June 7 at the annual meeting of the American Diabetes Association in New Orleans.

"The economic costs of diabetes threaten the financial integrity of our health care systems," says study co-author Lawrence S. Phillips, MD, Emory University School of Medicine Professor of Medicine, Division of Endocrinology. "We asked whether there is economic justification for screening for prediabetes and unrecognized diabetes since early treatment could help prevent or delay development of diabetes and its complications and reduce associated costs."

Phillips and his research team screened 1,259 adults who had never been diagnosed with diabetes. The volunteer participants underwent four screening tests, including random plasma and capillary glucose, and a 50g oral glucose challenge test (without a prior fast, at different times of the day) with plasma and capillary glucose measured one hour after the glucose drink. All participants also had a definitive 75g oral glucose tolerance test (OGTT) performed in the morning after an overnight fast.

The researchers found that 24 percent of the adults screened had either diabetes or prediabetes. In addition, they concluded that costs for screening and three years of treatment with metformin, or change in lifestyle for individuals found to have prediabetes or previously unrecognized diabetes, would be lower than costs for not screening.

The costs of two-step screening (only positive screens would have the OGTT) were projected to include the costs of testing, costs for false negatives (in individuals where the diagnosis would be missed), and costs for treatment of true positives (people found to have diabetes or prediabetes, treated with metformin, or change in lifestyle).

Projected health system costs for diabetes screening and management over a three-year period ranged from about $180,000 to $186,000 – all lower than costs for no screening, which would be about $206,000.

"We found that projected health system costs for screening and either treatment would be less than costs for no screening," says Phillips. "These data suggest that screening with preventive management should be implemented widely and that use of the glucose challenge test may be cost-effective."

Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life.

According to the American Diabetes Association, 23.6 million U.S. children and adults, or 7.8 percent of the population, have diabetes. While an estimated 17.9 million have been diagnosed with diabetes, 5.7 million people are unaware that they have the disease.

Pre-diabetes is a condition that occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. There are 57 million Americans who have pre-diabetes, in addition to the 23.6 million with diabetes.

In addition to Phillips, study authors were: K.M. Venkat Narayan, MD, MSc, MBA, and Joseph Lipscomb, PhD, of Emory University; and Ranee Chatterjee, MD, of the Johns Hopkins University School of Medicine. Chatterjee was lead study author.

The research was supported in part by the National Institutes of Health and the National Center for Research Resources.

As Quoted from Sciencedaily.com

Technorati Tags: Diabetes,Health,Cost,Disease

Read More...

• 0 comments »

Higher-protein meals may help overweight and obese people burn more fat, the results of a small study suggest.

Research has shown that overweight people are less efficient at burning fat after a meal than thinner people are. In the new study, Australian researchers looked at whether the protein composition of a meal affects that weight-related gap.

They found that overweight men and women burned more post-meal fat when they ate a high-protein breakfast and lunch than when they had lower-protein meals. That is, the added protein seemed to modify the fat-burning deficit seen in heavy individuals.

"Our research suggests that people with higher body fat burn fat better after a high-protein meal than people with lower levels of body fat," lead researcher Dr. Marijka Batterham, of the University of Wollongong in New South Wales told Reuters Health.

A number of studies have suggested that high-protein diets may help people shed weight more easily -- possibly, in part, because protein suppresses appetite better than fat or carbohydrates do.

The current study did not look at weight loss, so it's not possible to tell whether the increased fat-burning seen in overweight participants would translate into fewer pounds over time, Batterham said.

But answering that question, she said, will be the next step.

The findings, published in the journal Nutrition & Dietetics, are based on 18 adults whose post-meal metabolism was tested on 3 separate days. The average age was 40 years, eight subjects were overweight, six subjects had a normal weight, and four were obese.

More : uk.reuters.com

Technorati Tags: Overweight,burn fat,fat,meals,health

Read More...

• 0 comments »

What is it like to be sick outside of the United States?

Well, if you are among the 47 million uninsured or 25 million underinsured in America, health care in capitalist democracies such as Switzerland, Germany, Japan, Great Britain or Taiwan is decidedly better than the broken system we have here.

Switzerland requires all its citizens to have coverage.

In Germany, co-payments are only $15 every three months. In Japan, health insurance is private and patients can see a specialist whenever they like.

In Great Britain, doctors get bonuses for improving their patients' health. Taiwan stores its citizens' medical histories on electronic cards, which slashes administrative costs.

And in none of these countries do people go bankrupt because of unpaid medical bills.

How do I know this? Because I was at the state's first house party for the Frontline documentary "Sick Around The World," a screening organized by the Tennessee Health Care Campaign and the Tennessee Chapter of Physicians for a National Health Program. Retired doctor Art Sutherland is the president of the latter group, and Wednesday night he brought about 30 people into his East Memphis home.

These were people who, for the most part, have health insurance. For them, a lack of health care does not -- at least not today -- force them to choose between medicine or food.

But they realize that for too many Tennesseans, including the estimated 14 percent who are uninsured, the lack of health care is a matter of life and death.

There is no perfect system -- not in any of the countries featured in the documentary, nor in any country in the world. In fact, the documentary made clear that most of the foreign systems don't bring in enough money to cover the costs.

Unlike Michael Moore's "Sicko," this documentary isn't a politically charged indictment against America as much as it is a call to glean universal health care lessons from our global neighbors.

After all, if Taiwan can insure all its citizens, why can't we?

Why don't we?

"It's a really hard sell that health care is a right," said Charlotte Borst, a Rhodes College history professor on sabbatical this year. "To me, that's the biggest issue."

Once we agree that health care is a right, everything else, Borst believes, is just a matter of figuring out the details of a universal health care system.

One of those who viewed the hourlong documentary was Sandy Arnold, a pediatrician at Le Bonheur Children's Medical Center and formerly a doctor in Canada.

"It's part of the Canadian national identity," Arnold said, that health care for all is a right, and one of the values that distinguishes them from their neighbor to the south.

And therein lies America's rub. We believe the government is responsible for providing every child an education, and everyone police protection, even that an ambulance should attend to your emergent medical needs.

But the right to health care? In America? It's not yet part of our national identity.

Shifting that tide -- and winning the inevitable fight with the health care and pharmaceutical industries -- could take years.

But in the meantime, Sutherland and Emily Snyder, West Tennessee coordinator for the Tennessee Health Care Campaign, hope that voters educate themselves on Sens. John McCain's and Barack Obama's health care proposals before heading to the polls. (Get a side-by-side comparison of the presidential candidates' ideas at health08.org.)

"The United States needs to use its American ingenuity and use the sense of fairness I think we still have to solve this," Sutherland said.

To get involved

The local organizing group of the Tennessee Health Care Campaign meets next at 5 p.m. Tuesday at the Memphis Center for Independent Living, 1633 Madison. The group meets on the third Thursday of each month, same time and place.

For more information about the organization or hosting your own house party to screen "Sick Around The World," contact Emily Snyder, the West Tennessee coordinator for the Tennessee Health Care Campaign (thcc2.org), at esnyder@thcc2.org or 590-4873.

We believe the government is responsible for providing every child an education ... But the right to health care? In America? It's not yet part of our national identity.

source : commercialappeal.com

 

Technorati Tags: health,care

Read More...

• 0 comments »

Massachusetts health insurance coverage is available and affordable to 95 percent of the state's taxpayers. Only 5 percent of the taxpayers don't have health insurance in Massachusetts. Perhaps a good path for other states to follow when doing health insurance reforms.

About 95 percent of adults filing health care information with tax returns have health insurance coverage; majority of filers complying with health reform filing requirements, show the numbers provided by Massachusetts Department of Revenues.

Figures released today by the Massachusetts Department of Revenue show that an overwhelming majority of adult tax filers are covered by health insurance.

A DOR analysis concludes that 95 percent of 3.34 million adults filing health insurance information with their tax returns for tax year 2007 have health coverage, reinforcing demonstrated progress toward the goal of enrolling all state residents in health insurance.

Under the health care reform legislation passed in 2006, most tax filers are required to indicate to revenue officials through their tax filings whether or not they have health insurance coverage. Tax year 2007 was the first year for DOR to enforce the individual mandate through the collection of personal income taxes, for which a new state form, Schedule HC, was developed.

For the first year of implementation, taxpayers overwhelmingly complied with the health insurance tax filing requirement. Only 1.4% of tax filers required to file health insurance information with their tax returns failed to comply.

While 95% of filers have health coverage, just over 2.5 percent (about 86,000 tax filers) indicated they could have afforded coverage but chose not to obtain it, resulting in a loss of their personal exemption ($219 for an individual).

Slightly less than 2 percent (about 62,000 tax filers) said they could not afford health insurance based on affordability schedules established by the Connector and were not subject to the penalty.

The numbers reported today are based on a review of the data from 86 percent of expected total tax filings for tax year 2007. More than 200,000 taxpayers have filed for extensions and will not have their returns processed until after the October filing deadline. The figures released today do not include children or those who do not file tax returns and is subject to subsequent verification.

Penalties for those who can afford health insurance but choose not to obtain it accrue monthly in 2008, and can tally as much $912 for a full year without coverage. DOR is currently mailing individuals who lacked health insurance in 2007 but could have afforded coverage to highlight the higher penalties and provide information on opportunities for finding affordable coverage.

 

Technorati Tags: insurance,health

Read More...

• 0 comments »

Twice a day, 7-year-old Hannah Austin exhales all the air from her lungs. She then takes a puff of a low-dose steroid from a purple inhaler, holds her breath for a few seconds and exhales.

Like nearly 7 million other children in the United States, Hannah, a second-grader from Smyrna, Georgia, has asthma. This simple exercise with the inhaler allows her to breathe easier.

But on a day when the air quality is poor, she often struggles to catch her breath. "We know that environmental pollutants have a very significant impact on children with asthma," said Dr. Avril Beckford, a pediatrician in Austell, Georgia. Children are more vulnerable to the effects of air pollution because their lungs don't fully form until they are adolescents, the American Academy of Pediatrics noted.

The leading pediatricians group added that "because children spend more time outdoors than do adults, they have increased exposure to outdoor air pollution." "If you live near a polluted area of a city, it's like the child is smoking," said best-selling author and pediatrician Bill Sears. "We all know what smoking does for the lungs."

Sears called the long-term effect of air pollution on a developing child devastating. "Children do not grow as well because they do not breathe as well. The brain really needs a lot of oxygen. They don't think as well. They don't learn as well."

Hannah's asthma was diagnosed last summer. Her mother, Drew Austin, became alarmed when she noticed that Hannah was short of breath while swimming. "When her asthma is really bad, she just gets lethargic and starts coughing," Austin said.

Coughing, wheezing or whistling when exhaling, and shortness of breath are some of the most common symptoms of asthma in children.

Sears warned that the symptoms can lead to poor sleep habits. "When the child wakes up in the morning with a runny nose and baggy eyes, you can tell they didn't sleep well because they were coughing in the night," he said.

Proper diagnosis and treatment can help manage asthma symptoms. Experts also recommend that people with asthma avoid indoor and outdoor allergens and irritants.

Indoor triggers include dust mites, mold, furry pets, tobacco smoke and certain chemicals.

Outdoor irritants range from pollen to cold air to air pollution.

Michael Chang, an atmospheric research scientist at the Georgia Institute of Technology in Atlanta, estimated that 50 percent of air pollutants are created by cars and trucks.

He explained many parts of the U.S. are now transitioning to higher temperatures and more humid summers.

"We don't have the winds that blow things out of the air," Chang said. "The stuff we put into the atmosphere lingers longer."

He compared the air quality in many big cities to a chemical soup of thousands of compounds, including ground-level ozone and fine particulate matter. The Environmental Protection Agency describes ground-level ozone as the primary component of smog. It includes motor vehicle exhaust, industrial emissions, gasoline vapors and chemical solvents.

Chang's office is responsible for monitoring air quality and issuing smog alerts in Atlanta. He also tries to educate residents by telling them to pay attention to the warnings.

"Jogging late in the afternoon during the summer is not the best time," Chang said. "Ground-level ozone is at its worst at that time of day."

Beckford goes one step further, warning parents to not choose a house, school or playground that is close to a busy road or a highway.

source : cnn.com

Technorati Tags: pollution,kid,lung

Read More...

• 0 comments »

Vitamin supplements taken by millions of people do not increase life expectancy and may raise the risk of a premature death , according to a review of 67 studies with more than 230,000 subjects.

The review, by the Cochrane Collaboration which regularly pools data from trials to evaluate drugs and treatments, found supplements vitamin A, vitamin E and beta-carotene are detrimental to health. In 47 trials with 180,938 people and a low risk of bias, the "antioxidant supplements significantly increased mortality", the authors wrote. When the antioxidants were assessed separately and low risk of bias trials were included and selenium excluded, vitamin A was linked to a 16% increased risk of dying, beta-carotene to a 7% increased risk and vitamin E to a 4% increased risk.

Evidence for vitamin C and selenium was more equivocal, suggesting there was no benefit to taking these pills compared with a placebo.

"The bottom line is current evidence does not support the use of antioxidant supplements in the general healthy population or in patients with certain diseases," said Goran Bjelakovic, who performed the review at Copenhagen Universityhospital in Denmark. "There was no indication that vitamin C and selenium may have positive or negative effects. So regarding these we need more data from randomised trials."

All the supplements are categorised as antioxidants; research has suggested these chemicals underlie some of the beneficial effects of eating fruit and vegetables because they soak up harmful byproducts of metabolism which can damage cells and cause aging.

While the evidence of a beneficial effect of a diet rich in fruit and veg is solid, the Cochrane data suggest antioxidant supplements are either useless or detrimental.

Bjelakovic's team evaluated 67 randomised clinical trials with 232,550 subjects; 21 of the trials were on healthy subjects, while the rest tested patients with a range of diseases. The evidence suggests it would be safer to obtain the chemicals not as supplements but by eating plenty of fruit and vegetables.

source : guardian.co.uk

Technorati Tags: vitamin,supplement

Read More...

• 0 comments »

More than just a pretty smile, clean teeth and gums are a sign of total body health. And those painful sessions with the dental hygienist could save your life, new findings suggest.

Most people know that the tedium of good oral hygiene — regular brushing, flossing and trips to the dentist's office — reduces  tartar, plaque, cavities, gingivitis and bone loss and helps the breath smell like roses.

But recent research shows that diabetes, low birth weight babies and heart disease are also linked to gum and bone disease in the mouth that can be prevented by teeth cleanings. Treating gum disease might even prevent heart attacks, a new study suggests.

"Systemically, visits to the dentist and hygienist may reduce the risk of cardiovascular disease, stroke and possibly heart attack, and can decrease the likelihood of tooth loss for diabetics," said Gwen Cohen-Brown, a dentist and lecturer for the New York State Department of Health.

The tooth-heart link
When people neglect to brush their teeth or floss, bacteria accumulate between the teeth. These bacteria can make their way into the blood stream.

"Certain bacteria present in the mouth may be related to clogging up the arteries by contributing to the plaque that builds on the walls of the arteries," said New York University oral microbiologist Walter Bretz.

And treating gum disease, or periodontal disease, can improve the long-term function of endothelial cells that line blood vessel walls, according to a study conducted by researchers at the University of Connecticut Health Center. With better performing endothelial cells, plaques that cause heart disease will decrease, diminishing the risk of triggering a heart attack.

The authors of the study, detailed in the March 1 issue of the New England Journal of Medicine, estimate that severe periodontitis affects up to 1 percent of adults in the U.S., and as many as 80 percent of American adults have some form of periodontal disease.

Unclear pregnancy results
Periodontal disease is also quite common among pregnant women. Expectant mothers' gums react differently to the bacteria due to their increased levels of estrogen and progesterone. Women may experience swelling, bleeding or tenderness in the gum tissue.

Several studies have linked gum disease to an increased risk of giving birth to a premature and underweight baby.

Yet, an article published in a 2006 issue of the New England Journal of Medicine reported that, although treatment of gum disease in pregnant women is safe and improves periodontal health, preterm birth and low birth-weight babies were unaffected by the treatment.

The jury is still out on whether a mother's unhealthy gums can affect her unborn baby, but scientists are learning more from a large clinical trial currently under way at the University of Minnesota, focusing on whether treating periodontal diseases in pregnant women may prevent preterm and low birth-weight babies.

Diabetes and dental health
Unlike the case for pregnancy, researchers have found direct links between gum disease and diabetes. Gum disease is known to increase the risk of diabetes, and vice versa.

Studies show that inflammatory periodontal diseases may increase insulin in the same way that obesity increases insulin.

Meanwhile, doctors recognize diabetes as an important risk factor for severe gum disease and infection that may result in the destruction of tissues and bone surrounding the tooth.

Taking care of teeth can combat complications of diabetes and may reduce inflammation throughout the body associated with diseases such as cardiovascular disease. 

In addition to biannual visits with the dentist and hygienist, Cohen-Brown recommends patients brush after every meal, of course. If that's impossible, she said, brush in the morning and at night before bed, floss daily and stay away from carbohydrate-rich and sugary foods.

"When oral health improves, overall health improves," Cohen-Brown told LiveScience.

source : msnbc.msn.com

Technorati Tags: dentist,life

Read More...

• 0 comments »

Scientists say they have pinpointed a genetic link that makes people more likely to get hooked on tobacco, causing them to smoke more cigarettes, making it harder to quit, and leading more often to deadly lung cancer.

The discovery by three separate teams of scientists makes the strongest case so far for the biological underpinnings of the addiction of smoking and sheds light on how genetics and cigarettes join forces to cause cancer, experts said. The findings also lay the groundwork for more tailored quit-smoking treatments.

"This is kind of a double whammy gene," said Christopher Amos, a professor of epidemiology at the M.D. Anderson Cancer Center in Houston and author of one of the studies. "It also makes you more likely to be dependent on smoking and less likely to quit smoking."

A smoker who inherits this genetic variation from both parents has an 80 percent greater chance of lung cancer than a smoker without the variants, the researchers reported. And that same smoker on average lights up two extra cigarettes a day and has a much harder time quitting than smokers who don't have these genetic differences.

The three studies, funded by governments in the U.S. and Europe, is being published Thursday in the journals Nature and Nature Genetics.

The scientists surveyed genetic markers in more than 35,000 people in Europe, Canada and the United States, zeroing in on the same set of genetic differences. They aren't quite sure if what they found is a set of variations in one gene or in three closely connected genes. But they said the result is the same: These genetic quirks increase the risk of addiction and lung cancer.

The studies' authors disagreed on whether the set of variants directly increased the risk of lung cancer or did so indirectly by causing more smoking that led to the cancer.

The genetic variations, which encode nicotine receptors on cells, could eventually help explain some of the mysteries of chain smoking, nicotine addiction and lung cancer that can't be chalked up to environmental factors, brain biology and statistics, experts said. These oddities include why there are 100-year-old smokers who don't get cancer and people who light up an occasional cigarette and don't get hooked.

In the last 40 years, the rate of adult Americans smoking has been cut from 42 percent in 1965 to less than 21 percent now.

The new studies point to surprising areas of the genes not associated with pleasure and addiction rewards. That may help explain why people have trouble quitting, said Dr. Nora Volkow, director of the National Institute of Drug Abuse in Bethesda, Md., which funded one of the studies. Eventual testing for the genetic variants could lead to custom treatments for quitting smoking.

"This is really telling us that the vulnerability to smoking and how much you smoke is clearly biologically based," said psychiatry professor Dr. Laura Bierut, of Washington University in St. Louis, and a genetics and smoking expert who did not take part in the studies. She praised the research as "very intriguing."

The studies mostly looked at smokers and ex-smokers -- although two of the studies also looked at several hundred nonsmokers. The research only involved white people of European descent. People of Asian and African descent will be studied soon and may yield quite different results, scientists said. Smoking-related diseases worldwide kill about one in 10 adults, according to the World Health Organization.

The studies show on average the consequences of the set of variations in the alphabet of genetic code that people inherit from each parent:

-- Smokers who get the set of variants from only one parent see a risk of lung cancer that is about one-third higher than people without any variants. They also smoke about one more cigarette a day on average than other smokers. This group makes up about 45 percent of the population studied.

-- Smokers who inherit the variants from both parents have almost a one in four chance of developing lung cancer. Their risk is between 70 and 80 percent higher than the cancer risk of other smokers without the genetic variants. They smoke on average of two extra cigarettes a day, and have a 45 percent higher risk of peripheral artery disease. This group accounts for about one in nine people of European descent.

-- Smokers who don't have the variants are still more than 10 times more likely to get lung cancer than nonsmokers. Smokers without the variant overall have about a 14 percent risk of getting lung cancer. By comparison the risk of lung cancer for people who have never smoked is less than 1 percent, said another study author, Paul Brennan of the International Agency for Research on Cancer in Lyon, France.

Brennan and Amos, working on different teams, linked the genetic variation itself -- when triggered by smoking -- directly to lung cancer. Brennan said the nicotine receptors that the variants act on also can stimulate tumor growth.

Brennan's study also found that lung cancer risk for nonsmokers with the variants was higher than for those without the variants. However, his small sample size of nonsmokers requires further study. Amos' study didn't find increased lung cancer risk for people with the set of variants who have never smoked.

But Kari Stefansson, lead author of the largest of the three studies and chief executive of deCode Genetics of Iceland, said the increased lung cancer risk was indirect, and that the variant caused more addiction and more smoking. It was the extra cigarettes from increased daily smoking and the inability to quit that contributed to the higher cancer risk, Stefansson said.

"It's very likely that in the end there's going to be a test and this is going to be folded into a panel of tests for the risk of cancers," said Stefansson, whose company already does prostate cancer genetic tests. The tests will lead to better treatments, but probably not prevention of smoking, he said.

Stefansson and others emphasize that people without the variants should not take that genetic finding as a green light to smoke. There are other smoking-related diseases and they would still be at high risk of lung cancer.

For Stefansson, the research hits home. His father, a smoker, died of lung cancer. And Stefansson, who doesn't smoke, frequently lectures his 23-year-old daughter "who smokes like a chimney." She acts like she is immortal and smoking can't kill her, Stefansson said. But his own research shows that her genes are probably stacked against her.

source : foxnews.com

Technorati Tags: health,genetic,tobacco

Read More...

• 0 comments »

Ask anyone along the dusty, pothole filled road heading to the tiny village of Saini, and they'll know who she is. The one with four eyes. The one with two mouths. The one with two heads.

They are not ashamed of the extraordinary looking little girl, the villagers who live near her, the young parents, the overprotective local doctor. That's because while she may only be two and a half weeks old, she is far more famous than any resident of this part of the country has ever been. She is famous because she was born with a condition known as facial duplication. She has one body and two faces.

"At first I was a little bit afraid," Vinod Kumar Singh, the 24-year-old father of the girl who still does not have a name, told ABC News. "But then I accepted whatever God gives."

In this case, God has given what many in this rural part of India consider a reincarnation of Ganesh, the Hindu God who is half person and half elephant. At first, hundreds of locals came to Saini to touch the girl's feet, dance at her bedside and offer the family money, thinking she was as divine a person as they would ever see.

"People from corner to corner from all India and all abroad come here to take the knowledge about this child," said Harsharan Singh, the village math teacher. "It's a gift of God… Some people say she is like a goddess. They call the baby a face of a goddess."

Her two faces and the single dimple on their shared check are as placid as any baby's. She is the first child of a farming family, one of about 100 people living in a village 40 miles outside of New Delhi. Here, the average income is less than $2 a day, and the locals either work the field or support those who work the field in any way they can.

During a recent visit by ABC News, villagers fanned the baby, swatting dozens of flies away so she could sleep. The village, like so many in India, is modest. There is no electricity, there are no toilets, and there is no technology.

The parents did not know that anything was wrong with their daughter until she was born. Tens of millions of pregnant women in rural India do not receive prenatal care.

source : abcnews.go.com

Technorati Tags: two-headed,trigger

Read More...

• 0 comments »

Learning stress management techniques could help people with a type of high blood pressure common among the elderly to eliminate their need for antihypertensive drugs, a new study shows.

Individuals with the condition, known as isolated systolic hypertension, who participated in relaxation training had a better chance of being able to drop at least one of their blood pressure drugs than individuals in a control group who did not participate in relaxation training, Dr. Jeffery A. Dusek of Massachusetts General Hospital in Boston and colleagues found.

If the findings are confirmed in patients with other types of hypertension, Dusek and colleagues conclude, the benefits in preventing stroke, heart attack, kidney failure and other ill effects of high blood pressure -- as well as reducing spending on drugs -- would be "incalculable."

As people age, their systolic blood pressure -- the top number in the blood pressure reading -- tends to rise, while their diastolic blood pressure, or the bottom number, often drops, Dusek and his team explain in the Journal of Alternative and Complementary Medicine.

Up to three-quarters of elderly people with hypertension have isolated systolic hypertension, which is a "therapeutic challenge" to treat effectively, given the risk of lowering diastolic blood pressure too much, as well as the fact that many elderly people take multiple medications, they note.

To determine whether learning stress management techniques could help people manage systolic hypertension without drugs, the researchers randomized 122 hypertensive men and women aged 55 and older to 8 weeks of relaxation response training or a control group. All were taking at least two antihypertensive drugs at the study's outset.

Individuals in the relaxation response group participated in weekly sessions that included 15 minutes of instruction in how to produce the response (such as mindfulness meditation and deep breathing), along with a guided 20-minute relaxation response session. They were instructed to listen to a 20-minute relaxation response tape every day.

Patients in the control group listened to a series of 20-minute tapes of instructions on lifestyle modification techniques.

At the end of 8 weeks, 44 people in the relaxation response group and 36 control group participants had reduced their blood pressure to target levels and were eligible for an additional 8 weeks of training that included supervised antihypertensive medication elimination.

More : reuters.com

Technorati Tags: relaxation,hypertension,skills

Read More...

• 0 comments »

Leading doctors urged a return to older, tried-and-true treatments for high cholesterol after hearing full results Sunday of a failed trial of Vytorin.

Millions of Americans already take the drug or one of its components, Zetia. But doctors were stunned to learn that Vytorin failed to improve heart disease even though it worked as intended to reduce three key risk factors.

"People need to turn back to statins," said Yale University cardiologist Dr. Harlan Krumholz, referring to Lipitor, Crestor and other widely used brands. "We know that statins are good drugs. We know that they reduce risks."

The study was closely watched because Zetia and Vytorin have racked up $5 billion in sales despite limited proof of benefit. Two Congressional panels launched probes into why it took drugmakers nearly two years after the study's completion to release results.

Results were presented at an American College of Cardiology conference in Chicago Sunday and published on the Internet by the New England Journal of Medicine.

Doctors have long focused on lowering LDL or bad cholesterol as a way to prevent heart disease. Statins like Merck & Co.'s Zocor, which recently came out in generic form, do this, as do niacin, fibrates and other medicines.

Vytorin, which came out in 2004, combines Zocor with Schering-Plough Corp.'s Zetia, which went on sale in 2002 and attacks cholesterol in a different way.

The study tested whether Vytorin was better than Zocor alone at limiting plaque buildup in the arteries of 720 people with super high cholesterol because of a gene disorder.

The results show the drug had "no result — zilch. In no subgroup, in no segment, was there any added benefit" for reducing plaque, said Dr. John Kastelein, the Dutch scientist who led the study.

That happened even though Vytorin dramatically lowered LDL, fats in the blood called triglycerides and a measure of artery inflammation — CRP.

Some doctors noted that hormone pills for menopausal women and torcetrapib, a promising cholesterol drug Pfizer Inc. recently abandoned, also lowered cholesterol but were found in big studies to raise heart risks, not lower them.

more : abcnews.go.com

Technorati Tags: cholesterol,drug

Read More...

• 0 comments »

ATLANTA, Georgia (CNN) -- When her son Justin was a newborn, Shannon Kinninger looked up from the kitchen where she was washing dishes, and saw a large, heavy toy fall on his head. Justin didn't cry.

Kinninger thought that was odd, and it wasn't the only thing that seemed strange about Justin. At her weekly playgroup, she watched the other babies hit their developmental milestones more or less on schedule. Justin lagged far behind.

"When he was supposed to be sitting up, he wasn't sitting up. When he was supposed to be holding his head up, he wasn't holding his head up. When he was supposed to be rolling over, he wasn't rolling over," says Kinninger, a nurse who lives in Fayetteville, Georgia.

Kinninger brought up her concerns to her pediatrician, but he told her not to worry. "The doctor kept saying that boys develop more slowly than girls," she says. "He kept reassuring me he'd be OK."

Even though she felt frustrated, Kinninger accepted this explanation for years. Finally, when Justin was 4, she decided enough was enough. Justin wasn't potty trained, and he had unusual repetitive behaviors, such as switching lights on and off for extended periods of time, or washing his hands over and over. Plus, he wouldn't look at people -- he looked "through" them.

She switched doctors, and the new pediatrician referred her to a developmental pediatrician. "He said, 'He's autistic. I knew five minutes after you came in,' " Kinninger says. "I thought, finally, we get a diagnosis."

Now Kinninger thinks about all those lost years -- from babyhood to 4 years old -- critical years when Justin could have been receiving therapy for children with autism, but didn't. She now tells other parents of children with autism they need to be advocates for their children, from the very first moment they show signs of having autism.

Here, from mothers of children with autism, are ways parents should fight for their children with autism, from babyhood through the school years.

1. Trouble getting a diagnosis? Bring in video, letters.

If you're concerned your child has autism, and you're getting the same response Kinninger got from her pediatrician, remember doctor's visits are often short, and your child may not be displaying the worrisome behavior you've seen so often at home. Alison Singer, executive vice president of Autism Speaks, an awareness and advocacy organization, suggests videotaping your child's behavior and showing it to the doctor. "You could play it on your laptop, or even just bring in the video camera," she says.

Getting a letter of support from your child's day-care provider or preschool teacher might also help.

"Teachers are seen as other professionals, and a letter saying, 'In 20 years of teaching, this behavior is really unusual,' can go far," says Singer, who has a 10-year-old daughter with autism. If your child isn't in day care or school, even a letter from a neighbor who knows your child could help, she says.

Singer emphasizes that parents shouldn't push their pediatrician for a diagnosis. "We're saying, refer the child to a developmental pediatrician for additional screening and testing. Because when a parent thinks something is wrong with their child, they're usually right," she says.

Educating yourself about autism will also help you have a discussion with your pediatrician. Autism Speaks, First Signs, and the American Academy of Pediatrics all give excellent overviews. Autism Speaks' Video Glossary has more than 100 video clips comparing the behavior of children with autism spectrum disorders with the behavior of a typical child.

2. Sign up for early intervention

Any child younger than age 3 with a developmental delay is eligible to receive services through Early Intervention, a government-mandated program that provides services to eligible children. Services are free of charge, and vary from state to state, but may include speech and language instruction and occupational and physical therapy.

To learn how to apply for Early Intervention, click on this state-by-state directory from the National Dissemination Center for Children with Disabilities and scroll down.

Early Intervention is invaluable because it links parents to services in the community, but Lisa Goring, mother of a child with autism and director of family services at Autism Speaks, warns that parents may also have to search on their own, since it can be hard to find services without a long waiting list. "There just aren't enough service providers for the kids who need them," Goring says. To find services on your own, wrightslaw.com, which offers information about special education law and advocacy, has a Yellow Pages for Kids that lists providers.

Long waits are so prevalent that Nancy Wiseman, founder and president of the advocacy group First Signs, whose 12-year-old daughter has autism, has a few suggestions for how to get in quicker. First, parents should stress the age of their child (many clinics will give priority to children under 3), and should ask the pediatrician to make a call to the specialist. More suggestions are in her book "Could it be Autism? A Parent's Guide to the First Signs and Next Steps."

3. Know your child's rights in school

When your child enters public school, he or she has rights under federal and state laws. The U.S. Department of Education has information about federal laws and state laws. The National Association of Parents with Children in Special Education has information about children's legal rights as well.

Wiseman says that even with these protections, you'll still have to work to get what's best for your child.

For example, Wiseman moved to get into a different school district, and then a few years later, when that district no longer worked well for her daughter, she twice fought to place her child out of the district.

"It's very frustrating to battle a school, and you really have to do your homework," she says.

You and the district will come up with an Individual Education Plan. Wiseman recommends "The Complete IEP Guide: How to Advocate for Your Special Ed Child" by attorney Lawrence Siegel.

Also, school districts often have a Special Education Parent Teacher Association. Parents there can often give good advice on how to work with the school district.

4. Sign up for a research study

If you live near a major research university, Wiseman suggests finding out whether anyone is looking for children with autism for research studies. Sometimes, these universities will provide care for your child as part of the study. Wiseman's group, First Signs, has a list, as does Autism Speaks.

5. Get support from other parents

Judith Steuber, who raised two grandsons with autism, said that if she had to do it all over again, she would do one thing very differently. "From the beginning, I wish I'd had more support from other parents," says Steuber, who now acts as a mentor for special-needs parents in her school district. "I think that makes a big difference."

Autism Speaks has a state-by-state list of support groups. You can find a chapter of The Autism Society of America here.

There are electronic support groups on Yahoo, the Berkeley Parents Network, and Autism Web. The Arc has support groups for people with intellectual and developmental disabilities; Wiseman says many have a large number of parents of children with autism.

Technorati Tags: health,guide

Read More...

• 0 comments »

NEW YORK (Reuters Health) - Along with genetic, metabolic and environmental factors, a team of researchers at Johns Hopkins University in Baltimore suggest that autism may also be caused or triggered by maternal antibodies that cross over through the placenta and are directed against the brain tissues of the fetus, adversely affecting brain development.

Dr. Harvey S. Singer and colleagues note that children with autism have antibodies in the blood that react against brain tissue. Antibodies are an important part of the immune system in which proteins are produced and mount a defense in response to the presence of a foreign body, such as an invading virus.

Most studies into the origin of autism have focused on autoantibodies as a possible explanation. Autoantibodies are antibodies the body makes that react against the body's own tissues by mistake; this mechanism is involved in allergic reactions and autoimmune diseases.

However, another possible explanation involves the transfer of reactive antibodies from the mother through the placenta to the fetus.

To investigate the latter, the team measured the antibody-brain reaction in blood samples from 100 mothers with and 100 mothers without a child diagnosed with autism.

Mothers of children with autism had a stronger reactivity or more areas of reactivity between antibodies and brain proteins compared with mothers without an autistic child. The presence of maternal antibodies also correlated with having a child with developmental regression, a primary feature of autism.

"Our research suggests that the mother's immune system may be yet another factor or trigger in those already predisposed" to autism, Singer commented in a university release.

"The mere fact that a pregnant woman has antibodies against the fetal brain doesn't mean she will have an autistic child," Singer cautioned. "Autism is a complex condition and one that is likely caused by the interplay of immune, genetic and environmental factors."

The researchers are now studying the effect of maternal antibodies in pregnant mice. Preliminary results show that the offspring of mice injected with neural antibodies exhibit developmental and social behaviors suggestive of autism.

SOURCE: Journal of Neuroimmunology, February 2008.

Technorati Tags: antibodies,autism

Read More...

• 0 comments »

Among the important issues raised by the pregnancy of Oregonian Thomas Beatie is whether a female-to-male transgender person who becomes pregnant might be endangering the fetus, especially someone like Beatie, who has been taking testosterone for at least 10 years.

There's very little research on the subject to date, and some experts are at odds about it. Dr. Charles Garramoni, a Florida plastic surgeon who specializes in female-to-male transgender surgery (but was not involved in Beatie's case), said the chances of complications are probably slim.

"As long as he is under the strict care of a endocrinologist, as long he has hadn't just gotten the testosterone from the Internet or something, as long as the endocrinologist says everything is OK, there's no reason to think otherwise."

But Michael Bartalos -- a New York geneticist and internist who works with many transgender patients -- said that he would be concerned about the health of the eggs in Beatie's body.

Because women are born with all the eggs they will carry for life, long-time exposure to chemicals or hormones can have an adverse effect. Any possible damage done by 10 years of testosterone would be irreversible, he said.

And even if Beatie's baby is born healthy, he said, "Who knows what might happen to her in 20 years? [The baby] could be at higher risk for certain types of cancer development."

Beatie, a small-business owner, created a stir this week after announcing he is six months pregnant. Beatie, who was born female, underwent sexual reassignment surgery 10 years ago but, like many transgender people, kept his reproductive organs intact.

Another issue is whether Beatie and others like him could be setting their children up for playground misery and years upon years on a psychiatrist's couch. But Katherine Rachlin, a psychologist who works with transgender people and their families, believes this worry is unfounded, if understandable.

"People often ask that question about transgender parents in general, but research shows that the children adjust fine," Rachlin said.

source : abcnews.go.com

Technorati Tags: transgender,problem

Read More...

• 0 comments »