Health Care Tips  Health Care Blog Health Care Blog: April 2008
Cuddling up against mother's bare skin can help tiny premature babies recover more quickly from the pain of being stuck with needles and other procedures, Canadian researchers reported on Wednesday.
Babies held tightly against their mother's skin in a "kangaroo mother care" position squirmed and grimaced less than babies swaddled in blankets, the researchers found.
"Skin-to-skin contact by the mother, referred to as kangaroo mother care, has been shown to be efficacious in reducing pain in three previous studies," Celeste Johnston of McGill University School of Nursing in Montreal and her colleagues wrote in the journal BioMed Central Pediatrics.
But those studies involved older babies. Her team tested 61 preterm babies born between 28 and 31 weeks.
Such preemies spend weeks in neonatal intensive care units and are often subjected to painful medical procedures. Parents and nurses alike find it one of the most distressing things about having an infant in the unit, the researchers said.
Johnston's team assigned half the newborns to "kangaroo mother care" and half to the usual condition of being swaddled in an incubator.
"In the experimental condition, the infant was held in kangaroo mother care for 15 minutes prior to and throughout heel lance procedure," they wrote.
They measured the babies' responses using the Premature Infant Pain Profile, which measures grimacing, maximum heart rate and blood oxygen saturation levels.
"The pain response in very preterm neonates appears to be reduced by skin-to-skin maternal contact," Johnston said in a statement.
"This response is not as powerful as it is in older preterm babies, but the shorter recovery time using (kangaroo mother care) is important in helping maintain the baby's health." |
While enjoying a cola or two every day might seem harmless enough, recent research suggests that those tasty drinks could be compromising your bone health.
"There is enough evidence that high consumption of soda and carbonated beverages is associated with somewhat lower bone mass in children, and that's a real concern and people should be aware of it," said Dr. Lawrence Raisz, director of the University of Connecticut Center for Osteoporosis.
The exact mechanism behind the problem isn't clear, but experts believe that drinking soda -- particularly colas -- affects bone density in several ways. One reason may be that people who drink colas are simply less likely to get enough calcium and vitamin D in their diets, because the soda is replacing more nutritious beverages, such as milk or calcium-fortified juice.
Or, it could be related to the caffeine in colas, because caffeine has been linked to a higher risk of osteoporosis.
The third possible explanation focuses on one of the ingredients found in colas: phosphoric acid. Phosphoric acid can cause an imbalance in the body as the body seeks to neutralize the acid with calcium. If there isn't enough calcium in the diet, the body will take calcium from the bones.
"Phosphate is in milk, but milk also contains calcium and vitamin D. In soft drinks, there is just phosphoric acid and no calcium. Extra overzealous drinking may lead to a phosphoric acid imbalance, and if there's not enough calcium, the body goes to the bones to restore the balance," explained Dr. Primal Kaur, director of the Osteoporosis Center at Temple University Health Sciences Center in Philadelphia.
Low levels of calcium are associated with the development of osteoporosis, a disease that thins the bones so much that they're at risk of fracture. More than half of Americans, especially postmenopausal women, have an increased risk of developing osteoporosis, according to the National Osteoporosis Foundation.
In a study that included more than 2,500 people with an average age of about 60, researchers from Tufts University found that cola consumption by women was associated with lower bone mineral density at three hip sites, regardless of age, menopause, total calcium and vitamin D intake. The women reported drinking an average of five carbonated drinks a week, four of which were colas. |
Women who play sports are prone to tearing the knee ligament that connects the thighbone to the shinbone. Beyond the immediate pain and swelling it can cause, there's now reason to suspect that this type of injury may lead to another vexing health problem.
Researchers at the Mayo Clinic in Rochester, Minn., found that young women who had surgery to repair the anterior cruciate ligament (ACL) suffered significant bone loss around the knee even two years later. And that damage was seen even though they had undergone rehabilitation.
"Despite telling them to weight-bear early and put weight on the leg, people are going to protect an operative limb," said study author Dr. Diane L. Dahm, an assistant professor of orthopedics at Mayo. "So, it's probable that the forces going across that operative limb were not as great as the opposite limb, early on especially."
The findings were first reported at a meeting of the American Academy of Orthopaedic Surgery (AAOS).
Ligaments are tough fibers that hold bones together. The ACL, located toward the front of the knee, gives you stability on your feet. But if you land the wrong way or change direction quickly, that ligament can tear. You might even hear a "popping" sound when it happens.
Each year, an estimated 38,000 women sustain ACL tears. In fact, the incidence of ACL injuries is two to eight times greater among women than men, he AAOS said.
Even in the same sport, women are more likely to injure their ACL than men. Female basketball players, for example, are twice as likely as their male counterparts to tear an ACL, while the incidence of these injuries is four times greater among women soccer players than men who play this sport, the AAOS noted.
Although the reason for this gender gap isn't clear, orthopedic experts suspect hormones and differences in the way women use their muscles may play a role.
Dahm and her colleagues studied 18 female athletes ranging in age from 16 to 40. All were fairly active and involved in some sort of exercise, although not necessarily an organized sport. The researchers chose age 40 as the cutoff to eliminate any patients who might have osteoporosis related to early menopause.
After undergoing ACL reconstruction, the women participated in a rehabilitation program that involved routine visits with physical therapists and sports psychologists.
Before surgery, there were no significant differences in bone density between the injured and uninjured legs. Three months after surgery, however, the researchers found striking differences in bone density between the injured limb and the unaffected one. While there were improvements in the women's injured limbs over two years, "they did not get back to completely normal," Dahm observed. |
The Internet offers a dizzying amount of health information -- whatever ails you, someone is sure to have posted something about it somewhere on the Web.
But all that information can lead to overload -- or worse. You might end up heeding the wrong voice and getting some fairly bad advice.
"There's a lot of quackery on the Web," said Don Powell, president and CEO of the American Institute for Preventive Medicine. "There's a lot of bias on the Web. The Web is just wrought with misinformation and badly dated information."
One good basic piece of advice is to stick to sites ending in ".edu," ".gov" or ".org," Powell said. That means the site is run by a school, a government agency or a nonprofit organization and is, therefore, less likely to push a biased point of view, unlike some ".com" -- or commercial -- sites.
Another good way to judge a site is to see whether it's been accredited, Powell said. He noted two groups that are active in certifying sites as accurate and up-to-date: URAC and Health on the Net (HON).
"We ask people when they look on the Web that they make sure the site is accredited," he said. "It's a good way to establish trustworthiness."
Web sites published by companies or individuals can contain some good advice, but health consumers need to be more discerning when using those sites, said Dr. Jim King, a family practice doctor in Selmer, Tenn., and president of the American Academy of Family Physicians.
First, see who is paying for the information you are viewing. The ads supporting a site can be a hint to possible bias, King said. "It may be skewed one way or the other, based on their advertisements," |
Now new research has uncovered the existence of a pattern of activity across two regions of the brain that occur up to 30 seconds before some, but not all, errors are made.
The finding counters the popular view that human error is simply a function of instantaneous brain blips, while also suggesting that some mistakes are neurologically predictable. And in theory, the mapping of such brain sequences could ultimately lead to the development of brain-monitoring techniques intended to boost individual safety by warning of imminent mistakes.
"It's not that this pattern of brain activity always happens before an error," said study author Dr. Tom Eichele, of the department of biological and medical psychology at the University of Bergen, in Bergen, Norway. "But we did see that when you have this pattern, the likelihood of making an error is 50 percent greater than otherwise."
Eichele and his team reported the findings in this week's issue of the Proceedings of the National Academy of Sciences.
The authors set out to observe pre-error brain activity with the aid of functional MRIs. This scanning technology allows physicians to take snapshots of changes in brain blood flow that accompany any increase or decrease in activity throughout different regions of the brain.
Thirteen healthy men and women between the ages of 22 and 29 participated in the study.
All were asked to engage in a standard visual test known as the "flanker task." This visual exercise required the participants to quickly view repeated images of a central pointed arrow surrounded by peripheral arrows pointing either in the same director or in the opposite direction of the center arrow.
The participants had to repeatedly identify -- as fast as possible -- whether or not each successive picture displayed central and peripheral arrows pointing together or inversely. The researchers noted that typically when arrows do not all point in the same direction response time slows and becomes less accurate.
About 400 rounds of the flanker task exercise were conducted, and an analysis of fMRI brain scans taken during the test revealed that prior to the commission of an error, the brain launched two simultaneous activities in two distinct brain regions.
The first site of activity was the frontal lobe of the brain, which controls cognition and working memory. A boost in this region's activity usually occurs to optimize a person's ability to maintain and complete tasks. However, before making of a mistake, this area was found to gradually ratchet down its activity. |
The first signs that men are at higher risk of heart disease than women appear during the adolescent years, according a new study that tracked boys and girls through their teens.
"This is not what we would have predicted," said Dr. Antoinette Moran, chief of pediatric endocrinology and diabetes at the University of Minnesota Children's Hospital, and lead author of the report in the April 22 issue of Circulation. "Because boys lose fat and gain muscle in adolescence, while girls add body fat."
At the start, 11-year-old boys and girls were similar in body composition, blood pressure and blood levels of lipids (fats). As expected, the percentage of body fat decreased in the boys and increased in the girls over the adolescent years.
Yet the study of the 507 Minneapolis school children found that between the ages of 11 and 19, levels of triglycerides, a type of blood fat associated with cardiovascular disease, increased in the boys and dropped in the girls. Levels of HDL cholesterol, the "good" kind that helps keep arteries clear, went down in boys but rose in girls.
Blood pressure increased in both, but significantly more in boys. And insulin resistance, a marker of cardiovascular risk, which was lower in boys at age 11, rose until the 19-year-old men were more resistant than the women.
But excess weight is of major importance in both sexes, Moran said. "Being overweight or obese can cancel out these relationships and cause increased cardiovascular risk for males and females," she said. "Any protection that the young women had was wiped out by obesity."
A recent study found that more than a third of children and adolescents in the United States are overweight or obese.
The study points toward the importance of hormonal factors in cardiovascular disease risk, Moran explained. "We knew that women had extra protection from cardiovascular disease, and we knew it disappeared after menopause," she said. "This adds further weight to the role of hormones by looking at the other end of the age spectrum."
One possible lesson of the study is that it is never too early to start protective measures against heart disease, said Dr. Stephen R. Daniels, chairman of the department of pediatrics at the University of Colorado. |
To prevent injuries to your eyes while playing sports, you need to go pro -- as in protective eyewear, advises the American Optometric Association (AOA).
With spring here and more people heading outside for fun and exercise, the association noted that about 600,000 documented sports-related injuries are reported annually in the United States. Roughly 13,500 of these injuries result in permanent loss of sight.
Even non-contact sports such as tennis, golf and fishing pose a moderate to high risk of eye injury because of flying objects, such as balls, racquets and hooks.
"Eye protection should be of major concern to all athletes, especially in certain high-risk sports," Paul Berman, AOA optometrist and sports vision specialist, said in a prepared statement. "Thousands of children and adults unnecessarily suffer sports-related eye injuries each year. Every thirteen minutes, an emergency room in the United States treats a sports-related eye injury, and nearly all could be prevented by using the proper protective eyewear."
Everyday prescription eyewear or sunglasses probably won't do the trick as most conventional frames and lenses fail to meet minimal impact requirements for most sports, an AOA advisory cautioned.
Sports-protective eyewear, however, is tested to meet rigid standards, and some have been independently verified and received the AOA Seal of Acceptance.
Going to an optometrist for an eye exam is the first step and a crucial one for amateur athletes as well as professionals.
"Doctors of optometry work with their patients to provide unique, advantaged eyewear solutions in order to protect vision and improve performance in athletics," Berman said. "I encourage you to visit your local optometrist to discuss options for vision protection, correction and enhancement." |
Regular physical exercise may help protect against mild cognitive impairment, according to a Mayo Clinic study. People with mild cognitive impairment can handle everyday activities but often have trouble remembering details of conversations, events and upcoming appointments. Most, but not all, people with mild cognitive impairment experience a progressive decline in their cognitive abilities, and the underlying cause is usually Alzheimer's disease, according to background information in the study.
The physical benefits of exercise are well-known, but this is one of the first studies to examine whether exercise can help protect the brain. The Mayo researchers randomly selected 868 people, aged 70 to 89, taking part in the ongoing Mayo Clinic Study of Aging. Of these people, 128 had mild cognitive impairment, and 740 were cognitively normal. The researchers conducted surveys to gather data on the participants' levels of exercise between the ages of 50 and 65 and during the year prior to the survey.
Moderate physical exercise between the ages of 50 and 65 was associated with a reduced risk of cognitive impairment, but the same was not true of exercise during the year prior to the survey. The study was expected to be presented Wednesday at the American Academy of Neurology annual meeting, in Chicago. Lead investigator and neuropsychiatrist Dr. Yonas Endale Geda said the findings need to be replicated in a prospective cohort study, and also noted that this study did not address how physical exercise may protect against mild cognitive impairment.
"Regarding the mechanism of action of physical exercise and mild cognitive impairment, we speculate that either exercise induces chemicals that protect brain cells, or exercise is simply a marker for an overall healthy lifestyle, or there is some positive interaction among exercise, healthy lifestyle and intellectually stimulating activity," Geda said in a prepared statement.
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Racial and ethnic variations in how women perceive their cancer risk may influence how likely they are to get screened for cancer, particularly colon cancer, says a University of California, San Francisco study. The researchers interviewed 1,160 women, ages 50 to 80, about breast, cervical and colon cancer. The women's perceived personal risk for each type of cancer was measured on a word scale and compared with self-reported cancer screening behavior.
There were 338 white women (29 percent), 167 black women (14 percent), 239 Hispanic women (21 percent) and 416 Asian women (36 percent) in the study. The researchers found that perceived risk for each cancer varied by ethnicity. Asian women had the lowest perceived risk for breast, cervical and colon cancers and Hispanic women had the highest perceived risk.
"This perceived risk was associated with obtaining self-reported cancer screening tests after other factors were accounted for," the study authors wrote. Almost half the women (572) reported either a personal or family history of cancer, and this type of history was associated with higher perceived risk for breast and colon cancer. Compared to those with no history of cancer, women with a family history of the disease were almost twice as likely to have had a colonoscopy to screen for colon cancer.
Evaluation of perceived risk of cancer may be useful to clinicians who are recommending screening tests and incorporating an intervention to help diverse populations understand risk and interpret medical data, the researchers concluded.
The study was published in the April 14 issue of the journal Archives of Internal Medicine. According to background information in the study, a woman's risk of developing and dying from cancer varies by race and ethnicity. For example, black women are most likely to develop colon cancer and to die from breast or cervical cancer, while Hispanic women are at increased risk to develop and die from cervical cancer but less likely to develop breast or colon cancer.
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With a bit of planning, effort and common sense, many people can boundary their suffering or perhaps even avoid it altogether, according to Dr. Mark Dykewicz, professor of inside medicine and chief of allergy and clinical immunology at the Saint Louis University School of Medicine.
For the most part, seasonal allergies are caused by airborne pollens -- very fine powder released by trees, grasses and weeds as they pollinate and fertilize other plants of the same kind. Molds in outdoor air can also contribute to seasonal allergies. Although outdoor allergens can be present year-round in warmer climates, allergy season generally begins in late winter or early coil and runs through late summer or early fall.
- Use over-the-counter antihistamines for relief. For some people, these drugs are very effective at reducing the model symptoms of seasonal allergies, including sneezing, runny nose, itchy eyes and scratchy throat. Be aware that some older-generation antihistamines, such as Benadryl, can cause sleepiness and the impairment of thinking and driving. More recent formulations tend to cause no drowsiness or less drowsiness Dykewicz said.
- Keep your home's doors and windows closed. You can't totally seal off your home, but keeping doors and windows closed can help prevent pollens and outdoor molds from entering. As the climate turns nicer, use the air conditioner rather than opening a window to bring in "fresh" air.
- Limit outdoor activity, chiefly in the morning. Avoid being outdoors, especially to exercise, when pollen counts are high, or on windy days when pollen and molds are being blown about. In general, pollen counts are highest from about 5 a.m. to 10 a.m.
- When traveling by car, keep the windows up. Again, this helps keep out pollens, dust and mold.
- Take a shower and change clothes. Pollen can collect on clothes and in your hair, so when you've been outside for any significant amount of time, shower and change into fresh clothes as soon as you get home.
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Babies who get less than 12 hours of sleep a day face twice the risk of being overweight as preschoolers.
And, some parents may inadvertently contribute to their child's sleep problems by taking steps intended to soothe the child that, in reality, lead to disrupted sleep.
That's the conclusion of two reports in April's special issue of the Archives of Pediatrics & Adolescent Medicine, which is devoted to children and sleep.
The combination of too little sleep and too much TV is associated with markedly elevated risk of obesity, explained Dr. Elsie M. Taveras, an assistant professor of ambulatory care and prevention at Harvard Medical School and lead author of the first study.
Our findings clarify the long-debated relationship between parental behaviors and childhood sleep disturbances," the authors concluded. They suggest that co-sleeping and other uncommon parental behaviors have negative consequences for future sleep and are thus maladaptive."
Sleep problems in schoolchildren with ADHD are extremely common and strongly associated with poorer quality of life, daily functioning and school attendance in the child and poorer caregiver mental health and work attendance, wrote the researchers, who were headed by Valerie Sung, of the Centre for Community Child Health in Parkville.
Implementation of a sleep intervention in children with ADHD could feasibly improve outcomes beyond treatment of ADHD alone. It is possible that such intervention could reduce the need for medication in some children, they added. |
Researchers renowned the findings in a study of 5,840 people from birth to the age of 31; however, few heart-related troubles have appeared among the participants, probably because they are still relatively young. The researchers intend to follow them for at least another 20 years.
The Finnish study, probable to be published in the April 10 issue of the European Heart Journal, may highlight the role that starting healthy lifestyles at birth could play in preventing heart problems.
The researchers looked at the participant's levels of C-reactive protein (CRP) in their blood. The liver secrets CRP, and somewhat elevated levels can indicate a chronic, low-grade inflammation. The study, done on Finnish participants, found that those who were amongst the negligible at birth, but who then put on the most weight by age 31, had the highest average CRP levels.
Low-grade irritation is important, because it has been associated with future cardiovascular events in many population studies over the past few years, and it may play a role in the development of cardiovascular disease, study co-author Paul Elliott, head of the Department of Epidemiology and Public Health at Imperial College London, said in a prepared statement.
CRP levels were 16 percent higher per 1 kilogram lesser birth weight, 21 percent higher per 10 centimeters shorter length at birth, and 24 percent higher per 1 kg/m3 lower at birth, after adjusting for potential confounding factors. Every extra kg/m2 gained from the age of 14 to 31 was associated with a 16 percent rise in CRP levels; this association was greatest for people who had the highest BMI at age 14.
The finding that weight gain from adolescence to young adulthood appears to play a greater role in low grade inflammation than weight in adolescence per se, could have important implications for the primordial prevention of cardiovascular disease. Promoting healthier lifestyle in childhood and adolescence, leading to weight stabilization, might be a crucial step in establishing a low cardiovascular risk profile in young adults.
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Overseas visitors on temporary visas are not eligible for Medicare benefits unless they are from a country through which Australia has a 'Reciprocal Health Care Agreement'. Currently, Australia has agreements with United Kingdom, Malta, Finland, Sweden, Italy, New Zealand, the Netherlands and Ireland. If you are visiting Australia from these countries, you are normally covered for emergency treatment only in a public hospital. If you are unsure of your Medicare eligibility status, you should confirm with your local Medicare office, which is listed in your local telephone book.
A number of private health funds provide health cover for overseas visitors. Some have special tables of repayment for overseas visitors and others provide similar coverage under hospital tables available to Australian residents. Benefits available, membership costs and eligibility can vary between funds.
The contact details for the health funds can be establish in the 'Yellow Pages'under health insurance. Or, if you would like information relating to the various health funds via the Internet, the Private Health Insurance Administration Council website details all registered health funds within each state. It also provides contact details for each fund and, if they have a web site, a link to each fund's website.
Overseas visitors health cover does not count towards Lifetime Health Cover as it is not required to contribute to the support of community rating as normal Australian private health insurance does. Community rating requires Australian private health funds to charge everyone the same premium regardless of health status and claims history.
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Reproductive technology is the term used to describe the range of medical treatments available to assist couples to conceive. The majority of people seeking assisted conception technologies are infertile. Infertility means being unable to conceive a baby naturally after at least 12 months of regular, unprotected sexual intercourse. It affects approximately 15% of Australian couples of reproductive age. The causes can lie equally with a woman or a man and in 20% of couples infertility is unexplained or 'idiopathic' (1).
Previously there were only two remedies available for infertile couples: remaining childless or adopting a baby. Whilst remaining childless is a legitimate choice made by a number of couples, many men and women experience a strong desire to have a child. The inability to have a child can be devastating and involve a lengthy process of loss and grief.
Since the late 1970s, significant scientific and medical advances in reproductive technology have changed the way women can have children, and even definitions of motherhood and fatherhood. Reproductive technology, however, does have its drawbacks. The success rate is relatively low and the treatments can be both financially and emotionally draining. There are also ongoing debates about the ethical, moral and legal dimensions of reproductive technology. |
All health-care professionals are invited to go to the Clinical Center Grand Rounds Series. (March 1, 2008 - August 31, 2008). After attending this activity, participants will be able to (1) define options and alternatives that will guide clinical practice, (2) evaluate practical information existing about clinical research principles based on state-of-the-art scientific discovery and clinical advances, and (3) analyze information and opportunities to increase and improve collaboration among investigators.
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the Johns Hopkins University School of Medicine and The National Institutes of Health. The Johns Hopkins University School of Medicine is accredited by the ACCME to provide continuing medical education for physicians. The Johns Hopkins University School of Medicine designates this educational movement for a maximum of 23 AMA PRA Category 1 Credit(s). Physicians should only claim credit commensurate with the extent of their participation in the activity.
It is the policy of the Johns Hopkins University School of Medicine that the speaker and provider disclose real or apparent conflicts of interest relating to the topics of this educational activity, and also disclose planning of unlabeled/unapproved uses of drugs or devices during their presentation(s). The Johns Hopkins University School of Medicine OCME has established policies in place that will identify and decide all conflicts of interest prior to this educational activity. Detailed disclosure will be made in the activity handout materials.
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