Monday, December 29, 2008
Jetting off to sunnier climes this winter, kids in tow?If so, take steps to guard the little ones' health, advises an expert.
"The most common infectious disease threats to children traveling to underdeveloped, tropical regions of the world may result from exposure to contaminated food and water, and disease carrying insects. With the help of available destination-specific vaccines such as hepatitis A, typhoid fever and yellow fever, parents can feel more comfortable traveling with young children," Dr. Andrea Summer, an associate professor of pediatrics at Medical University of South Carolina, said in an ASTMH news release.
In addition, children should be up to date on all routine vaccinations, including an annual flu shot.
Vaccines are just one way to protect children, and parents need to take other precautions. Summer offered the following tips:
- Avoid contact with animals. In developing countries, animals often aren't vaccinated and can carry a number of transmittable diseases, including rabies.
- Use bed nets, long pants, long sleeve shirts and DEET-based repellents to protect against mosquitoes, which can carry diseases such as malaria and dengue fever.
- Beware of toxins such as insecticides, lead-based paints, rodent bait, and plants and flowers that may be poisonous.
- If children are going to be playing in water, parents need to bring proper safety devices, such as life preservers, which are not available in many underdeveloped and rural areas.
- Parents should also bring a child car seat or booster seat with them, since they aren't always available in developing countries.
"Prevention doesn't end when travelers return home. There are various post-travel symptoms, such as fever, persistent or bloody diarrhea, and respiratory infections that parents should watch for in children, as they can be indicators of a more serious problem and require immediate medical attention," Summer said.
Monday, December 22, 2008
Age is a factor for women with heavy menstrual bleeding who undergo a procedure to remove the endometrium, or lining of the womb. The younger they are at the time of the procedure, the more likely they will eventually require a hysterectomy, according to a new report.
Dr. Mindyn K. Longinotti, from Kaiser Permanente Northern California in San Francisco, told Reuters Health, "The main change that has occurred in my counseling of patients after this research is the ability to discuss failure rates of endometrial ablation based on the patient's age." Over the long term, the probability of not needing a hysterectomy is "more likely in women over the age of 45."
Longinotti and colleagues conducted a study to identify what factors predicted that so-called endometrial ablation wouldn't solve the problem of heavy bleeding and that a hysterectomy would be needed eventually.
Among 3681 women who underwent endometrial ablation, 774 (21 percent) subsequently needed a hysterectomy, the investigators report in the medical journal Obstetrics & Gynecology.
Age was the only significant risk factor for subsequent hysterectomy, the researchers found, with women under age 45 being twice as likely to have a hysterectomy as women over 45.
The likelihood of needing a hysterectomy increased with the time after endometrial ablation, and after 8 years the probability was 12 percent for women older than 50 at the time of ablation, 19.8 percent for women aged 45 to 49.9 years, 31 percent for women aged 40 to 44.9 years, and 40.6 percent for women younger than 40 years.
"Additional studies with longer follow-up are necessary to determine whether endometrial ablation is more likely to replace, or merely delay, hysterectomy in women aged younger than 40 years at the time of the procedure," the researchers conclude.
Dr. Mindyn K. Longinotti, from Kaiser Permanente Northern California in San Francisco, told Reuters Health, "The main change that has occurred in my counseling of patients after this research is the ability to discuss failure rates of endometrial ablation based on the patient's age." Over the long term, the probability of not needing a hysterectomy is "more likely in women over the age of 45."
Longinotti and colleagues conducted a study to identify what factors predicted that so-called endometrial ablation wouldn't solve the problem of heavy bleeding and that a hysterectomy would be needed eventually.
Among 3681 women who underwent endometrial ablation, 774 (21 percent) subsequently needed a hysterectomy, the investigators report in the medical journal Obstetrics & Gynecology.
Age was the only significant risk factor for subsequent hysterectomy, the researchers found, with women under age 45 being twice as likely to have a hysterectomy as women over 45.
The likelihood of needing a hysterectomy increased with the time after endometrial ablation, and after 8 years the probability was 12 percent for women older than 50 at the time of ablation, 19.8 percent for women aged 45 to 49.9 years, 31 percent for women aged 40 to 44.9 years, and 40.6 percent for women younger than 40 years.
"Additional studies with longer follow-up are necessary to determine whether endometrial ablation is more likely to replace, or merely delay, hysterectomy in women aged younger than 40 years at the time of the procedure," the researchers conclude.
Tuesday, December 16, 2008
U.S. death rates for heart disease and stroke have dropped by about 30 percent since 1999, according to the latest American Heart Association statistics.
The improvement comes even though more Americans are sedentary and obese than ever before, experts noted.
"Our work isn't done, since the major risk factors for heart disease and stroke have not seen the same declines as the death rates, and several [risk factors] are rising," AHA President Dr. Timothy Gardner said in an association news release.
Still, between 1999 and 2006 there was a 30.7 percent decline in coronary heart disease deaths and a 29.2 percent drop in stroke deaths.
The findings were published online Dec. 15 in the AHA journal Circulation.
Despite the recent drop, cardiovascular conditions such as heart attacks and stroke remain the leading cause of death in the United States, accounting for 34.2 percent of the more than 2.4 million deaths reported in 2006.
And statistics for Americans with heart risk factors remain static. For example, while average cholesterol levels for men 40 and older and women 60 and older dropped from 204 mg/dL to 199 mg/dL between 1999 and 2006, little change was seen for other age groups, the AHA report noted.
Most Americans aren't exercising, either. Nearly two-thirds (62 percent) of adults reported no vigorous daily activity lasting at least 10 minutes in the 2006 National Health Interview Survey. That exercise threshold is the minimum recommendation for heart-strengthening exercise.
And yet the AHA says it has still met its goal of reducing coronary heart disease and stroke by 25 percent by 2010.
How did this happen? One expert said it's not entirely clear, but advances in medicine might take the lion's share of the credit.
"We can speculate which aspects of cardiology have created the most improvements," said Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York City. "Some interventions have proved to be considerably effective."
She cited stents, the tiny flexible tubes inserted routinely after artery-opening procedures to keep vessels open. Steinbaum also mentioned implanted defibrillators and pacemakers. "All of cardiology has been improving," she said.
Yet the new report also foreshadows future problems, she noted. For example, it is now possible to measure coronary artery calcification -- deposits that can thicken to block arteries. One U.S. study found that 15 percent of men ages 33 to 45 and 5.1 percent of women of the same age already had significant artery calcification, making them more likely to have cardiovascular problems in the years ahead.
America's children aren't in the best shape, either, Steinbaum said. She said there's already been talk of giving cholesterol-reducing statin drugs to young people.
"We might not see any immediate change in the death rate, but we might start seeing a change in incidence," she said. "What concerns me most of all is that we might start seeing an increase in heart disease in young people."
The incidence of overweight (body mass index at the 95th percentile) increased among children 6 to 11 years of age from 4 percent in 1971-74 to 17 percent in 2003-2006, the new report said. Among infants from 6 months to 23 months of age, the prevalence of high weight-for-age was 7.2 percent in 1976-1980 and 11.5 percent in 2003-2006.
It all cycles back to lifestyles, Gardner said.
"The challenge we face with reducing risk factors is figuring out what motivates people to change behavior, narrowing the gaps in gender and socioeconomic disparities, and assessing what we can do on a broad scale to affect the environments where people live, work and play," he said.
The improvement comes even though more Americans are sedentary and obese than ever before, experts noted.
"Our work isn't done, since the major risk factors for heart disease and stroke have not seen the same declines as the death rates, and several [risk factors] are rising," AHA President Dr. Timothy Gardner said in an association news release.
Still, between 1999 and 2006 there was a 30.7 percent decline in coronary heart disease deaths and a 29.2 percent drop in stroke deaths.
The findings were published online Dec. 15 in the AHA journal Circulation.
Despite the recent drop, cardiovascular conditions such as heart attacks and stroke remain the leading cause of death in the United States, accounting for 34.2 percent of the more than 2.4 million deaths reported in 2006.
And statistics for Americans with heart risk factors remain static. For example, while average cholesterol levels for men 40 and older and women 60 and older dropped from 204 mg/dL to 199 mg/dL between 1999 and 2006, little change was seen for other age groups, the AHA report noted.
Most Americans aren't exercising, either. Nearly two-thirds (62 percent) of adults reported no vigorous daily activity lasting at least 10 minutes in the 2006 National Health Interview Survey. That exercise threshold is the minimum recommendation for heart-strengthening exercise.
And yet the AHA says it has still met its goal of reducing coronary heart disease and stroke by 25 percent by 2010.
How did this happen? One expert said it's not entirely clear, but advances in medicine might take the lion's share of the credit.
"We can speculate which aspects of cardiology have created the most improvements," said Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York City. "Some interventions have proved to be considerably effective."
She cited stents, the tiny flexible tubes inserted routinely after artery-opening procedures to keep vessels open. Steinbaum also mentioned implanted defibrillators and pacemakers. "All of cardiology has been improving," she said.
Yet the new report also foreshadows future problems, she noted. For example, it is now possible to measure coronary artery calcification -- deposits that can thicken to block arteries. One U.S. study found that 15 percent of men ages 33 to 45 and 5.1 percent of women of the same age already had significant artery calcification, making them more likely to have cardiovascular problems in the years ahead.
America's children aren't in the best shape, either, Steinbaum said. She said there's already been talk of giving cholesterol-reducing statin drugs to young people.
"We might not see any immediate change in the death rate, but we might start seeing a change in incidence," she said. "What concerns me most of all is that we might start seeing an increase in heart disease in young people."
The incidence of overweight (body mass index at the 95th percentile) increased among children 6 to 11 years of age from 4 percent in 1971-74 to 17 percent in 2003-2006, the new report said. Among infants from 6 months to 23 months of age, the prevalence of high weight-for-age was 7.2 percent in 1976-1980 and 11.5 percent in 2003-2006.
It all cycles back to lifestyles, Gardner said.
"The challenge we face with reducing risk factors is figuring out what motivates people to change behavior, narrowing the gaps in gender and socioeconomic disparities, and assessing what we can do on a broad scale to affect the environments where people live, work and play," he said.
