Health Care Tips  Health Care News livemedinfo-News: October 2009
 Finding defies belief that resistance wears thin much sooner.
FRIDAY, Oct. 30 (HealthCare News) --Exposure to whooping cough will provide immunity for an average of three decades, new research suggests.
Doctors had previously thought that immunity lasted for much less time. But the new study, by researchers based at the University of Michigan and the University of New Mexico, rebuts that assumption.
Whooping cough, also known as pertussis, has become more common in the United States and elsewhere since the 1980s. Some health experts have thought that immunity is wearing off for people who'd been vaccinated or had been infected by the disease.
For the study, researchers used medical data from England and Wales from before a vaccine was available (1945-1957) as well as later (1958-1972). They created a mathematical model to determine how long immunity lasted after people were exposed naturally to the disease.
They found that immunity after natural infection lasts for at least three decades, on average, and maybe even as long as 70 years. The study suggests that people who lose some of their immunity might still have some protection and even gain more immunity when they're exposed again to whooping cough.
"This is surprising because clinical epidemiologists currently believe the duration of pertussis immunity is somewhere between four and 20 years," study co-author Pejman Rohani, of the University of Georgia, said in a news release from the publisher of PLoS Pathogens. The findings are published online Oct. 30 in the journal.
But there are caveats. "It's worth pointing out that in the past 20 years or so, the nature of the vaccines that have been used has changed quite fundamentally," Rohani said. "The data we're using are from a time when a whole-cell vaccine was in use. Now an acellular vaccine, which stimulates a different part of the immune system, is typically used, especially in North America."
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 Another study shows kids shed virus up to 13 days after fever starts.
THURSDAY, Oct. 29 (HealthCare News) -- U.S. researchers say they've spotted the first case of a Tamiflu-resistant H1N1 flu virus passing between two people -- raising the specter that more widespread resistance will render the antiviral drug less useful in combating the pandemic.
A second study found that children are still shedding H1N1 virus nearly two weeks after symptoms first appeared, although the lead author of that study emphasized that this is not synonymous with the virus being infectious for that long.
The H1N1 virus is spreading rapidly, although it has not changed from the typically mild illness observed last spring and summer, experts said at a press conference held Thursday at the Infectious Diseases Society of America's annual meeting in Philadelphia.
"We have the same [H1N1] disease from the spring and summer but just a lot more of it right now," said Rear Admiral Dr. Stephen Redd, director of the Influenza Coordination Unit at the U.S. Centers for Disease Control and Prevention.
"An increasing proportion of people are visiting doctors with influenza-like illness, the disease is widespread and we are seeing more deaths in children in particular, and we would expect that to continue as the number of cases increases," he said.
Antiviral drugs have been dispatched from the U.S. government stockpile to treat children, Redd added.
So far, almost all strains of H1N1 have responded to both oseltamivir (Tamiflu) and another antiviral, zanamivir (Relenza), while displaying resistance to amantadine, a drug in a different class. As a result, Tamiflu and Relenza have been used widely for both the prevention and treatment of H1N1.
However, in June and July of 2009, 65 campers and staff at a summer camp in North Carolina became ill with H1N1 and were treated with Tamiflu, while 600 other campers and staff took the antiviral to prevent the illness.
Two females who shared a cabin developed symptoms after starting on Tamiflu and were later found to have a virus with two viral mutations that rendered them resistant to the drug. The mutated virus was not found in other people tested.
What's troubling is that one of the females appears to have transmitted the mutated virus to her cabin mate. "It is likely that this resistant virus was passed from one camper to the other based on the timing between the illnesses and 2 genetic mutations found in the virus in both campers," explained Dr. Natalie Janine Dailey, lead author of the study and an epidemic intelligence service officer with the North Carolina Division of Public Health Communicable Disease Branch. "A small number of cases of oseltamivir-resistant have been seen in the U.S. so far, but these were the first cases reported in otherwise healthy individuals and the first which appeared to have spread from one person to another."
"This suggests that using oseltamivir to prevent influenza in healthy people may increase the risk of resistance," she said. "If resistance became widespread, oseltamivir would no longer be effective."
With this in mind, Dailey believes that the H1N1 vaccine, instead of antivirals, should be used for prevention as it becomes available, although treatment with antivirals should begin immediately in people who are hospitalized or who are at high risk, such as pregnant women, children under the age of 2 and people with underlying health conditions.
A second team of researchers looked at 26 elementary-school students in Pennsylvania and their household contacts who had tested positive for H1N1 to assess virus "shedding patterns."
"We found the median duration of shedding to be six days, with a minimum of one day and a maximum of 13 days," said study author Dr. Achuyt Bhattarai, an epidemic intelligence service officer with the CDC.
The same numbers were found in children over the age of 9, representing a longer time frame that is typically seen in adults. Bhattarai said, "this is consistent with earlier studies of seasonal flu."
This and future data should help officials decide when children should be allowed to return to school.
The teleconference also addressed the current delays and shortages in available H1N1 vaccine.
"We're all disappointed and frustrated by the current situation with the vaccine supply but we need to recognize we're not alone. The situation is true globally," said Dr. Bruce Gellin, director of the U.S. Department of Health and Human Services' National Vaccine Program.
The situation points up problems in the current vaccine production system, which relies on eggs as incubators of the virus.
"There's certainly lots of room for improvement in these systems," Gellin said. "Some of the early issues are resolving, particularly real difficulties with yield and variability among manufacturers. Some yields were half what was expected, some were less than half. That was a large part of the issue. We're encouraged that many of these things are being optimized and it's the same with the seasonal vaccine every year. We continue to do tune-ups which are going to translate to more doses over the coming weeks and hopefully then, the lines will get shorter."
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 WEDNESDAY, Oct. 28 (HealthCare News) -- Transcendental meditation reduces stress and improves the emotional and mental well-being of breast cancer patients, new study findings suggest.
The two-year trial included 130 patients at Saint Joseph Hospital in Chicago, aged 55 and older, randomly assigned to either a transcendental meditation group or to a usual care control group. Quality of life was assessed every six months.
"Emotional and psychosocial stress contribute to the onset and progression of breast cancer and cancer mortality," study author Sanford Nidich, senior researcher at the Institute for Natural Medicine and Prevention at Maharishi University of Management in Fairfield, Iowa, said in a news release from Saint Joseph Hospital.
"The transcendental meditation technique reduces stress and improves emotional well-being and mental health in older breast cancer patients. The women in the study found their meditation practice easy to do at home and reported significant benefits in their overall quality of life," Nidich added.
"It is wonderful that physicians now have a range of interventions to use, including transcendental meditation, to benefit their patients with cancer. I believe this approach should be appreciated and utilized more widely," study co-author Dr. Rhoda Pomerantz, chief of gerontology at Saint Joseph Hospital, said in the release.
The study, published in a recent issue of the journal Integrative Cancer Therapies, received funding from the U.S. National Institutes of Health's National Center for Complementary and Alternative Medicine.
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 TUESDAY, Oct. 27 (HealthCare News) -- New research suggests that alcohol may boost the progression of cancer by stimulating a pathway inside cells.
The findings could have meaning for the prevention and treatment of cancer, which has been linked to alcohol use in some cases. In particular, scientists suspect that alcohol is connected to colon and breast cancer, although it's not known exactly how.
A new study, published online in advance of the January 2010 issue of the journal Alcoholism: Clinical & Experimental Research, says that a pathway known as the epithelial-mesenchymal transition (EMT) could play a role in the process in which cancer cells affected by alcohol grow and spread.
"Alcohol consumption is known to increase the risk of several cancers, including cancers of the oral cavity, esophagus, liver, colon, rectum, and, in women, the breast," study co-author Christopher B. Forsyth, an assistant professor of medicine and biochemistry at Rush University Medical Center, said in a news release from Rush. "We also suspect an association with cancers of the pancreas and lung. However, the mechanisms by which alcohol increases the risk for these cancers have not been established. EMT is an active area of cancer research and growing evidence supports a role for EMT during cancer progression and metastases for several cancer types but previously not for alcohol-associated cancers."
The researchers made their findings after studying four alcoholic men and four healthy men.
"Our data are the first to show that alcohol turns on cell signals as well as biomarkers characteristic of EMT in cancer cells," Forsyth said. "We also show alcohol turns on the EMT pathway in non-cancer intestinal cells, thus supporting a possible role for alcohol stimulation of EMT in cancer initiation. Thus, our study supports a possible new mechanism through which alcohol may promote cancer progression by stimulating EMT. This now provides a new target for therapeutic intervention for treatment of alcohol-related cancers and for prevention of alcohol-related cancer metastasis."
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 MONDAY, Oct. 26 (HealthCare News) -- Crushing the notion that you can be both fat and fit, new research has found that current professional football linemen already have some risk factors for heart disease.
In a study comparing professional football players to minor and major league baseball players, researchers found that football linemen were more likely to have higher fasting blood sugar levels, larger waist circumferences and a greater waist-to-height ratio.
Although the idea that a football player could be at risk for heart disease might seem paradoxical because football players have to be in top physical condition, the lineman position also requires players to bulk up, with many tipping the scales at more than 300 pounds. All that extra weight may put players at risk later in life.
"We've identified a subset of players that are exercising like crazy and they're extremely fit, but the exercise isn't completely protective," said one of the study's authors, Dr. John Helzberg, co-director of the division of gastroenterology at Saint Luke's Hospital in Kansas City, Mo.
Helzberg was quick to point out that the study was not designed to look at the rates of heart disease or deaths from heart disease later in life but to identify only current risk factors. The hope is that by identifying the risk factors, steps could be taken to tackle the risk factors now, and interventions could be designed to help players when they retire.
Results of the study were scheduled to be presented Oct. 26 at the American College of Gastroenterology's annual scientific meeting in San Diego.
Previous research has suggested that football players face myriad risks later in life, such as higher rates of chronic pain, depression and even dementia. Helzberg said the idea for the current study came from a news report that suggested that football players were twice as likely to die before the age of 50 as baseball players.
To get an idea of how football players' health really compared with that of baseball players, Helzberg and his colleagues assessed a range of risk factors in 69 professional football players and 155 baseball players -- both minor and major league.
Many football players, such as quarterbacks and receivers, have heart disease risk profiles similar to those of baseball players. However, the 19 men playing lineman positions -- including guards, tackles, centers and defensive ends -- had significantly higher fasting blood sugar levels, waist circumferences and waist-to-height ratios, which are all considered risk factors for cardiovascular disease. And, when three such risk factors are combined, it's considered metabolic syndrome, which often indicates an increased risk for heart disease.
Of the linemen, 26 percent had fasting glucose levels above 100 milligrams per deciliter (mg/dL) compared with 7 percent of the baseball players. That level is considered prediabetic, according to the American Diabetes Association.
Nearly 100 percent of the linemen had a waist circumference greater than 100 centimeters (39.4 inches), which is considered a risk factor for heart disease, whereas only 8 percent of the baseball players had waists that size. Having a waist-to-height ratio greater than 0.5 also increases the risk for cardiovascular disease, and 95 percent of the linemen had a ratio greater than that, compared with 24 percent of the baseball players, according to Helzberg.
"These guys are very big, and yes, they have more muscle, but a lot of the weight is fat, and anyone at a higher weight is at risk of metabolic syndrome," said Dr. Jonathan Whiteson, co-director of the Joan and Joel Smilow Cardiopulmonary Rehabilitation and Prevention Center at the NYU Langone Medical Center in New York City.
"What happens is that you don't have to have rip-roaring abnormalities, but when you put these factors together, you create metabolic syndrome," Whiteson said. "This can put them at risk for premature heart disease, stroke, vascular disease in the legs and sudden death," he explained.
"The message is clear," he said. "Being fat is not fit. It's a medical condition."
But there are other worries as well, he added. "What's always a concern of mine is that these people are role models for children, and you see young boys who want to play football bulking up," Whiteson said. "We should be promoting a better health profile than linebackers."
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 FRIDAY, Oct. 23 (Healthcare News) -- Exposure to too much light at night may cause depression, suggests a new study.
Ohio State University researchers found that mice kept in a lighted room 24 hours a day had more depressive symptoms than mice that had a normal day-night cycle. The study also found that mice that lived in a constantly lit room, but could take refuge in a dark tube when they desired, had fewer depressive symptoms than mice that couldn't get away from the 24-hour light.
"The ability to escape light seemed to quell the depressive effects," lead author Laura Fonken, a graduate student in psychology, said in a news release from Ohio State University.
The findings indicate the need to learn more about how artificial light affects humans, said study co-author Randy Nelson, a professor of neuroscience and psychology.
"Constant light with no chance of escape increased depressive symptoms," Nelson said in the news release. "The increasing rate of depressive disorders in humans corresponds with the increasing use of light at night in modern society. Many people are now exposed to unnatural light cycles, and that may have real consequences for our health," he added.
The study, presented at the annual meeting of the Society for Neuroscience held Oct. 17 to 21 in Chicago, is scheduled to be published in the Dec. 28 issue of the journal Behavioural Brain Research.
Research into the effects of artificial light on health "is important for people who work night shifts, and for children and others who watch TV late into the night, disrupting their usual light-dark cycle," Fonken said.
Nelson noted that hospital intensive care units are brightly lit throughout the night, which may have a negative effect on patients.
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 THURSDAY, Oct. 15 (News)New cases of genital warts have declined sharply since vaccination of teen girls and young women against the human papillomavirus (HPV) began in Australia in 2007, a new study has found.
Certain types of HPV are linked with the development of cervical cancer.
Researchers analyzed data on new clients receiving treatment for genital warts at the Melbourne Sexual Health Center between 2004 and 2008. During that time, the center had 36,055 clients, and genital warts were diagnosed in 10.6 percent of cases. The number of women under age 28 who were newly diagnosed with genital warts decreased by 25 percent each quarter throughout 2008, the researchers found.
Australia began providing free vaccinations with Gardasil for females ages 12 to 26 in 2007. In the period before the vaccinations began, new cases of genital warts rose by nearly 2 percent each quarter, the study authors noted.
The study also found that newly diagnosed cases of genital warts among young men fell by an average of 5 percent each quarter throughout 2008. Rates of newly diagnosed genital warts among older women and men didn't decline.
The findings are published in the Oct. 15 online edition of the journal Sexually Transmitted Infections.
"The magnitude of the reduction in women [under] 28 years indicates a potential for substantial reductions in wart-associated morbidity and costs, and has important implications for countries deciding between the [Gardasil and Cervarix] vaccine," the researchers wrote.
Gardasil protects against HPV types 6, 11, 16 and 18, while Cervarix protects against HPV types 16 and 18. Types 6 and 11 are associated with highly infectious genital warts, while types 16 and 18 are associated with cervical cancer.
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 WEDNESDAY, Oct. 14 (News) -- Bicyclists are facing higher wound rates and longer hospital stays, with both worsening over the past 11 years at a Denver trauma center, according to the results of a study of biking injuries.
Chest injuries rose by 15 percent and abdominal injuries tripled over the last five years, the study authors found. Cyclists themselves appear to be part of the problem: Helmet use did not go up over the study period, and more than 33 percent of 329 hurt cyclists had a significant head injury.
"We were astounded by that data," said Dr. Jeffry Kashuk, professor of surgery at the University Of Colorado School of drug and senior attending surgeon at the Rocky Mountain Regional Trauma Center at Denver Health Medical Center. "We're talking about injured spleens and livers, internal bleeding, rib fractures, and hemothorax [blood in the chest]," he affirmed in a news release from the American College of Surgeons.
The study was scheduled be presented during the 2009 Clinical Congress of the American College of Surgeons, held Oct. 11 to 15 in Chicago.
"Denver is very much a bicycle community. If we are seeing an increase in injuries in a metropolitan area that has fairly mature bike infrastructure from the standpoint of bike pathways, there's reason for concern about what's happening in metropolitan areas that don't have that level of adulthood," Kashuk said. "There seems to be a major increase nationally in the use of the bicycle for urban transportation. If our data is a microcosm of what is going on nationally, we may be on the cusp of an injury epidemic."
Researchers at the University of Colorado want to more study the issue of biking injuries.
"On a local and national level, people need to be aware of the fact that a push for bike transportation for the sake of health, the environment, and lower transportation costs has real potential to raise medical costs because our transportation may not be ready for it," Kashuk added. "Look at all the safety factors that have been incorporated in automobiles and streets and highways. If even a percentage of that kind of investment went into safety vis-a-vis bike paths and community infrastructure, we would protect people from major injury."
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 TUESDAY, Oct. 13 (News) -- Even as the H1N1 swine flu vaccine is circulated coast to coast, many people say they have safety concerns that may stop them from getting vaccinated.
Although experts say those fears are unwarranted, a recent Associated Press-GfK poll found only about half of Americans said they are preparation to get the vaccine. Most of those are older people - so far among the least weak to the virus.
Almost three-quarters of respondents said they were worried about the vaccine's safety (although many of these said they still were going to get the shot).
A University of Michigan poll found that only 40 percent of parents required to get their children inoculated.
And a review released Tuesday, commissioned by the American Society of Health-System Pharmacists that polled pharmacy directors at 341 hospitals across the country, found that many hospital employees are asking if the H1N1 vaccine is secure.
In response, experts and officials continue to strain that not only is the vaccine safe, it's the surest way to protect you from the H1N1 swine flu virus.
"The H1N1 vaccine is made in precisely the same way, using the same material, the same companies, the same process as the seasonal flu vaccine we make every single year and give to tens and tens of millions of people," said Dr. Anthony Fauci, manager of the U.S. National Institute of Allergy and Infectious Diseases.
Fauci explained that even the seasonal flu vaccine is distorted slightly each year, with slightly different strains.
Had the H1N1 virus emerged just a little bit earlier, it would have been included in this year's regular flu shot, he stated.
"We wouldn't be talking about safety now if [the H1N1 vaccine] were given within the context of the seasonal flu," Fauci sustained.
Nor has the vaccine been made too quickly, as some have worried. In fact, "it hasn't been faster at all," said Dr. Robert Frenck, a professor of pediatrics at Cincinnati Children's Hospital and a member of the American Academy of Pediatrics' committee on infectious diseases.
The seasonal flu vaccine goes into manufacture around March and is available around August. The H1N1 virus was lonely in May and became available this month.
Side effects from the H1N1 vaccine have been mild, including softness and swelling at the injection site and a mild fever. In China, four of 39,000 people vaccinated reported muscle cramps and headaches.
"We've had experience with this particular variety of killed vaccine for 20 years, and the risks are primarily distended arm and low-grade fever," said Dr. Nathan Litman, director of pediatrics at the Children's Hospital at Montefiore Medical Center in New York City. "There are some very, very rare other events, but some of them happen naturally even in those who don't have the vaccine. The risk of disease and complication of disease is far greater than the vaccine."
Some concerns were precipitated by an earlier experience with swine flu vaccine. In 1976, the U.S. government vaccinated 43 million people against swine flu following an outbreak at Fort Dix in New Jersey. Some 500 of those vaccinated developed a rare neurodegenerative situation called Guillain-Barre syndrome, which many experts believe was linked to the shot. Twenty-five of those 500 died.
But the equation for this year's swine flu pandemic is already greatly different. The 1976 virus never spread beyond 240 soldiers stationed at the base, while the current outbreak has already appalled more than 340,000 people worldwide, killing 4,100 or more, according to the World Health Organization.
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MONDAY, Oct. 12 (Livemed News) -- U.S. researchers have attain a first step toward growing a living "heart patch" to repair damage from heart disease.
Using mouse embryonic stem cells, Duke University bioengineers performed a series of lab experiments that mimicked the way embryonic stem cells extend into heart muscle.
The researchers used a special mold they created to make a 3-D "patch" made of heart muscle cells called cardiomyocytes. The mold had features that enabled the researchers to control the way and orientation of the growing cells.
The newly created tissue displayed two critical features of heart muscle cells - the ability to convention and to conduct electrical impulses, the study authors explained in a Duke University news release.
The results were scheduled to be obtainable at the Biomedical Engineering Society's annual scientific sessions, held Oct. 7 to 10 in Pittsburgh.
"While we were able to grow heart muscle cells that were able to agreement with strength and carry electric impulses quickly, there are many other factors that need to be considered," Nenad Bursac, an assistant professor at Duke's Pratt School of Engineering, said in the news release.
The rate of heart muscle cell growth is just one area that requires further research.
"Human cardiomyocytes tend to grow a lot slower than those of mice," Bursac said. "Since it takes nine months for the human heart to total development, we need to find a way to get the cells to grow faster while maintaining the same essential properties of native cells."
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THURSDAY, Oct. 1 (Livemedinfo News) - Trauma patients who were drunk before they were injured were more likely to survive than sober trauma patients, U.S. researchers have found. Another recent study had a similar finding.  The latest study of 7,985 trauma patients found that 7 percent of sober patients died compared to 1 percent of intoxicated patients. All of the patients were of similar age and had similar injuries. The findings appear in the October issue of the journal American Surgeon. "This study is not cheering the use of alcohol," principal investigator Dr. Christian de Virgilio of the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, said in a news release. "It is seeking to further explore earlier studies that had found alcohol may improve the body's response to harsh injuries. If alcohol is proven to improve the body's response to traumatic injury, it could lead to treatments that help patients survive and recover more quickly." It's believed that alcohol may reduce the risk of death by changing the body's chemical response to wound. A study published in the September issue of the Archives of Surgery looked at more than 38,000 head trauma patients and found that the death rate was 7.7 percent for those who'd consumed alcohol and 9.7 percent for those who hadn't had alcohol. Labels: Alcohol helps to protect trauma patients, Trauma patients |
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Finding defies belief that resistance wears thin much sooner.
Another study shows kids shed virus up to 13 days after fever starts.
WEDNESDAY, Oct. 28 (HealthCare News) -- Transcendental meditation reduces stress and improves the emotional and mental well-being of breast cancer patients, new study findings suggest.
