Health Care

The buck will stop there

WASHINGTON - MedPage Today noted that on Oct. 1, 2008 , Medicare will not reimburse hospitals for costs to treat injuries from eight preventable conditions. Medicare will add three more conditions to that list next year. The eight conditions are: patient falls, pressure ulcers, urinary tract infections, vascular catheter-tied infections, mediastinitis, air emboli, removal of objects left in the body during surgery, and injury caused by incompatible blood products. The rule change prohibits hospitals from billing patients for "any charges associated with the hospital-acquired complication." The change in payment policy will help assure "Medicare payments for inpatient services will be more accurate and better reflect severity of the patient's condition," said Herb Kuhn, acting deputy administrator at the U.S. Centers for Medicare & Medicaid Services. On Oct. 1, hospitals will have to report secondary admission diagnoses to CMS ; a year later, CMS will begin checking admission records against discharge diagnoses. If any of the eight conditions appear on discharge but not admission, CMS will refuse payment.

LOS ANGELES - People with more time in the sun as kids may have a lower risk of Multiple Sclerosis (MS) than people with less sun exposure in childhood, states a study in Neurology. Scientists studied 79 pairs of identical twins with the same genetic risk for MS in which only one twin had MS. The twins had to specify whether they or their twin spent more time outside on hot days, cold days, and in summer, and which one spent more time sun tanning, at the beach, and playing team sports as a child. The study found the twin with MS spent less time in the sun as a child than the twin without MS. Depending on the activity, the twin who spent more time outside had a 25-57% lower risk of MS. "Sun exposure appears to have a protective effect against MS," said study authors Drs. Talat Islam and Thomas Mack, of the Keck School of Medicine of the University of Southern California. "Exposure to ultraviolet rays may induce MS protection by alternative mechanisms, either directly by altering the cellular immune response or indirectly by producing immunoactive vitamin D."

BURLINGTON, VT - Reuters Health noted diabetics, mostly women, who take thiazolidinediones, including drugs such as Avandia and Actos, may have higher risk of getting cancer. "There is more to these drugs than first meets the eye," Dr. Maria Ramos-Nino, of the University of Vermont . "The long-term [results] and benefits aren’t understood." Dr. Ramos-Nino and her team studied the tie between thiazolidinediones and cancer prevalence among nearly 9,000 diabetics in a database. A randomly selected sample of 1,003 was interviewed as to personal and clinical characteristics, including history of malignancy. The findings were in BMC Medicine. After factoring in the potential effects of other risk factors, investigators found the use of any thiazolidinedione was tied to a 59% higher risk of cancer. The use of Avandia raised malignancy risk 89%; risk tied to Actos wasn’t statistically significant. "We aren’t aware of a convincing explanation or previous results to support the finding in this study of an association with cancer for rosiglitazone, but not for pioglitazone," researchers write.

SAN DIEGO - HealthDay News noted a chemical in curry may help the immune system clear away brain plaques tied to Alzheimer's disease, a study suggests. It builds on data linking curry consumption to lower Alzheimer's risk, including one study that found only 1% of older Indians had Alzheimer's - 25% of the rate seen in the U.S. For this study online at the Proceedings of the National Academy of Sciences, scientists from the David Geffen School of Medicine in Los Angeles and the Human BioMolecular Research Institute in San Diego looked at blood samples of Alzheimer's patients. They found bisdemethoxycurcumin helped immune cells called macrophages to clear amyloid beta, a protein that forms brain plaques tied to Alzheimer's. Bisdemethoxycurcumin is the active ingredient in curcuminoids, a natural substance found in turmeric root, a spice often found in curry powders.

CARDIFF , WALES - Asking the doctor more questions might help patients get more satisfactory care, but many patients aren’t sure where to start. A review of 33 studies found giving patients checklists or providing in-office coaching can help them ask their healthcare provider for more useful data that often extends the consultation. Lead review author Paul Kinnersley, in The Cochrane Library, said when interventions took place immediately before a consultation, they resulted in a small but significant increase in the time of the office visit. Interventions that occurred some time before the consultation had no effect. Interventions produced small gains in patient satisfaction, plus a possible reduction in patient anxiety before and after visits. Coaching had a slightly larger benefit in patient satisfaction than providing checklists. “Coaching is a more intensive intervention and may have some therapeutic impact,” said Kinnersley, co-director of the Cardiff University Communications Skills Unit.

BOSTON - HealthDay News noted drinking more than one soda a day, even if it's sugar-free, is tied to higher incidence of metabolic syndrome, risk factors linked to diabetes and cardiovascular disease. The study link was "striking" but not a surprise, said Dr. Ramachandran Vasan, senior author and professor of medicine at Boston University School of Medicine. "This is the first study to show the [tie] in a prospective fashion and large population," he said. That group was 6,000-plus people in the Framingham ( Mass. ) Heart Study, following residents since 1948. When the soda part of the study began, all participants were free of metabolic syndrome, risk factors including high blood pressure, elevated levels of blood fats called triglycerides, low levels of artery-protecting HDL cholesterol, high fasting blood sugar levels, and excessive waist size. In the four-year study, people who drank more than one soft drink a day were 44% more likely to develop metabolic syndrome than those who didn't drink a soda a day. The findings were in the journal Circulation. Dr. Vasan says he isn’t a nutritional expert but believes "this is a marker of dietary behavior" - people who like to drink sweet soda like to eat the kind of foods that cardiac nutritionists warn against.

SAN FRANCISCO - If your child is lactose intolerant, you probably shy away from giving him or her dairy products. That may not be the best tactic, experts told HealthDay News. The American Academy of Pediatricians guidelines advise parents to not give up on giving lactose intolerant children dairy products. Calcium in these foods is important for bone mineral health, and dairy products contain other nutrients important for growth in children and teens. Lactose intolerance is often mild enough so kids can tolerate at least some milk products. "Lactose intolerance is relatively common," noted Dr. Melvin Heyman, professor of pediatrics at the University of California , and on the committee that wrote the guidelines. While he wasn’t familiar with any study citing the exact prevalence, he figures 20 or 30% of U.S. kids have "some lactose intolerance." Parents often confuse milk protein intolerance and lactose intolerance. "Some people get allergic to protein in milk," he added. That can be serious but probably affects 3-5% of U.S. kids, he said. An intolerance for lactose - sugar in milk - is much more common.

NEWARK , DE - One of every seven Delaware adults has at least one disability, and their general health is “fair” to “poor,” University of Delaware researchers found. The study included physical, sensory, cognitive, and learning impairments, keys of the Healthy Delawareans with Disabilities 2010 Project. Findings and recommendations were in the Delaware Health Status Report for Persons with Disabilities, which will be a tool for state agencies, policymakers, community organizations, healthcare providers, and families. Ilka Riddle, researcher at UD's Center for Disabilities Studies, said, “Results show the health of Delaware adults with disabilities isn’t in a good state, and services are needed to help these citizens live healthier lives,” Riddle noted. The 339 participants were recruited from state service enrollment lists, healthcare facilities, and health fair. Most were unemployed or unable to work and earned less than $15,000 per year. Of most concern, Riddle said, were the 72% who reported they’re overweight or obese.

AMSTERDAM , HOLLAND - Women with symptomatic uterine fibroids, benign tumors inside the uterus that often cause heavy menstrual bleeding, pain, and other symptoms, may be able to avoid hysterectomy by having uterine artery embolization (UAE), a "valuable alternative," Dutch scientists told Reuters Health. "Every woman should be offered [UAE], based on our scientific data," senior investigator Dr. Jim Reekers said. UAE requires an incision of less than one inch in the groin. A small tube is inserted and tiny particles are injected to block the arteries that supply blood to the fibroids causing them to shrink. In the American Journal of Obstetrics and Gynecology, Dr. Reekers and colleagues at the Academic Medical Centre note previous studies of UAE haven’t included a comparison of patients undergoing other treatments, such as hysterectomy.

MONTPELLIER , FRANCE - Caffeine may help older women protect thinking, noted a study in the journal Neurology. It found women 65 and older who drank more than three cups of coffee (or tea) per day had less decline over time on tests of memory than women who drank one cup or less. The results held up after scientists adjusted for other factors that could affect memory abilities, such as age, education, disability, depression, high blood pressure, medications, cardiovascular disease, and other chronic illnesses. "Caffeine is a psycho-stimulant which appears to reduce cognitive decline in women," said study author Dr. Karen Ritchie, of the French National Institute for Health and Medical Research. "While we have some ideas as to how this works biologically, we need to have a better understanding of how caffeine affects the brain before we can start promoting caffeine intake as a way to reduce cognitive decline. The results are interesting - caffeine use is widespread and it has fewer side effects than other treatments for cognitive decline, and it requires a relatively small amount for a beneficial effect."

LA JOLLA , CA - Type 2 diabetics who drag themselves through the day may be among the 36% of diabetics suffering from obstructive sleep apnea (OSA), HealthDay News disclosed. Sleep apnea is impaired breathing due to collapsed airways, triggering multiple nighttime awakenings. Whittier Institute for Diabetes scientists analyzed data from 279 adults type 2 diabetics and found one out of three also suffered OSA. Men, particularly those over 62, were more than twice as likely as women to have sleep apnea. Previous study indicated a tie of OSA, glucose intolerance, and insulin resistance, so the tie with type 2 diabetes isn’t surprising. This is the first study to analyze data from men and women at a diabetes clinic, scientists said. "The findings [show OSA] has a high prevalence in adults with type 2 diabetes," principal investigator Dr. Daniel Einhorn stated. "Given that treatment of [OSA] has the potential to decrease blood pressure and improve [blood sugar] control, individuals with type 2 diabetes should be screened regularly for [OSA]."

DURHAM, NC - Hostile men prone to frequent intense anger and depression could be harming their immune systems and putting themselves at risk for coronary heart disease and related disorders like type 2 diabetes and high blood pressure. Dr. Steven Boyle,., of Duke University Medical Center , and colleagues studied 313 male Vietnam veterans in a larger 20-year study on the effects of Agent Orange. For the study, in the journal Brain, Behavior, and Immunity, the vets underwent a standard psychological test used to assess hostility, depression, and anger. The men had a series of blood levels taken on three occasions 1992-2002. Men whose psychological screening showed the highest level of hostility, depressive symptoms, and anger had a 7.1% rise in their C3 levels, while men with low levels of these attributes showed no change over the study period. Researchers factored in smoking, age, race, alcohol use, and body mass index (obesity).

WINSTON-SALEM , NC - A relatively new, minimally invasive treatment was 100% successful in eradicating small malignant kidney tumors in a study of more than 100 patients, said scientists at Wake Forest University Baptist Medical Center . The patients had CT-guided radiofrequency ablation (RFA) at Wake Forest Baptist for kidney tumors ranging from 0.6 to 8.8cm. A total of 125 tumors in 104 patients were treated 2000-2006. In all patients, a biopsy confirmed renal cell carcinomas (RCC), a common type of renal malignancy. Of 95 tumors smaller than about 1.5 in., all were eradicated completely by a single treatment, along with 14 of the larger tumors. Seven more of the 16 remaining larger tumors were gone after a second treatment, for a 93% success rate for all 125 tumors. Results in the American Journal of Roentgenology were based on follow-up exams over an average of 14 months.

BARCELONA , SPAIN - Nurses develop occupational asthma at more than double that of the general population, noted a multinational study disclosed by MedPage Today. Nurses had a relative risk of 2.2 for asthma occupationally, noted a report in The Lancet, trailing only printers among jobs in the study. Only nursing had a statistically significant higher risk, said Dr. Manolis Kogevinas, of Barcelona 's Municipal Institute of Medical Research. Reasons for nurses' high prevalence remain unclear; higher use of latex gloves is one possibility, Dr. Kogevinas and colleagues noted, although latex content in gloves has decreased substantially in response to concerns about hypersensitivity. "Nurses could be exposed to sensitizing substances, respiratory allergens, and irritants including sterilizers and disinfectants such as glutaraldehyde or bleach," they also suggested. Investigators studied 6,837 people who had been in the European Community Respiratory Health Survey 1990-1995 and had reported no respiratory symptoms or history of asthma at the time.

INDIANAPOLIS , IN - A book by Indiana University education professor Patricia Rogan and Pamela Walker, of Syracuse University , offers a guide to promoting active, meaningful lives for adults with disabilities. Tackling such issues as postsecondary education, employment, transition from school to adult life, and relationships, Make the Day Matter!: Promoting Typical Lifestyles for Adults with Significant Disabilities (Brookes, 2007) has current practices for supporting fulfilling lives for all adults. The book is intended for service providers working with adults with significant disabilities. Rogan, professor and chair of secondary education and area coordinator of special education at IU's School of Education , said, "Many adults with disabilities in our society have been denied typical lifestyles due to segregation, negative attitudes toward them, and lack of access to community opportunities," she said. "Adults with disabilities are largely unemployed, enroll in postsecondary education at a rate of about 40% below the general population, and often report being lonely and disconnected."

SEATTLE - A hearing test soon after birth may help identify babies at risk for sudden infant death syndrome (SIDS), a study noted by HealthDay News found. SIDS kills about one in 1,000 infants worldwide; most are two to four months old and boys are more likely than girls to die. Dr. Daniel Rubens and his team at the Children's Hospital and Regional Medical Center studied data on 31 Rhode Island babies who died of SIDS, and found they all shared the distinctive difference in newborn hearing test results for the right inner ear. Those who died of SIDS scored four points lower in standard newborn hearing tests across three different sound frequencies in the right ear. Dr. Rubens noted healthy infants typically test stronger in the right ear than in the left; SIDS infants had lower scores for the right ear than the left. The study was in the journal Early Human Development. "This opens a new line of inquiry into SIDS research," Dr. Rubens stated. "It's possible that with a simple, standard hearing test, babies could be identified as at risk for SIDS, allowing measures to be implemented in advance of a tragic event."

BOSTON - TIME Magazine reported Harvard University and University of California/San Diego researchers reviewed a database of 12,067 people - a group with many families and friends - who participated in a major U.S. heart study 1971-2003. They met with heart researchers every two to four years. To facilitate follow-up, researchers asked participants to name family members and at least one friend who could be called on if the participant changed addresses. New England Journal of Medicine authors mined that data and found that when a participant's friend became obese, that first participant had a 57% greater chance of becoming obese. In pairs of people in which each identified the other as a close friend, when one person became obese the other had a 171% greater chance of following suit. "You are what you eat isn't the end of the story," says study co-author James Fowler, a political scientist at UC/San Diego. "You are what you and your friends eat."

BIRMINGHAM, AL - HealthDay News noted a high number of us may suffer "whispering" strokes, symptoms so mild they often go ignored, but can cause physical and mental harm. About 18% of almost 22,000 older adults in a study reported having such symptoms, stated a report in the journal Stroke. People with these symptoms had lower-than-normal tests of physical and mental functioning. "What we’re trying to say to the lay public and primary care physicians is these strokes are a major public health problem," said lead researcher George Howard, biostatistics professor at the University of Alabama School of Public Health. He and his team are issuing reports on study participants, all of whom were 45 or older; 40% are black and half are women. They filled out standard questionnaires on mental/physical status and a separate form asking if they had had symptoms of a stroke, such as: Sudden numbness/weakness of the face arm or leg, especially on one side; sudden confusion, trouble speaking, or understanding; sudden trouble seeing in one/both eyes; sudden severe headache with no known cause, sudden trouble walking, dizziness, or loss of balance or coordination. More than 3,400 people said they had had such symptoms but weren’t diagnosed with either a stroke or a "mini-stroke."

LONDON - Zebrafish ability to regenerate damaged retinas has given scientists a clue about restoring human vision and could yield experimental treatment for blindness within five years, Reuters reported. British scientists said they grew successfully in the lab a type of adult stem cell found in the eyes of both fish and mammals that develops into neurons in the retina. In the future, these cells could be injected into the eye to treat diseases such as Macular Degeneration, glaucoma, and diabetes-related blindness, said Astrid Limb, of University College London's Institute of Ophthalmology . Damage to the retina - which sends messages to the brain - is responsible for most sight loss. "Our findings have enormous potential," Limb said. "It could help in all diseases where the neurons are damaged, which is basically nearly every disease of the eye." In the journal Stem Cells, scientists stated cells have been tested in rats with diseased retinas, where they migrated successfully into the retina and took on characteristics of surrounding neurons. The team is working on the same approach in humans.

HOUSTON - Blood samples from 220-plus ALS patients at Methodist Neurological Institute used in a study yielded significant changes in/around 10 specific genes in sporadic ALS , the most common form. Results were in the New England Journal of Medicine. “This discovery helped identify new biological pathways for ALS progression in [those] with this debilitating disease,” said Dr. Stanley Appel, neurology department chair at Methodist Hospital and co-founder of the Methodist Neurological Institute. “ ALS is most likely caused by … environmental and genetic components. This type of study provides us with a better understanding of the genetic contribution.” Sporadic (non-inherited) ALS affects 90% of ALS patients. The study notes this discovery points to several genetic breakdowns that might make people more susceptible to ALS . Using state-of-the-art micro-array technology to analyze thousands of genes in a complete set of genes quickly, investigators scanned for differences in blood samples from 1,200 people with and 2,000 people without sporadic ALS .

GRAPEVINE, TX - Is your mascara clumpy, liquid foundation thick? Can’t remember what year you bought your half-used lipstick? Skin experts say old makeup may cause you blemishes or a dangerous infection. “Most women have a drawer full of partially used cosmetics,” says Dr. Angela Bowers, medical staff dermatologist at Baylor Regional Medical Center . When do you throw them out? “Cosmetics usually don’t include expiration dates,” adds Dr. Bowers, but go by when you first opened it. Eye make-ups and liquid foundations last the least time and should be tossed after three months. Powders and foundations opened more than a year ago can cause problems. Makeup applicators should be replaced regularly. “If you use sponges to apply makeup, replace those at least once a week,” says Dr. Bowers. Sharing lipsticks, glosses, or balms with someone who may have a strain of the herpes virus could leave you with cold sores of your own.

BLOOMINGTON , IN - Monday Morning in Washington, DC noted for decades parents of children with disabilities were advised to institutionalize their child and in effect "forget you ever had them." Of more than 500,000 people in out-of-home residential settings, experts report a high percentage have no regular contact with family. Gradually, states are replacing institutions with community-based residential settings that support family connections, but there has been no good way to help make that connection. Now, there is an opportunity for family members to reunite. To enter data in the FindFamily Registry, go to www.FindFamilyRegistry.org.

WASHINGTON - Monday Morning in Washington, DC disclosed an Oral Health Professional's Guide to Serving Young Children with Special Health Care Needs is a Web-based continuing education course for oral health professionals with information to ensure young children with special health care needs have access to health promotion and disease prevention services that address their unique oral health needs. The curriculum was prepared by the National Maternal and Child Oral Health Resource Center at Georgetown University . Topics include an overview of children with special healthcare needs and oral health, provision of optimal oral health care, oral health supervision, oral disease prevention, and behavior management. The course is free and available at www.mchoralhealth.org/SpecialCare.

ROCHESTER , MN - Among cooking oils, olive oil is touted as one of the healthiest: it has monounsaturated fat, which can lower total cholesterol and low-density lipoprotein ( LDL , “bad”) cholesterol. Choosing olive oil is a bit like choosing wine; some are more flavorful and offer more health benefits. Mayo Clinic’s Women’s HealthSource has tips: Virgin, extra virgin, or refined - Virgin, extra virgin tend to be higher in polyphenols (strong antioxidant) than are more-processed, refined olive oils. Antioxidants are viewed as beneficial because they help the body rid itself of unstable free radicals and minimize harmful cellular inflammation. A study comparing virgin olive oil, refined olive oil, and a combination found virgin olive oil appears to have greater heart health benefits. Freshness - The fresher the oil, the more antioxidant value. Quality oils include a packaging date. At purchase, it should be no more than one year old. Price/flavor - You could opt for lower cost, less flavorful virgin oil for cooking and invest in pricier and more flavorful virgin or extra virgin oils for vinaigrettes or over salads or side dishes. Storage - Olive oils have a shelf life of about 1-2 years, so keep in a cool dark place.

JERUSALEM - A new treatment significantly cuts severity of muscle weakness in Myasthenia Gravis (MG), giving hope for new drugs to treat neurological disorders, states a study in the journal Neurology. Oral EN101 antisense inhibits production of acetylcholine sterase, a top enzyme in the neuromuscular junction, where nerves tie with muscles. Antisense is a synthetic, short segment of DNA that locks onto a strand of mRNA and blocks output of specific proteins. "This is the first time we've been able to show antisense is effective and safe when taken orally for neurological disease," said study author Dr. Zohar Argov, of Hadassah Hebrew University Medical Center , and member of the American Academy of Neurology. "Oral delivery of antisense has been sought since it is expected to improve patient compliance because daily injections won't be needed." MG patients have more fatigue and less strength in voluntary muscles. Symptoms may include drooping eyelid, double vision, difficulty swallowing, or slurred speech. "Oral antisense may become another mode of therapy in neuromuscular disease and further study is needed," said Dr. Argov.

LONDON - Protein fragments which form plaques in the brains of those with Alzheimer's disease seem to cause death of retinal cells in glaucoma, the potentially blinding eye disease, British scientists told HealthDay News. In animal studies, drugs that blocked key molecular pathways for amyloid-beta cut eye damage and preserved retinal cells, said lead scientist Dr. Francesca Cordeiro, assistant professor of retinoneural degeneration at University College . Several methods of blocking those molecular pathways were tried in tests of rats bred to have glaucoma, she explained. "One treatment prolonged the lives of retinal cells," she noted. "Combining all treatments had a greater effect." Confirmation of the damaging role of amyloid-beta in further studies could lead to new treatments for glaucoma, a leading cause of blindness in the U.S. A clue pointing to a causal role for amyloid-beta was discovery of glaucoma-like retinal cell death in people with Alzheimer's, Dr. Cordeiro said. Lab work showed accumulation of amyloid-beta in dying retinal cells; adding the protein to cultured retinal cells induced their death.

DALLAS - Most of us rely on the bathroom scale to tell us when middle-aged spread is getting out of hand. It might be better to keep a tape measure ready. Research shows adding several inches to the waist, even if body weight falls in a normal range, markedly hikes the risk of unhealthy plaque build-up in the arteries of the heart and the rest of the body. The University of Texas ’ Southwestern Medical Center study, in the Journal of the American College of Cardiology, claims the relationship of waist measurement to hip measurement was tied much more closely to early, hidden signs of heart disease than other common measures of obesity; i.e., body mass index or waist circumference alone. We may obsess about unsightly cellulite on hips, but it’s the pot belly we ought to worry about. “In our 30s and 40s, we often gain three to four inches in the midsection,” said Dr. James de Lemos, professor of medicine and director of the Coronary Care Unit at the medical center. “It’s a day-to-day, meal-to-meal battle, but it’s worth fighting. Even a small pot belly puts us at higher risk when compared to a flat tummy.”

BOSTON - Myths abound oniabetes and food, one most common being a “diabetes diet” that prohibits sugar and other items. A report from Harvard Health Publications dispels this and other misconceptions, and explains what people with diabetes should eat to keep blood sugar steady. The advice is like that for the general population, but with extra emphasis on weight, blood sugar, and heart disease risk factors, states Healthy Eating for Type 2 Diabetes. Eat a variety of healthy foods, watch total calories, and exercise. What you eat daily is up to you, but overall goals are: Achieve, maintain healthy weight; include plenty of fruits and vegetables - limit white potatoes; cut saturated fats, trans fats - replace them with healthy vegetable oils; pick complex carbohydrates over refined sugars, refined starches; boost fiber intake; opt for beans, nuts, fish, and poultry versus red meat; drink alcohol in moderation; limit salt intake; get enough calcium, and take a multivitamin daily.

MUNICH - Reuters Health noted a pulsed electron avalanche knife (PEAK-fc), which cuts tissue with short bursts of electric pulses, makes it easier to do cataract surgery in complicated cases, states the British Journal of Ophthalmology. Cataracts develop as the eye lens clouds; the risk of this common eye woe rises with age and exposure to other risk factors such as UV light exposure, smoking, and diabetes. Blurred vision and cloudy spots are common. Cataracts can be treated by replacing the natural lens with an artificial one. In this study, Dr. Siegfried Priglinger, of Ludwig-Maximilians University , and his team evaluated safety and effectiveness of PEAK-fc in 20 patients getting complicated cataract surgery. The surgeries were successful in most patients. Unlike conventional techniques, PEAK-fc caused very little damage to healthy tissues around the target area. No problems related to the device were noted. "PEAK-fc was successful for a variety of surgical maneuvers commonly encountered in patients undergoing complicated (cataract) surgery," Dr. Priglinger and colleagues conclude. "PEAK-fc allowed cutting in a very precise manner, resulting in ... minimal collateral damage at the edges of the cut."

BALTIMORE - Women with migraines and sight symptoms have a 50% greater risk of ischemic stroke than women without the headaches, scientists told MedPage Today. Smoking, oral contraceptives, and onset of headaches with aura a year before the stroke also increased the risk, Leah MacClellan, of the University of Maryland , and colleagues wrote in Stroke: Journal of the American Heart Association. Conversely, scientists found no tie between stroke and migraine without aura. The chance that a woman 15-44 with migraine and aura will have an ischemic stroke is one-to-two for every 1,000 women each year, said Dr. Steven Kittner, a study co-author and director of the Maryland Stroke Center . To assess relationships, scientists analyzed data from the Stroke Prevention in Young Women Study (1992-1996; 2001-2003). Their study included 386 women 15-49, with a first ischemic stroke. Women with migraine and aura had 1.5 greater odds of ischemic stroke. The risk was highest among those with no history of hypertension, diabetes, or myocardial infarction versus non-migrainers, scientists said.

BOSTON - Do you care for someone in your family who has a chronic illness or dementia? Have you felt depression, anger, guilt? Has your health deteriorated since taking on these duties? If your said “yes” to any of these, you may have caregiver stress. CNN disclosed this woe is being referred to more as "caregiver syndrome" in the medical community due to its numerous consistent signs/symptoms. In Caring for Persons with Dementia, Dr. Jean Posner, a Baltimore neuro-psychiatrist, referred to caregiver syndrome as "a debilitating condition brought on by unrelieved, constant caring for a person with a chronic illness or dementia." More Americans find themselves caring for someone who's aging., or ill, or both. The American Academy of Geriatric Psychiatrists says one of every four U.S. families cares for someone over 50. In 2000, the Census Bureau reported, just under 35 million Americans were 65 or over; by 2030, the number is projected at than 71 million-plus.

ROCHESTER , MN - Women with dementia start losing weight at least 10 years before diagnosis, states a study in Neurology. Scientists studied records of 481 people with dementia versus 481 people of the same age and gender without dementia. The average weight was the same for those in the two groups 21-30 years before the year of diagnosis. Women who would develop dementia began losing weight up to 20 years pre-diagnosis. On average, those with dementia weighed 12 pounds less than those without it the year of diagnosis. "One explanation for weight loss is that, in very early stages of dementia, people develop apathy, loss of initiative, and loss in the sense of smell," said study author Dr. David Knopman, of the Mayo Clinic, and member of the American Academy of Neurology. "When you can't smell food, it won't have much taste, and you might be less inclined to eat it. Apathy and loss of initiative may make women less likely to prepare nutritious meals and more likely to skip meals." Men in this study who got dementia didn’t lose weight in the years before diagnosis.

ADELAIDE , AUSTRALIA - Postgraduate student Martin Sale and his team from the University of Adelaide found time of day influences a brain’s ability to learn - and the human brain learns more effectively in the evening. By identifying when the brain is best able to operate, rehabilitation therapy can be targeted to that time, when recovery is maximized. “Our research has several future applications,” Sale says. “If the brains of stroke patients can be artificially stimulated to improve learning, they may be able to recover better and faster.” Researchers used a magnetic coil over the head to stimulate nerve activity in the brain, and linked it to an electrical stimulus of the hand. Sale , of the School of Molecular and Biomedical Science, found the brain’s capacity to control hand movements is influenced by the time of day and larger changes are induced when experiments are performed in the evening versus mornings.

PHILADELPHIA - You’re diabetic and seek exercise. It’s possible, says Dr. Stephen Rosen, chief of endocrinology & metabolism at Pennsylvania Hospital . Diabetes affects 20.8 million people in the U.S. , the American Diabetes Association states. Staying active is a great way to prevent/control diabetes. Dr. Rosen, an expert on metabolic diseases and a Philadelphia physician doing new research and therapies to treat and manage diabetes. He has exercise tips for diabetics: Wear well-fitted shoes; dress in light clothing; exercise after meals, if possible, to reduce hypoglycemia risk; stretch prior to exercise; remember to drink regularly during exercise; take soft candy; build exercise tolerance, and don’t do intense exercise without talking with your personal physician. “Exercise is an important part of a healthy lifestyle,” says Dr. Rosen. "Following these tips - and consulting your person physician will ensure that you manage your diabetes and remain physically fit and otherwise healthy.”

WASHINGTON - Monday Morning in Washington, D.C. noted the Postsecondary Education Research Center , run by TransCen, posted a Web site (www.transitiontocollege.net) that provides data and resources on college options for students with intellectual disabilities (ID). It answers questions on developing/expanding services for students with ID in college, and has access to the free online PERC Self-Assessment Tool. That allows users to evaluate programs or services for students with ID on college campuses and provides a snapshot of the quality of existing services and gives users a concise report. It also gives users a chance to create an itemized action plan to address areas in need of improvement.

SAN FRANCISCO - Scientists told HealthDay News that chronic social stress may worsen diseases such as Multiple Sclerosis (MS). The Texas A&M University team said certain interventions may prevent or halt stress-related inflammation. In experiments on mice, scientists found social stress raised central nervous system inflammation. Stress seems to elevate levels of a cytokine called interleukin-6, which led to more severity of MS-like illness in the mice. Cytokines are pro-inflammatory proteins that regulate immune and inflammatory functions. Scientists found giving the mice IL-6 neutralizing antibody treatments during stressful events halted stress-related worsening of the MS-like disease. Results were stated at the American Psychological Association's convention by lead researcher Dr. Mary Meagher, who noted, "People exposed to chronic social conflict experience high levels of stress and consequent dysregulation of the immune system, thereby increasing vulnerability to infectious and autoimmune disease. The cytokine response … appears to play a key role in exacerbating the acute CNS infection and the development of subsequent autoimmune responses."

CHAPEL HILL , NC - A patient’s expectations about the side effects of chemotherapy usually focus on nausea, hair loss, fatigue, etc. Worries about severe allergic reactions to therapy is usually not a concern. A study from the University of North Carolina ’s Lineberger Comprehensive Cancer Center , Vanderbilt-Ingram Comprehensive Cancer Center , and the Sarah Canon Cancer Center in Nashville showed an unusually high rate of allergic reaction in cancer patients living in the middle South who got a common drug used for treating cancer. This study was presented at the annual meeting of the American Society of Clinical Oncology and was online at the Journal of Clinical Oncology. Cetuximab, marketed by Bristol-Meyers Squibb as Erbitux, is a widely-used chemotherapeutic agent for treating colon cancer, head and neck tumors, and is being studied for ovarian, lung, breast, and gastrointestinal tumors. “We realized patients who lived on a line across North Carolina , Tennessee , northern Arkansas , and southern Missouri had these adverse reactions to the drug,” said study leader Dr. Bert O’Neil, assistant professor of medicine at UNC. The U.S. rate of severe allergic reactions to cetuximab is about 2%; 22% of patients in this study showed severe allergic reactions to the drug.

NEWARK , DE - HealthDay News noted scientists hope to find pliable, new vocal cord tissue to replace damaged tissue that can alter or silence a person's voice. The project is funded by a $1.8 million grant from the National Institute on Deafness and Other Communication Disorders. A University of Delaware team will investigate two tissue engineering ways for regenerating flexible folds of connective tissue (lamina propria) that vibrate and produce sound as air is forced up from the lungs via the trachea. Overuse or abuse can result in scarring of the lamina propria, which disrupts the natural pliability and leads to hoarseness or other vocal problems. One approach involves injecting gelatin-like materials into damaged tissue to improve pliability and prevent scar formation. The second approach is creation of functional tissue from a "combination of vocal fold connective tissue cells (fibroblasts), artificial extracellular matrix, and biological cues and mechanical stimuli that capture mechanical and biological characteristics of natural organs.

VIZCAYA, SPAIN - Reuters Health noted a study in Cephalalgia shows preventive migraine therapy with nadolol or topiramate significantly improves migraine patients quality of life, although that stays below average. Nadolol, sold in the U.S. as Corgard, is a beta-blocker to treat high blood pressure and chest pain by slowing heart rate and relaxing blood vessels. Topiramate, sold as Topamax, treats seizures in epileptics. "Preventive medication should not only reduce the frequency of attacks, but also improve quality of life," write Dr. Juan Garcia-Monco, of Hospital de Galdacano, and his team. They studied 76 consecutive migraine patients at least 16 years old, evaluating them at study start and after 16 weeks of nadolol use at 40mg per day, or topiramate at 100mg daily. The study was done by 61 patients. Preventive therapy led to significant improvement in the physical domains of the Short Form 36 Health Survey, a standard test used to assess various aspects of patients' health. Scores on the mental domains were basically even, and all domains stayed below the average of the general population.

PORTLAND , OR - One in 700 Americans has Multiple Sclerosis (MS) - women more than men, and generally shows signs ages 20-40. While the cause is unknown, many doctors believe its due to damage around nerve cells. Inflammation destroys the myelin sheath covers of nerve cells and leads to multiple areas of sclerosis (scar tissue). Healthcare practitioners often urge eating fish at least twice weekly because fish have high levels of omega-3 acids. They contain eicosapentaenoic acid and docosahexaenoic acid, known to affect key blood proteins and are produced by the immune cells of those with MS. A study on effects of omega-3 on MMP-9 in MS patients suggests the intake of fish oil with omega-3 fatty acids may have potential benefit in MS by cutting MMP-9 levels. The Immunomodulatory Effects of Fish Oil in Multiple Sclerosis study was done by the Oregon Health & Science University Dept. of Neurology and Portland Dept. of Veterans Affairs Medical Center. Scientists found there was a 58% decrease in MMP-9 levels secreted from immune cells of MS volunteers after three months of fish oil supplementation versus baseline levels.

NEW YORK - Since it was approved for over-the-counter sales, the morning-after pill has been a commercial success for its maker, but popularity and solid safety record haven't deterred critics from seeking to overturn the milestone ruling. The pill, marketed by Barr Pharmaceuticals Inc. as Plan B, was the focus of bitter debate for three years. After repeated delays, the U.S. Food and Drug Administration declared on Aug. 24, 2006 that customers 18 and older should be able to buy it in pharmacies without a prescription. All national pharmacy chains stock it. Despite the booming sales, and evidence the pill is safe if used properly, critics remain active. Conservative groups, including the Family Research Council and Concerned Women for America , filed a lawsuit in federal court in Washington seeking to reverse the FDA ruling. They contend FDA acted unwisely under political pressure and lacked authority to approve the same drug for over-the-counter and prescription-only distribution based on the user's age.

BOSTON - Harvard World Health News noted blood sugar control is vital in diabetes, specialists say. It can help prevent woes like blindness, amputations, and kidney failure. Controlling blood sugar isn’t enough. Nearly 73,000 Americans die from diabetes annually, yet due to misunderstanding of proper treatment, most patients aren’t doing close to what they should to help themselves. The U.S. Centers for Disease Control and Prevention says 7% are getting all treatments they need. In part, the fault for missed opportunities to prevent complications and deaths lies in the medical system. Most diabetics are treated by primary care doctors with a few hours of diabetes instruction in medical school. Doctors often spend 10 minutes with diabetics, far too little for such a complex disease, specialists say. It’s the fault of proliferating ads for diabetes drugs that emphasize blood sugar control, which is difficult and expensive and hasn’t been proven to save lives. It’s the fault of public health campaigns that foster the idea diabetes reflects an out-of-control diet and sedentary lifestyle and the thing to do is lose weight. Most diabetics try hard but are unable to control their disease this way, and most of the time it progresses as years go by, no matter what they do.

ALBERTA , CANADA - A Canadian study found boys get higher positive self-perceptions as readers when they worked with female assistants versus male assistants. The study in the journal Sex Roles focused on 175 third- and fourth-grade boys identified by their teachers as struggling readers. The boys were in a 10-week reading intervention to see the effect of the reading teacher’s gender on reading recital, self-perception as readers, and view of reading as masculine, feminine, or gender-neutral. “As competent reading is the strongest predictor of school success, it’s crucial to find ways to engage boys to become stronger readers,” says Herb Katz, University of Alberta professor. “Boys and girls enter kindergarten with similar performance in reading; by spring of third grade, boys have lower reading scores, which makes this an opportune time for intervention.” Over the 10 weeks, the assistant visited children at school for 30-minute sessions, reading books with high interest for boys. There was duet reading - student and tutor read simultaneously, and solo reading - the student read alone. Says Katz, “The hiring of male teachers to address boys’ poor reading scores may be naïve.”