More children need medical help for RSV than previously known
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More than 2 million children with Respiratory Syncytial Virus (RSV) are seen in hospitals, emergency rooms and doctors’ offices in the United States every year—many more than doctors know. In fact, only 3 percent of children with RSV in an outpatient setting actually receive a diagnosis of RSV infection.
Although attention is focused on young babies and those with high-risk medical conditions, more older children who were previously healthy need medical attention from RSV infections. Of the 2.1 million children younger than 5 years of age with RSV infection, 78 percent of them are older than 12 months, according to a University of Rochester Medical Center published in this week’s New England Journal of Medicine.
Most children with RSV infections, both those who were hospitalized and those who were treated in doctors’ offices, had no other medical conditions or high-risk characteristics that significantly identified them as being at greater risk for severe RSV disease, except for being younger than 2 years of old.
New study raises concerns about screen time among urban children with asthma
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Urban children with asthma engage in an average of an hour more of screen time daily than the maximum amount American Academy of Pediatrics (AAP) recommends. This is the first study to examine screen time among children with asthma.
“We know that both asthma and excessive screen time can be associated with other difficulties, including behavior problems, difficulty with attention, poor school performance and obesity,” said Kelly M. Conn, M.P.H., of General Pediatrics at Golisano Children’s Hospital at Strong and lead author of the study, which was published recently in Academic Pediatrics. (Academic Pediatrics changed its name from Ambulatory Pediatrics this year.) The study was conducted out of the University of Rochester Medical Center.
As a part of a larger study on how to more effectively treat asthma, Conn and her colleagues surveyed parents of urban children with asthma in Rochester, NY, to better understand their screen time viewing habits. Screen time includes TV watching and video tapes, playing video and computer games and using the Internet. The study found that 74 percent of the 226 children whose parents were surveyed exceeded more than two hours of screen time per day. On average, these children with asthma watched 3.4 hours daily.
Dialysis Patients Residing at Higher Altitude Have Lower Rate of Death
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Compared to dialysis patients living near sea level, dialysis patients living at an altitude higher than 4,000 feet have a 12-15 percent lower rate of death, according to a study in the February 4 issue of JAMA.
A recent study found that patients with end-stage renal (kidney) disease (ESRD) living at higher altitude achieved greater hemoglobin concentrations (a protein in red blood cells that primarily transports oxygen from the lungs to the rest of the body) while receiving lower doses of erythropoietin (a hormone that stimulates the production of red blood cells). Increased iron availability caused by activation of hypoxia-induced (oxygen deficiency) factors at higher altitude may explain this finding, according to background information in the article.
Wolfgang C. Winkelmayer, M.D., Sc.D., of Brigham and Women’s Hospital and Harvard Medical School, Boston, and colleagues examined whether increased altitude would be associated with a reduced rate of death for patients initiating chronic dialysis. Using a comprehensive dialysis registry, the researchers identified 804,812 patients with ESRD who initiated dialysis between 1995 and 2004 and who met the study entry requirements. Most patients resided below an altitude of 250 ft. (40.5 percent) or between 250-1,999 ft. (54.4 percent). Only 1.9 percent of incident dialysis patients lived between 4,000 and 5,999 ft. and 0.4 percent higher than 6,000 ft. Patients were stratified by the average elevation of their residential zip code.
Cardiac Imaging Method May Expose Patients to High Radiation Dose
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Use of the imaging technique known as cardiac computed tomography (CT) angiography (CCTA) has the potential to expose patients to high doses of radiation, and methods available to reduce radiation dose are not frequently used, according to a study in the February 4 issue of JAMA.
The 64-slice (able to scan 64 images per rotation) CCTA has emerged as a useful diagnostic imaging method for the assessment of coronary artery disease and has been proposed to be useful for evaluating patients in emergency departments with chest pain. “With the constantly increasing number of CCTA-capable scanners worldwide, the volume of CCTA scans performed is likely to show substantial further increase,” the authors write. They add that the clinical usefulness of CCTA for the assessment of coronary artery disease has to be weighed against the radiation exposure of CCTA and the small but potential risk of cancer. Many clinicians may still be unfamiliar with the magnitude of radiation exposure that is received during CCTA in daily practice and with the factors that contribute to radiation dose, according to background information in the article.
Jörg Hausleiter, M.D., of the Deutsches Herzzentrum München, Klinik an der Technischen Universität München, Munich, Germany, and colleagues investigated the magnitude of radiation dose of CCTA in daily practice, factors contributing to radiation dose and the use of currently available strategies to reduce radiation dose. The trial, the Prospective Multicenter Study On Radiation Dose Estimates Of Cardiac CT Angiography In Daily Practice I (PROTECTION I), an international, multicenter study (21 university hospitals and 29 community hospitals) included 1,965 patients undergoing CCTA between February and December 2007. Analysis was used to identify independent predictors associated with radiation dose, which was measured as dose-length product (DLP; equals the average radiation dose over a specific investigated volume multiplied by the scan length), which best mirrors the radiation a patient is exposed to by the entire CT scan, according to the authors.
Divorce, antidepressants, or weight gain/loss can add years to your face
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Your mother’s wrinkles — or lack there of, may not be the best predictor of how you’ll age. In fact, a new study claims just the opposite. The study, involving identical twins, suggests that despite genetic make-up, certain environmental factors can add years to a person’s perceived age. Results just published on the web-based version of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS), reveal that factors like divorce or the use of antidepressants are the real culprits that can wreak havoc on one’s face.
“A person’s heritage may initially dictate how they age – but if you introduce certain factors into your life, you will certainly age faster. Likewise, if you avoid those factors you can slow down the hands of time,” said ASPS Member Surgeon and study author Bahaman Guyuron, MD, professor and chairman, department of plastic surgery, University Hospitals Case Medical Center. “In this study, we looked at identical twins because they are genetically programmed to age exactly the same, and in doing so we essentially discovered that, when it comes to your face, it is possible to cheat your biological clock.”
During the study, Dr. Guyuron and his colleagues obtained comprehensive questionnaires and digital images from 186 pairs of identical twins. The images were reviewed by an independent panel, which then recorded the perceived age difference between the siblings.
Treating Sleep Apnea Can Be a Lifesaver
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Obstructive sleep apnea isn’t merely a snoring problem. This serious medical condition strains the cardiovascular system and increases the risk of high blood pressure, congestive heart failure, irregular heart rhythms, stroke and sudden cardiac death.
The February issue of Mayo Clinic Health Letter examines this condition, including risk factors and common symptoms and treatments.
Obstructive sleep apnea occurs when the muscles at the back of the throat relax during sleep and obstruct airflow. The airway narrows or even closes at the end of the exhalation. Breathing may stop momentarily.
Growth hormone treatment after weight loss surgery prevents loss of muscle mass
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Growth hormone treatment for six months after weight loss surgery reduces patients’ losses in lean body mass and skeletal muscle mass, according to a new study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM).
Weight loss surgery techniques, such as gastric banding, have been shown to be effective in reducing body weight and obesity-related diseases, such as diabetes. Although the results of these procedures are widely beneficial, there are some complications. Following surgery, patients are at risk of losing needed lean body mass and skeletal muscle mass due to the serious complications associated with rapid and sustained weight loss. This new study investigated whether growth hormone treatment could prevent or reduce these losses.
“Besides its more commonly known effect on linear growth during childhood, growth hormone benefits body composition throughout life by increasing muscle mass and reducing fat mass,” said Dr. Silvia Savastano, M.D., Ph.D., researcher at University Federico II of Naples in Italy and lead author of the study. “The results of our study show that the use of short-term treatment with growth hormone during a standardized program of low calorie diet and physical exercise is effective in reducing the loss of muscle mass and increasing the loss of fat mass after bariatric surgery.”
Dutch report 3rd death from human form of mad cow
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A third person has died in the Netherlands from variant Creutzfeldt-Jakob Disease, the human form of mad cow disease, the National Institute for Public Health and the Environment (RIVM) said.
The RIVM said late on Monday the patient died at the beginning of January and investigations were underway to assess whether other people could have been infected, although the chances were small.
Two other deaths from the human form of the disease were confirmed in the Netherlands in 2005 and 2006.
TNF-blocker therapy for RA may trigger psoriasis
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Evidence continues to mount that so-called TNF-blockers used to treat rheumatoid arthritis (RA) may lead to psoriasis. The latest study by UK researchers adds to individual case reports of psoriasis occurring in RA patients treated with TNF blockers.
“We observed 25 cases of new-onset psoriasis in our cohort of almost 10,000 patients with rheumatoid arthritis receiving anti-TNF therapy,” investigator Dr. Kimme L. Hyrich told Reuters Health. This compared to “no cases reported in our non-biologic treated control cohort.”
As reported in the Annals of the Rheumatic Diseases, Hyrich of the University of Manchester and colleagues studied data on 9826 anti-TNF-treated patients and 2880 treated with so-called DMARDS (short for disease modifying anti-rheumatic drugs).
Egg intake linked to diabetes risk
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People who sit down to a daily breakfast of eggs may have an increased risk of developing type 2 diabetes, new research suggests.
In a long-term study of 57,000 U.S. adults, researchers found that those who ate an egg a day were 58 percent to 77 percent more likely than non-egg-eaters to develop type 2 diabetes.
The findings, published in the journal Diabetes Care, do not necessarily mean that eggs themselves put people on a path to diabetes, according to the researchers. But they do suggest it is wise to limit your egg intake.
More German children need measles jabs: WHO study
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More children in Germany must be vaccinated against measles to prevent another widespread outbreak, a World Health Organization (WHO) study published on Monday said.
More than 12,000 people were infected with measles three years ago in Germany, Romania, Britain, Switzerland and Italy in an unusual epidemic caused by relatively low immunization rates against the contagious viral disease.
“The 2006 measles outbreak ... must be regarded as a wake-up call,” experts from Berlin’s Robert Koch Institute and two German public health centers said in the latest WHO Bulletin, in a study that focused only on Germany.
Cholera under-reported, infects millions a year
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Cholera infects millions of people each year, 10 times the number of cases reported by countries who fear losing tourist or trade income by acknowledging the real scale of an outbreak, experts at the World Health Organization said Monday.
Claire-Lise Chaignat, cholera coordinator at the WHO, said the diarrheal disease that is spreading fast in Zimbabwe is also under-reported because the stigma attached to it means people often fail to seek treatment.
“People see it as a dirty disease,” she said in the latest WHO Bulletin. “People don’t want to talk about it. They think it’s normal to have diarrhea. Quite often, nobody is interested in providing the minimal support needed for prevention.”
U.S. doctors urged to use heart scans judiciously
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Doctors should be judicious in their use of X-ray heart imaging techniques and avoid their routine use to screen for cardiac problems, a leading U.S. medical group said on Monday.
The American Heart Association urged doctors to weigh risks and benefits carefully in ordering diagnostic tests such as computed tomography, or CT, angiograms and nuclear stress tests in order to minimize the doses of ionizing radiation.
Such low-dose radiation has the potential to cause cancer.
Education doesn’t prevent cognitive decline
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Although a higher level of education attainment is associated with a higher level of cognitive functioning, it does not protect against cognitive decline in old age, contrary to the results of some reports, according to a study sponsored by the U.S. National Institutes of Health.
The association between higher educational attainment and reduced cognitive decline is based largely on studies that measured change at two points in time, study co-author, Dr. Robert S. Wilson, told Reuters Health.
“These studies have had difficulty separating education’s correlation with level of cognition from its correlation with rate of change. Studies such as ours that measure cognition at three or more time points are better able to separate these effects,” he said.
Hormone linked to depression after pregnancy
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Increased levels of corticotropin-releasing hormone (CRH), which is produced by the placenta, identifies women who are at risk for developing depression after their pregnancy ends, according to a study published in the Archives of General Psychiatry.
“The high incidence and severe consequences of postpartum depression make the identification of women at risk an important research goal,” Dr. Ilona S. Yim at the University of California, Irvine, and co-investigators write in their report. They point out that several lines of evidence link CRH, a key hormone involved in regulating many other hormones, to depressive symptoms following delivery.
To further investigate, the researchers conducted a study in which hormone levels in the blood were measured several times throughout pregnancy in 100 women, starting at week 15. Sixteen women developed postpartum depression.
