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Some Blood Types Might Raise Type 2 Diabetes Risk: Study
December 18, 2014


THURSDAY, Dec. 18, 2014 (HealthDay News) -- In what scientists say is a first, a new analysis suggests that some blood types place women at a higher risk for developing type 2 diabetes.

How much higher? According to a team of French researchers, women with blood type B positive appear to face a 35 percent greater risk for developing type 2 diabetes than women with blood type O negative.

However, experts questioned the value of the findings when so many other risk factors for the blood sugar disease can be countered with lifestyle changes.

At play in the study was the basic principal that, as the American Red Cross notes, "not all blood is alike."

Type A blood, for example, carries the A antigen on its surface, sparking a specific immune response whenever foreign substances enter the body. Type B blood carries the B antigen, while type AB carries both, and type O carries neither.

An additional variable, known as the Rhesus (Rh) factor, further distinguishes one person's blood from another's as Rh positive or negative. The result is eight distinct blood types: O positive, O negative, A positive, A negative, B positive, B negative, AB positive and AB negative.

Because accurately matching blood types can prove critical (particularly in the case of blood transfusions), identifying blood type is commonplace.

But screening blood type for diabetes risk is not.

Enter a team led by Guy Fagherazzi, of the Centre for Research in Epidemiology and Population Health at the Gustave Roussy Institute in Villejuif, France. The researchers set out to analyze data on more than 82,000 French women. All the women were tracked from 1990 to 2008.

In the Dec. 18 issue of the journal Diabetologia, Fagherazzi and his colleagues report that women with type A blood ended up with a 10 percent higher overall risk for diabetes than women with type O blood. Those with type B blood faced a more than 20 percent greater risk, while the risk profile of the AB blood type proved inconclusive.

Looking at just the Rh factor, the team found that diabetes risk was the same whether or a not a woman was Rh positive or Rh negative.

Then, the authors combined blood types with Rh factors.

The result: relative to women with O negative blood, diabetes risk was 17 percent greater among A positive women, 22 percent higher among A negative women, 26 percent greater among AB positive women, and 35 percent higher among B positive women.

As to whether the finding might apply to men, the authors suggested in their study that it's likely it would, since nothing in the finding appeared to be gender-specific.

They also suggested that the impact of blood type on diabetes risk may play out on a number of levels, including inflammation, molecular structure, the microbial composition of the gut and metabolic activity.

Fagherazzi stressed in the study that the exact nature of the blood type-diabetes association will remain unclear until further study.

But Dr. Robert Ratner, chief scientific and medical officer at the American Diabetes Association, questioned the value of the finding.

"This is a highly problematic paper," he said. "And I'm really not sure it sheds any light on the subject. Over an 18-year period they were only able to identify about 3,500 cases of diabetes out of 82,000 women. That figure is so low, compared with what we know about diabetes here and in France, that it basically means they didn't really identify people with diabetes. And that means that all of their statistics are highly doubtful."

"So, I would say this is a poor paper with very faulty data, about which I would draw no conclusions," Ratner said. "It doesn't teach us anything. And we are certainly not going to screen for diabetes based on blood type. We have far better ways of identifying risk."

Dr. John Buse, director of the Diabetes Care Center at the University of North Carolina at Chapel Hill, seconded the thought.

"The important thing for people to know is that diabetes is a very common illness," he said. "And there are lots of risk factors that we can do something about. If you're overweight, you can lose weight. If you're sedentary, you can become more active. If you smoke, you can stop. Blood type is not a risk marker that anyone can do anything about, and we're not going to screen for it."

The French researchers did not respond to requests for comment on the study.

More information

Visit the American Diabetes Association for more on risk factors for this blood sugar disease.
Copyright © 2014 HealthDay. All rights reserved.

SOURCES: Robert Ratner, M.D., chief medical and scientific officer, American Diabetes Association, Alexandria, Va.; John Buse, M.D., Ph.D., professor, medicine, University of North Carolina School of Medicine, and director, Diabetes Care Center, Chapel Hi...

Can You Balance on One Leg? You May Have Lower Stroke Risk
December 18, 2014


THURSDAY, Dec. 18, 2014 (HealthDay News) -- If you can't balance on one leg for at least 20 seconds you may be at risk of a stroke, Japanese researchers suggest.

Difficulty standing on one leg may indicate that small strokes or tiny bleeds have already occurred, which means the risk for more serious strokes is high, the investigators reported online Dec. 18 in the journal Stroke.

"Individuals showing instability while standing on one leg, as well as problems walking, should receive increased attention, as this physical frailty may signal potential brain abnormalities and mental decline," said lead author Yasuharu Tabara, an associate professor in the Center for Genomic Medicine at the Kyoto University Graduate School of Medicine.

Stroke, a leading cause of disability and death, occurs when blood flow to a part of the brain is interrupted because of a clot or bleeding.

For the study, Tabara's team had nearly 1,400 men and women, average age 67, try to balance on one leg for a minute. The researchers also took MRI scans to assess disease in the small blood vessels of participants' brains, in the form of "silent" strokes -- or microbleeds.

The researchers found that the inability to balance on one leg for more than 20 seconds was linked to having had tiny strokes or small bleeds in the brain. Balance problems were also associated with reduced thinking and memory skills.

Dr. Richard Libman, chief of vascular neurology at North Shore-LIJ Health System in Manhasset, N.Y., said that "narrowing or blockages of tiny blood vessels deep within the brain can give rise to small strokes or tiny amounts of bleeding."

These small strokes, which are a major contributor to mental decline and dementia, have also been associated with walking and balance difficulty and falling, he explained.

"The authors of this study have devised a simple test of balance, which seems to be able to reflect 'small vessel disease' of the brain," Libman said.

"This test may be an inexpensive, low-tech method to screen people for small vessel disease who are most likely at risk for further strokes and brain damage," Libman added.

Tabara said that among those who had had two or more tiny strokes, about one-third had trouble balancing. Among those who had had one stroke, 16 percent had trouble balancing.

In addition, 30 percent of those with evidence of more than two small bleeds struggled with balance, as did 15 percent of those who suffered one small bleed.

People with brain vessel damage were older, had high blood pressure and thicker neck (carotid) arteries than those who had not had strokes or bleeds, the researchers found.

Struggling to stand on one leg for an extended time was also associated with markedly lower scores on memory and thinking tests, the study found.

More information

For more on stroke, visit the American Stroke Association.
Copyright © 2014 HealthDay. All rights reserved.

SOURCES: Yasuharu Tabara, Ph.D., associate professor, Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Japan; Richard Libman, M.D., chief, vascular neurology, North Shore-LIJ Health System, Manhasset, N.Y.; Dec. 18, 2014, Stro...

Study Supports Benefit of Widely Used Glaucoma Drug
December 18, 2014


THURSDAY, Dec. 18, 2014 (HealthDay News) -- Prostaglandin analogue eye drops -- a common form of glaucoma drug -- significantly reduce the risk of vision loss in patients with the eye disease, a new study finds.

British researchers led by David Garway-Heath, of the Moorfields Eye Hospital and UCL Institute of Ophthalmology in London, tracked outcomes for more than 500 people newly diagnosed with open-angle glaucoma -- the most common form of the disease and one of the leading causes of blindness.

About 45 million people worldwide have this type of glaucoma, and the number is expected to rise to 53 million by 2020 and 80 million by 2040, according to the researchers.

However, they found that the use of latanoprost -- a form of prostaglandin analogue eye drops -- reduced the risk of vision loss in these patients by more than 50 percent over two years, compared to those who received an inactive placebo.

The study, published Dec. 18 in The Lancet, received funding from drug maker Pfizer.

"Medication to lower raised eye pressure has been used for decades as the main treatment for open-angle glaucoma to delay progressive vision loss," Garway-Heath said in a journal news release. "But, until now, the extent to which the most frequently prescribed class of pressure-lowering drugs (prostaglandin analogues) have a protective effect on vision was not known," he said.

"Our findings offer solid proof to patients and practitioners that the visual deterioration caused by glaucoma can be reduced using this treatment," Garway-Heath added.

Two experts in eye health said the study offers reassurance to patients.

Dr. Mark Fromer is an ophthalmologist at Lenox Hill Hospital in New York City. He said that glaucoma is typically treated by interventions that lower the level of pressure within the eye.

"Elevated eye pressure can lead to optic nerve damage," which can harm vision, Fromer explained, so glaucoma "is most commonly treated with a prostaglandin analogue eye drop to reduce eye pressure."

The new study shows "that the use of these medications can greatly reduce the risk of visual loss, and a significant benefit in the treatment group could be seen at one year," he added.

Another expert agreed. "Prostaglandin analogues are typically the first line in treatment for most glaucoma patients as they are an easy, once-a-day medication with a low side-effect profile," said Dr. Reena Garg, assistant professor at the New York Eye and Ear Infirmary of Mount Sinai in New York City.

But Garg also stressed that these medications are not a cure for glaucoma.

In glaucoma, "visual loss can only be slowed, not stopped," Garg said. "It is necessary to educate patients that while glaucoma cannot be cured, proper follow up with a trained specialist can slow the progression of the disease allowing patients to maintain good vision throughout their lifetime."

More information

The U.S. National Eye Institute has more about glaucoma.
Copyright © 2014 HealthDay. All rights reserved.

SOURCES: Mark Fromer, M.D., ophthalmologist, Lenox Hill Hospital, New York City; Reena Garg, M.D., assistant professor, New York Eye and Ear Infirmary of Mount Sinai, New York City; The Lancet, news release, Dec. 18, 2014...

Most States Not Ready to Handle Infectious Disease Outbreaks: Report
December 18, 2014


THURSDAY, Dec. 18, 2014 (HealthDay News) -- Ebola's entrance into the United States -- along with Angelina Jolie's chickenpox and the National Hockey League's mumps outbreak -- have highlighted cracks in the nation's public health defense against infectious disease, according to a new health policy report released Thursday.

Half of U.S. states are poorly prepared to prevent, detect and respond to infectious disease outbreaks. That was the main conclusion of the report issued jointly by the Trust for America's Health and the Robert Wood Johnson Foundation.

"Ebola has served as a major wake-up call to the United States," said Jeffrey Levi, executive director of the Trust for America's Health.

"It's a reminder that an infectious disease anywhere is a threat everywhere, and Ebola has raised attention to serious gaps in our ability to manage disease outbreaks and contain their spread. It was very disturbing that many of the most basic infectious disease controls failed when tested," he said.

The report ranks states based on 10 indicators of preparedness. The indicators include funding of public health efforts, vaccination rates, infection control at medical centers, attempts to prepare for climate change, and surveillance efforts to track cases of HIV and E. coli.

Half the states scored five or lower on the list of 10 indicators. Five states tied for the top score. Maryland, Massachusetts, Tennessee, Vermont and Virginia all received a score of 8 out of 10, according to the report. Arkansas has the lowest score at 2 out of 10. No state received a perfect ranking.

"When I was in medical school, the leading experts declared that infectious diseases had been conquered in the United States. It's now clear how wrong they were," Dr. Eric Toner, senior associate at the University of Pittsburgh Medical Center's Center for Health Security, said of the report's findings.

Levi blamed the nation's half-hearted defense against infectious diseases on complacency, combined with a "tendency to focus on the newest and most alarming threat at the expense of maintaining a steady defense against ongoing and costly illnesses."

"When there is no major threat dominating headlines, we start letting our guard down, cut funds for programs, and then are caught off-guard and underprepared for the next outbreak," he said.

Levi and Toner broke down the infectious disease threats facing America into four main categories:

  • Traditional infectious diseases such as the flu, mumps, chickenpox and whooping cough. Vaccines are available for these diseases, but not enough people are getting them. The report noted that more than 2 million preschoolers, 35 percent of seniors and a majority of adults don't receive all of the recommended vaccinations.
  • Chronic infectious diseases for which complacency has hampered efforts to control their spread. Diseases in this category include HIV, tuberculosis and hepatitis. New HIV infections grew by 22 percent among young gay men and 48 percent among young black men between 2008 and 2010, the report found.
  • Emerging infections that will strike the United States as a result of climate change. These include mosquito-borne illnesses like chikungunya, West Nile virus, malaria and dengue fever, which have been striking the southern states more frequently.
  • Antibiotic-resistant bacteria and superbugs. More than 2 million Americans fall sick from antibiotic-resistant bacteria and more than 23,000 die from those infections each year, the report found.

States also did a particularly poor job of reducing infections of the blood caused by catheters placed into large veins during hospitalization, the report found. Just 10 states reduced the number of such infections between 2011 and 2012. Only 16 states performed better than the national baseline for these infections, the report found.

The new report "primarily reflects what we observed during the Ebola crisis," said Dr. Ambreen Khalil, an infectious disease specialist at Staten Island University Hospital in New York. "While some hospitals were very well prepared, most were not equipped to handle such cases or even identify the severity of the issue."

The report recommended a number of steps that can be taken to better defend the nation against infectious diseases, Levi said. These include:

  • Making sure each state has a well-trained public health workforce equipped with strong laboratories.
  • Developing and implementing solid containment strategies, including vaccination for contagious bugs and treatment of chronic infections.
  • Training hospitals to respond to outbreaks that could flood the facilities with huge numbers of patients, and regularly testing their preparedness.
  • Improving communications with the public, to keep them up to date on emerging threats without creating panic.
  • Increasing federal funding into research for vaccines, stronger antibiotics and other treatments that can counter outbreaks.

"Unfortunately, there is often a very limited market for these medical countermeasures," Toner said. "Therefore, there's not been a strong incentive for the industry to invest in research and development efforts. But vaccines and antimicrobial drugs are essential tools in fighting infectious disease."

More information

For more on the Outbreaks report, visit the Trust for America's Health.
Copyright © 2014 HealthDay. All rights reserved.

SOURCES: Jeffrey Levi, Ph.D., executive director, Trust for America's Health; Eric Toner, M.D., senior associate, Center for Health Security, University of Pittsburgh Medical Center; Ambreen Khalil, M.D., infectious disease specialist, Staten Island Unive...

Arriving Now at Gate 42: Measles
December 18, 2014


THURSDAY, Dec. 18, 2014 (HealthDay News) -- Traveling through the same U.S. airport gate, one infected passenger transmitted the measles virus to three others within a four-hour time span, illustrating just how easily the virus can spread, a new report shows.

"The exposures in this report were not prolonged and occurred in a domestic rather than an international terminal, highlighting the fact that measles is highly contagious," wrote a team led by Jared Vega, an infectious disease specialist at the U.S. Centers for Disease Control and Prevention.

The researchers stressed that measles "continues to pose a risk for infection among unvaccinated persons in the United States." None of the four people infected had been vaccinated.

The measles "cluster" of cases originated at one gate at an unnamed U.S. international airport, according to the study. Transmission likely occurred on Jan 17. The gate in question was located in a terminal that only serviced domestic flights.

The first patient outlined in the report was a 21-year-old man. He developed a measles rash on Feb. 1. He had traveled on two domestic flights that connected at the airport about two weeks beforehand -- on January 17 and 18, the study reported.

Patient 2 was a 49-year-old man who also developed a measles rash on Feb. 1. He had reported traveling from the airport on Jan 17. A third patient, age 19, came down with the measles rash on Jan 30. He said he had spent four hours on a layover in the airport on Jan. 17 as well.

Finally, patient 4, a 63-year-old man, developed a measles rash on Feb. 5. He had also traveled through the airport on Jan. 17.

Proximity was key: Patients 1 and 2 were on the same flight, seated a row apart. And, "both spent time at the departure gate before the flight," the report noted. Patients 3 and 4 also spent time at the same gate "during the time that patients 1 and 2 were present," the study said.

In fact, "patient 4 passed through the same domestic gate around the time the other three patients were waiting to depart," Vega's team noted.

It's still not clear which of the four patients was the primary source of the infections. But, laboratory tests confirmed that all four patients were infected with the same strain of measles.

"Based on the available information, it is likely that transmission occurred in the airport at the domestic gate," the researchers said. "The source case of this presumed cluster was not identified, and no other cases were identified beyond this cluster of four cases."

Two experts in infectious illness weren't surprised by quick spread of the mini-outbreak.

"Measles is one of the most contagious infectious diseases known, and up to nine out of 10 susceptible individuals exposed to an infected person will develop the disease," explained Dr. Leonard Krilov, chief of pediatric infectious disease at Winthrop-University Hospital in Mineola, N.Y.

"The virus is transmitted by the respiratory route -- infectious droplets generated by coughing, sneezing or talking -- from infected individuals," he added. "The virus can survive in these airborne droplets or on contaminated surfaces for two hours, contributing to its contagiousness."

Getting the measles shot remains everyone's best defense against this often serious ailment, stressed Dr. Ambreen Khalil, an infectious disease specialist at Staten Island University Hospital in New York City.

"Unvaccinated people, who come in contact with these secretions, are susceptible," Khalil said. "As clearly shown [in this cluster] only unvaccinated individuals were affected."

And while most people think of measles as a transient childhood illness involving rash, Krilov said the public needs reminding just how serious the illness can be.

"Up to 30 percent of people who get measles develop complications that include pneumonia, ear infections and diarrhea," he said. "The severity of measles is underscored by the observation that two out of every 1,000 infected people die from the disease, most from secondary severe pneumonia. Encephalitis is a less common but severe complication as well."

However, widespread vaccination has greatly reduced the burden of measles-linked illness and death.

Prior to the vaccine's introduction, over 500,000 cases occurred [in the United States]," Krilov said. "As a tribute to the success of the vaccine, in 2014 just over 600 cases have been reported."

The findings were published online Dec. 18 in the CDC journal Morbidity and Mortality Weekly Report.

More information

There's more on measles at the American Academy of Pediatrics.Copyright © 2014 HealthDay. All rights reserved.

SOURCES: Leonard Krilov, chief, pediatric infectious disease and vice chairman, department of pediatrics, Winthrop-University Hospital, Mineola, N.Y.; Ambreen Khalil, M.D., infectious disease specialist, Staten Island University Hospital, New York City; ...

Many Flu Infections Aren't Good Match for Vaccine: CDC
December 18, 2014


THURSDAY, Dec. 18, 2014 (HealthDay News) -- The flu is starting to tighten its grip on much of the United States, particularly in the South and Midwest, U.S. health officials reported Thursday.

And more than half of the flu infections examined so far have been caused by the strain known as influenza A H3N2, which appears to have mutated from the H3N2 strain included in this year's flu vaccine.

That mutated strain has federal officials concerned because the vaccine may not offer the protection seen in seasons when the vaccine is a better match.

Still, health officials are urging that everyone over 6 months of age get vaccinated, because the vaccine will offer some protection, especially for strains that might become more widespread as the flu season progresses.

"Vaccination is our most effective means to prevent influenza and its complications," said Melissa Rolfes, an epidemic intelligence service officer with the U.S. Centers for Disease Control and Prevention. "We encourage everybody over the age of 6 months to get vaccinated," she said.

"Currently," added Rolfes, who authored Thursday's report, "flu activity in the United States is low, but it's increasing."

Flu seasons that feature widespread H3N2 infections can be tough. H3N2 viruses were predominant during the 2012-13, 2007-08 and 2003-04 flu seasons -- the three seasons with the highest death rates in the past decade, CDC officials noted. In the past, death rates from H3N2 have been more than double that of other flu strains.

Rolfes said H3N2 flu tends to affect the old and the very young. "In previous seasons where H3N2 has been the predominant virus, we do tend to see more deaths among older adults and also very young children," she said.

For the week ending Dec. 6, widespread flu activity was reported in Colorado, Delaware, Florida, Georgia, Illinois, Kentucky, Louisiana, Maryland, Minnesota, New York, North Carolina, Ohio, Pennsylvania and Texas, according to the report, published in the CDC's Morbidity and Mortality Weekly Report.

Rolfes said it's difficult to predict whether this will be a bad flu season, but there have been no signs yet that it will be severe.

However, Dr. Marc Siegel, an associate professor of medicine at NYU Langone Medical Center in New York City, said it could be a rough ride for the next few months. "The combination of a H3N2 [strain] that is a predominant strain and a vaccine that may not be a perfect match may make it a severe flu season," he said.

Despite the vaccine mismatch, Siegel also recommends that everyone get vaccinated. The reason: although the H3N2 virus in circulation is slightly different genetically than the one in the vaccine, the vaccine may still be somewhat effective.

"We are not going to know how valuable the shot is until March or April. The goal is to have fewer people hospitalized and fewer people seen in emergency rooms, and that isn't known yet," he said.

Siegel expects this year's flu season to peak by late January or February.

Many school districts are already paying a price.

Several public and private schools in Georgia, North Carolina and Tennessee said this week they will be closing early for Christmas break, because up to 30 percent of their students and teachers were out sick, according to USA Today.

In Illinois and Ohio, some schools have closed and then reopened after cleaners scrubbed buildings in a bid to limit infections, the newspaper reported.

According to CDC estimates, each year an average of 5 percent to 20 percent of Americans get the flu and more than 200,000 people are hospitalized from flu-related complications -- the most serious being pneumonia.

Estimates of flu-related deaths in the United States range from a low of about 3,000 to a high of about 49,000 people. Some people, such as older people, young children, pregnant women, and people with certain health conditions, are at high risk for serious flu complications. Those health conditions include asthma, heart disease, liver and kidney disorders and people with weakened immune systems, according to the CDC.

More information

For more on flu, visit the U.S. Centers for Disease Control and Prevention.
Copyright © 2014 HealthDay. All rights reserved.

SOURCES: Melissa Rolfes, Ph.D., U.S. Centers for Disease Control and Prevention; Marc Siegel, M.D., associate professor of medicine, NYU Langone Medical Center, New York City; Dec. 19, 2014, CDC's Morbidity and Mortality Weekly Report; USA Today...

Scratch From Pet Rat Kills Child; CDC Warns of Risk
December 18, 2014


THURSDAY, Dec. 18, 2014 (HealthDay News) -- The tragic death from "rat-bite fever" of a 10-year-old San Diego boy highlights the risk carried by the pet rodents, according to a report from the U.S. Centers for Disease Control and Prevention.

"Rat-bite fever is a rare but potentially fatal illness that should be considered in persons with rash, fever and joint pain, and when a history of rodent exposure is reported," said a team led by Dr. Jessica Adam of the CDC's Epidemic Intelligence Service.

The case outlined in the report occurred in August of 2013. Adam's team said the boy, previously healthy, first developed a fever of 102.6 degrees and "experienced rigors, fevers, vomiting, headaches and leg pains."

His doctor initially diagnosed the illness as infection with a gastrointestinal virus. But "during the next 24 hours, the patient experienced vomiting and persistent fever. He was confused and weak before collapsing at home," the CDC report said.

By the time paramedics reached the boy he was "unresponsive," and he died in a hospital emergency department.

Blood tests and autopsy reports revealed infection with Streptobacillus moniliformis, a potentially deadly germ that causes rat-bite fever and "can be transmitted to humans through rodent bites or scratches; approximately one in 10 bites might cause infection," according to the CDC authors.

Adam and her colleagues said that the boy had two pet rats: the first one tested negative for S. moniliformis, but the second, recently acquired, tested positive. "The autopsy report noted that patient had been scratched by his pet rats," the researchers said.

Adam's team suggested that rat-bite fever could be under-reported because the condition does not have to be reported to health authorities in the United States.

Trying to determine its overall incidence, they looked through hospital records in San Diego County for 2000-2012 and found 16 cases during that time period, which did not include the one fatal case involving the 10-year-old in 2013.

"Most infections (94 percent) were pet-associated," the team noted. "One patient had an occupational exposure (rat breeder). Sixteen of 17 patients reported exposure to rats. Of these, 44 percent reported only having handled a rat, 38 percent reported being bitten and 13 percent reported a scratch."

Based on the findings, Adam's team said that doctors need to be alert to rat-bite fever when symptoms occur, and they stress that "nearly all domestic and wild rats carry S. moniliformis."

Quick treatment is crucial, because even though rat-bite fever is treatable with antibiotics, fatalities do occur in about 13 percent of untreated cases.

The researchers also stressed that a scratch or bite from the rat isn't necessary for transmission, since infection can occur "through ingestion of food or water contaminated with the bacteria."

Their advice to owners of pet rats? "Wear gloves and wash their hands thoroughly after handling rats or cleaning rat cages, avoid rat secretions and promptly seek medical care if they have rat-bite fever symptoms after contact with rats."

The findings are published in the Dec. 18 issue of the CDC journal Morbidity and Mortality Weekly Report.

More information

Find out more about rat-bite fever at the American Academy of Pediatrics.
Copyright © 2014 HealthDay. All rights reserved.

SOURCE: Morbidity and Mortality Weekly Report, Dec. 18, 2014...

Severe Hot Flashes During Menopause May Raise Hip Fracture Risk Later: Study
December 18, 2014


THURSDAY, Dec. 18, 2014 (HealthDay News) -- A new study suggests a possible link between certain menopause symptoms -- moderate to severe hot flashes and night sweats -- and higher rates of hip fractures and weaker bones.

Hot flashes are common during menopause, affecting about 60 percent of women. The hormonal changes during menopause also affect women after menopause, since they then face a higher risk of weakened bones and osteoporosis.

"Our findings suggest women who exhibit moderate or severe menopausal symptoms are more likely to have issues with bone health than their peers," study co-author Dr. Carolyn Crandall, of the David Geffen School of Medicine at the University of California, Los Angeles, said in a news release from the Endocrine Society. "This is the first large cohort study to examine the relationship between menopausal symptoms and bone health in menopausal women."

While the researchers found an association between some menopause symptoms and bone health, they did not prove that hot flashes and night sweats cause hip fractures.

The study analyzed the medical records of more than 23,000 U.S. women aged 50 to 79 who were tracked for eight years, on average.

Compared to women with no menopausal symptoms, those with moderate or severe hot flashes were more likely to fracture a hip. Those with moderate to severe menopausal symptoms also had weaker bones in the neck and spine, as revealed by bone density tests.

"More research is needed to illuminate the connection between bone health and menopausal symptoms such as hot flashes," Crandall said. "Improved understanding would help clinicians advise women on how to better prevent osteoporosis and other bone conditions. Women who have hot flashes and want to protect their bones may benefit from healthy lifestyle habits such as avoiding smoking and excessive alcohol consumption, exercising and getting sufficient calcium and vitamin D."

The study was published Dec. 18 in the Journal of Clinical Endocrinology & Metabolism.

More information

For more about menopause, try the U.S. National Institute on Aging.Copyright © 2014 HealthDay. All rights reserved.

SOURCE: The Endocrine Society, news release, Dec. 18, 2014...

Being Fit Keeps Blood Pressure in Check
December 18, 2014


THURSDAY, Dec. 18, 2014 (HealthDay News) -- Being in good shape seems to reduce your risk of high blood pressure, researchers report.

They looked at data from more than 57,000 Americans, including more than 35,000 with high blood pressure, who underwent treadmill tests between 1991 and 2009.

Those in the poorest shape had a more than 70 percent chance of having high blood pressure at the start of the study, compared to a 50 percent chance for those with high levels of fitness.

Of the more than 8,000 people diagnosed with high blood pressure during the study, 49 percent had lower fitness levels and 21 percent had higher fitness levels. People with the highest fitness levels were 20 percent less likely to develop high blood pressure than those with the lowest fitness levels.

The link between fitness and high blood pressure was seen regardless of age, gender, race, obesity, resting blood pressure or diabetes, according to the study published recently in the Journal of the American Heart Association.

Further research is needed to find out how fitness levels affect high blood pressure risk over time, senior study author Dr. Mouaz Al-Mallah, a cardiologist at the Henry Ford Heart and Vascular Institute in Detroit, said in a journal news release.

"If you're exercising and you're fit, your chances of developing hypertension are much less than someone else who has the same characteristics but isn't fit," Al-Mallah said. "Increasing exercise and fitness levels probably protects against many diseases."

About one-third of U.S. adults have high blood pressure, according to the American Heart Association.

More information

The American Academy of Family Physicians has more about high blood pressure.
Copyright © 2014 HealthDay. All rights reserved.

SOURCE: Journal of the American Heart Association, news release, Dec. 17, 2014...

Xtoro Approved for Swimmer's Ear
December 18, 2014


THURSDAY, Dec. 18, 2014 (HealthDay News) -- Xtoro (finafloxacin otic suspension) eardrops have been approved by the U.S. Food and Drug Administration to treat swimmer's ear, clinically known as acute otitis externa.

The infection of the outer ear and ear canal, most often caused by ear canal bacteria, has typical symptoms including pain, swelling, redness and discharge, the FDA said in a news release.

The drug's safety and effectiveness were evaluated in a clinical study of more than 1,200 people, aged 6 months to 85 years. The most common side effects were ear itching and nausea.

Xtoro is produced by Alcon Laboratories, based in Fort Worth, Texas.

More information

The FDA has more about this approval.
Copyright © 2014 HealthDay. All rights reserved.


Common Painkillers May Help Prevent Certain Skin Cancers, Study Finds
December 18, 2014


THURSDAY, Dec. 18, 2014 (HealthDay News) -- Common painkillers, including ibuprofen, might slightly reduce your risk of developing a form of skin cancer, researchers say.

Use of ibuprofen (Advil, Motrin) and naproxen (Aleve) appear to reduce the risk of squamous cell skin cancer by 15 percent, the researchers concluded after reviewing nine prior studies. Squamous cell skin cancer is usually caused by sun exposure.

These painkillers "have potential as part of a skin cancer-prevention strategy," said review co-author Catherine Olsen, a senior research officer with QIMR Berghofer Medical Research Institute in Brisbane, Queensland, Australia.

But Olsen and other experts aren't ready to recommend popping these or other nonsteroidal anti-inflammatory drugs (NSAIDs) to prevent skin cancer. For one thing, these drugs are associated with risks of their own.

"Don't rely on aspirin or other nonsteroidal anti-inflammatory drugs to protect your skin," said Dr. Joshua Zeichner, director of cosmetic and clinical research at Mount Sinai Hospital in New York City, who wasn't involved in the study.

"The best treatment is primary prevention," he said, citing sunscreen, sun-protective clothing and taking advantage of shade.

About 2.2 million Americans are diagnosed with either squamous cell or basal cell skin cancer each year, according to the American Cancer Society. About 20 percent of these skin cancers are thought to be squamous cell.

Researchers believe squamous cell skin cancers aren't usually dangerous unless they go untreated and spread ("metastasize"). "They rarely metastasize, although that's been reported," Zeichner said.

The cancers normally appear on parts of the body exposed to the sun, and are often easily removed. They rarely cause death.

Olsen said scientists have wondered about the ability of certain painkillers to prevent skin cancer because researchers believe the drugs might have cancer-fighting powers for other kinds of tumors.

The painkillers reviewed included aspirin, in addition to ibuprofen and naproxen. These drugs treat pain and reduce inflammation, although they can also cause serious side effects such as bleeding in the digestive system.

For the study, published Dec. 18 in the Journal of Investigative Dermatology, the researchers combined the results of nine existing studies. They determined that use of these kinds of drugs -- except aspirin -- might reduce the risk of squamous cell skin cancer by 15 percent, Olsen said.

"The analysis also suggested decreased risk of squamous cell cancer associated with aspirin use," Olsen said, "but this finding was not statistically significant."

The association between the painkillers and reduced squamous cell cancer risk was most pronounced in people with potentially pre-cancerous growths known as actinic keratoses or a history of skin cancer. However, the association seen in the study does not prove a cause-and-effect relationship.

The researchers think the painkillers may lower the risk of skin cancer by disrupting the activity of proteins that contribute to swelling and the development of tumors, Olsen said.

However, she added that more research is needed into issues such as the proper dosage before recommendations could be made.

Zeichner said patients wondering whether they should take a painkiller to prevent skin cancer due to a history of skin damage and skin cancer should talk to their doctor about it.

More information

For more about squamous cell carcinoma, see the American Cancer Society.
Copyright © 2014 HealthDay. All rights reserved.

SOURCES: Joshua Zeichner, M.D., director, cosmetic and clinical research, department of dermatology, Mount Sinai Hospital, New York City; Catherine Olsen, Ph.D., senior research officer, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Aus...

'Homing Signal' in Brain Helps Humans Navigate, Research Shows
December 18, 2014


THURSDAY, Dec. 18, 2014 (HealthDay News) -- A "homing signal" in the brain tells people which way to travel, and the strength of the signal affects people's ability to navigate, researchers report.

Their study is the first to uncover why some people are better at finding their way than others, and also offers new insight into why getting lost is a common problem among people with Alzheimer's disease.

The British scientists discovered that a part of the brain called the entorhinal region tells you which direction you are currently facing, and also which direction you need to travel to reach your destination.

For the study, brain scans were conducted on 16 people as they tried to find their way on landscapes displayed on a computer. The findings were published Dec. 18 in the journal Current Biology.

"In this simple test, we were looking to see which areas of the brain were active when participants were considering different directions," study leader Dr. Hugo Spiers, of University College London, said in a college news release.

"We were surprised to see that the strength and consistency of brain signals from the entorhinal region noticeably influenced people's performance in such a basic task. We now need to investigate the effect in more complex navigational tasks, but I would expect the differences in entorhinal activity to have a larger impact on more complex tasks," he added.

"This type of 'homing signal' has been thought to exist for many years, but until now it has remained purely speculation," Spiers said. "Studies on London cab drivers have shown that the first thing they do when they work out a route is calculate which direction they need to head in. We now know that the entorhinal cortex is responsible for such calculations and the quality of signals from this region seem to determine how good someone's navigational skills will be."

The entorhinal region is also one of the first parts of the brain affected by Alzheimer's disease, and this study may help explain why people start to get lost in the early stages of the disease, the researchers said in the news release.

They suggested a navigation test similar to the one used in the study might help diagnose Alzheimer's at an early stage and monitor progression of the disease.

More information

George Washington University has more about the brain and navigation.
Copyright © 2014 HealthDay. All rights reserved.

SOURCE: University College London, news release, Dec. 18, 2014...

Frail Elderly Might Benefit From High-Dose Flu Shot
December 18, 2014


THURSDAY, Dec. 18, 2014 (HealthDay News) -- A high-dose influenza vaccine is better than the standard vaccine for frail seniors under care in nursing homes, a new study suggests.

Researchers report that the high-dose shot produces a stronger immune response in this elderly population, a potential sign it will keep more cases of flu at bay.

"For frail older adults, the high-dose vaccine appears to be a better option to protect against flu than the standard dose," said study leader Dr. David Nace, of the University of Pittsburgh. "Even in the frail, long-term care population, the high-dose flu vaccine looks like it produces a greater antibody response than the standard dose vaccine."

About nine out of every 10 flu-related deaths in the United States are among people aged 65 and older, according to the U.S. Centers for Disease Control and Prevention. People aged 85 and older in long-term care communities are at high risk of developing flu, and their immune systems may be less responsive to vaccines, the researchers say.

In the new study, researchers compared the high-dose and standard vaccines in 187 frail older adults with an average age of 87.

The high-dose vaccine prompted a modest but stronger improvement in the immune response to all but one flu strain at 30 and 180 days after vaccination.

The study, published Dec. 18 in the Journal of Infectious Diseases, was funded in part by Sanofi Pasteur.

In an accompanying commentary, two CDC researchers said it's crucial to vaccinate elderly nursing home residents and health care workers.

More information

For more about the flu, see the U.S. National Foundation for Infectious Diseases.
Copyright © 2014 HealthDay. All rights reserved.

SOURCE: Journal of Infectious Diseases, news release, Dec. 18, 2014...

Many People Misuse Devices for Asthma, Allergic Reaction
December 18, 2014


THURSDAY, Dec. 18, 2014 (HealthDay News) -- Few people know how to properly use the medical devices that contain lifesaving medications for severe allergic reactions and asthma attacks, a new study shows.

Just 16 percent knew the correct way to use an epinephrine injector for someone with a life-threatening allergy. And only 7 percent knew how to use an asthma inhaler as directed.

"This isn't a new concern. We always worry about our patients, especially those with food allergies," said one of the study's authors, Dr. Aasia Ghazi, from the Allergy and Asthma Specialists of Dallas.

"We had a patient call in the middle of a reaction, and she didn't remember how to use the epinephrine injector. That's why we looked to see what's going on, and what are the barriers that keep patients from using these devices properly?" Ghazi explained.

The study was published online Dec. 18 in the Annals of Allergy, Asthma and Immunology.

A life-threatening allergic reaction is known as anaphylaxis. The incidence of anaphylaxis is rising, according to background information in the study. A shot of epinephrine -- a stimulating hormone -- into a muscle can stop anaphylaxis, according to the study authors.

"A life can be saved with an epinephrine injection. It's a big deal," said Ghazi.

Asthma inhalers can be used to deliver medicine to stop an asthma attack, or they can deliver preventive medications that help stop asthma attacks from occurring. They can be used alone or along with an additional device called a spacer. Spacers are chambers that temporarily hold the medication, which can be especially helpful when giving medication to children, according to the American Lung Association.

Misuse of asthma inhalers or spacers can lead to too little medicine being used. That means symptoms might not be treated properly. It can also lead to overuse of medication, according to background information in the study.

Ghazi and her colleagues recruited 102 patients prescribed epinephrine and 44 prescribed asthma inhalers or spacers for the study. Eleven percent of those prescribed epinephrine had used the device before. Eighty percent of those with asthma reported having used an inhaler -- also called a metered-dose inhaler, or MDI -- or a spacer before, the researchers said.

The study volunteers demonstrated how to use a device to the researchers.

Of the 84 percent who misused the epinephrine, more than half missed three or more steps involved in the correct use of the device. The most common error was not leaving the shot in for 10 seconds.

"We instruct patients to leave the unit in place for 10 seconds to make sure 100 percent of the medication is injected," Ghazi said.

Of the 93 percent who misused asthma inhalers or spacers, 63 percent missed three or more steps. The most common mistake was not exhaling before depressing the canister to inhale the medication, according to the study.

Time appeared to be a significant factor in patients' memories. For those prescribed epinephrine injectors within a year, 10 percent had perfect use. If they had the device for one to five years, just 5 percent had perfect use. If someone had been given the device five years prior, perfect use dropped to just 1 percent, the study found.

"This study really drives home the need to reinforce the use of these devices every time a patient comes in," said Dr. Jennifer Appleyard, chief of allergy and immunology at St. John Providence Health System in Detroit. "And, it's not enough to just give instructions. People need to show me how they use the device," she added.

Appleyard, who was not involved with the study, said that epinephrine injectors come in kits that have training devices. She also suggested practicing with expired devices by injecting a piece of fruit, such as an orange. "It's important to feel comfortable with the injector. Everyone needs to practice," Appleyard said.

Some devices have instructions written on them, and others will talk you through the steps, according to Ghazi.

Both experts said if your doctor hasn't shown you how to use your medical devices, you need to speak up. "Talk to your caregiver, and make sure you're getting instructions whenever you visit. Make sure you're getting it right, and clarify any doubts you have," Ghazi said.

More information

Read more about how to use an epinephrine injector from the U.S. National Library of Medicine.
Copyright © 2014 HealthDay. All rights reserved.

SOURCES: Aasia Ghazi, M.D., Allergy and Asthma Specialists of Dallas, and adjunct assistant professor, University of Texas Medical Branch, Galveston, Texas; Jennifer Appleyard, chief of allergy and immunology, St. John Providence Health System, Detroit; D...

Sensitive Parenting May Boost Kids' Social Skills, School Performance
December 18, 2014


THURSDAY, Dec. 18, 2014 (HealthDay News) -- The type of parenting children receive at an early age may have a long-term effect on their social skills and school success, a new study indicates.

The study included 243 people from poor families in Minnesota who were followed from birth until age 32. Those who received more sensitive parenting early in life had better social skills -- including romantic and peer relationships -- and higher levels of academic achievement into adulthood. However, the study did not prove that sensitive parenting causes social and academic success.

Sensitive parenting includes responding promptly and appropriately to a child's signals, being positive in interactions with a child, and providing a secure base for a child to explore the environment, according to the study published in the journal Child Development.

"Altogether, the study suggests that children's experiences with parents during the first few years of life have a unique role in promoting social and academic functioning -- not merely during the first two decades of life, but also during adulthood," study leader Lee Raby, a postdoctoral researcher at the University of Delaware, said in a journal news release.

"This suggests that investments in early parent-child relationships may result in long-term returns that accumulate across individuals' lives," Raby said. "Because individuals' success in relationships and academics represents the foundation for a healthy society, programs and initiatives that equip parents to interact with their children in a sensitive manner during the first few years of their children's life can have long-term benefits for individuals, families and society at large."

More information

The U.S. National Library of Medicine has more about parenting.
Copyright © 2014 HealthDay. All rights reserved.

SOURCE: Child Development, news release, Dec. 18, 2014...

Health Highlights: Dec. 18, 2014
December 18, 2014


Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Former NFL Players' Lawsuit Over Painkillers Dismissed by Judge
A lawsuit by former NFL players who said they were subjected to improper care and misuse of painkillers was dismissed Wednesday by a federal judge.
The lawsuit by the 1,300 retired players claimed the league and its teams, doctors and trainers withheld information about injuries and dispensed painkillers to mask pain and minimize lost playing time, the Associated Press reported.
One of the specific allegations was that prescriptions were filled out in players' names without their knowledge.
In his ruling, Judge William Alsup of the U.S. Northern District in California wrote that the lawsuit was pre-empted by the collective bargaining agreement between the league and the players' association, the AP reported.
No court has ruled that a professional sports league must supervise its teams on health and safety issues, Alsup wrote.


No Evidence Paleo Diet Matches Early Human Eating Habits: Study
There's no proof that the popular paleo (Paleolithic) diet actually matches what early humans ate, a new study says.
The diet -- heavy in meat, fish and vegetables and light in grain products and processed food -- is supposed to be similar to how humans' ancestors ate between 10,000 and 2.5 million years ago, ABC News reported.
But there is little evidence that early humans consumed a specialized diet or regarded any one food group as especially important, according to study author Ken Sayers, an anthropologist at Georgia State University.
"Whatever angle you chose to look at the diets of our early ancestors, it's hard to pinpoint any one particular feeding strategy," he told ABC News.
In fact, it's more likely they were opportunistic feeders, Sayers said.
The study was published in the Quarterly Review of Biology.Copyright © 2014 HealthDay. All rights reserved.


Smog Exposure During Pregnancy Linked to Autism Risk
December 18, 2014


THURSDAY, Dec. 18, 2014 (HealthDay News) -- Children born to moms who were exposed to high levels of air pollution late in pregnancy may have an increased risk of developing autism, a U.S. study suggests.

Researchers found that of nearly 1,800 U.S. women who gave birth between 1990 and 2002, those exposed to the most air pollution during pregnancy were twice as likely to have a baby who later developed autism. And exposure during the third trimester, specifically, showed the strongest correlation to autism risk.

Experts said the findings, reported in the Dec. 18 online edition of Environmental Health Perspectives, add to evidence that air pollution may contribute to autism.

"This reinforces our confidence that air pollution is a risk factor," said Michael Rosanoff, director of public health research for the advocacy group Autism Speaks.

Rosanoff, who was not involved in the study, stressed that people should keep the odds in perspective: A twofold increase in a small risk is still a small risk.

In addition, it's important to note that while this study found an association between air pollution exposure in pregnancy and the risk of autism, the study doesn't prove that smog exposure caused autism.

Still, the findings are important because they point to an autism risk factor that can be changed, Rosanoff said.

Several studies have found a correlation between exposure to air pollution during pregnancy and an increased risk of autism spectrum disorders, or ASDs -- a group of developmental disorders that affect a child's ability to communicate and socialize.

Now the new findings add some key pieces to the bigger picture, according to senior researcher Marc Weisskopf, an associate professor at the Harvard School of Public Health in Boston.

"Most importantly," Weisskopf said, "we're finding that the association is specific to pregnancy, especially the third trimester."

His team found no statistical link between autism risk and moms' air pollution exposure before or after pregnancy.

"That helps rule out a lot of other factors that could explain the association," Weisskopf said.

For example, he noted, it could be argued that exposure to air pollution is just a marker of lower income and less prenatal care, which could be the "real" risk factor. But if that were the case, Weisskopf said, pollution exposure before and after pregnancy should be tied to autism risk, too.

Rosanoff agreed that pinpointing the third trimester as a "critical window" helps strengthen the case that air pollution, itself, is contributing to autism in some cases.

Exactly why is not clear, though.

"With brain development, different events happen during different parts of pregnancy," Weisskopf said. "During the third trimester, there's a lot of neuron growth and migration in the brain."

But, he said, more research is needed to understand how fine-particle air pollution could affect the fetal brain.

The findings are based on 245 children with autism spectrum disorders and more than 1,500 without. All of the children were born to women taking part in a long-term health study of U.S. nurses. Weisskopf's team used air-quality data from the U.S. Environmental Protection Agency (EPA) to estimate monthly pollution levels in each woman's neighborhood before, during and after pregnancy.

The investigators found that a particular type of air pollution -- fine-particle pollution -- was tied to the risk of autism spectrum disorders. Those fine particles are released into the air when fossil fuels are burned. Car exhaust, wood burning and industrial sources (such as power plants) all contribute, according to the EPA. Indoors, burning candles or using fireplaces can produce fine-particle pollution.

Weisskopf stressed that while air pollution was tied to a relatively higher risk of autism spectrum disorders, the absolute risk to any one woman exposed during pregnancy could be very small.

"We don't know how much of the risk of autism this accounts for," Weisskopf said. "It could be quite small."

Plus, Rosanoff said, autism spectrum disorders are complex disorders that arise from some combination of genetic predisposition and any number of environmental risk factors that are not yet fully understood.

"There is no one environmental factor that leads to autism," Rosanoff said.

Autism spectrum disorders range widely in severity -- from milder problems with social interaction to "classic" cases of autism, where a child may speak little or not at all, and obsessively focus on only a few, repetitive behaviors. And experts believe that the different combinations of risk factors lead to individual cases of autism spectrum disorders, according to Autism Speaks.

For now, Weisskopf said, pregnant women can take steps to avoid air pollution, such as avoiding walks near busy roadways. The EPA suggests checking the online Air Quality Index for your local area, and staying indoors on days when air quality is poor.

More information

The U.S. National Institute of Environmental Health Sciences has more on autism.Copyright © 2014 HealthDay. All rights reserved.

SOURCES: Marc Weisskopf, Ph.D., associate professor, environmental and occupational epidemiology, Harvard School of Public Health, Boston; Michael Rosanoff, M.P.H., director, public health research, Autism Speaks, New York City; Dec. 18, 2014, Environm...

Health Tip: Tossing Leftover Food
December 18, 2014


(HealthDay News) -- Leftovers can only last so long before they're at risk for spoiling.

The Academy of Nutrition and Dietetics offers these guidelines for storing food:

  • Cooked turkey that has been properly refrigerated should be eaten within four days; gravy and stuffing within a day or two.
  • Three or four days is best for cooked vegetables and casseroles.
  • While cheesecake may last for seven days, fruit and cream pies should be eaten within two to three days.
  • No matter how many days it's been, toss any food that you aren't sure is safe.

Copyright © 2014 HealthDay. All rights reserved.


Health Tip: Eating Disorder Can Hurt Your Child
December 18, 2014


(HealthDay News) -- An eating disorder, such as binge eating, bulimia or emotional eating, can be dangerous at any age, particularly for a teenager.

The American Academy of Family Physicians mentions these potential health consequences of an eating disorder:

  • Weight gain or loss.
  • Difficulty concentrating.
  • Problems of the stomach, heart, teeth or kidneys.
  • Osteoporosis.
  • Dry skin.
  • In severe cases, death.

Copyright © 2014 HealthDay. All rights reserved.


Global Life Expectancy Continues to Climb
December 18, 2014


WEDNESDAY, Dec. 17, 2014 (HealthDay News) -- People around the world are living much longer than they did a few decades ago, a new study indicates.

Worldwide life expectancy rose from 65.3 years in 1990 to 71.5 years in 2013, but women had slightly greater gains than men. During that time, life expectancy at birth increased 6.6 years for females and 5.8 years for males.

If current trends continue, life expectancy in 2030 will be 85.3 years for females and 78.1 years for males, said researchers led by the Institute for Health Metrics and Evaluation at the University of Washington.

"People today are less likely than their parents to die from certain conditions, but there are more people of older ages throughout the world," said Dr. Christopher Murray, institute director.

"This is an encouraging trend as people are living longer. We just need to make sure we are making the right health policy decisions today to prepare for the health challenges and associated costs that are coming," Murray said in an institute news release.

The average age of death rose from 46.7 in 1990 to 59.3 in 2013, says the study, published Dec. 18 in The Lancet.

Death rates from drug abuse and kidney disease rose, but death rates fell 83 percent for measles and 51 percent for diarrhea.

There was a decline in death rates for most cancers, including breast, cervical and colon cancers. However, death rates increased for pancreatic cancer, kidney cancer and non-Hodgkin lymphoma.

Death rates fell more than one-third for many disorders, including stomach cancer, Hodgkin lymphoma, rheumatic heart disease, peptic ulcer disease, appendicitis and schizophrenia.

Some of the biggest increases in premature death since 1990 were seen for diabetes, HIV/AIDS, heart disease related to high blood pressure, chronic kidney disease and Alzheimer's disease.

There were a number of disparities in terms of age and gender. For example, declines in death rates were greater for women than for men in all age groups except among people 80 and older. Also, men ages 30 to 39 and older than 80 had some of the smallest declines in death rates.

The gender gap in death rates for adults ages 20 to 44 is widening due to conditions such as HIV/AIDS, violence, traffic crashes and mothers' deaths, the researchers found.

Among children younger than 5 years, diarrhea, lower respiratory tract infections, neonatal disorders and malaria remain among the leading causes of death.

Three conditions -- heart disease, stroke and chronic obstructive pulmonary disease -- accounted for nearly one-third of all deaths in 2013. However, there has been a significant decline in the death rates associated with those diseases since 1990, the study found.

More information

The American Academy of Family Physicians outlines what you can do to maintain your health.

SOURCE: Institute for Health Metrics and Evaluation, news release, Dec. 17, 2014...

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