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Falls on the Rise Among U.S. Seniors
January 19, 2015


MONDAY, Jan. 19, 2015 (HealthDay News) -- For American seniors, a fall can have disabling or even fatal consequences. And a new study finds that the rate of older people who suffer a fall is actually on the rise.

A research team led by Dr. Christine Cigolle, of the University of Michigan Medical School in Ann Arbor, tracked national data from adults aged 65 and older. They found that the number of older adults with at least one self-reported fall in the past two years rose from about 28 percent in 1998 to about 36 percent in 2010.

"Contrary to our hypothesis, we observed an increase in fall prevalence among older adults that exceeds what would be expected owing to the increasing age of the population," the researchers said.

According to Cigolle's team, falling remains the most common cause of injury among older Americans, and it's believed that about one-third of seniors will suffer a fall each year.

Two experts stressed that there are ways seniors can lower their odds for a tumble, however.

"Interactive educational programs that teach senior citizens how to strengthen their muscles and retain their balance are important to help this population improve their balance and strength and, thus, decrease their risk of falls," said Grace Rowan, a registered nurse and leader of the falls prevention program at Winthrop-University Hospital in Mineola, N.Y.

Dr. Matthew Hepinstall works at the Center for Joint Preservation & Reconstruction at Lenox Hill Hospital in New York City. He said that, "as an orthopaedic surgeon, I encounter the results of falls on a nearly daily basis."

Many injuries heal or can be surgically repaired, Hepinstall said, but "these injuries can have devastating effects on quality of life, including hospitalization, surgery and often nursing home stays. Many patients do not regain their prior level of function and independence, and those who do are often plagued by apprehension about future falls."

He said that there are many ways to help prevent falls in the home, including:

  • elimination of throw-rugs,
  • keeping the path to the bathroom well-lit at night,
  • avoiding medications that cause light-headedness or disorientation,
  • maintaining good nutrition and hydration,
  • engaging in exercise programs that boost muscle mass and balance.

Hepinstall stressed that any "changes in medication and exercise regimen should be discussed with a doctor." And he added that "not all falls are preventable, and medical management of osteoporosis can reduce fracture risk."

The findings were published online Jan. 19 in JAMA Internal Medicine.

More information

The U.S. National Institute on Aging has more about falls and older adults.

Copyright © 2015 HealthDay. All rights reserved.

SOURCES: Matthew Hepinstall, M.D., orthopaedic surgeon, Lenox Hill Hospital Center for Joint Preservation & Reconstruction, New York City; Grace Rowan, R.N., registered nurse educator, leader, falls prevention program, Winthrop-University Hospita...

Parents Need to Take Lead on Teen Concussion Prevention
November 25, 2014


TUESDAY, Nov. 25, 2014 (HealthDay News) -- Parents need to take an active role in protecting their children from sports concussions, an expert warns.

Parents must make sure sports-playing teens have the right protective gear and undergo standard, Dr. David Dodick, chair of the American Migraine Foundation and a professor of medicine at the Mayo Clinic College of Medicine in Scottsdale, Ariz. in an American Migraine Foundation, said in a foundation news release.

Any coach involved with teens sports needs to have appropriate training. Teen sports teams need concussion sideline and after-injury protocol, said Dodick. He also advised that there should be either a health professional available at games to evaluate blows to the head, or a safety officer who can give simple tests to determine if an athlete has suffered a concussion.

It's also important to make sure that schools forbid students with concussions from playing and don't allow them to return to play until cleared by a concussion specialist, Dodick said.

Teens need to understand how serious a concussion can be. Parents should also make sure their teen knows the signs and symptoms of concussion, which include nausea and vomiting, dizziness, confusion, headache, slowed thinking, memory loss, insomnia or excessive sleeping, irritability/depression or mood swings, and sensitivity to light and/or noise.

If your child has any of these symptoms after a head injury, see a doctor immediately, said Dodick, who noted that symptoms can worsen over hours or days.

Another way to reduce children's risk of concussion is for them to play with others who are similar in height, weight, strength and level of training.

More information

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

SOURCE: American Migraine Foundation, news release, Nov. 19, 2014...

Stroke Prevention Guidelines Emphasize Healthy Lifestyle
October 29, 2014


WEDNESDAY, Oct. 29, 2014 (HealthDay News) -- Want to lower your risk of a first-time stroke? New guidelines from the American Heart Association and American Stroke Association reinforce the idea that a healthy lifestyle is crucial.

The new guidelines advise people to exercise, control blood pressure and eat what's known as Mediterranean or DASH-style (Dietary Approach to Stop Hypertension) diets that emphasize fruits, vegetables, whole grains and seeds, plus poultry and fish.

"We have a huge opportunity to improve how we prevent new strokes, because risk factors that can be changed or controlled, especially high blood pressure, account for 90 percent of strokes," said Dr. James Meschia, lead author of the guidelines and professor and chairman of neurology at the Mayo Clinic in Jacksonville, Fla., in an American Heart Association news release.

The guidelines recommend that people:

  • Eat a Mediterranean or DASH-style diet with nuts added. These diets emphasize eating plenty of fruits and vegetables, and limiting saturated fats, such as red meat, cheese and butter.
  • Monitor blood pressure at home with a portable cuff device and avoid developing high blood pressure by exercising, eating properly and avoiding excess weight. Get your blood pressure checked by your health care provider every year. If you take blood pressure medications and they aren't working, ask your provider to adjust them.
  • Limit the levels of sodium in the diet.
  • Don't smoke. Smoking and taking oral birth control pills raises stroke risk, as does smoking if you get migraines with aura. Avoid secondhand smoke.

"Talking about stroke prevention is worthwhile," Meschia said. "In many instances, stroke isn't fatal, but it leads to years of physical, emotional and mental impairment that could be avoided."

The guidelines appear online Oct. 29 in the journal Stroke.

More information

For more about stroke prevention, try the National Stroke Association.
Copyright © 2014 HealthDay. All rights reserved.

SOURCE: American Heart Association, news release, Oct. 29, 2014...

Cyberbullying Seems to Ramp Up in Middle School
September 20, 2014


FRIDAY, Sept. 19, 2014 (HealthDay News) -- As kids transition from elementary to middle school, they are increasingly the targets of cyberbullies, according to a recent study.

But the researchers studying U.S schoolkids in grades 5 through 8 found that verbal and physical bullying declines as students get older.

Because bullying patterns vary, bullying intervention and prevention strategies must address all types of bullying as well as differences in bullying among boys and girls, the researchers said. The study was published recently in School Psychology Quarterly.

"School-based interventions need to address the differences in perpetrator and victim experiences," said study author Cixin Wang, an assistant professor at the University of California, Riverside's Graduate School of Education.

"The key is to use individualized specific interventions for bullying, not a one-size-fits-all approach," Wang said in a journal news release.

Researchers examined three semesters of data compiled on 1,180 students at schools in the Midwest. The investigators looked at the amount and type of bullying that took place as well as the number of students victimized. They also considered variables such as the children's gender, grade and whether or not English was their native language.

The study revealed that students who were bullied could be classified into four groups:

  • 11 percent were frequent victims.
  • 29 percent were occasional victims of traditional bullying, such as verbal or physical bullying.
  • 10 percent were occasional victims of traditional bullying and cyberbullying.
  • Half were infrequent victims of bullies.

The bullies themselves were also grouped into three categories: 5 percent bullied frequently; 26 percent were occasional traditional bullies; and 69 percent bullied infrequently.

Although the amount of bullying decreased over time, the authors found that it surged between fifth and sixth grade when the students in the study moved from elementary to middle school.

Overall, the study found that girls were more often the targets of cyberbullying and verbal and relational bullying than boys. Boys, however, were more likely to be physically bullied.

Whether or not students spoke English as a second language did not appear to have an impact on whether or not they were bullied, the findings showed.

The study authors said schools could help prevent bullying among students through the following strategies:

  • Focus bullying prevention and intervention programs on students in sixth and eighth grades, teaching them social-emotional learning skills and healthy ways to cope with new peer groups and social hierarchies.
  • Consider different bullying interventions for boys and girls. Strategies targeting girls should focus on relationship issues and how to use social media responsibly. For boys, interventions should focus on physical bullying.
  • Schools and parents should also talk to students about cyber safety. Children should be supervised when using the Internet and mobile devices so they learn how to avoid being victimized. Any reports of bullying should be taken seriously.

More information

The U.S. Department of Health and Human Services has more about cyberbullying.

SOURCE: University of California, Riverside, news release, Sept. 12, 2014...

Health Tip: Prevent Children From Falling Out a Window
September 05, 2014


(HealthDay News) -- A child can fall from a window in a moment's notice, so it's important for parents to help prevent such a tragedy.

The National Safety Council offers these suggestions:

  • Always supervise young children, and keep windows locked when children are near.
  • If opening a window, make sure a child can't reach it.
  • Teach your child to stay away from windows and patio doors.
  • Don't keep furniture near a window that a child could climb on.
  • A screen will not prevent a child from falling out a window.
  • Use a window guard. Check with the local fire department for safety requirements.

Copyright © 2014 HealthDay. All rights reserved.


Stroke Prevention for Women: Start Early
June 17, 2014


TUESDAY, June 17, 2014 (HealthDay News) -- Stroke typically affects women in their later years, but doctors are now beginning to focus on helping them cut their risk earlier in life.

This increased attention to risk factors in early adult years was recommended by new guidelines that were released earlier this year by the American Heart Association and the American Stroke Association.

Those guidelines are now being phased into practice by primary care doctors, experts say. For women, that translates to more screening for risk factors during office visits and more interventions to ensure a healthy lifestyle to reduce stroke risk, said Dr. Louise McCullough, director of the Stroke Center at the University of Connecticut in Farmington.

McCullough is the co-author of a summary of the guidelines that was published June 16 in the Annals of Internal Medicine.

Stroke is a serious interruption or reduction of blood flow to the brain, and McCullough said women have "unique risk factors."

Among them are the use of birth control pills and hormone replacement therapy after menopause, which both increase stroke risk. Pregnancy-associated disorders also may have long-lasting effects on a woman's health and her stroke risk, she added.

Here's why all that is important: An estimated
6.8 million persons in the United States have had a stroke, 3.8 million of whom are women, according to the summary. Women have poorer recovery and worse quality of life than men after a stroke, the summary says.

And here's what women can expect if their primary care doctor adheres to the new guidelines.

Your doctor will screen for high blood pressure. It is the most changeable risk factor, and it's more common in women than in men.

Depending on your age, your doctor may screen for atrial fibrillation, an abnormal heart rhythm, by measuring pulse rate and doing an electrocardiogram.

Your doctor may ask you about any history of headaches. Migraine headache with aura can increase stroke risk, and McCullough said reducing the frequency of migraine should be the goal as a possible way to reduce stroke risk.

Certain pregnancy-related conditions affect risk, McCullough said. "If you have pregnancy-induced high blood pressure, you are fourfold more likely to develop high blood pressure in adulthood and two times more likely to have a stroke," she said. Keeping blood pressure under control is crucial.

Stroke during pregnancy is not common, but experts have found the risk is highest in the 12 weeks after giving birth. So women who have a new headache, blurred vision or other unusual symptoms should be checked out.

Depression and emotional stress also boost stroke risk, McCullough said, so your doctor should ask about that, too.

The guidelines also recommend focusing on a healthy lifestyle that helps prevent stroke. These measures include keeping weight at a healthy level, eating a healthy diet, not smoking, getting regular physical activity and keeping alcohol intake moderate, if women drink.

"This article is going to be very helpful in getting the message out to the primary care physicians," said Dr. Ravi Dave, director of interventional cardiology at the University of California Los Angeles Medical Center in Santa Monica.

He noted that some of the risk factors for stroke may be news to women, such as the link between depression and stroke. "I would encourage these patients with depression to get treated for it," he said.

In recent years, Dave said, researchers have been pinpointing differences in heart attack symptoms between men and women. Now, the same thing is happening with risk factors for strokes, teasing out the gender differences. For women, the message is clear, he said: Alert your doctor if you have any of these stroke risk factors, or suspect you do.

More information

Learn more about the new guidelines for reducing stroke risk in women at the American Heart Association.
Copyright © 2014 HealthDay. All rights reserved.

SOURCES: Louise McCullough, M.D., Ph.D., director, stroke center, and professor of neurology, University of Connecticut, Farmington; Ravi Dave, M.D., director of interventional cardiology, University of California Los Angeles Medical Center, Santa Monica,...

Doctor Shares Tips for Preventing Falls Among Seniors
May 27, 2014


TUESDAY, May 27, 2014 (HealthDay News) -- Numerous factors increase the risk of falls as people age, but there are ways to reduce that risk, a doctor says.

Blood pressure drugs can cause problems such as dizziness when going from sitting or lying down to standing, said Dr. Jason Rice, a primary care internist at Loyola University Health System in Maywood, Ill.

"If you are taking blood pressure medication, there may be a few moments of unsteadiness when you get up because the medicine blocks a mechanism that can cause a brief drop in blood pressure. This can be a fall risk," he said in a Loyola news release.

"It's important to always stand up slowly and get your bearings before walking. Also, staying hydrated helps to prevent drops in blood pressure," he advised.

Another factor that can cause dizziness is an age-related reduction in the elasticity of blood vessels, which can affect blood flow.

"Without the squeezing of the blood vessels, blood flow does not return to the heart from distant parts of the body as effectively, especially from the legs. This poses a problem for people when they are changing positions and fighting gravity. Make sure to stand up slowly and hold on to a stable surface before walking," Rice said.

Dizziness and falls can be caused by low blood sugar, especially among people with diabetes. If you're using blood sugar-lowering medications, be sure to take them with an adequate meal in order to prevent your blood sugar from dropping too low, according to Rice.

"It's always important for diabetics to check their blood sugar level, but especially if they have unusual symptoms. Low blood sugar can be treated immediately with fruit juice, but this should be discussed with a physician to ensure there isn't a problem that needs to be addressed," Rice advised.

Poor vision is another age-related problem that increases the risk of falls, because eyesight plays an important role in balance. Older adults should get regular vision checks, Rice recommended.

"In all of these cases, taking your time, being aware of your surroundings and assessing your stability before walking are key to preventing falls," he concluded.

More information

The U.S. National Institute on Aging has more about falls and older adults.
Copyright © 2014 HealthDay. All rights reserved.

SOURCE: Loyola University Health System, news release...

Skin Cancer Prevention Tips
May 11, 2014


SUNDAY, May 11, 2014 (HealthDay News) -- One in five Americans will develop skin cancer at some point in their lives, making it the most common type of cancer in the nation.

However, skin cancer is also one of the most preventable types of cancer, according to Dr. Mark Lebwhol, professor of dermatology at the Icahn School of Medicine at Mount Sinai Health System in New York City and president-elect of the American Academy of Dermatology.

"Fortunately, most skin cancers, even melanoma, can be cured and treated when detected early," he said in a Mount Sinai news release. "Knowing your own skin is the key to discovering skin cancer early on. See a dermatologist for a skin check if you notice a spot, mole or lump on your body that is changing, growing or bleeding."

Lebwohl also offered the following skin cancer prevention tips:

Apply sunscreen with an SPF of 30 or more to all areas of exposed skin every day throughout the year. Re-apply about every two hours, even on cloudy days.

Wear protective clothing -- long-sleeved shirt and pants, wide-brimmed hat and sunglasses -- whenever possible. Never sunbathe and never use tanning beds.

Get an annual skin checkup from a doctor and do skin self-checks every month to keep track of your brown spots and freckles. If you have a lot of brown spots, you might consider total body photography. This will provide your doctor with a photographic record of your moles and make it easier to spot any potentially dangerous changes.

When checking your moles, keep in mind the ABCDEs. Alert your doctor if you find:

  • Asymmetry, where one half of the mole is different than the other half.
  • Borders that are irregular, scalloped or poorly defined.
  • Color variations between areas of the mole, with shades of tan and brown, black, white, red or blue.
  • Diameters that that are the size of a pencil eraser (6 millimeters) or larger. However, be aware that some melanomas can be smaller.
  • Evolving, when a mole appears different from the rest or is changing in size, shape and color.

More information

The U.S. National Cancer Institute has more about skin cancer prevention.

Copyright © 2014 HealthDay. All rights reserved.

SOURCE: Mount Sinai Health System, news release, April 28, 2014...

Spotting Cause of Newborn Brain Injury Could Aid Prevention, Report Says
April 03, 2014


THURSDAY, April 3, 2014 (HealthDay News) -- Identifying the cause of brain injury among newborns could help doctors develop new prevention strategies, according to a joint report from two leading groups of U.S. obstetricians and pediatricians.

The updated guidelines on neonatal encephalopathy (the term for newborn brain disorder or injury) -- released by the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics -- advise doctors to examine every possible factor that could have contributed to the brain injury. Previous recommendations issued in 2003 focused on determining if a lack of oxygen at the time of birth caused neonatal encephalopathy.

"Although a significant portion of newborn brain injuries are due to problems around the time of labor and delivery, some cases occur before the pregnant patient even arrives at the hospital and the labor floor," Dr. Mary D'Alton, task force chair, said in a news release from the American College of Obstetricians and Gynecologists.

The possible causes the task force advises doctors to consider include mother's medical history; obstetric factors or issues during birth, and problems with the placenta.

"We know that neonatal encephalopathy is a brain disorder with a variety of causes," said D'Alton, a maternal-fetal medicine specialist at Columbia University Medical Center in New York City. "Metabolic disorders, inflammations and infections, genetic conditions, and oxygen deprivation to the infant are all potential causes, but we don't know how many cases are preventable. By doing a root-cause analysis, we hope to identify issues that may help prevent some cases of neonatal encephalopathy in the future."

The new guidelines are published in the April issue of Obstetrics and Gynecology and the May issue of Pediatrics.

Experts reacted enthusiastically to the report.

"We see this report as a safety document," said Dr. Jay Goldsmith, a pediatrician at Tulane University in New Orleans and a liaison between the American Academy of Pediatrics and the task force. "It covers complete evaluation of all babies who are encephalopathic at birth and, if there are safety issues that we can identify, how to try to correct them."

The updated guidelines reflect advances in the treatment of neonatal encephalopathy. For example, neonatal hypothermia treatment cools a newborn's body temperature from 98.6 degrees to 92.3 degrees for 72 hours. The goal of the treatment is to minimize long-term brain damage.

Advances in newborn brain imaging can also help doctors determine when an infant's brain injury occurred and how severe it is.

"The benefits of both of these advances are highly dependent on prompt recognition of neonatal encephalopathy," said D'Alton. "Milder cases of newborn brain injury may not always be recognized, so education is key."

The task force also emphasized a more active role for pediatricians in diagnosing newborns with brain injury. "There are approximately 3,000 U.S. hospitals and birthing centers that deliver babies, but only 1,000 of them have neonatal intensive care units," Goldsmith said in the news release.

"Health care providers at the other 2,000 hospitals are responsible for providing treatment or referring to a center that is capable of providing therapeutic hypothermia. That's the pediatric side of the responsibility," he added.

More information provides more information on hypoxic ischemic encephalopathy.

Copyright © 2014 HealthDay. All rights reserved.

SOURCE: American College of Obstetricians and Gynecologists, news release, March 26, 2014...

Many U.S. Hospitals Fall Short in Preventing Infections
February 19, 2014


WEDNESDAY, Feb. 19, 2014 (HealthDay News) -- Many U.S. hospitals don't follow rules meant to protect patients from preventable and potentially deadly infections, a new study shows.

Researchers examined adherence to infection control policies in more than 1,600 intensive care units at 975 hospitals across the nation.

They focused on three of the most common types of preventable infections in hospitals: central line-associated bloodstream infections; catheter-associated urinary tract infections; and ventilator-associated pneumonia.

About one in 10 hospitals did not have checklists to prevent bloodstream infections, and one in four did not have checklists to prevent ventilator-associated pneumonia. About one-third of hospitals had no policy to prevent catheter-associated urinary tract infections.

"Hospitals aren't following the rules they put in place themselves to keep patients safe," team leader Patricia Stone, a professor of health policy at Columbia University School of Nursing, said in a Columbia news release. "Rules don't keep patients from dying unless they're enforced."

Even when hospitals had checklists, they were followed only about half of the time, the researchers report in the February issue of the American Journal of Infection Control.

Each year in the United States, health care-associated infections cause about 100,000 deaths and lead to about $33 billion in extra medical costs, according to background information with the study.

"Every hospital should see this research as a call to action -- it's just unconscionable that we're not doing every single thing we can, every day, for every patient, to avoid preventable infections," Stone said.

One way that hospitals can improve compliance with infection control rules is to have an electronic monitoring system that tracks if health care workers are following infection control rules. Previous research has shown that these systems reduce infection rates. Only about one-third of the ICUs in the study had this type of system.

Another approach is to have staff who are certified in infection control, but more than one-third of the hospitals in the study did not have a full-time person with such qualifications, the researchers noted.

More information

The National Patient Safety Foundation outlines how hospital patients can protect themselves from infections.
Copyright © 2014 HealthDay. All rights reserved.

SOURCE: Columbia University Medical Center, news release, Feb. 6, 2014...

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