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Cyberbullying Seems to Ramp Up in Middle School
September 19, 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.
Copyright © 2014 HealthDay. All rights reserved.


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

Trulicity Approved for Type 2 Diabetes
September 19, 2014

 

FRIDAY, Sept. 19, 2014 (HealthDay News) -- Trulicity (dulaglutide) has been approved by the U.S. Food and Drug Administration to treat type 2 diabetes, which accounts for 90 percent of diabetes cases in the United States.

The drug contains a hormone that helps stabilize blood sugar at normal levels, the agency said in a news release. Trulicity's safety and effectiveness were evaluated in clinical trials involving 3,342 people with type 2 diabetes.

The drug has been studied as a standalone treatment and in combination with other therapies, the agency said.

Trulicity's label has a boxed warning that some lab rodents given the drug developed a certain type of thyroid tumor called medullary thyroid carcinoma (MTC). While it's not known if the drug could cause the same problem in people, those at risk of developing MTC shouldn't be given the drug, the FDA said.

The drug also should not be given to people with type 1 diabetes, those who have increased blood or urine ketones or to people with severe gastrointestinal problems, the agency warned.

The FDA said it is requiring additional studies of the drug to further evaluate its use in children, any cardiovascular risks and its potential to cause MTC.

Trulicity is produced by Eli Lilly, based in Indianapolis.

More information

To learn more about this approval, visit the FDA.
Copyright © 2014 HealthDay. All rights reserved.


...

Avian Flu In Harbor Seals Could Infect People
September 19, 2014

 

FRIDAY, Sept. 19, 2014 (HealthDay News) -- The avian flu that killed 160 harbor seals in New England in 2011 could be spread through respiratory drops and therefore poses a potential threat to humans, according to a new study.

Although no human illnesses have been linked to the harbor seal virus, researchers at St. Jude Children's Research hospital have discovered natural mutations to the avian H3N8 seal virus that might allow it to travel through the air in droplets.

Current seasonal flu vaccines wouldn't help in such a scenario, the study's authors added. What's more, the researchers found that humans don't have an evidence of protection against this virus.

"The transmissibility of the seal H3N8 virus coupled with the apparent lack of immunity makes this strain a concern," the researchers wrote in the study, which was published in a recent issue of Nature Communications.

Deadly cases of avian H5N1 and H7N9 flu have been confirmed around the world. Mutations in a specific protein allowed the H5N1 virus to spread through respiratory droplets.

The researchers isolated the H3N8 virus and found it could grow and infect human lung cells. They also found the virus spread among ferrets through respiratory droplets.

"This study highlights a gain-of-function experiment that occurred in nature and shows us there are avian flu viruses out there beyond H5N1 and H7N9 that could pose a threat to humans," explained the study's corresponding author, Stacey Schultz-Cherry, a member of the St. Jude Department of Infectious Diseases, in a hospital news release.

"Avian H3N8 viruses are established in horses and dogs. This study raises a red flag about the threat this strain poses to humans exposed to animals infected with the virus," she said. Avian H3N8 may have also triggered a human flu pandemic in the 1880s, according to the researchers.

The researchers say their findings highlight the need to monitor flu viruses among wild and domestic animals to better understand potential risks to people and the genetic changes that can allow a virus to spread through respiratory droplets.

More information

The U.S. Centers for Disease Control and Prevention has more information on avian flu.
Copyright © 2014 HealthDay. All rights reserved.


SOURCE: St. Jude Children's Research Hospital, news release, Sept. 4, 2014...

Adults Over 45 Not Meeting U.S. Muscle Strengthening Guidelines, Study Says
September 19, 2014

 

FRIDAY, Sept. 19, 2014 (HealthDay News) -- Although there is mounting evidence that muscle-strength training provides key health benefits, most middle-aged and older adults in the United States don't engage in this type of exercise, according to new research.

Less than one-quarter of adults over 45 meet the muscle-strengthening recommendations set by the Department of Health and Human Services, the study found.

Strength is essential for promoting health and fitness and staying independent, researchers advised. Muscle-strengthening activities include yoga, sit-ups, push-ups, weights, elastic bands and weight machines. In many cases, people use their own body weight for resistance during strength training.

For the study, the researchers analyzed data from the 2011 U.S. Behavioral Risk Factor Surveillance System, a telephone health survey conducted by the U.S. Centers for Disease Control and Prevention. Participants answered questions about the type of physical activities they engage in and how often. They were also asked if they exercised in order to strengthen their muscles.

Of all those who answered the questions on muscle strengthening, about 24 percent said they met the government's recommendations.

Among those less likely than others to meet these guidelines were women, widows, those age 85 or older, people who were obese, and Hispanics. Participants who didn't graduate from high school were also less likely to meet U.S. strength-training recommendations.

Jesse Vezina, of Arizona State University, and his fellow researchers concluded that interventions designed to encourage people to participate in strength training should target these high-risk groups.

The study's findings were published online Sept. 18 by the CDC.

More information

The American College of Sports Medicine provides more information on resistance training and building muscle mass for older adults.
Copyright © 2014 HealthDay. All rights reserved.


SOURCE: U.S. Centers for Disease Control and Prevention, news release, Sept. 18, 2014...

Scientists Spot How Bacterial Pneumonia Damages the Heart
September 19, 2014

 

FRIDAY, Sept. 19, 2014 (HealthDay News) -- Doctors have known that bacterial pneumonia can raise your risk of heart problems, but new research pinpoints why.

The bacteria actually invade and kill heart cells, increasing the chances of heart failure, abnormal heart rhythms and heart attacks in patients, scientists report.

In mice, monkeys and human heart tissue, researchers found direct evidence of heart damage caused by the bacteria, and they tried a vaccine that might one day prevent such an attack. But they also discovered that an antibiotic currently used to treat pneumonia may actually make it easier for the bacteria to damage the heart.

"When people are hospitalized for pneumonia, about 20 percent of them have something happen to their hearts, and those people are much more likely to die," explained lead researcher Carlos Orihuela, an associate professor in the department of microbiology and immunology at the University of Texas Health Science Center at San Antonio.

"Finding out why they are having these incidents is a big deal," he said. "We were able to show how and why that happens, and how to prevent it."

The report was published online Sept. 18 in the journal PLOS Pathogens.

Specifically, Orihuela's team found high levels of troponin, an indicator of heart injury, in the blood of mice with bacterial pneumonia. Moreover, the mice had abnormal heart rhythms.

When the investigators examined the hearts of the mice, they found tiny scars called microlesions, which indicate heart damage.

In these lesions, Orihuela's group found the bacteria Streptococcus pneumoniae, which told them that bacteria were able to thrive in the hearts of mice. They also saw signs that the heart muscle next to these lesions was dying.

The researchers said that pneumolysin, a poison produced by the bacteria, was responsible for killing heart cells.

In addition, a molecule called CbpA was needed to allow the bacteria to enter the heart, they noted.

"There is a potential vaccine," Orihuela said. But how broadly it would be used isn't clear, he said. "We have to work on that," he added.

The researchers tried the experimental vaccine, which was made up of CbpA and a non-toxic type of pneumolysin. In the mice, it made antibodies that prevented the bacteria from damaging the heart, Orihuela said.

The researchers next looked at heart tissue from monkeys that had been treated with antibiotics but still died from bacterial pneumonia. The investigators found microlesions, but no trace of the bacteria.

This was also the case in samples of human heart tissue taken from people who also had been treated with antibiotics but still succumbed to the disease. Two of the nine samples had microlesions, but no bacteria.

To see if antibiotics might have had a damaging effect on the heart, Orihuela's team infected mice with bacterial pneumonia and gave them high doses of the antibiotic ampicillin when heart lesions appeared.

The mouse hearts showed the same degree of damage as the monkey and human heart tissue had shown, even though the bacteria had been killed.

Orihuela said that ampicillin caused the bacteria to "pop open," releasing pneumolysin as it destroyed the bacteria. This could explain the heart damage, as the poison is then released directly into the heart, he said.

"There are other kinds of antibiotics -- so-called bacteriostatics. Those kill the bacteria, but they don't cause the bacteria to pop -- maybe those are better," Orihuela said.

Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, said earlier studies have shown that patients with pneumonia have a higher risk of developing heart failure and other types of heart problems.

There have been a number of mechanisms suggested that may account for this, he said. "This new study finds that a common bacteria that causes pneumonia can lead to microscopic bacteria-filled lesions within the heart," Fonarow said.

"This microlesion formation and subsequent heart muscle damage may provide a viable explanation for why pneumonia can lead to heart failure and other heart problems," he said.

More information

Visit the American Lung Association for more on pneumonia.
Copyright © 2014 HealthDay. All rights reserved.


SOURCES: Carlos Orihuela, Ph.D., associate professor, department of microbiology and immunology, University of Texas Health Science Center, San Antonio; Gregg Fonarow, M.D., professor, cardiology, University of California, Los Angeles; Sept. 18, 2014, ...

FDA Approves Another Weekly Injectable Drug for Type 2 Diabetes
September 19, 2014

 

FRIDAY, Sept. 19, 2014 (HealthDay News) -- The U.S. Food and Drug Administration approved a new type 2 diabetes drug, Trulicity, on Thursday. Trulicity is part of a class of once-a-week injectable drugs that help manage blood sugar levels in adults with type 2 diabetes.

"Trulicity is a new treatment option, which can be used alone or added to existing treatment regimens to control blood sugar levels in the overall management of type 2 diabetes," Dr. Mary Parks, deputy director of the FDA's Office of Drug Evaluation II, said in an agency news release.

About 26 million Americans have type 2 diabetes. More than 90 percent of all diabetes cases are type 2 diabetes, according to the FDA. The disease causes high blood sugar levels, which can lead to serious complications including heart disease, vision problems and nerve and kidney damage.

Trulicity (generic name dulaglutide) is a type of drug called a glucagon-like peptide-1 (GLP-1) receptor agonist. These drugs help to lower blood sugar levels, according to the FDA.

Before approving the drug, the FDA evaluated six clinical trials that included nearly 3,500 people with type 2 diabetes. The drug was studied alone and in combination with other types of diabetes medications, including metformin, mealtime insulin injections and others.

Those taking weekly Trulicity injections had improvements in their long-term blood sugar levels, the FDA said.

The most common side effects were nausea and vomiting, diarrhea, abdominal pain and a decreased appetite, according to the FDA.

The drug will carry a boxed warning stating that the use of some GLP-1 receptor agonists has been associated with thyroid tumors in rodents. The FDA said Trulicity should not be prescribed for patients with a personal or family history of a type of thyroid cancer called medullary thyroid carcinoma, or for patients with multiple endocrine neoplasia syndrome type 2. People with this disease have tumors in more than one gland in their body and are at increased risk for medullary thyroid carcinoma.

The drug, made by Eli Lilly and Company, is not intended for use in people with type 1 diabetes, people with severe stomach or intestinal problems, or as the first drug treatment for someone with type 2 diabetes, the FDA said.

The FDA said it will require the drug's manufacturer to conduct a number of studies after the drug approval (called post-marketing studies), including a study to evaluate cardiovascular issues for people who have a higher risk of heart problems, the news release said.

More information

Learn more about type 2 diabetes from the American Diabetes Association.
Copyright © 2014 HealthDay. All rights reserved.


SOURCE: U.S. Food and Drug Administration, news release, Sept. 18, 2014...

Do Greener Neighborhoods Produce Healthier Babies?
September 19, 2014

 

FRIDAY, Sept. 19, 2014 (HealthDay News) -- Pregnant women who live in leafy, green neighborhoods are less likely to have premature or low birth weight babies, a new study suggests.

Researchers analyzed data from more than 64,000 births in Vancouver, Canada, and found that expectant mothers who lived in a neighborhood with plenty of trees, grass and other vegetation had a 20 percent lower risk of very preterm birth (before 30 weeks) and a 13 percent lower risk of moderate preterm birth (30 to 36 weeks).

Babies born to mothers who lived in greener neighborhoods were also less likely to be small for their gestational age, and weighed an average of 1.6 ounces more at birth than those whose mothers were from less green neighborhoods.

The findings held up even after the researchers adjusted for factors such as neighborhood income and walkability, and exposure to air pollution and noise, according to the study published online recently in the journal Environmental Health Perspectives.

"This was a surprise. We expected the association between greenness and birth outcomes to disappear once we accounted for other environmental exposures such as air pollution and noise," study lead author Perry Hystad, an assistant professor of environmental and occupational health and safety at Oregon State University, said in a university news release.

"The research really suggests that greenness affects birth outcomes in other ways, such as psychologically or socially," he added.

The study doesn't show a direct cause-and-effect relationship between green environments and better birth outcomes, and further investigation is needed to learn more about the link. Greater amounts of green space may provide residents with more opportunities to socialize and enhance their sense of belonging, or may help reduce stress and depression, Hystad suggested.

"We know green space is good. How do we maximize that benefit to improve health outcomes? The answer could have significant implications for land use planning and development," he said.

Premature and underweight babies often have more health and developmental problems as they grow, and the cost of care also can be much higher, Hystad said.

More information

The March of Dimes outlines how to reduce the risk of preterm labor and birth.
Copyright © 2014 HealthDay. All rights reserved.


SOURCE: Oregon State University, news release, Sept. 4, 2014...

Brain Structure Might Help Predict Risky Behavior
September 19, 2014

 

FRIDAY, Sept. 19, 2014 (HealthDay News) -- Your brain structure could help predict how willing you are to take financial risks, a new study suggests.

Researchers at Yale University found those with greater volume in a part of the brain known as the parietal cortex may be more likely to engage in risky behavior than people with less volume in this area.

The study, funded by the U.S. National Institute on Aging, involved two groups of young adult men and women living in the Northeast. The researchers sought to determine how brain structure influences risk taking when economics or money is involved.

The first group of 28 people made decisions about lotteries of varying levels of risk. Their brains were analyzed using MRI technology. The findings, published Sept. 10 in the Journal of Neuroscience, were confirmed in a second group of 33 people.

"Based on our findings, we could, in principle, use millions of existing medical brain scans to assess risk attitudes in populations," Ifat Levy, an assistant professor in comparative medicine and neurobiology at Yale School of Medicine, said in a university news release. "It could also help us explain differences in risk attitudes based in part on structural brain differences."

The researchers noted, however, their findings don't establish a cause-and-effect relationship. "We don't know if structural changes lead to behavioral changes or vice versa," Levy explained.

It's known that the parietal cortex thins with age, the researchers pointed out. Previous studies have shown that people become less willing to take risks as they age. The study authors said that more, larger studies are needed to expand on their research.

"It could be that this thinning explains the behavioral changes; we are now testing that possibility," said Levy.

More information

The U.S. National Institute of Neurological Disorders and Stroke provides more information on the workings of the human brain.
Copyright © 2014 HealthDay. All rights reserved.


SOURCE: Yale University, news release, Sept. 9, 2014...

Some U.S. Troops May Face Greater Skin Cancer Risk
September 19, 2014

 

FRIDAY, Sept. 19, 2014 (HealthDay News) -- U.S. military troops deployed to sunny climates may have an increased risk of skin cancer, according to a new study.

Many returning troops reported getting sunburned while serving abroad, researchers revealed. In some cases, military personnel developed blisters on their skin or noticed a change in the color, shape or size of their moles since being deployed overseas.

All of these things can be risk factors for skin cancer, the study authors noted.

"The past decade of United States combat missions, including operations in Iraq and Afghanistan, have occurred at a more equatorial latitude than the mean center of the U.S. population, increasing the potential for ultraviolet irradiance and the development of skin cancer," explained the study's lead researcher, Dr. Jennifer Powers. She is an assistant professor in the division of dermatology at Vanderbilt University Medical Center in Nashville, Tenn.

The study involved roughly 200 U.S. veterans examined at the post-deployment clinic of the Tennessee Valley Healthcare System of the U.S. Department of Veterans Affairs. Of these vets, just over 60 percent developed sunburns while serving overseas. Almost 30 percent had worrisome changes in their moles since being deployed to a region with a hot climate, according to the study.

Only 4 percent of these troops reported having their skin examined by a doctor since being deployed, the researchers noted in a university news release.

Although almost 80 percent of the veterans said they worked in direct sunlight for more than four hours daily, only about one-quarter were advised about the risks associated with exposure to the sun's harmful UV rays. The study also found that just 27 percent of the troops had regular access to sunscreen while they were working. Almost one-third said they had no access to sunscreen while working.

Although avoiding sunburn may not be a high priority for troops serving overseas, not providing U.S. military personnel access to sunscreen could increase their long-term health risks, the researchers cautioned. Melanoma skin cancer claims almost 10,000 lives in the United States each year, according to the news release.

"This study demonstrates room for improvement for skin cancer prevention and early detection in the military population, including possible screening of higher-risk personnel," Powers said.

The study was presented at the World Congress on Cancers of the Skin in Edinburgh, Scotland. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. National Cancer Institute has more about skin cancer.
Copyright © 2014 HealthDay. All rights reserved.


SOURCE: Vanderbilt University Medical Center, news release, Sept. 15, 2014...

Tight Blood Sugar Control Doesn't Prevent Strokes in Diabetics: Study
September 19, 2014

 

FRIDAY, Sept. 19, 2014 (HealthDay News) -- A six-year study of people with type 2 diabetes found that intensively lowering blood pressure had a long-lasting effect in preventing heart attacks, strokes and deaths. But intensive blood sugar control didn't produce those benefits, the researchers found.

For the study, investigators followed nearly 8,500 participants of a completed diabetes trial. Some participants had had their blood pressure and blood sugar levels strictly controlled, while others had received standard care. The researchers wanted to assess the long-term effects of the intensive control, which ended when the trial concluded.

"One of the points of doing this study was to see if lowering blood sugar for five years might, down the track, translate into protection against stroke and heart attack -- it didn't," said researcher Dr. Bruce Neal, a professor of medicine at the University of Sydney in Australia.

Diabetes is a risk factor for heart disease and stroke. And many diabetics have other risk factors for heart attack and stroke, such as high blood pressure, high cholesterol and excess weight, according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

The original study -- dubbed the ADVANCE study -- "showed clearly that you got these great benefits from blood pressure reduction and you also got some benefit from blood sugar lowering," Neal said.

The unanswered question, Neal said, was if intensive blood pressure and blood sugar control were stopped, would the benefits go away or last.

To find out, they stopped the intensive treatment, but continued to follow the trial participants for an additional 5.9 years.

Over that time, they did find a lasting benefit of intensively lowering blood sugar levels to 6.5 percent in preventing kidney disease, a common complication of uncontrolled diabetes, Neal said. "Probably the five years of treatment we gave them led to changes in the kidney that continued to protect people for many years after."

Among patients who had their blood pressure reduced in the original trial to 135/75 mm Hg -- considered intensive control -- the benefit in reducing the risk of dying from a heart attack or stroke remained, although to a lesser degree, as time went by, Neal said.

"The implication is to continue to take blood pressure drugs if you want to get maximum protection," he said.

The report was published in the Sept. 19 online edition of the New England Journal of Medicine to coincide with presentation of the findings at the annual meeting of the European Association for the Study of Diabetes in Vienna.

Dr. Simon Heller, a professor of clinical diabetes at the University of Sheffield in England, said it isn't surprising that the benefit of intensive blood pressure control lasts beyond the period of intense control, although it may wane as the years go by.

His take on the study? "The main way to reduce heart attacks and strokes in people with type 2 diabetes is to treat increased blood pressure and to reduce cholesterol," he said.

"Blood sugar lowering is not apparently very good at reducing heart attacks or strokes, although it is very effective in reducing the risk of nasty diabetic complications such as diabetic eye disease, nerve damage and most important of all, kidney damage," Heller added.

In the trial, Diamicron MR (gliclazide) -- an older medication -- was the drug used most often to reduce blood sugar. This is in a class of drugs called sulfonylureas.

It's possible, Neal said, that a newer diabetes drug might have a more beneficial effect in preventing heart attacks and strokes.

Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City, agreed. "These newer drugs seem to be much more friendly in terms of heart attacks and strokes," said Zonszein, who was not involved with the study.

"Maybe you didn't see an improvement because patients were exposed to sulfonylureas, which have been associated with a high rates of death from heart attack and stroke," he said.

Medications preferred today to lower blood sugar include Januvia (sitagliptin), Onglyza (saxagliptin), Tradjenta (linagliptin) and Nesina (alogliptin), Zonszein said.

More information

For more about type 2 diabetes, visit the American Diabetes Association.
Copyright © 2014 HealthDay. All rights reserved.


SOURCES: Bruce Neal, M.B., professor of medicine, University of Sydney, Australia; Simon Heller, M.D., professor of clinical diabetes, and honorary consultant physician, University of Sheffield, U.K.; Joel Zonszein, M.D., director, Clinical Diabetes Cente...

Health Highlights: Sept. 19, 2014
September 19, 2014

 

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

Doctor Admits to Fraudulent Cancer Treatment

A Michigan cancer doctor who admitted putting patients through unnecessary chemotherapy treatments and bilking health insurers pleaded guilty to fraud Tuesday.

U.S. Attorney Barbara McQuade said she would seek life in prison for Dr. Farid Fata, 49, who pleaded guilty to 16 charges, including conspiracy and money laundering, the Associated Press reported.

The case is "shocking," McQuade told the AP. "It wasn't a matter of stealing money but torturing patients by lying to them about having cancer... Chemotherapy is poison intended to kill cancer cells."

Federal prosecutors said Fata, of Oakland Township, submitted claims of about $225 million to Medicare over six years for chemotherapy and other cancer treatments, all the while knowing many patients didn't have cancer. Medicare paid more than $91 million, and private insurance companies were billed too, the news report said.

Michigan Hematology Oncology, Fata's cancer clinic, had seven offices plus a cancer-detection business.

Sentencing is scheduled for Feb. 23, 2015 the AP reported.
Copyright © 2014 HealthDay. All rights reserved.


...

More Schools Stocking Shots That Counter Serious Allergic Reactions
September 19, 2014

 

FRIDAY, Sept. 19, 2014 (HealthDay News) -- More states are passing legislation permitting or requiring schools to stock the medication epinephrine to use for any child having a severe allergic reaction.

Epinephrine auto-injectors are the primary treatment for "anaphylaxis," an allergic reaction that can lead to throat swelling, breathing difficulties, a steep drop in blood pressure and even death.

In people with severe allergies to certain foods, such as peanuts or tree nuts, insect venom or certain drugs, anaphylaxis can occur within moments of exposure to the allergen, explained Dr. Scott Sicherer, a professor of pediatrics, allergy and immunology at the Jaffe Food Allergy Institute at Mount Sinai School of Medicine in New York City.

But if given soon enough, epinephrine can halt the anaphylactic reaction, saving the child's life, Sicherer said.

"An anaphylactic reaction can progress rapidly and can be fatal," he said. "What we know is the theme for individuals who died from it is they did not get prompt epinephrine -- either they were delayed in getting it or they didn't get it at all."

While many parents of children with serious food allergies supply a prescription epinephrine auto-injector (brand names: EpiPen, Auvi-Q) to the school nurse or teacher, not all kids have an epinephrine auto-injector prescribed specifically for them. And, about 25 percent of first-time food allergy reactions happen at school, according to the American Academy of Allergy, Asthma and Immunology (AAAAI). Those parents may not even realize the child has an allergy.

Those statistics, along with a highly publicized case in 2012 in which a 7-year-old Virginia girl died after eating a peanut on the playground, have prompted a recent wave of legislation intended to make epinephrine available to any child in case of an emergency.

Most states now have laws that allow schools to stock epinephrine for general use, according to Food Allergy Research & Education (FARE), a national nonprofit organization. Some states go further, requiring that schools keep epinephrine auto-injectors on hand. Those states include Delaware, Maryland, Michigan, Nebraska, Nevada, North Carolina and Virginia, according to FARE. California Gov. Jerry Brown signed similar legislation this week.

"Legislatures have recognized that schools need to have this emergency capability in case a child or even a staff member has an anaphylactic incident because they have been exposed to something they're allergic to, whether it's food or an insect sting," said Charlotte Collins, senior vice president of policy and programs for the Asthma and Allergy Foundation of America.

Of the remaining states with no current laws allowing epinephrine to be stocked at school, legislation to permit schools to stock epinephrine is pending in most of them. Only two states -- New Hampshire and Rhode Island -- have no current or pending legislation regarding stocking epinephrine in schools, according to FARE.

About one in 13 U.S. children -- or as many as two in every classroom -- have at least one food allergy, according to FARE and the AAAAI. The most common cause of food-related anaphylaxis is peanuts, but other common allergens, including dairy, sesame or tree nuts such as cashews, pecans or walnuts, can also cause severe reactions.

The stock epinephrine movement was helped along by federal legislation signed into law by President Barack Obama in November 2013. The School Access to Emergency Epinephrine Act gives states incentives for passing legislation requiring that schools have epinephrine on hand and training personnel how to use it in case of emergency. Obama's daughter, Malia, has a peanut allergy.

While ideally all states would require schools to stock epinephrine, laws that at a minimum allow schools to provide epinephrine for use in an emergency are also important because the laws typically contain language permitting staff members to use any available epinephrine, even an auto-injector prescribed to another child, if needed, Collins explained.

"The laws are saying, 'We don't want you to hesitate to try to help this child,'" Collins said.

Yet even in states that require schools to stock epinephrine, actually getting the medication into the schools will take time, she added. Schools need to find funds to purchase the medication. Rules and protocols set by other agencies may also need to be changed. For example, in some states, pharmacy boards need to change rules to permit physicians to write a prescription to a school district rather than an individual patient, Collins said.

The good news is that training staff doesn't take long, Sicherer said. Epinephrine auto-injectors are preloaded with medication that's automatically dispensed through a short needle when pressed against the upper thigh.

Even in states with laws requiring epinephrine in schools, parents should still provide an epinephrine auto-injector prescribed to their child, make sure that teachers are trained to use it, and ensure there is a written plan for how school staff will respond in case of an emergency involving an allergic reaction, Sicherer said.

More information

Food Allergy Research & Education has a map detailing states with epinephrine auto-injector legislation.
Copyright © 2014 HealthDay. All rights reserved.


SOURCES: Scott Sicherer, M.D., professor, pediatrics, allergy and immunology, Jaffe Food Allergy Institute, Mount Sinai School of Medicine, New York City; Charlotte Collins, J.D., senior vice president, policy and programs, Asthma and Allergy Foundation o...

U.S. Gun Deaths Lowest in Hawaii, Highest in D.C.
September 19, 2014

 

FRIDAY, Sept. 19, 2014 (HealthDay News) -- When it comes to firearm deaths, Hawaii has the fewest gun deaths in the United States, while the District of Columbia has the highest, according to new research.

Over the past decade, deaths from gun-related violence -- including murders, suicides and unintentional shootings -- varied widely across the United States, the study revealed. Hawaii's rate was roughly three per 100,000 citizens. On the opposite end of the spectrum, the District of Columbia had the highest rate of gun deaths, with about 22 per 100,000 citizens.

Aside from geography, race/ethnicity also played a role in gun death rates. The national rate of gun deaths was twice as high among black people as it was among whites. The researchers noted, however, that the number of black people killed as a result of gun violence fell in seven states and the District of Columbia. Meanwhile, gun deaths involving white people fell in only four states.

Gun deaths among Hispanics also declined in four states, while gun deaths involving non-Hispanics increased in nine states, according to the study published online Sept. 18 in BMJ Open.

The research, led by Bindu Kalesan, an assistant professor at Columbia University in New York City, examined all recorded gun deaths in the United States between 2000 and 2010.

The study also found that gun-related deaths increased in both Florida and Massachusetts. In these states, there were more gun deaths among whites and non-Hispanics. These states also reported an increase in gun-related murder rates.

The researchers pointed out these trends do not seem to reflect gun-control efforts and law in individual states. For example, the Brady Center to Prevent Gun Violence ranked Massachusetts the third most restrictive state for firearm legislation in 2011.

After Massachusetts passed a tough law restricting gun use in 1998, gun ownership rates dropped sharply, but violent crimes and murders increased. The influx of firearms from nearby states with weaker firearm laws could be to blame, the researchers suggested in a journal news release.

Meanwhile, in 2011 the Brady Center to Prevent Gun Violence ranked Florida the 40th most restrictive state for firearm legislation. Although Florida gun deaths increased, the state had an overall drop in violent crime from 2000 to 2010.

The study authors concluded that curbing gun violence may require reducing access to firearms and strengthening interstate border controls to prevent the transport of guns.

Aside from D.C., states with fewer gun-related deaths over the decade include: Arizona, California, Illinois, Maryland, Nevada, New York and North Carolina.

The drop in firearm death rates in California was largely the result of a decline in the number of gun-related suicides. Across the United States, however, the number of gun-related murders and suicides did not change between 2000 and 2010. Nationally, deaths resulting from unintentional shootings dropped significantly, the study found.

More information

The U.S. National Institute of Justice has more about gun violence in America.
Copyright © 2014 HealthDay. All rights reserved.


SOURCE: BMJ Open, news release, Sept. 18, 2014...

Oral Health in Women of Childbearing Age Needs Improvement
September 19, 2014

 

FRIDAY, Sept. 19, 2014 (HealthDay News) -- Women of childbearing age in the United States should be encouraged to maintain better oral care and visit the dentist routinely, according to a new study from the U.S. Centers for Disease Control and Prevention.

Researchers found young pregnant women, those who are non-Hispanic black or Mexican-American, as well as those with lower income and less education, need to improve their oral care.

Oral disease, with symptoms such as cavities or gum disease, may be prevented or treated with regular dental visits. In addition to causing pain, past research has suggested that dental problems may be linked to certain pregnancy problems, according to background information in the study.

The study's authors noted prenatal check-ups may provide doctors with a key opportunity to encourage women to get routine preventative dental care.

For the study, researchers looked at self-reported oral health information compiled on nearly 900 pregnant women and almost 4,000 women of childbearing age (between 15 and 44 years old) who weren't pregnant. The information was taken from the 1999 to 2004 National Health and Nutrition Examination Survey (NHANES).

Regardless of whether or not they were pregnant, the researchers found disparities in oral health and use of dental services among women in this age group.

The percentage of women who reported having very good oral health was much higher among older pregnant women than younger pregnant women. This suggests that older pregnant women are more aware of their oral health needs and seek out dental care. It could also be that they're more likely to have dental insurance than younger pregnant women.

The percentage of younger women who weren't pregnant who said they had good oral health however, was much higher than the percentage of older pregnant women who said they had good oral health. The study's authors concluded this may be because younger women hadn't developed the same cumulative effects of dental disease.

More information

The U.S. Department of Health and Human Services provides more information on women's oral health.
Copyright © 2014 HealthDay. All rights reserved.


SOURCE: U.S. Centers for Disease Control and Prevention, news release, Sept. 18, 2014...

Health Tip: Getting More Whole Grains
September 19, 2014

 

(HealthDay News) -- Whole grains are nutrient-rich foods that are full of fiber to help you feel full.

The Academy of Nutrition and Dietetics suggests ways to work more whole grains into your diet:

  • Include a whole grain food for breakfast, such as whole-grain toast, oatmeal or cereal.
  • When shopping, choose whole-grain options of tortillas, buns, bread, bagels and pasta.
  • Consider more unusual grains, such as bulgur, whole rye, millet, sorghum and quinoa.
  • Snack on whole grains, such as air-popped popcorn or 100 percent whole wheat or rye crackers.

Copyright © 2014 HealthDay. All rights reserved.


...

Family Squabbles Can Derail Recovery From Cancer Surgery
September 19, 2014

 

THURSDAY, Sept. 18, 2014 (HealthDay News) -- Cancer patients burdened by stress and family conflicts before surgery may face a higher risk for complications following their operation, a new study suggests.

Investigators found that patients with a so-called quality-of-life "deficit" appeared to have a nearly three times greater risk for complications compared to those with a normal or good quality of life.

"We've long known that patient quality of life is a complex and important construction," said study lead author Dr. Juliane Bingener, a professor of surgery at the Mayo Clinic in Rochester, Minn. "It involves spiritual health, mental health, social support and family support. And we know that for cancers such as colon, pancreatic and lung cancer, it can predict overall survival. But what we didn't know is if it also correlates with complication risk following surgery."

What the researchers found, Bingener said, "is that if a patient has a deficit in their quality of life before surgery, then their risk for having a serious complication within the first two weeks following surgery is much higher than it is for patients with a good quality of life."

Post-surgical complications included fever, bleeding and infections, some of which were fatal.

The findings, published in a recent issue of the Journal of Gastrointestinal Surgery, were based on 431 colon cancer patients who underwent surgery in 1993. The study only found an association between quality of life and surgical outcomes; it did not prove cause and effect.

Patient surveys ranked quality of life on the basis of a wide range of physical, social and psychological measures, including pain, fatigue and nausea, as well as "distress" related to daily routines, the work environment, and interactions with family and friends.

The research team found that nearly one in five patients experienced some type of complication, including death in two cases, before hospital discharge.

Thirteen percent of patients were determined to have a relatively poor quality of life before surgery. That translated into a 16 percent risk for developing a serious complication while still in the hospital, the researchers said.

By comparison, those with better quality-of-life scores faced a complication risk of 6 percent.

"The situation is very individual for each patient. And other factors can play a major role in complication risk, such as a patient's age or the presence of other diseases," said Bingener. "But all things being equal, there was a very clear correlation between a poor quality of life and a higher risk for problems following surgery."

The role played by family members, caregivers and close friends can be important, Bingener suggested.

"Support can have a big influence on quality of life," she noted. While there's no cookie cutter recipe that everyone who wants to help can follow before surgery, she said simply being there and having a conversation to find out what the patient's needs are can help reduce worry and offer reassurance. "That in itself may ultimately boost quality of life," Bingener said.

Dr. Otis Brawley, chief medical officer for the American Cancer Society, said the findings strike him as "reasonable," given the burden patients face while recovering from surgery.

"It's important to note that patients emerging from any type of surgery tend to do a lot better when they cooperate with the rehabilitation regimen set forth for them," he said. "But patients who feel stressed or depressed tend not to participate fully. If you're scared or in shock, you either don't do the exercises or you don't do them as vigorously as one should."

That can boost your odds for complications, Brawley said. For example, failing to do recommended breathing exercises can result in pneumonia, and refusing to walk or follow prescribed leg movements can lead to serious blood clots, he added.

"So, yes, the way people in a patient's circle handle the situation leading up to surgery can make a difference," Brawley said, adding it's important not to panic.

"The most helpful thing you can do," Brawley said, "is to try to have a positive attitude, and to choose to deal with what comes next as constructively as possible."

More information

For more about cancer surgery recovery, visit the American Cancer Society.


SOURCES: Juliane Bingener, M.D., professor, surgery, department of surgery, Mayo Clinic, Rochester, Minn.; Otis Brawley, M.D., chief medical officer, American Cancer Society, and professor, oncology and epidemiology, Emory University, Atlanta, Ga.; August...

Vitamin E, Selenium Supplements Don't Seem to Prevent Cataracts
September 18, 2014

 

THURSDAY, Sept. 18, 2014 (HealthDay News) -- Daily supplements of selenium or vitamin E don't seem to protect against the development of age-related cataracts among men, a new study indicates.

Previous animal research has suggested that one or both could help prevent cataracts. To investigate this further, William Christen, from Brigham & Women's Hospital and Harvard Medical School in Boston, and his colleagues examined data from a randomized, placebo-controlled trial of selenium and vitamin E. The trial was initially designed to study prevention of prostate cancer.

Of the more than 35,000 men involved in the initial study, more than 11,000 were asked to report if they had been diagnosed with cataracts or undergone cataract removal surgery since the study began. All of the black men in the study were aged 50 years or older. All of the other men were aged 55 years or older.

The average treatment and follow-up period was about six years. There were almost 400 cases of cataracts during that time, according to the findings published Sept. 18 in JAMA Ophthalmology.

Among the men taking selenium, there were 185 cases of cataracts, compared to 204 in the group that didn't take this supplement. Meanwhile, 197 cases of cataracts were diagnosed among the men taking vitamin E, compared to 192 in the group that didn't take it.

The men taking the supplements and those who didn't also had similar rates of cataract removal, the researchers pointed out in a journal news release.

"These randomized trial data from a large [group] of apparently healthy men indicate that long-term daily supplemental use of vitamin E has no material impact on cataract incidence," the study authors wrote.

"The data also exclude any large beneficial effect on cataract for long-term supplemental use of selenium, with or without vitamin E, although a smaller but potentially important beneficial effect could not be ruled out," they added.

One expert concurred.

"To date, there has been no study that has conclusively identified vitamins or minerals as being a useful aid in the prevention of cataracts," said Dr. Mark Fromer, an ophthalmologist at Lenox Hill Hospital in New York City and eye surgeon director for the New York Rangers hockey team.

"At the present time, there are no preventative solutions to slowing the progression of cataract formation other than decreasing exposure to ultraviolet light through the use of sunglasses," Fromer said.

More information

The U.S. National Eye Institute has more about cataracts.

Copyright © 2014 HealthDay. All rights reserved.


SOURCE: Mark Fromer, M.D., ophthalmologist, Lenox Hill Hospital, New York City, and eye surgeon director, New York Rangers; JAMA Ophthalmology, news release, Sept. 18,...

Almost Everyone Needs a Flu Shot: CDC
September 18, 2014

 

THURSDAY, Sept. 18, 2014 (HealthDay News) -- Less than half of all Americans got a flu shot last year, so U.S. health officials on Thursday urged that everyone 6 months and older get vaccinated for the coming flu season.

"It's really unfortunate that half of Americans are not getting the protection from flu they could get," said Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, during a morning news conference.

The result is lost days from work and school and a lot of preventable suffering, hospitalizations and deaths, he said.

Just one-third of adults 18 to 64 -- the age group hit especially hard last flu season -- were vaccinated against flu last year, according to new CDC figures.

Also, more than 100 children died from flu-related complications last year, Frieden noted.

"Many of those deaths might have been prevented if children had gotten a flu vaccination," he said. Ninety percent of the children who died were unvaccinated, he added.

Dr. Paul Offit, a professor of pediatrics at the Children's Hospital of Philadelphia, said during the press briefing that every year children die in his hospital from flu.

"Parents' reaction is invariably the same," he said. "They can't believe this happened to them."

Most of these parents didn't want their child vaccinated because they didn't consider flu serious or they thought the vaccine wasn't safe, Offit said.

"The riskiest aspect of getting vaccines is driving to the office to get them," Offit said.

While just 46 percent of Americans overall were vaccinated against flu last year, children fared better than adults -- with 59 percent of kids immunized compared to 42 percent of adults, the CDC said.

Coverage was highest among children younger than 5 years and adults 65 and older, according to the CDC's Sept. 19 Morbidity and Mortality Weekly Report.

This year the CDC recommends the flu nasal spray vaccine for children 2 to 8 years old, Frieden said. But if the nasal spray isn't available immediately, these kids should get the shot, he said.

There is some encouraging news in the new report, the nation's health experts said.

Slightly more than half of pregnant women got flu shots in recent years. "It's important because pregnant women are most susceptible to severe complications from flu," Frieden said.

Dr. Laura Riley, director of labor and delivery at Massachusetts General Hospital in Boston, said at the news conference that the flu vaccine is safe during pregnancy.

"It protects the mother from severe illness and it protects the baby from infection in the first six months of life before the baby can be vaccinated," Riley said.

Among health care workers, vaccination rates are rising, Frieden said. Overall, 75 percent of health care workers were vaccinated last flu season.

Vaccination coverage was highest among doctors and nurses, at 90 percent.

"Influenza is constantly evolving, and it's unpredictable," said Dr. William Schaffner, past president of the National Foundation for Infectious Diseases, during the press conference.

"That is why everyone 6 months and older should get a flu shot every year," he said. "What is it about 'everyone' that we don't understand?" Schaffner asked.

Flu activity in the United States tends to pick up in October and usually peaks between January and March, according to the CDC.

Frieden said about 150 million doses of flu vaccine should be available for the U.S. market this year. This is up somewhat from last flu season.

More information

For more on flu, visit the U.S. Centers for Disease Control and Prevention.

Copyright © 2014 HealthDay. All rights reserved.


SOURCES: Sept 18, 2014, press conference with Thomas Frieden, M.D., M.P.H., director, U.S. Centers for Disease Control and Prevention; William Schaffner, M.D., past president, National Foundation for Infectious Diseases, professor of preventive medic...

Obama Calls for National Plan to Fight Antibiotic Resistance
September 18, 2014

 

THURSDAY, Sept. 18, 2014 (HealthDay News) -- President Barack Obama escalated the fight against antibiotic-resistant bacteria on Thursday, ordering key federal agencies to pursue a national strategy to deal with the threat.

Obama signed an executive order that creates a new cabinet-level task force charged with crafting a national action plan for dealing with new "superbugs" -- which are ordinary and previously treatable bacteria that have become resistant to standard antibiotics through repeated exposure to the drugs.

The president also called for better federal oversight of the use of antibiotics in health care, strengthened efforts aimed at tracking the superbugs, and the development of next-generation antibiotics that can overcome bacterial resistance.

Finally, the order announced a $20 million prize for the development of a rapid diagnostic test that doctors can use to identify highly resistant bacterial infections.

Antibiotic-resistant bacteria are associated with 23,000 deaths and 2 million illnesses in the United States each year, according to the U.S. Centers for Disease Control and Prevention. These infections cost $20 billion annually in the United States, according to a news release from the Obama administration.

Dr. Jesse Goodman, director of the Center on Medical Product Access, Safety and Stewardship at Georgetown University Medical Center, called Obama's order a "great step forward," but cautioned that the fight will require a "sea change" in current thinking.

"Doctors, farmers and agribusiness, health systems and the public all need to think totally differently about antibiotics," Goodman said. "They are precious resources and we must reduce their inappropriate use. Better diagnosis and stronger infection control practices can make a big difference right now and safely reduce antibiotic use."

More information

To learn more about antibiotic resistance, visit U.S. Centers for Disease Control and Prevention.

Copyright © 2014 HealthDay. All rights reserved.


SOURCES: Sept. 18, 2014, news release, The White House; Sept. 18, 2014, news release, Georgetown University Medical Center, Washington,...

Grief Can Weigh on Immune System in Older Folks, Study Says
September 18, 2014

 

THURSDAY, Sept. 18, 2014 (HealthDay News) -- Older people become more physically vulnerable during bereavement, new research shows.

That's because the balance of stress hormones during bereavement changes with age, British researchers say. As a result, older people who are grieving are more likely to have weakened immune systems and develop infections, the study found.

"During the difficult weeks and months after loss, we can suffer from reduced neutrophil function. Neutrophils are the most abundant type of white blood cell and as such are essential at combating infections and illness, so we become vulnerable when this happens," Dr. Anna Phillips, a reader in behavioral medicine at the University of Birmingham, said in a university news release.

There is a link between neutrophil function and the balance of stress hormones, the study authors noted. Two stress hormones respond differently to grief with age: cortisol and dehydroepiandrosterone sulphate (DHEAS).

The study authors said that their research, published online recently in Immunity and Ageing, is the first to compare the relationship between stress hormones and immune function across different generations.

The study involved adults who were coping with the loss of a spouse or close family member. For younger people, the ratio of these two stress hormones was more balanced. For older people, however, the ratio was much higher, the research revealed.

"The effects of loss are poorly understood on the whole -- we know that it affects the immune system amongst other things -- but we don't fully understand the role played by our stress hormones," said Phillips. "We hope that this is a step towards that understanding, and being able to provide the best possible support."

Study co-author Janet Lord, a professor of immune cell biology at the University of Birmingham, added that "cortisol is known to suppress elements of the immune system during times of high stress, so having an unbalanced ratio of cortisol and DHEAS is going to affect how able we are to ward off illness and infection when grieving."

However, Lord pointed out in the news release, cortisol "is also incredibly useful -- particularly in activating some anti-stress and anti-inflammation pathways -- so it's not as simple as trying to suppress the cortisol in vulnerable people."

Possible treatments for those at increased risk of stress are hormonal supplements and similar products, the researchers suggested.

But Phillips concluded, "there is, quite simply, no substitute for a strong support network of family and friends to help manage the risks during a period of grieving."

More information

The American Cancer Society provides more information on coping with loss.
Copyright © 2014 HealthDay. All rights reserved.


SOURCE: University of Birmingham, news release, Sept. 9, 2014...

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