jueves, 31 de enero de 2013

Rubella Update

Rubella Update

Rubella Update

New on the MedlinePlus Rubella page:
01/28/2013 04:17 PM EST

Source: Centers for Disease Control and Prevention, American Academy of Pediatrics, American Academy of Family Physicians - PDF

Syphilis Update

Syphilis Update

Syphilis Update

New on the MedlinePlus Syphilis page:
01/28/2013 04:07 PM EST

Source: Centers for Disease Control and Prevention - PDF

Hepatitis B Update

Hepatitis B Update

Hepatitis B Update

New on the MedlinePlus Hepatitis B page:
01/28/2013 08:27 PM EST

Source: Centers for Disease Control and Prevention, American Academy of Family Physicians, American Academy of Pediatrics - PDF

After Surgery Update

After Surgery Update

After Surgery Update

New on the MedlinePlus After Surgery page:
01/28/2013 04:41 PM EST

01/28/2013 04:41 PM EST

Rehabilitation Update

Rehabilitation Update

Rehabilitation Update

New on the MedlinePlus Rehabilitation page:
01/29/2013 03:19 PM EST

Source: American Physical Therapy Association - Video
01/29/2013 03:19 PM EST

Source: American Music Therapy Association

Hydrotherapy

Hydrotherapy



Hydrotherapy

Other common name(s): water therapy, balneotherapy, hydrothermal therapy
Scientific/medical name(s): none

Description

Hydrotherapy is the use of water as a medical treatment. The water can be in the form of water vapor, steam, liquid, or ice, and can be either taken internally or used externally.

Overview

Hydrotherapy has been proven helpful in many ways. It is used as a means of physical therapy, both to help a person relax and to relieve minor aches and pains. However, there is no evidence that any form of hydrotherapy can prevent or treat cancer.

How is it promoted for use?

There are many medically accepted uses of hydrotherapy. Each involves water in the form of ice, liquid, or steam. Some of the more common examples of hydrotherapy include using water to clean wounds, use of warm moist compresses, ice packs, whirlpool or steam baths, and drinking water in order to prevent or reduce dehydration.
Warm compresses (heat packs) expand blood vessels, which can temporarily increase circulation, help to relax muscles, and reduce pain. Warm water in the form of a bath, massaging water jets, or hot tub also provides relaxation and stress relief. The water vapor produced by a humidifier can reduce the discomfort of minor sore throats and colds. Warm water vapor from a sauna, hot shower, or "sweat lodge" can warm and moisten the nose and breathing passages.
Hydrotherapy in the form of ice packs is used to reduce inflammation and swelling. The coldness constricts blood vessels and reduces circulation to the area, which helps to decrease swelling. The use of water for heating and cooling the body is also called hydrothermal therapy.
Dehydration, which can be a serious medical problem, is treated by giving water or liquids, either by mouth or intravenously.
Hydrotherapy is also used in physical rehabilitation and exercise. When performed in water, exercises can cause less strain on the bones and joints. The water also offers resistance to movement, which helps build muscle strength.
Some claim that warm water baths or cleansing baths boost the immune system, invigorate the digestion, calm the lungs, and stimulate the mind. Streams of warm water directed at different parts of the body are claimed to help headaches, nervous disorders, paralysis, and multiple sclerosis, as well as liver, lung, and gallbladder disease.
Some proponents claim one form of hydrotherapy, which involves frequent enemas, cleanses the bowels and helps cure cancer (see our document, Colon Therapy).

What does it involve?

In most types of hydrotherapy, water is either directly applied to the desired area (an ice pack or a warm damp towel) or the body is partly immersed in water (a hot tub or bath). It can be rubbing the skin with a cold wet towel, or sitting in a steam bath. Massage, yoga, and other exercise can be done in the water. Underwater births can also be considered a form of hydrotherapy.
Internal means of hydrotherapy can include drinking a certain amount of water daily, drinking mineral water or "enriched" water, or getting an intravenous (IV) infusion. Some involve flushing out the nose, vagina, or colon (see section above).
In some alternative remedies, a stream of warm water is directed over a part of the body, such as the foot, back toward the heart. Or a person may be wrapped in a cold wet sheet and covered with blankets while the sheet dries. Other types of hydrotherapy may involve bathing or soaking in water that contains minerals, mud, herbs, aromatherapy oils, Epsom salts, Dead Sea salts, or other materials.

What is the history behind it?

Hydrotherapy has been used throughout history by many diverse cultures. Even the Old Testament mentions the healing powers of mineral waters. By the time of the ancient Greeks, the use of water as a healing agent was well-established. The early Roman and Turkish baths are still popular tourist attractions today.
The modern use of hydrotherapy is linked to Vincent Preissnitz, who established the "Graefenberg cure" in the 1800s for treating almost every ailment. This treatment involved the use of water in every conceivable way, often alternating between hot and cold water.
Traditional Native American healing uses sweat lodges as a type of remedy. Sweating is thought to be a form of cleansing that purges poisons from the body. This belief is similar to the Scandinavians' use of saunas. Several of the springs first used by Native Americans have been converted into resorts and remain popular today. President Franklin D. Roosevelt's use of one such spring brought worldwide attention to the use of hydrotherapy.

What is the evidence?

Water has long been known to be essential to human life. The Food and Nutrition Board of the National Academies of Science reports that Adequate Intake (AI) of water is around 3.7 liters per day for adult men (over 18 years), and about 2.7 liters for adult women. For pregnant women, daily intake is about 3 liters, and 3.8 for nursing women. A liter is a little more than a quart, so for men, this translates to nearly 4 quarts a day. But this amount of water includes all the liquid in your food and drinks, not just plain water intake. For example, a person eating fresh fruits generally will not need to drink as much as a person eating dried fruits, because fresh fruits have a high percentage of water.
In conditions of high heat, prolonged exercise, and a lot of sweating, even more liquid is needed. There are also medical conditions in which a person may need more fluid to help prevent health problems such as kidney stones or constipation. There are few situations in which a person may need to take in smaller amounts of fluid, such as kidney failure or heart failure.
Aside from basic hydration, hydrotherapy is an accepted way to treat symptoms for many conditions, although many forms of it have not been studied carefully. There are many types of hydrotherapy and all sorts of possible uses. Each type of hydrotherapy requires its own studies.
Some types of hydrotherapy are actually well-proven conventional therapies, such as ice packs for slight sprains and hot compresses for sore muscles. Warm compresses or warm water soaks are also sometimes used in mainstream medicine to help treat local skin conditions, such as infection (see our document, Heat Therapy). Cold is known to reduce the blood flow to the part of the body where it is applied, while heat does the opposite. Since water transmits cold and heat so well, it can be used to change the skin temperature quickly to help reduce or increase blood flow where it is applied.
Certain types of hydrotherapy can be useful for patients with severe burns, rheumatoid arthritis, spinal cord injuries, and bone injuries. An analysis of studies done on hydrotherapy for lower back pain suggested that it might be helpful, although further studies are needed.
Physical therapy is a mainstream treatment that is sometimes given in a pool, where the water can help to support the person's body weight and reduce impact on joints.
Hydrotherapy has not been proven to work in slowing the growth or spread of cancer. Available scientific evidence does not support claims that alternative uses of hydrotherapy, such as cold body wraps or colon therapy, can cure cancer or any other disease.

Are there any possible problems or complications?

Most forms of hydrotherapy are considered safe. However, colon therapy can cause perforation of the colon, which can lead to death. People who are frail, elderly, or very young may become dehydrated or develop serious blood chemistry imbalances in very warm water or saunas. People with diabetes, numbness, or poor sensation may be at higher risk of scalding or burns from hot soaks or compresses. Pregnant women and people with heart or lung problems may have trouble with very hot or cold water.
Those with poor circulation or problems, such as Reynaud's disease or frostbite, may find them worsened by cold water, ice, and cold wraps. Excessive heat or cold applied directly to the skin for long periods of time may cause pain, drying, and tissue damage.
Bacterial infection due to improperly cleaned whirlpools and hot tubs has also been reported. Fungal skin infection has resulted from mud baths. Essential oils and other additives can irritate skin.
Drinking very large amounts of water over short periods of time can lead to serious mineral imbalances in the blood, and death from water intoxication.
Relying on this type of treatment alone and avoiding or delaying conventional medical care for cancer may have serious health consequences.

To learn more

More information from your American Cancer Society

The following information on complementary and alternative therapies may also be helpful to you. These materials may be found on our Web site (www.cancer.org) or ordered from our toll-free number (1-800-227-2345).
Guidelines for Using Complementary and Alternative Therapies
Dietary Supplements: How to Know What Is Safe
The ACS Operational Statement on Complementary and Alternative Methods of Cancer Management
Complementary and Alternative Methods for Cancer Management
Placebo Effect
Learning About New Ways to Treat Cancer
Learning About New Ways to Prevent Cancer

References

Burns SB, Burns JL. Hydrotherapy. J Altern Complement Med. 1997;3:105-107.
Cassileth B. The Alternative Medicine Handbook: The Complete Reference Guide to Alternative and Complementary Therapies. New York, NY: W.W. Norton; 1998.
Harmer AR, Naylor JM, Crosbie J, Russell T. Land-based versus water-based rehabilitation following total knee replacement: a randomized, single-blind trial. Arthritis Rheum. 2009 Feb 15;61(2):184-191.
Hydrotherapy, balneotherapy. Aetna InteliHealth Web site. Accessed at www.intelihealth.com/IH/ihtIH/WSIHW000/8513/34968/362192.html on January 14, 2011.
National Academies of Science Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes (DRIs): Recommended Intakes for Individuals, Macronutrients. Accessed at http://iom.edu/en/Global/News%20Announcements/~/media/Files/Activity%20Files/Nutrition/DRIs/DRISummaryListing2.ashx on January 18, 2011.
Pittler MH, Karagülle MZ, Karagülle M, Ernst E. Spa therapy and balneotherapy for treating low back pain: meta-analysis of randomized trials. Rheumatology (Oxford). 2006;45:880-884.
Ruiz de Casas A, Herrera A, Suárez AI, Camacho FM. Skin infection with Fusarium in an immunocompetent patient [in Spanish]. Actas Dermosifiliogr. 2006;97:278-280.
Tejirian T, Abbas MA. Sitz bath: where is the evidence? Scientific basis of a common practice. Dis Colon Rectum. 2005;48:2336-2340.
Note: This information may not cover all possible claims, uses, actions, precautions, side effects or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for consultation with your doctor, who is familiar with your medical situation

CMAMMA - Genetics Home Reference ▲ Combined malonic and methylmalonic aciduria

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CMAMMA - Genetics Home Reference

Genetics Home Reference: your guide to understanding genetic conditions


Combined malonic and methylmalonic aciduria

(often shortened to CMAMMA)
Reviewed January 2013

What is CMAMMA?

Combined malonic and methylmalonic aciduria (CMAMMA) is a condition characterized by high levels of certain chemicals, known as malonic acid and methylmalonic acid, in the body. A distinguishing feature of this condition is higher levels of methylmalonic acid than malonic acid in the urine, although both are elevated.
The signs and symptoms of CMAMMA can begin in childhood. In some children, the buildup of acids causes the blood to become too acidic (ketoacidosis), which can damage the body's tissues and organs. Other signs and symptoms may include involuntary muscle tensing (dystonia), weak muscle tone (hypotonia), developmental delay, an inability to grow and gain weight at the expected rate (failure to thrive), low blood sugar (hypoglycemia), and coma. Some affected children have an unusually small head size (microcephaly).
Other people with CMAMMA do not develop signs and symptoms until adulthood. These individuals usually have neurological problems, such as seizures, loss of memory, a decline in thinking ability, or psychiatric diseases.

How common is CMAMMA?

CMAMMA appears to be a rare disease. Approximately a dozen cases have been reported in the scientific literature.

What genes are related to CMAMMA?

Mutations in the ACSF3 gene cause CMAMMA. This gene provides instructions for making an enzyme that plays a role in the formation (synthesis) of fatty acids. Fatty acids are building blocks used to make fats (lipids). The ACSF3 enzyme performs a chemical reaction that converts malonic acid to malonyl-CoA, which is the first step of fatty acid synthesis in cellular structures called mitochondria. Based on this activity, the enzyme is classified as a malonyl-CoA synthetase. The ACSF3 enzyme also converts methylmalonic acid to methylmalonyl-CoA, making it a methylmalonyl-CoA synthetase as well.
The effects of ACSF3 gene mutations are unknown. Researchers suspect that the mutations lead to altered enzymes that have little or no function. Because the enzyme cannot convert malonic and methylmalonic acids, they build up in the body. Damage to organs and tissues caused by accumulation of these acids may be responsible for the signs and symptoms of CMAMMA, although the mechanisms are unclear.
Read more about the ACSF3 gene.

Metabolic Syndrome Update

Metabolic Syndrome Update

Metabolic Syndrome Update

New on the MedlinePlus Metabolic Syndrome page:
01/27/2013 10:12 PM EST

Source: Hormone Health Network - PDF

Methods for Delivering Insulin and Monitoring Blood Sugar: A Review of the Research for Children, Teens, and Adults With Diabetes - Consumer Summary | AHRQ Effective Health Care Program

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Methods for Delivering Insulin and Monitoring Blood Sugar: A Review of the Research for Children, Teens, and Adults With Diabetes - Consumer Summary | AHRQ Effective Health Care Program

Agency for Healthcare Research Quality www.ahrq.gov

Methods for Delivering Insulin and Monitoring Blood Sugar: A Review of the Research for Children, Teens, and Adults With Diabetes

Formats

    Table of Contents

    Is This Information Right for Me?

    Yes, if:

    • Your doctor* has told you that you have type 1 or type 2 diabetes and you have to take insulin to control your blood sugar.
    • You check your blood sugar level throughout the day to know how much insulin to take.
    * In this summary, the term “doctor” refers to the health care professionals who may take care of you, including your physician, endocrinologist, diabetes educator, nurse practitioner, or physician assistant.

    No, if:

    • Your doctor has told you that you have diabetes, but you do not need to take insulin.
    • Your doctor has told you that you have gestational diabetes. This type of diabetes appears in pregnant women who did not have diabetes before becoming pregnant.

    Progestogens To Prevent Preterm Birth: A Review of the Research About Progestogens for Women at Risk - Consumer Summary | AHRQ Effective Health Care Program

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    Progestogens To Prevent Preterm Birth: A Review of the Research About Progestogens for Women at Risk - Consumer Summary | AHRQ Effective Health Care Program

    Agency for Healthcare Research Quality

    Progestogens To Prevent Preterm Birth: A Review of the Research About Progestogens for Women at Risk

    Formats

      Table of Contents

      Is This Information Right for Me?

      Yes, if:

      • At least once before you had a baby too early because labor started on its own before 37 weeks of pregnancy (for example, at 20 weeks). This is called “spontaneous (spon-TAY-nee-us) preterm birth.” An example is if your “water broke” before 37 weeks of pregnancy. You may be pregnant now or are thinking about becoming pregnant again.
      • Your doctor* has told you that you have a short cervix. (The cervix is the narrow tube-like opening in the lower part of your uterus. The uterus is where your baby grows while you are pregnant.)
      • Your doctor has told you that you are at risk for preterm birth. If you are not sure if you are at risk for preterm birth, ask your doctor.
      • You have heard about the use of hormones called “progestogens” (pronounced pro-JES-toe-jenz) to prevent preterm birth and want to know about the research on the benefits and possible side effects of this treatment.
      * In this summary, the term “doctor” refers to any of the health care professionals who may take care of you, including your obstetrician or other physician, nurse practitioner, midwife, or physician assistant.

      No, if:

      • You are 37 weeks or more along in your pregnancy.
      • You never had a baby born too early because of spontaneous preterm birth.
      • You are pregnant with more than one baby, such as twins or triplets.

      blog.aids.gov — HIV Policy & Programs. Research. New Media.

      blog.aids.gov — HIV Policy & Programs. Research. New Media.

      Rapid, On-site HIV Testing: Increases Life Expectancy and Is Cost-effective

      Dr. Jacques Normand
      Dr. Jacques Normand
      Incorporating rapid HIV testing in drug treatment programs is both cost effective and increases life expectancy for an HIV-positive person, according to an NIH-funded study published in September 2012 in the journal of Drug and Alcohol Dependence Exit Disclaimer. This study expands upon a previous finding of the National Drug Abuse Treatment Clinical Trials Network Rapid HIV Testing and Counseling Study that showed that onsite rapid HIV testing in substance abuse treatment programs correlated with increased receipt of HIV test results. (See Dr. Ron Valdiserri’s earlier blog post on this study.)
      The study used a computer simulation model to project life expectancy, lifetime costs, and quality-adjusted life years (QALY’s) for HIV infected individuals. The model projected that the life expectancy for an HIV-positive person engaged in substance abuse treatment who is unaware of his/her HIV infection is 17.1 years with no intervention. The model calculated that referring these patients to clinics outside of the substance abuse treatment facility for HIV testing would increase life expectancy to 17.9 years, while offering onsite rapid HIV testing with a description of the testing procedure (that is, providing information only) would increase life expectancy to 20.8 years.
      Providing rapid HIV testing in drug treatment programs is also a good investment of health care dollars. This study demonstrated that providing onsite rapid HIV testing was cost-effective using the Cost Effectiveness of Preventing AIDS Complications (CEPAC) model, taking into account various patient demographics including CD4 cell counts, viral burden (HIV RNA level), ART therapy regimen, presence of an acute AIDS-defining illness, etc. as well as the costs for medical treatment (DHHS, 2011).
      Substance abuse places individuals at great risk for contracting HIV through the risky behaviors it engenders—behaviors that extend far beyond injection drug use.  Treating HIV infection with today’s effective antiretroviral therapy not only improves the quality of life for those living with HIV, but it also reduces transmission to others.  But effective treatment cannot begin until an infection is identified, which is why implementing HIV testing in centers where vulnerable populations — such as persons with substance use disorders — seek treatment can be so valuable. In fact, NIDA is investing heavily in this area to optimize ways to reach vulnerable populations (Seek), test them for HIV (Test), link those who test positive to the care they need (Treat), and develop services to help them maintain their treatment regimens (Retain).
      For more information on how to implement rapid HIV testing in a variety of treatment settings, please visit the website on the NIDA/SAMHSA Blending Initiative for a compilation of resources on rapid HIV testing.

      Health Tip: Promote Healthy Teeth: MedlinePlus

      Health Tip: Promote Healthy Teeth: MedlinePlus

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      Health Tip: Promote Healthy Teeth

      Brush twice a day
      URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_133519.html (*this news item will not be available after 04/29/2013)
      By Diana Kohnle
      Tuesday, January 29, 2013 HealthDay Logo
      Related MedlinePlus Page
      (HealthDay News) -- Your pearly whites are one of the first things people notice, so it's important to keep them looking their best.
      The American Dental Association suggests these healthy dental habits:
      • Brush teeth twice daily for two minutes per session using a fluoride toothpaste.
      • Floss your teeth at least once daily.
      • Restrict starchy and sugary snacks.
      • When playing sports or engaging in other physical activity, wear a mouthguard.
      • Don't smoke.
      • Don't pierce any part of your mouth or lips.
      • Schedule regular visits with your dentist.

      HealthDay

      Health Tip: A Few 'Don'ts' During Pregnancy: MedlinePlus

      Health Tip: A Few 'Don'ts' During Pregnancy: MedlinePlus

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      Health Tip: A Few 'Don'ts' During Pregnancy

      Never use tobacco or drink alcohol
      URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_133518.html (*this news item will not be available after 04/29/2013)
      By Diana Kohnle
      Tuesday, January 29, 2013 HealthDay Logo
      Related MedlinePlus Page
      (HealthDay News) -- You're probably tired of all of the "don't do this" advice you've heard during your pregnancy.
      But the American Academy of Family Physicians says it's very important to heed a few of them, namely:
      • Don't smoke.
      • Don't use illicit drugs.
      • Don't drink alcohol.
      • Don't clean the cat's litter box.
      • Don't eat raw meat.
      • Don't use a sauna or hot tub.
      • Don't douche. Just bathe normally.

      HealthDay
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      Pregnancy

      NIH study advances understanding of movement control, January 28, 2013 News Release - National Institutes of Health (NIH)

      NIH study advances understanding of movement control, January 28, 2013 News Release - National Institutes of Health (NIH)


      For Immediate Release
      Monday, January 28, 2013

      NIH study advances understanding of movement control

      Voluntary movements involve the coordinated activation of two brain pathways that connect parts of deep brain structures called the basal ganglia, according to a study in mice by researchers at the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health. The findings, which challenge the classical view of basal ganglia function, were published online in Nature on Jan. 23.
      “By improving our understanding of how the basal ganglia control movements, these findings could aid in the development of treatments for disorders in which these circuits are disrupted, such as Parkinson’s disease, Huntington’s disease and addiction,” says NIAAA Acting Director Kenneth R. Warren, Ph.D.
      The predominant model of basal ganglia function proposes that direct and indirect pathways originating in a brain region called the striatum have opposing effects on movement.  Activity of neurons in the direct pathway is thought to promote movement, while activity in the indirect pathway is thought to inhibit movement.  Newer models, however, suggest that co-activation of these pathways is necessary to synchronize basal ganglia circuits during movement.
      “Testing these models has been difficult due to the lack of methods to measure specific neurons in the direct and indirect pathways in freely moving animals,” explains first author Guohong Cui, Ph.D., of the NIAAA Laboratory for Integrated Neuroscience (LIN).
      To overcome these difficulties, Dr. Cui and senior author Rui Costa, Ph.D., D.V.M, worked with LIN chief David M. Lovinger Ph.D., NIAAA Cellular Biophotonics Section Acting Chief Steven Vogel, Ph.D., and their colleagues to devise a new approach for measuring the activity of neurons deep within the brain during complex behaviors.  Their technique uses fiber optic probes implanted in the mouse brain striatum to measure light emissions from neurons engineered to glow when activated.
      Using this new approach, the researchers detected neural activity in both the direct and indirect pathways when mice performed a bar-pressing task. No such activity was detected when the mice were inactive.
      “These neuronal activity patterns differ from previous predictions that one pathway would be active when animals begin moving while another would be active when animals are at rest,” notes Dr. Costa, of the Champalimaud Neuroscience Program in Lisbon, Portugal. 
      Drs. Lovinger and Vogel add that the new technique developed for this study will be useful for studying a variety of neuron types in other brain regions during performance of a full repertoire of behaviors.
      The National Institute on Alcohol Abuse and Alcoholism, part of the National Institutes of Health, is the primary U.S. agency for conducting and supporting research on the causes, consequences, prevention, and treatment of alcohol abuse, alcoholism, and alcohol problems. NIAAA also disseminates research findings to general, professional, and academic audiences. Additional alcohol research information and publications are available at http://www.niaaa.nih.gov.
      About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.
      NIH...Turning Discovery Into Health ®
      ###

      High Blood Pressure in Kids May Be Less Common Than Thought: MedlinePlus

      High Blood Pressure in Kids May Be Less Common Than Thought: MedlinePlus

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      High Blood Pressure in Kids May Be Less Common Than Thought

      U.S. study offers somewhat encouraging finding, but experts say it's tough to pin down 'correct' rate
      URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_133522.html (*this news item will not be available after 04/29/2013)
      Tuesday, January 29, 2013 HealthDay Logo
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      TUESDAY, Jan. 29 (HealthDay News) -- The number of U.S. kids with full-blown high blood pressure could be lower than previously thought, if new research findings are on the mark.
      In a study of nearly 200,000 children aged 3 to 17 years, researchers found that only 0.3 percent met the standard for high blood pressure -- elevated readings at three consecutive doctor visits.
      That stands in contrast to past studies, which have suggested that anywhere from 0.8 to 4.5 percent of American kids have high blood pressure.
      But experts say the "correct" rate among U.S. kids is still unknown. And even if blood pressure is lower than earlier estimates, children should still have their blood pressure measured at routine checkups, said Dr. Stephen Daniels, an expert in pediatric high blood pressure who was not involved in the new study.
      The American Academy of Pediatrics and the U.S. National Heart, Lung, and Blood Institute both recommend that kids have yearly screenings for high blood pressure, starting at age 3.
      "I don't think that should change," said Daniels, the chief pediatrician at Children's Hospital Colorado and head of pediatrics at the University of Colorado School of Medicine in Aurora. "I wouldn't want parents to get the message that their child doesn't need to have their blood pressure measured."
      As for why the new figure is lower than past estimates, it's probably due to how the study was done, according to lead researcher Dr. Joan Lo, a research scientist with Kaiser Permanente Northern California in Oakland.
      The children in her study were from three different U.S. states, and all were visiting the doctor for routine "well-child" visits. Past studies have mainly been done in schools, in a single city or region. And some of those studies were run in urban areas, with a high proportion of black and obese kids -- both of whom are at increased risk of elevated blood pressure, Daniels noted.
      Still, the true rate of high blood pressure among U.S. children remains unclear, according to Daniels.
      "This new study is narrow in its own way," he said, noting that the kids involved had health insurance and got routine check-ups. The group was racially diverse, but Daniels said they may have been better off -- financially and health-wise -- than a random sample of U.S. kids would be.
      The findings, which appear in the February issue of the journal Pediatrics, are based on 199,513 children and teens enrolled in three large health plans.
      Almost 11,000 of those kids had an elevated blood pressure reading at their first doctor visit during the study period. But after repeat tests at their next two visits, less than 4 percent of them were ultimately diagnosed with high blood pressure.
      All in all, just 0.3 percent of the whole study group had confirmed high blood pressure, the researchers found.
      Both Lo and Daniels said the findings underscore the importance of doing repeat measurements to confirm that a child actually has high blood pressure, and not just a temporary spike.
      To nail down the true prevalence of high blood pressure, Daniels said researchers need to follow a nationally representative sample of children who have three consecutive blood pressure readings taken over time.
      But whatever the true rate is, no one is calling for a change in children's routine care.
      High blood pressure may not be highly common in children -- which is "good news," Daniels said. But kids with high blood pressure often become adults with the condition. If not treated properly, high blood pressure can lead to coronary heart disease, heart failure, stroke, kidney failure and other health problems.
      "Blood pressure tracks from childhood to adulthood," Lo said. "So diagnosing hypertension in a child suggests it will also be present in adulthood, although this is not 100 percent predictable."
      High blood pressure is diagnosed differently in children than in adults. There is no cut-off number, which in adults is a reading of 140/90 mm Hg or higher. Children are diagnosed with the condition if they have three consecutive readings that are at or above the 95th percentile for their age, sex and height.
      Treatment depends on the cause, if it's known. If blood pressure is very high, Daniels noted, it is likely due to an underlying condition, like kidney disease. Otherwise, a child's numbers can often be reined in with a healthy diet, exercise and, if needed, weight loss.
      SOURCES: Stephen Daniels, M.D., Ph.D., chairman, pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora; Joan Lo, M.D., research scientist, Kaiser Permanente Northern California, division of research, Oakland, Calif.; February 2013, Pediatrics
      HealthDay
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      Children's Health
      High Blood Pressure

      Study: Lungs From Heavy Smokers OK for Transplant: MedlinePlus

      Study: Lungs From Heavy Smokers OK for Transplant: MedlinePlus

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      Study: Lungs From Heavy Smokers OK for Transplant

      But recipients need to know the source of the potential transplant, researchers say
      URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_133520.html (*this news item will not be available after 04/29/2013)
      By Mary Elizabeth Dallas
      Tuesday, January 29, 2013 HealthDay Logo
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      TUESDAY, Jan. 29 (HealthDay News) -- Lungs of heavy smokers can be donated safely for use in adult double-lung transplants, a new study contends.
      Researchers from Temple University in Philadelphia found that lungs from carefully selected donors who smoked at least a pack a day for more than 20 years may be used in certain transplant situations without affecting recipients' survival rates or deaths from lung cancer.
      The study authors said the use of lungs donated by heavy smokers could help more patients get the life-saving double-lung transplant they need.
      "Our findings demonstrate that the current criteria for lung transplantation can potentially be revised to include donors with a heavy smoking history," Dr. Sharven Taghavi, from Temple University Hospital, said in a news release from the Society of Thoracic Surgeons. "This may help decrease the shortage of donor lungs and decrease waiting list mortality."
      "For example, a surgeon may choose to transplant lungs from a healthy donor who has good lung function despite heavy smoking, or lungs may be accepted from a less-than-ideal donor for a very sick patient," Taghavi said.
      In conducting the study, the researchers examined data from the United Network for Organ Sharing on 5,900 people who received a double-lung transplant between 2005 and 2011. Of these patients, 13 percent received lungs donated by a heavy smoker.
      The study found that patients who received carefully screened lungs from donors who smoked had short- and medium-term survival rates similar to those who got lungs from people who didn't smoke. The researchers added that the lung function of the patients who received lungs from heavy smokers was not worse and there was no difference in deaths from cancer.
      The study's authors noted, however, that lungs from heavy smokers must be examined closely to ensure they are free of cancer and other disease.
      Dr. Yoshiya Toyoda, also from Temple, said the smoking history of the patients providing the lungs might not always be accurate..
      "Lungs from heavy smokers must be carefully evaluated," Toyoda said in the news release. "We recommend a CT scan for evidence of tumors and emphysema in addition to routine assessment including blood gas, bronchoscopy and visual inspection."
      Toyoda also said potential recipients of lungs from heavy smokers must be made aware of the possible higher risk of developing lung cancer.
      The U.S. National Heart, Lung, and Blood Institute reports that every year only 50 percent of people who need a double-lung transplant will actually get one. Complicating matters, double-lung transplants now outnumber single-lung transplants.
      More than 1,600 people were on the Organ Procurement and Transplantation Network waiting list for a lung transplant at the end of 2012, the study authors said.
      The study was to be presented Tuesday at the annual meeting of the Society of Thoracic Surgeons in Los Angeles. Research presented at medical meetings is considered preliminary because it hasn't been subjected to the same scrutiny as studies published in peer-reviewed publications.
      SOURCE: Society of Thoracic Surgeons, news release, Jan. 29, 2013
      HealthDay
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      Can Brightly Colored Fruits, Veggies Protect Against ALS?: MedlinePlus

      Can Brightly Colored Fruits, Veggies Protect Against ALS?: MedlinePlus

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      Can Brightly Colored Fruits, Veggies Protect Against ALS?

      Study tied foods like carrots, spinach and yams to lower risk of Lou Gehrig's disease
      URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_133521.html (*this news item will not be available after 04/29/2013)
      By Mary Elizabeth Dallas
      Tuesday, January 29, 2013 HealthDay Logo
      HealthDay news image
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      TUESDAY, Jan. 29 (HealthDay News) -- Eating bright orange, red or yellow fruits and dark-green vegetables rich in antioxidants may help prevent or delay the onset of amyotrophic lateral sclerosis, also known as ALS or Lou Gehrig's disease, according to a new study.
      Researchers found that increasing consumption of carotenoids, particularly beta-carotene and lutein, might reduce the risk for this progressive neurological disease, which attacks nerve cells in the brain and spinal cord.
      Carrots, yams and mangoes are rich in beta-carotenes, and spinach, collard greens and egg yolks are good sources of lutein.
      The study found, however, that diets rich in the antioxidants lycopene, beta-cryptoxanthin and vitamin C do not apparently reduce the risk for ALS, which causes the muscles to waste away and eventually results in paralysis.
      The study was published online Jan. 29 in the journal Annals of Neurology.
      "ALS is a devastating degenerative disease that generally develops between the ages of 40 and 70, and affects more men than women," senior study author Dr. Alberto Ascherio, a professor of epidemiology and nutrition at Harvard School of Public Health, said in a journal news release. "Understanding the impact of food consumption on ALS development is important."
      Analyzing information on more than 1 million people, the researchers identified nearly 1,100 cases of ALS. The researchers found that increased overall carotenoid intake -- especially among those who ate diets rich in beta-carotene and lutein -- seemed to be linked to a lower risk for the devastating condition.
      Those who ate more carotenoids daily also were more likely to exercise, have an advanced degree, have increased vitamin C intake and take vitamin C and E supplements.
      The researchers pointed out, however, that long-term vitamin C supplements did not lower people's risk for this degenerative disease.
      "Our findings suggest that consuming carotenoid-rich foods may help prevent or delay the onset of ALS," Ascherio concluded. "Further food-based analyses are needed to examine the impact of dietary nutrients on ALS."
      The findings, which used data from five previous studies, do not establish a cause-and-effect protective relationship between carotenoid consumption and ALS risk.
      About 20,000 to 30,000 Americans have ALS, and 5,000 more are diagnosed with the disease every year, according to the U.S. National Institutes of Neurological Disorders and Stroke.
      SOURCE: Annals of Neurology, news release, Jan. 29, 2013
      HealthDay
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      'Coming Out' Can Bring Health Benefits, Study Says: MedlinePlus

      'Coming Out' Can Bring Health Benefits, Study Says: MedlinePlus

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      'Coming Out' Can Bring Health Benefits, Study Says

      Openness about sexual orientation may reduce stress for lesbians, gays and bisexuals
      URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_133524.html (*this news item will not be available after 04/29/2013)
      By Robert Preidt
      Tuesday, January 29, 2013 HealthDay Logo
      TUESDAY, Jan. 29 (HealthDay News) -- Being open about their sexual orientation offers health benefits for lesbians, gays and bisexuals, according to a new study.
      "Coming out is no longer a matter of popular debate but a matter of public health," said study lead author Robert-Paul Juster, of the Centre for Studies on Human Stress at the University of Montreal's Louis H. Lafontaine Hospital.
      He and his colleagues looked at 87 men and women, about age 25, who had different sexual orientations (gay, lesbian, bisexual or heterosexual) and found that lesbians, gays and bisexuals who were out to others had lower levels of the stress hormone cortisol and fewer symptoms of anxiety, depression and burnout.
      When a person is under chronic stress, cortisol contributes to "wear and tear" on a number of the body's systems. Taken together, this strain is called allostatic load, the study said.
      "Our goals were to determine if the mental and physical health of lesbians, gay men and bisexuals differs from heterosexuals and, if so, whether being out of the closet makes a difference. We used measures of psychiatric symptoms, cortisol levels throughout the day, and a battery of over 20 biological markers to assess allostatic load," Juster said in a university news release.
      The researchers found that, contrary to their expectations, gay and bisexual men had lower depressive symptoms and allostatic load levels than heterosexual men. And, "lesbians, gay men, and bisexuals who were out to family and friends had lower levels of psychiatric symptoms and lower morning cortisol levels than those who were still in the closet," Juster added.
      The findings, published Jan. 29 in the journal Psychosomatic Medicine, highlight the positive effect that self-acceptance and being open about their sexual orientation can have on the health and well-being of lesbians, gays and bisexuals, the study authors said.
      But that may only be the case in open and tolerant societies.
      "Coming out might only be beneficial for health when there are tolerant social policies that facilitate the disclosure process," Juster said. On the other hand, he added, societal intolerance during the disclosure process generates increased distress and contributes to mental and physical health problems.
      SOURCE: University of Montreal, news release, Jan. 29, 2013
      HealthDay
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      Sharp rise in buprenorphine-related emergency department visits from 2005 to 2010

      Sharp rise in buprenorphine-related emergency department visits from 2005 to 2010

      The Substance Abuse and Mental Health Services Administration (SAMHSA) Behavioral Health is Essential to Health, Prevention Works, Treatment is Effective, People Recover
      Bookmark and Share
      Date: 1/29/2013 10:30 AM
      Media Contact: SAMHSA Press Office
      Telephone: 240-276-2130

      Sharp rise in buprenorphine-related emergency department visits from 2005 to 2010

      Visits involving non-medical use of buprenorphine also increase
      Hospital emergency department visits linked to buprenorphine, a medication to treat opioid addiction, increased substantially – from 3,161 visits in 2005 to 30,135 visits in 2010 with 52 percent (15, 778) in 2010 involving non-medical use – according to a new report by the Substance Abuse and Mental Health Services Administration (SAMHSA).

      Of the buprenorphine-related, non-medical use related visits in 2010, 41 percent involved just the use of buprenorphine. The remaining 59 percent of these non-medical visits involved the use of other substances such as pharmaceuticals including benzodiazepine (27 percent), narcotic pain relievers (12 percent), and illicit drugs like marijuana (11 percent), heroin (9 percent) and cocaine (8 percent). In 2010, most buprenorphone-related emergency department visits for non-medical use involved males (66 percent). Patients aged 26 to 34 years old represented the largest proportion of visits for non-medical use of the medication.

      Buprenophine was approved as a treatment for opioid addiction in 2002 and is usually prescribed to patients by certified physicians, mostly in office-based treatment settings. Since its introduction the use and availability of the partial opioid medication has significantly increased. In 2005 5,656 certified physicians were prescribing buprenorphine to 100,000 patients. By 2010, 18,582 certified physicians were prescribing the medication to more than 800,000 patients

      Although its overdose risk and abuse potential is thought to be lower than other treatments for opioid addiction such as methadone, buprenorphine, like any prescription medication, may cause serious harmful health consequences. This is particularly true when the drug is taken improperly or for non-medical uses. In 2010, there were 2.3 million emergency department visits related to the misuse of all drugs.

      Federal, state, and other entities have taken steps to reduce the risk of buprenorphine diversion and abuse. For example, FDA has required a Risk Evaluation and Mitigation Strategy for certain buprenorphine products that will include physician education and medication guides. SAMHSA announced recently that the agency will monitor for buprenorphine abuse and diversion, and provide resources for physician education. The Federation of State Medical Boards is updating its guidelines for buprenorphine use in Office Based Treatment settings.

      The report, entitled, Emergency Department Visits Buprenorphine is based on findings from the 2005 to 2011 Drug Abuse Warning Network (DAWN) reports. DAWN is a public health surveillance system that monitors drug-related morbidity and mortality through reports from a network of hospital across the nation.   The complete survey findings are available on the SAMHSA web site at:  
                

      For more information about SAMHSA visit: http://www.samhsa.gov/

      SAMHSA is a public health agency within the Department of Health and Human Services. Its mission is to reduce the impact of substance abuse and mental illness on America’s communities.



      Last updated: 1/29/2013 11:02 AM

      No higher risks after heavy postpartum bleeding: MedlinePlus

      No higher risks after heavy postpartum bleeding: MedlinePlus

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      No higher risks after heavy postpartum bleeding

      URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_133548.html (*this news item will not be available after 04/29/2013)
      Tuesday, January 29, 2013 Reuters Health Information Logo
      By Genevra Pittman
      NEW YORK (Reuters Health) - Women who bleed heavily after giving birth aren't at any higher risk of most complications during their next pregnancy, according to a new UK study.
      Postpartum hemorrhage - when a woman loses at least half a quart of blood - typically occurs when the muscles in her uterine wall don't contract correctly after childbirth.
      Although that much bleeding can be scary, researchers said the new findings are "reassuring" for women hoping to have another child after a first-time hemorrhage.
      "Intuitively, that would have been what I would expect also," said Dr. Laura Riley, an obstetrician at Massachusetts General Hospital in Boston.
      "It's really all about that particular pregnancy that puts most people at risk for bleeding," such as having a big baby or a long induction time, she told Reuters Health.
      Postpartum hemorrhage can be dangerous when a woman loses a quart or more of blood - which can lead to a quick drop in blood pressure and shock. Less blood loss isn't always concerning because pregnant women have more blood circulating to begin with, Riley said - but it can still cause anemia.
      Hemorrhage is treated with drugs such as oxytocin and misoprosotol, or with a blood transfusion.
      The new study is based on data covering more than 34,000 women in Aberdeen, UK who gave birth between 1986 and 2005. Among those women, about 10 percent had a postpartum hemorrhage during their first childbirth.
      Older and heavier new moms, as well as smokers, were more likely to have heavy bleeding, Dr. Gail Fullerton from Aberdeen Maternity Hospital and her colleagues found.
      Most women who both had and hadn't had a postpartum hemorrhage went on to get pregnant a second time, an average of five years later. Those women also had a similar risk of miscarriage and other pregnancy complications, according to findings published in the obstetrics and gynecology journal BJOG.
      However, mothers who had heavy bleeding the first time around were more likely to bleed again: about 18 percent of them had another postpartum hemorrhage, compared to seven percent of women who didn't have extra bleeding during their first childbirth. That is consistent with past studies, the researchers said.
      "Postpartum hemorrhage is a difficult time for women - it can be very, very stressful for women and their partners. And there is a worry that women may be put off from having a second pregnancy," Fullerton told Reuters Health. In that sense, she said, "the paper has been very reassuring."
      Riley, who wasn't involved in the new research, said women who had one postpartum hemorrhage shouldn't be too worried about complications with future pregnancies.
      The one exception, she added, is among women who have had multiple Cesarean sections in a row - in which case there is a higher risk of heavy blood loss.
      She recommended women try to start their pregnancy at a healthy weight and not gain too much while pregnant to lower their chances of having a big baby. In addition, women should eat an iron-rich diet to build up their iron stores in case they do lose blood, Riley said.
      Fullerton agreed.
      "The most important thing is optimizing their blood level before they come into labor, keeping a healthy diet… and obviously keeping their weight down as much as possible," she said.
      SOURCE: http://bit.ly/VKOtlg BJOG, online January 23, 2013.
      Reuters Health
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