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Health News
for 05/13/2010

(last updated 7:30am EST 05/13/2010)

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• Being a ‘supertaster’ no piece of cake... Being a ‘supertaster’ no piece of cake
05/13/2010
Being a “supertaster” may sound like a foodie’s dream come true, but in reality, it’s no picnic. Forget coffee, tomatoes, vegggies and most sweets. And for supertasters, beer tastes like urine. (1 h ago)

• 12 ways to wipe years off your face 12 ways to wipe years off your face
05/13/2010
The most effective ways to wipe years off your face and increase elastin, fight free radicals and fade dark spots. (1 h ago)

• Walgreens backs off on plan to sell gene... Walgreens backs off on plan to sell genetic test
05/13/2010
Walgreens has announced that it's holding off on its plans to carry a personal genetic test kit it was to start selling Friday after learning that federal Food and Drug Administration was "unable to identify" that the kit had been approved by the agency. (1 h ago)

• Tainted lettuce recall expands to Tennes... Tainted lettuce recall expands to Tennessee
05/12/2010
An outbreak of E. coli poisoning has expanded to Tennessee, where one more person has been sickened after eating romaine lettuce grown on an Arizona farm. (52 m ago)

• Don't like your diagnosis? Think about m... Don't like your diagnosis? Think about moving
05/12/2010
Doctors in some parts of the United States are more likely to tell Medicare patients they are sick than in other parts, researchers said in a finding that could explain regional differences in health spending. (1 h ago)

• FDA: Stop drinking your lotion, people! FDA: Stop drinking your lotion, people!
05/12/2010
Confused, itchy people are mistakenly drinking Benadryl skin gel, says the FDA, in some cases leading to numb lips, nausea and hallucinations. (2 h ago)

• Low vitamin D tied to depression in olde... Low vitamin D tied to depression in older people
05/12/2010
NEW YORK (Reuters Health) - Older men and women with lower levels of vitamin D in their blood are more prone to become depressed over time, new research shows. (3 h ago)

• Below-the-skin defibrillator restores he... Below-the-skin defibrillator restores heartbeat
05/12/2010
Threading electrodes under the skin along the breastbone may be safer, and just as effective, as implanting electrodes to shock a fluttering heart into beating normally, researchers said Wednesday. (3 h ago)

• Lens implant may be safer than laser sur... Lens implant may be safer than laser surgery
05/12/2010
Implantable lenses could be a safer alternative to laser surgery for moderately nearsighted people, a British review of earlier research suggests. (5 h ago)

• Why Alzheimer's drugs fail Why Alzheimer's drugs fail
05/12/2010
Brain plaques, long considered the chief killer of brain cells and the cause of Alzheimer's disease, may actually play a protective role under a new theory that is changing the way researchers think about the disease. (6 h ago)

• Infections cause 68 pct of child deaths,... Infections cause 68 pct of child deaths, study finds
05/12/2010
More than two thirds of the estimated 8.8 million deaths in children under five worldwide in 2008 were caused by infectious diseases like pneumonia, diarrhea and malaria, according to a study on behalf of the World Health Organization and the United Nations Children's Fund (UNICEF). (9 h ago)

• NYT: Doubt cast on many food allergies NYT: Doubt cast on many food allergies
05/12/2010
Many who think they have food allergies actually do not, according to a new report commissioned by the federal government. (10 h ago)

• A mom’s voice is powerful medicine A mom’s voice is powerful medicine
05/12/2010
Next time you feel anxious and tense, like a knot of nerves, instead of scheduling a massage or some time in the sun, you might want to call your mom. (11 h ago)

• Poorer heavy kids may suffer more heart ... Poorer heavy kids may suffer more heart woes
05/11/2010
Overweight children from lower- and middle-income neighborhoods may fall short of their thinner peers in one measure of cardiovascular fitness, but the same may not be true of those from more affluent areas, a new study suggests. (1 d ago)

• Better care in post-quake Haiti, but how... Better care in post-quake Haiti, but how long?
05/11/2010
Four months after the quake that leveled the capital, foreign volunteers, donated medicine and free hospitals are giving Haiti's impoverished people the best health care of their lives. (1 d ago)

• Pre-term births on decline in U.S. Pre-term births on decline in U.S.
05/11/2010
The U.S. rate of pre-term births has fallen for the second year in a row, U.S. researchers reported on Tuesday. But the rates remain high compared to other developed countries. (1 d ago)

• FDA urges docs to report misleading drug... FDA urges docs to report misleading drug ads
05/11/2010
The Food and Drug Administration is asking doctors to keep an eye out for misleading drug advertisements as part of the agency's latest effort to police the pharmaceutical industry's multibillion-dollar marketing machine. (1 d ago)

• First lady offers 70 goals to fight chil... First lady offers 70 goals to fight child obesity
05/11/2010
Women could help reduce childhood obesity by maintaining a healthy weight when they become pregnant and by breast-feeding their babies, a government panel has found. (1 d ago)

• Desperate patients go offshore for stem ... Desperate patients go offshore for stem cells
05/11/2010
Facing death inspires desperate measures. Like having your stem cells drawn in Florida, sent to Israel for processing, and shot into your ailing heart in the Dominican Republic. How far would you go to save your own life? (1 d ago)

• Haiti's Amputees: 1 step forward, 2 step... Haiti's Amputees: 1 step forward, 2 steps back
05/10/2010
Six weeks after Schneily Similien received his artificial leg, the 4-year-old amputee and his family are finding that life in post-quake Haiti is one step forward, two steps back. (2 d ago)

• E. Coli Lettuce Outbreak Spreads to Tenn... E. Coli Lettuce Outbreak Spreads to Tennessee
05/13/2010
CDC Confirms 23 Cases of Poisoning from Arizona Lettuce Farm, Tennessee is 4th State with Illness (1 h ago)

• Scientists Hope to Trigger Fat-Burning C... Scientists Hope to Trigger Fat-Burning Cells
05/12/2010
Testing on Mice Found 20% Weight Drops, Human Tests are Next (2 h ago)

• Expert: 3-D Games Can Help Ease Pain, An... Expert: 3-D Games Can Help Ease Pain, Anxiety
05/12/2010
Pain Expert Dr. Jeffery Gold Tells WebMD Immersive Virtual Reality Games Will Be a Key Tool in Treatment Programs (5 h ago)

• Kids' Food Allergies Often Misdiagnosed Kids' Food Allergies Often Misdiagnosed
05/12/2010
Though Allergies Can Be a Serious Problem, Review Finds that Lack of Clear Guidelines Leads to Overdiagnosis (5 h ago)

• Bill Gates Checks on Polio Progress in I... Bill Gates Checks on Polio Progress in India
05/12/2010
Microsoft Founder's Foundation has Committed Nearly $1 Billion to Eradicating Disease, Other Health Projects in Country (6 h ago)

• Video: Ashton on Biden's Son's Mild Stro... Video: Ashton on Biden's Son's Mild Stroke
05/12/2010
Dr. Jennifer Ashton discussed what doctors say was a mild stroke suffered by Beau Biden, the son of Vice President Joe Biden, and the treatment he's likely to undergo. (10 h ago)

• Testing Your Genes, Right at the Drugsto... Testing Your Genes, Right at the Drugstore
05/12/2010
Personal Genetics Tests Can Determine Risks for Cancer and Diabetes, but Critics Worry What Patients Will Do with the News (23 h ago)

• Video: Do-It-Yourself DNA Test Kit Video: Do-It-Yourself DNA Test Kit
05/11/2010
Some stores will soon begin selling personal genetic tests, designed to predict everything from diabetes to cancer. As Ben Tracy reports there are critics and controversy surrounding the sale of the DNA kits. (1 d ago)

• Video: Families on Loan in Recession Video: Families on Loan in Recession
05/11/2010
"Safe Families" is a growing network of "volunteer" families who take in kids temporarily while their parents get back on their feet economically. Katie Couric revisits families taking advantage of this program in Chicago. (1 d ago)

• Health Care Overhaul Could Cost $155B Mo... Health Care Overhaul Could Cost $155B More
05/11/2010
New CBO Report Says 10-Year Cost Could Surpass $1 Trillion if Additional Spending Is Approved By Congress (1 d ago)

• Video: Greens that Take Away the Blues Video: Greens that Take Away the Blues
05/11/2010
Did you know that eating spinach and asparagus can boost your mood? Learn more supermarket secrets with registered dietitian and author Elisa Zied on this week's episode of Dr. Jennifer Ashton's "Health and Wellness." (1 d ago)

• Obama Drug Control Strategy Marks Policy... Obama Drug Control Strategy Marks Policy Shift
05/11/2010
New Strategy Boosts Community-Based Programs, Encourages Early Screening and Expands Treatment to Mainstream Facilities (1 d ago)

• Video: Acid Reflux Drug Side-Effects Video: Acid Reflux Drug Side-Effects
05/11/2010
Dr. Jennifer Ashton discussed a new study that found dangerous side effects in long-term use of acid reflux drugs. (1 d ago)

• Romaine Lettuce Recall for E. Coli Expan... Romaine Lettuce Recall for E. Coli Expands
05/11/2010
FDA: Food Distributor in Oklahoma Recalling Lettuce from Same Arizona Farm that Sickened Students (1 d ago)

• Are Nexium and Prilosec Too Popular? Are Nexium and Prilosec Too Popular?
05/11/2010
Series of Studies Raises Concern about Popular Drugs that Treat Acid Reflux and other Stomach Problems (1 d ago)

• Video: Concerns Over Stomach Meds Video: Concerns Over Stomach Meds
05/10/2010
A new series of studies is raising concerns about drugs that treat stomach problems. As Dr. Jon LaPook reports, these medicines could do more harm than good. (2 d ago)

• At 100, Americans Are Adapting to New Id... At 100, Americans Are Adapting to New Ideas
05/10/2010
Eating Well, Staying Active and Socially Connected Are How Seniors Are Staying Tuned In (2 d ago)

• Chimp Attack Victim Evaluated for Transp... Chimp Attack Victim Evaluated for Transplant
05/10/2010
Charla Nash Seeks Face, Hand Transplant at Brigham and Women's Hospital after Being Turned Down by Cleveland Clinic (2 d ago)

• More Kids' Jewelry Recalled Due to Toxic... More Kids' Jewelry Recalled Due to Toxic Cadmium
05/10/2010
The U.S. Consumer Product Safety Commission Announced Recall of 19,000 "Best Friends" Bracelets Made in China (2 d ago)

• What You Eat When You're Alone What You Eat When You're Alone
05/10/2010
"Early Show" Anchors Open Up About Their Secret Food Favorites (2 d ago)

• Pruhealth Policyholders Sign Up to Local... Pruhealth Policyholders Sign Up to Local Hospital List
05/13/2010
PruHealth launched its new local hospital list in January 2010 and has since seen 40 per cent of new individual policyholders signing up to this list. (1 h ago)

• Princeton NJ Psychiatrists Offer Two Spe... Princeton NJ Psychiatrists Offer Two Special Treatments for Children
05/13/2010
One of the premiere psychiatrists in Princeton, NJ, Dr. Yitzhak Shnaps, provides two special treatments for children. (1 h ago)

• Farah Rehman Lokey, MD Honored for Excel... Farah Rehman Lokey, MD Honored for Excellence in Pediatric Medicine
05/13/2010
Farah Rehman Lokey, MD celebrates fifth year with East Valley Pediatrics (1 h ago)

• Jenny Kenoyer Honored by Cambridge Who's... Jenny Kenoyer Honored by Cambridge Who's Who for Excellence in Nursing and Senior Advocacy
05/13/2010
Jenny Kenoyer, retired nurse, builds a second career advocating for seniors' rights (1 h ago)

• Omaha Dentist Finds New Ways To Educate ... Omaha Dentist Finds New Ways To Educate Patients About Dental Health
05/13/2010
Leading general and cosmetic dentist in Omaha has added a new patient education library and educational dental videos to the practice's website in order to keep patients informed about good oral health. (1 h ago)

• Potential Causes of Birth Injuries Potential Causes of Birth Injuries
05/13/2010
Medical malpractice is the leading cause of birth injuries in our country today. (1 h ago)

• Bergen County Dentist From Bogota Dental... Bergen County Dentist From Bogota Dental Center Now Offers CEREC, a More Accurate and Efficient Way to Receive Restoration Dentistry
05/12/2010
Local residents turn to Dr. Sherzoy in Bergen County for questions and answers about one hour visits for Crowns, Inlays, and Onlays. (17 h ago)

• Optical Express Provides Strong Presence... Optical Express Provides Strong Presence at ASCRS Annual Meeting
05/12/2010
Optical Express' chief medical director Steve Schallhorn along with several surgeons and IMAB members present at the successful American Society of Cataract and Refractive Surgery 2010 annual meeting. (17 h ago)

• Center Parcs Help Keep Families Together... Center Parcs Help Keep Families Together at Great Ormond Street Hospital
05/12/2010
Center Parcs launches its first Charity Partnership with Great Ormond Street Hospital Children's Charity. (17 h ago)

• Circle + Bloom Launches Innovative Mind-... Circle + Bloom Launches Innovative Mind-Body Program for IVF/IUI
05/11/2010
The company also announces the launch of a program to use while pregnant along with its special program for In-Vitro Fertilization and Intrauterine Insemination. (1 d ago)

• Corrective eye surgery reviewed Corrective eye surgery reviewed
05/12/2010
“A new method of correcting short sight could be better and safer than laser eye surgery,” The Independent reported. This news story is based on a systematic review of studies comparing laser eye surgery to phakic intraocular lenses, which are surgically implanted lenses in the eye that work similarly to contact lenses. The two techniques were found to be equally successful, both resulting in similar proportions of people with 20/20 vision a year after surgery. Those given phakic lenses were also less likely to have diminished ‘best spectacle corrected visual acuity’ (BSCVA), an important safety standard in eye surgery. The main drawback of this review is the limited amount of research currently available. Only three trials treating 228 eyes were included. This reduces its statistical power for detecting differences between the treatments. This is a well-conducted review, but the question of which treatment is the safest and most effective will need to be established in further, longer-term trials. Where did the story come from? This research was a Cochrane Review written by clinicians from the Moorfield Eye Hospital in London, and published in The Cochrane Library. The news stories have accurately reflected these research findings, but have not considered the limitations surrounding the small body of evidence that is currently available. What kind of research was this? This was a systematic review of the two main forms of corrective surgery for moderate to severe short-sightedness (myopia). Myopia is a problem of vision that causes distant objects to appear blurred, while close objects can still be seen clearly. This is because light rays are focusing in front of the retina (the back of the eye), rather than directly on the retina, which is necessary to produce a clear image. Myopia occurs when the eye is too long from front to back, or the cornea (the front of the eye) is too steeply curved. As a result, there is a mismatch between the length of the eye and its focusing power. The two compared techniques were excimer laser refractive surgery and phakic intraocular lenses (IOLs), which work in slightly different ways. Laser surgery alters the cornea, which reduces its refractive power (ability to bend light). This enables visual images to reach the back of the retina. Phakic lenses are surgically implanted either in front of the iris (the coloured part of the eye) or just behind it. This extra lens works by spreading out light rays so that they do not fall short of the retina, similar to the way a contact lens or a pair of glasses would. A systematic review of randomised controlled trials (RCT) is the most reliable way of assessing the efficacy and safety of treatments. However, when combining findings from different trials, there is usually some unavoidable limitation due to the differences in methods between the trials. What did the research involve? The researchers carried out an extensive search of medical and scientific databases to identify randomised controlled trials (RCTs) that had compared laser surgery with phakic lenses. To be eligible, trials had to have been in adults between the ages of 21 and 60 with moderate to severe myopia of more than -6.0 diopters (a measure of how well the eye’s lens can focus) and who had no eye disease or other reason for short-sightedness (e.g. cataracts). The main outcome of interest was the percentage of people who had 20/20 vision or better after 12 months after surgery. Various other secondary outcomes were considered, including the percentage of eyes that were within a 0.5 to 1.0 target diopter at 6 or 12 months. The researchers were also interested in the incidence of complications, ranging from minor (glare, dry eyes) to severe (significant permanent visual loss that got worse after treatment). The two authors independently assessed the studies for quality and eligibility. What were the basic results? The researchers identified three eligible studies in a total of 132 patients and 228 eyes. Myopia ranged from moderate to severe (-6.0 to -20.0 diopters), and included up to 4.0 diopters of astigmatism (when the eye is not the usual symmetrical spherical shape but is longer in one direction than the other, causing extra focusing problems). All patients had stable vision without deterioration in the 12 months before the trial. Two studies compared LASIK laser surgery (laser assisted stromal in-situ keratomileusis) with phakic lenses (the standard lens). One study compared PRK laser surgery (photorefractive keratectomy) with a different type of lens implant - a toric lens (which has the additional power to correct astigmatism). In total, 166 eyes provided data for the primary outcome of the percentage of eyes with 20/20 vision or better at 12 months after surgery (i.e. only two of the three studies looked at the primary outcome). Both techniques had the same success rate, and there was no difference in the proportion who achieved this outcome with laser compared to phakic lenses (odds ratio 1.33, 95% confidence interval [CI] 0.08 to 22.55). Phakic lens surgery had fewer side effects than laser surgery in that fewer people lost their ‘best spectacle corrected visual acuity’ (BSCVA) 12 months after surgery (i.e. fewer people's vision deteriorated with phakic lenses: OR 0.35, 95% confidence interval [CI] 0.19 to 0.66; data from 216 eyes). BSCVA is a measure of how good a person’s sight is on a visual chart with the most appropriate spectacle prescription. For this research, deterioration in BSCVA was considered to be a loss of two or more lines on the visual chart. Phakic lenses were also associated with better contrast sensitivity than laser surgery, and better satisfaction on patient questionnaires. However, two patients developed cataracts after phakic IOL. How did the researchers interpret the results? The reviewers conclude that phakic lenses are safer than eximer laser surgical correction for moderate to severe short-sightedness, and that phakic lenses are preferred by patients. The researchers say that although phakic lenses are usually considered only for short-sightedness above -7.0 diopters, they may also be considered preferable to laser for more moderate short-sightedness. Conclusion This is a well-conducted Cochrane review, which carried out a thorough search for all suitable trials comparing laser eye surgery with phakic intraocular lenses for moderate to severe short-sightedness. Both techniques achieved the same success rate for the proportion of people who had 20/20 vision 12 months after surgery. People given phakic lenses were less likely to have a loss in their ‘best spectacle corrected visual acuity’ after treatment. However, on two occasions, cataracts developed after phakic lens surgery. The main drawback to this review is that there is limited research currently available, and the reviewers could only include three trials, treating 228 eyes. This reduces the statistical power for detecting accurate differences between the treatments, particularly when looking at secondary outcomes, such as rare adverse effects. The statistical power was then further reduced as not all of the trials reported on the same outcomes. The small numbers also mean that accurate comparisons cannot be carried out between the different populations (such as severity of short-sightedness, presence of astigmatism) or treatments (such as type of laser surgery or lens). As the researchers say, further RCTs are needed to detect differences between subgroups, and to determine the most suitable short-sightedness range for inserting phakic lenses. Follow-up of a larger range of people will also be needed to identify any rarer and potentially more serious adverse effects. Corrective eye surgery is already established as a treatment for myopia. This is a good review, but the question of which treatment is the safest and most effective will need to be answered in further, longer-term trials. Links To The Headlines Laser-free 'cure' for short sight. The Independent , May 11 2010 Sewing lenses directly into the eye 'gives better results than laser surgery'. The Daily Telegraph , May 11 2010 Links To Science Barsam A, Allan BDS. Excimer laser refractive surgery versus phakic intraocular lenses for the correction of moderate to high myopia . Cochrane Database of Systematic Reviews 2010, Issue 5 (7 h ago)

• Overtime 'leads to heart risks' Overtime 'leads to heart risks'
05/12/2010
Working just three hours of overtime each day will raise the risk of heart disease by 60%, according to the Daily Mail. The news comes from a study that compared the working habits of 6,000 civil servants to their risk of heart disease over an 11-year period. Even after discounting for the influence of cardiovascular risk factors, such as smoking, there was still a 60% greater risk of developing heart disease among people who worked three to four hours of overtime each day. Working one or two extra hours did not seem to have any effect. There were some small problems with this research, including the possibility of chance findings due to the small number of people who developed heart disease in the high overtime group. However, this was a well-conducted study, and overall it suggests that working three to four hours of overtime every day may increase the risk of heart disease. It is not yet clear why this was the case, therefore further research will be needed to identify the mechanisms behind the relationship. Where did the story come from? The study was carried out by researchers from the Finnish Institute of Occupational Health, University College London, and other institutions in France and Turkey. It was funded by grants from various sources, including the Medical Research Council and British Heart Foundation. The study was published in the European Heart Journal, a peer-reviewed medical journal. The news stories have generally reflected the findings of this research accurately. What kind of research was this? This research was part of the Whitehall II Study, a large cohort study on members of the civil service, which has provided data for numerous other pieces of medical research. The study has been ongoing for 25 years, but this particular part of the research followed participants for an average of 11 years to see how work characteristics related to the development of coronary heart disease (CHD). To help maintain accuracy of results, a study of this type would need to ensure that people were free of CHD at the study’s start. It would also need to make appropriate adjustments for other confounding factors when assessing the relationship between working habits and cardiovascular events. What did the research involve? The Whitehall II study commenced in 1985, recruiting British civil servants aged between 35 and 55. The study has conducted several follow-up phases: this new study is concerned with those participants who provided responses to questions on working hours between 1991 and 1994. After excluding those who did not work full-time, had not responded to the question on working hours, or already diagnosed with CHD, the study included 6,014 adults (4,262 men and 1,752 women) who were then aged 39–61 years. The participants were followed for an average of 11 further years, and were each given a clinical examination between 2002 and 2004. Assessment of work at baseline (1991-94) included the question “On an average weekday, approximately how many hours do you spend on work (during the daytime and work brought home)?” Responses on total working hours ranged from 1-12 hours. They were grouped into overtime categories of no overtime (7–8 hour normal working day); one hour of overtime every day (9 hour day); two hours (10 hour day); or three to four hours of overtime (11–12 hour day). Cases of CHD up to 2002-04 were assessed by flagging participants’ records in the NHS Central Registry, which would notify the researchers of any deaths and their causes. They also used the registry to identify non-fatal heart attacks, and clinical records to identify angina. In analysing the relationship between working hours and CHD, the researchers adjusted for a wide variety of social, demographic and work-related factors, such as job role, salary, absence due to sickness, medical factors, diet, exercise and sleep. What were the basic results? Out of the 6,014 participants, 3,256 (54%) did not usually work overtime, 1,247 (21%) worked approximately one extra hour, 894 (15%) worked two extra hours, and 617 (10%) worked three or four extra hours a day. After an average of 11 years and 67,544 person-years of follow-up, there were a total 369 cases of fatal CHD, non-fatal heart attacks or definite angina. When adjusting for social and demographic characteristics, three to four hours of overtime per day increased the risk of any of these outcomes by 60% compared to employees who did no overtime (hazard ratio 1.60, 95% confidence interval [CI] 1.15 to 2.23). The relationship remained significant after adjusting for 21 potential confounding risk factors , such as BMI, smoking and cholesterol (HR 1.56, 95% confidence interval [CI] 1.11 to 2.19). Working less than one or two extra hours per day was not associated with increased risk. How did the researchers interpret the results? The researchers concluded that working overtime is linked to an increased risk of developing coronary heart disease. This link was still evident even after discounting the effects of other known risk factors. Conclusion This cohort study examining the association between overtime work and the development of heart disease has a number of strengths. It examined a large cohort of more than 6,000 people, it carried out regular follow-ups and collected extensive data on a wide range of medical, lifestyle and socio-demographic factors. Furthermore, this large range of data was taken into account when examining the relationship between heart disease and overtime. The methods of detecting new cases of CHD during follow-up also seem to be reliable. However, there are some points to note: The study only found a significant relationship between working three to four extra hours per day. Although the overall study had a large sample, there were only 51 people who worked this amount of overtime and developed CHD during follow-up. Using such a small number of individuals to calculate risk increases the likelihood of producing chance findings. There was no relationship between usually working one or two extra hours and CHD. This result seems at odds with the relationship seen in those working longer hours. Overtime was only assessed at one time point. Although the question asked the participants how many hours they spent working on a typical workday, the responses may not reflect a regular pattern for everyone. Also, overtime may constitute different things to different people. This could in turn lead to different perceptions of stress and workload. In particular, these results in the civil service population may not apply to other professions. Although the research adjusted for many confounders, there is the possibility that others have not been examined. Importantly, mental health diagnoses such as depression or anxiety were not examined. There is the possibility that people with existing CHD may have had their illness missed at the time of the baseline questionnaire, meaning they would have been incorrectly included in the study. Equally, new cases of CHD may have been missed during follow-up. On the basis of this study, it can only be concluded that working three to four hours of overtime everyday may increase the risk of heart disease. Further research is needed to identify how longer work hours affect the body in ways that increase the risk of coronary heart disease. Links To The Headlines Working overtime increases heart risk, a study finds . BBC News, May 12 2010 Too much overtime is bad for your health, says study . The Guardian , May 12 2010 Extra work weakens heart . The Independent , May 12 2010 Overtime 'raises heart risk by 60%': Fatal link to just three hours' extra work a day . Daily Mail , May 12 2010 Staying late in the office could cause heart attacks and early death, study shows . The Times , May 12 2010 Links To Science Virtanen M, Ferrie JE, Singh-Manoux et al. Overtime work and incident coronary heart disease: the Whitehall II prospective cohort study . European Heart Journal (2010) [First published online May 11 2010] Editorial: Overtime is bad for the heart (8 h ago)

• Nuts may 'lower' cholesterol Nuts may 'lower' cholesterol
05/11/2010
“Eating nuts may help lower cholesterol levels,” BBC News reported. This news story is based on a pooled analysis of 25 studies, looking at the effects of experimental nut diets on blood cholesterol and fat levels. A nut-enriched diet was found to be associated with both reduced total cholesterol and LDL (“bad”)-cholesterol. On average, in people who consumed 67g of nuts a day, total cholesterol was reduced by 5.1% and LDL-cholesterol by 7.4%. Nut-enriched diets had a lesser effect on reducing the cholesterol levels of people with higher BMIs. These diets lasted between three and eight weeks, so it is unclear whether this reduction in cholesterol has any effect on the risk of coronary heart disease in the long term. Although nuts are low in saturated fat, they are nevertheless very high in fat and calories. Plain, unsalted nuts should be eaten in moderation as part of a healthy diet. Where did the story come from? The study was carried out by researchers from Loma Linda University in California and the Instituto de Salud Carlos III in Barcelona. Funding came from Loma Linda University and the International Tree Nut Council Nutrition Research and Education Foundation. Some of the researchers have also received funding from the California Walnut Commission, the Almond Board of California, the National Peanut Board and the International Tree Nut Council. The study was published in the peer-reviewed medical journal Archives of Internal Medicine. The research was generally covered well by the newspapers, which all included the advice that people who want to increase their nut intake should avoid salty nuts. What kind of research was this? The researchers say that previous epidemiology studies have shown that frequent nut consumption reduces the risk of coronary heart disease. The aim of this research was to see whether it was possible to estimate the effects of nut consumption on the levels of different types of fat in the blood. The researchers carried out a systematic review and a pooled analysis, in which they grouped the data from various published trials on the effects of nut consumption on cholesterol levels and blood fat. They also wanted to see whether other factors, such as a person’s age or the type of nut, affected the outcomes. What did the research involve? The researchers carried out a systematic search of a medical research database for scientific papers which looked at the effect of nuts on blood fat and cholesterol levels, and had been published between January 1992 and December 2004. To be included, studies had to be based on humans, and either to have had a control group or to have taken stable baseline fat measurements from participants before they started the experimental diet. The experimental diets had to be supplemented solely by nuts, and to have lasted at least three weeks. The participants’ weight also had to have remained the same during the diet. The researchers excluded studies in which participants had taken fat or cholesterol-lowering medication. Twenty-five studies of various design were suitable for inclusion in the analysis. In studies that had used a crossover design, in which participants received the experimental diet followed by the control diet or vice-versa, participants contributed two data points, one from when they were a control and one where they were receiving the experimental diet. This resulted in a total 1,284 data points and 583 participants. The researchers looked at whether age, gender, body mass index (BMI) type of nut and type of diet modified the effect of nut consumption on cholesterol and fat measurements in the blood. They also considered the type of study design and the degree of control that the study’s investigator had over the participants’ overall diet, and whether this impacted the effect of nuts on the blood measurements. For some analyses, the participants’ data was classified into groups. For example, cholesterol was classified as (low) less than 130mg/dL, (medium) 130-160 mg/dL, or (high) greater than 160 mg/dL. Other fats (triglycerides) were classified as less than 150 mg/dL or more than 150 mg/dL, and BMI was classified as normal weight (less than 25), overweight (25-30) or obese (more than 30). What were the basic results? Compared with control diets, nut diets were associated with a reduction in total cholesterol and levels of low-density lipoprotein (LDL) (“bad”) cholesterol. Nut consumption did not have an effect on the levels of high-density lipoprotein (HDL) (“good”) cholesterol, but it did increase the ratio of HDL compared to total cholesterol (p < 0.001). Nut diets did not appear to affect blood triglyceride levels, except in participants who had high blood triglyceride levels before the study began, in whom blood triglyceride levels were reduced following the diet (p<0.05). Age, gender and the type of nut did not influence the effects of nuts on blood cholesterol. However, BMI did have an effect. Participants with a lower BMI at the beginning of the study had lower cholesterol as an effect of eating nuts. Participants with higher LDL-cholesterol at the start of the study had a greater decrease of total cholesterol at the end of the diet. Participants with LDL-cholesterol greater than 160 mg/dL at the start of the study were associated with a decrease of 17.5 mg/dL (approximately 11%) at the end. Having LDL-cholesterol at less than 130 mg/dL at the study start was associated with a decrease of 5.0 mg/dl (approximately 4% of 130). Nut diets were associated with a 7.4% reduction in cholesterol and 9.6% reduction in LDL-cholesterol, compared to a western diet, 4.3% and 6.7% compared to a Mediterranean diet, and 4.1% and 6.0% compared to a low-fat diet. The researchers then made estimates of how differing amounts of nuts would affect blood fat and cholesterol levels. They suggested that if a participant ate 71g of nuts per day as part of a 2,000-kcal diet (20% of dietary energy), this was associated with a 4.5% decrease in total blood cholesterol, and a 6.5% decrease in LDL-C. How did the researchers interpret the results? The researchers say that their study suggests that “increasing the consumption of nuts as part of an otherwise prudent diet can be expected to favorably affect blood lipid (fat/ cholesterol) levels (at least in the short term) and have the potential to lower CHD risk”. They attempt to explain the association by saying that “nuts are rich in plant sterols, natural compounds that might contribute to cholesterol lowering by interfering with cholesterol absorption”. However, they also say that “more research is needed to answer the important question of why nuts are less effective in lowering blood cholesterol concentration among subjects with obesity”. Conclusion This study conducted a pooled analysis of 25 studies, which looked at the effect that a nut-supplemented diet had on cholesterol and fat levels in the blood. A nut-enriched diet was found to be associated with a decrease in blood cholesterol. There are a few limitations which affect how these results can be interpreted: Although the data pooled results from 25 studies the overall population was relatively small. The small size increases the likelihood that the differences observed were due to chance. The 25 studies had different diets to which the nut supplementation was added. The researchers did not give details of the energy, fat and cholesterol content of these background diets, which may have varied, potentially affecting the collective results. In addition, the studies varied on the degree of dietary control that the researchers had over the participants, such as whether they checked compliance to the diets or advised on other foods that should be eaten or avoided during the experimental nut diet. The experimental diets were typically between three and eight weeks long, which is a relatively short period of time. It is unclear what effect a nut-enriched diet would have over the longer term. It is unclear whether the reductions in cholesterol and LDL-cholesterol would be enough to lower the risk of coronary heart disease. Further analysis is needed to assess how much an individual would need to lower their cholesterol in order to lower their risk of coronary heart disease in the long term. These preliminary results warrant further investigation into how to optimise our diets to lower blood cholesterol levels. As many nuts are heavily salted or coated with sugar and other vegetable oils, people are advised to choose raw unsalted nuts. They should also be aware that although nuts are low in saturated fat, they are nevertheless very high in fat and calories, and should be eaten in moderation as part of a healthy diet. Links To The Headlines Eating nuts can lower cholesterol, say experts. BBC News, May 10 2010 How a handful of nuts a day can keep your heart healthy. Daily Mail , May 10 2010 Packet of nuts a day 'can reduce cholesterol levels'. The Daily Telegraph , May 10 2010 Links To Science Sabaté J, Oda K, Ros E. Nut Consumption and Blood Lipid Levels. Arch Intern Med 2010; 170: 821-827 (1 d ago)

• Use of stomach drugs debated Use of stomach drugs debated
05/11/2010
There is a risk of side-effects for “millions who take unnecessary stomach drugs”, reported the Daily Mail. It said that proton pump inhibitors (PPIs), used for treating symptoms of ulcers and heartburn (dyspepsia) by reducing stomach acid, are wrongly prescribed in up to two-thirds of cases. The news is based on an editorial by a US Doctor, on the potential side-effects, over-prescription, and problems associated with these drugs. This article is the opinion of the author, in which he references several scientific studies researching the issue. As such, the accuracy of the estimates of over prescription would need further investigation. Importantly, this editorial is based on the situation in the US, and may not necessarily reflect what is happening in the UK. However, the newspaper report is correct in saying that UK Doctors have recently expressed their concerns about the over-prescription of these drugs here. There is NICE guidance on treatment of ulcers and heart burn which includes how to prescribe PPIs. PPIs can be used for non-ulcer dyspepsia but prolonged use of high doses should be avoided. What did the editorial focus on? This was an editorial written by Dr Mitchell Katz of the Department of Public Health, San Francisco, California for the journal, Archives in Internal Medicine. The article discusses the use and prevalence of proton pump inhibitors (PPI) medication in the US, plus the risks associated with this type of drug. PPIs reduce the amount of gastric acid the body produces for use in digestion. PPIs are prescribed for the short-term treatment of stomach ulcers, as a form of ‘gastro-protection’ to prevent ulcers in those taking non-steroidal anti-inflammatory drugs, or to treat other conditions affecting the oesophagus and stomach, such as heart burn. Dr Katz suggests that the number of prescriptions in the US is greater than the number of people with these conditions, and cites estimates that between 53 and 69% of PPIs prescriptions are inappropriate. The editorial is for an issue of the journal which contains five studies that have used PPIs for research in patients with different illnesses. Dr Katz says that the use of most drugs involves a balance between the side effects and benefits. He refers to these studies to highlight different negative and positive aspects of using PPI drugs. He also suggests reasons why this particular drug is possibly being over-prescribed. What risks did the article report? One study looked at the risk of fractures in a large cohort of 130,487 post-menopausal women over a follow-up period of 7.8 years. They found that women who were taking PPIs had a modestly increased risk of fractures of the spine, lower arm and overall fractures compared to women who had not been taking the drug (Hazard ratio [HR] 1.24, 95% confidence interval [CI] 1.15 to 1.36). Dr Katz suggests that previous research has also shown an increased risk of infection with the bacterium clostridium difficile, which can lead to diarrhoea. He quotes a separate article in the same issue of the journal, which showed that using PPIs as part of the treatment for clostridium difficile infection was associated with a 42% increase in the rate of re-infection with this bacteria. Why might PPI drugs be over-prescribed? Dr Katz suggests that patients tend to be given a larger dose than is necessary for some conditions. He describes one study in the journal, which found that for people who were taking PPIs for bleeding caused by stomach ulcers, high doses were no more effective at preventing bleeding than low doses. Dr Katz also says that approximately 25% of adults report dyspepsia (indigestion) and, although PPIs can reduce this condition, the adverse effects of this treatment may outweigh the benefits. He suggests that in some patients, alternative treatments, such as eating smaller meals, weight loss, smoking cessation and stress reduction, may all help. He further suggests that referring to common symptoms such as heartburn by “fancy” names like “gastroesophageal reflux” leads to patients thinking they need treatment in the form of pills. The last journal article summarised by Dr Katz centred on the use of guidelines to standardise the prescribing practices for PPIs. Applying these guidelines during the study led to a decrease in the prescriptions of PPIs given while patients were staying in hospitals. However, the study showed that this decrease was only for patients who had not been receiving PPIs when they were admitted to hospital. The study also showed that the majority of PPI prescribing occurs amongst outpatients. Conclusion This was an editorial that described papers contained within the journal relating to the use of PPIs, and discussed the effect of a high prescription prevalence of PPIs in the US. While it raises interesting points of discussion, it should be remembered that it is intended as a narrative review by a single author, drawing on a small number of selected studies for illustrative purposes. This type of opinion-based article can be informative, but cannot take the place of a systematic review of all studies relevant to a particular health issue. Although PPIs are licensed drugs that play an important role in medical care, the balance of risks and benefits may change if they are prescribed inappropriately. A more detailed systematic review would be required to establish the risk-to-benefits ratios of using PPIs in various conditions over the long-term. The evidence presented in this narrative article should also be interpreted in a geographic context, as the prescription situation for PPIs in the US may not reflect that in the UK. As the author of the editorial concludes in his summary: ‘the over-prescription of PPIs should also remind us to critically evaluate our own treatment paradigms: “more is better” or “do no harm”. Narrative pieces like this are an initial step towards the systematic analyses needed by clinicians so that they can make evidence-based prescription decisions. Links To The Headlines Side-effect risk to millions who take unnecessary stomach drugs . Daily Mail , May 11 2010 Links To Science Katz MH. Failing the Acid Test: Benefits of Proton Pump Inhibitors May Not Justify the Risks for Many Users . Arch Intern Med . 2010;170(9):747-748. (1 d ago)

• Early babies 'feel more pain' Early babies 'feel more pain'
05/10/2010
Premature babies face a “lifetime of pain sensitivity”, according to The Times. It says a new study has shown that premature babies become over-sensitive to pain due to the intensive-care treatments, such as injections, that they receive after birth. This story is based on a small observational study in which the researchers compared the brain activity of small groups of premature and babies who are born full-term. They tested exposure to both medically necessary heel lances used for taking blood, as well as responses to a non-harmful stimulus, by tapping their feet with a rubber bung. The results showed that the premature babies had a greater brain response to lancing only. Pain is a complex and subjective experience that is difficult to measure, particularly in children who cannot communicate their experience verbally. On this basis, the assumption that a greater brain response equates to experiencing more pain is not validated, a shortcoming that the researchers themselves highlight. As such, newspaper claims of children going on to experience a “lifetime of pain” seem unsupported by the research, which is an early foray into this important subject. Where did the story come from? The study was carried out by researchers from University College London and was funded by the Medical Research Council, the British Pain Society and the UCL/UCLH Comprehensive Biomedical Research Centre. The study was published in the peer-reviewed medical journal NeuroImage. What kind of research was this? This was an observational study that compared the neurological response of eight infants born at term (i.e. not premature) during heel lances with the responses of seven prematurely born infants. The heel lances were all clinically essential, and were performed in order to take a small blood sample. To make these analyses of pain response comparable, they were carried out when the infants were the same ‘postmenstrual age’, a measure of age which takes into account the degree of prematurity. What did the research involve? The researchers say that previous research has established that older children born pre-term have greater pain sensitivity than their full-term peers. In this research, they attempted to investigate the links between noxious (physically harmful) stimuli and brain activity in both premature and term babies. The researchers undertook their study in a hospital setting in a special care baby unit. The eight term babies were ‘normal term infants’ aged less than seven days. The seven pre-term babies were studied when they reached the equivalent post-menstrual age (which ranged from 40 to 116 days after birth). The researchers compared the responses of the two groups of babies to both noxious and non-noxious stimuli, i.e. to heel-lance and to ‘innocuous’ tapping of a rubber bung against the babies’ heels. They also had a no-stimulation period as a control. Responses to the stimuli were assessed using EEG to measure brain activity. The EEG has 17 electrodes placed on the scalp and body, although activity at two particular sites (CPz and Cz) were considered the most important. The analysis methods used to compare the study data appear to be quite complex, but seem appropriate for this study. The researchers used a technique called ‘principle component analysis’ to analyse the brain activity at two electrode sites. What were the basic results? The study found that the response to heel lance was dependent on age, while the response to non-noxious stimulus was not. The authors say this suggests that a larger population of cortical neurons is activated in the premature infants than in controls when they experience the same stimulus. How did the researchers interpret the results? The researchers say that their study has shown that premature infants who have spent at least 40 days in intensive or special care “have an increased neuronal response to noxious stimuli compared to healthy newborns at the same corrected age”. Conclusion This small observational study has some shortcomings. The researchers highlight the main limitation with this study – the assumption that the amplitude of response, in terms of brain waves at particular sites, directly reflects the magnitude of perceived pain. They say that ‘while generally true’, this may not always be the case. The study did not use other well-known methods to assess whether the neonates were actually experiencing pain, such as validated pain scales, which assess facial expressions or crying. Additionally, premature babies are highly likely to have had more heel lances than term infants, so the study may just be measuring the heightened sensitivity of the feet to such stimuli. If this is the case, it is not correct to say that this study demonstrates that premature babies feel more pain than term ones. It is also unclear whether the researchers adjusted for factors such as the baby’s weight, which may affect the amplitude of EEG readings. Overall, this study of an important subject area is an early one. It provides some evidence that children who are born prematurely process noxious stimuli (by way of heel lance) differently to babies born full term. However, it is not yet clear whether this means they experience more pain per se, or why the neurological responses may be different. More research is needed to explore the factors. Links To The Headlines Premature babies face lifetime of pain sensitivity . The Times , May 10 2010 Premature babies 'feel more pain in later life' . Daily Mail , May 10 2010 Links To Science Slater R, Fabrizi L, Worley A et al . Premature infants display increased noxious-evoked neuronal activity in the brain compared to healthy age-matched term-born infants . NeuroImage [Article in Press, Uncorrected Proof] (2 d ago)

• Breast cancer: new genetic clues Breast cancer: new genetic clues
05/10/2010
“Five newly discovered genetic variants” raise the risk of breast cancer, reported The Guardian. It said new research has found that women with the variants are 16% more likely to develop the disease. This genetic analysis study compared the DNA of more than 16,500 women with breast cancer and a family history of the disease with about 12,000 unaffected women. One in nine women will be affected by breast cancer at some point in their lives, and having a first degree relative with the disease can increase risk. In addition to finding the five new variants, 13 associations identified in previous research were also confirmed. The researchers say that having all five of the new variants explains about 1.2% of the familial risk of breast cancer, while other known variants together account for about 28% of the risk. Combined, these associations account for only 30% of the risk and more research will need to uncover the other genes that contribute to the remaining risk. It is important to emphasise that having these variants does not mean that someone will definitely develop the disease, only that the variants are linked with an increased risk. Where did the story come from? The study was carried out by researchers from the Institute of Cancer Research in Surrey, and various medical and academic institutions in the UK and the Netherlands. The study was funded by the Wellcome Trust and by Cancer Research UK. The study was published in Nature Genetics, the peer-reviewed scientific and medical journal. This analysis article appraises the uncorrected proof version of this research paper. News coverage has provided a clear account of this research, although it should be emphasised that this study investigated which genetic factors are common in women who have inherited breast cancer, i.e. this study specifically researched women with a family history of the disease. One in 20 breast cancer cases are thought to be inherited, and several genetic variants responsible for this have already been identified. This study has identified five more. What kind of research was this? The study was a genome-wide association study that investigated the association between genetic variants and breast cancer. It included only women who had both breast cancer and a family history of the disease. Genome-wide association studies, a form of case-control study , provide a way to examine the association between genetic factors and disease. The researchers explain that recent studies have identified 13 variants that are associated with an increased risk of breast cancer. However, they say that these appear to play only a small role in the approximately doubled risk of breast cancer seen in first-degree relatives of affected women. Their study was an attempt to identify additional variants. What did the research involve? The researcher recruited 3,659 UK breast cancer cases, all with a family history of the disease. The women’s genetic codes were analysed and compared with those from 4,897 control women who did not have breast cancer. To make control subjects comparable to cases, they are usually matched in terms of characteristics such as age, although it is unclear from this publication whether matching was undertaken in this study. As is common in this type of research, a second group of cases and controls was recruited to validate the associations seen in the first phase. This included 12,576 cases and 12,223 controls. In this second phase, the researchers specifically assessed the contribution of the 15 variants that they found to be linked with breast cancer in their first analysis. The variants studied did not include those that were already known through prior research. In this second part of the study, the cases were women with breast cancer but not necessarily a family history of the disease. What were the basic results? In the first phases, the study found a significant association between breast cancer and seven different genetic variants, all of which had been linked with the disease in previous research. Therefore this finding confirmed known associations, particularly that two variants on chromosome 10 (rs2981579 and rs3803662) were most strongly linked with breast cancer. In the second phase of their study, the researchers identified five new variants (on chromosomes 9, 10 and 11) that were associated with disease. They say that these newly identified variants account for approximately 1.2% of the family risk of breast cancer. How did the researchers interpret the results? The researchers say that they have identified five new variants that are associated with breast cancer risk in women with a family history of disease. They say that it is likely that further additional variants may be identified if their data is followed up. Conclusion This well-conducted genome-wide association study adds to what is known about the familial risk of breast cancer. The researchers note that the previously identified 13 variants and their five new ones together account for 8% of the familial risk of breast cancer. They also know that mutations in BRCA1 and BRCA2 genes and other regions account for about another 20% of familial risk. The rest, they say, is likely to be due to a combination of a large number of common variants that have smaller individual effects. It is important to interpret these complex findings about risk in their context: most women do not get breast cancer and several factors beyond family history, such as age and post-menopausal obesity, can contribute to the risk. The majority of breast cancer cases occur in women with no family history of disease. The genetics of breast cancer are clearly complex, and further studies are needed to determine what other genetic factors further contribute to risk. This study showed links with variants (changes of a single letter in the genetic code) rather than whole genes (such as BRCA1 and BRCA2). This means that more study is needed to identify how each variant affects breast cancer risk. Women who were heterozygous for the variants (i.e. had one variant at each variant position as opposed to two) had between 5% and 16% (maximum) increased risk of having breast cancer compared to those who did not have the variant. The combination of having all five variants was not assessed in this study. The combination of having all five variants was not assessed in this study. Findings about which genes increase the risk of breast cancer may play a future role in contributing to screening tests, which are currently based on identifying whole genes. Women who are identified by this system as having a genetically-increased risk of the disease are currently offered different management to the general population, with more intensive screening offered to women who carry faulty TP53, BRCA1 and BRCA2 genes. Links To The Headlines Breast cancer gene clue discovery . BBC News, May 10 2010 Breast cancer genetic risk factors discovered . The Guardian , May 10 2010 Links To Science Turnbull C, Ahmed S, Morrison J et al . Genome-wide association study identifies five new breast cancer susceptibility loci . Nature Genetics , [Published online] May 9 2010 (2 d ago)

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05/11/2010
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• Memo to boss: 11-hour days harm your hea... Memo to boss: 11-hour days harm your heart
05/11/2010
People working 10 or 11 hours a day are more likely to suffer serious heart problems, including heart attacks, than those clocking off after seven hours, researchers said on Tuesday. Heart disease - Health - Conditions and Diseases - Cardiovascular Disorders - Heart Attack (1 d ago)

• New bone marrow transplant method eases ... New bone marrow transplant method eases risk
05/10/2010
Bone marrow transplants are undergoing a quiet revolution: No longer just for cancer, research is under way to ease the risks so they can target more people with diseases from sickle cell to deadly metabolic disorders. (2 d ago)

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05/10/2010
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• Aging population behind rising cancer co... Aging population behind rising cancer costs
05/10/2010
The cost of treating cancer in the United States nearly doubled over the past two decades, but expensive cancer drugs may not be the main reason why, according to a surprising new study. Cancer - United States - Health - Conditions and Diseases - Organizations (2 d ago)

• Health overhaul law potentially costs $1... Health overhaul law potentially costs $115B more
05/11/2010
President Barack Obama's new health care law could potentially add at least $115 billion more to government health care spending over the next 10 years, congressional budget referees said Tuesday. (1 d ago)

• Coverage for young adults will raise pre... Coverage for young adults will raise premiums
05/10/2010
The government says letting young adults stay on their parents' health insurance until they turn 26 will nudge premiums higher for employer plans. (2 d ago)

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• Seen that? - Poloxamer 188: Potential Dr... Seen that? - Poloxamer 188: Potential Drug Against Muscular Dystrophy
05/13/2010
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05/10/2010
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