Those babies are born earlier than average and with a higher risk of breathing problems and seizures, and they [...]]]> A baby is born every hour with signs of opiate drug withdrawal, according to a new U.S. study — and the number of newborns in withdrawal has tripled over the past decade.

Those babies are born earlier than average and with a higher risk of breathing problems and seizures, and they require careful monitoring and treatment to wean them off the drugs before they can go home.

Researchers also found that the number of new moms who tested positive for use of opiates — which include powerful painkillers such as oxycontin — increased five-fold between 2000 and 2009. In the most recent study year, between five and six out of every 1,000 women had the drugs in their system.

“This study is part of a bigger call to the fact that opiates are becoming a big problem in this country,” said Dr. Stephen Patrick from the University of Michigan in Ann Arbor, who worked on the study.

Recent research has shown the number of people who both abuse opiates and who overdose has been increasing in the U.S. According to the Centers for Disease Control and Prevention, 14,800 people died of a prescription drug overdose in 2008 — triple the estimate from 20 years earlier.

It’s unclear if there are long-term health impacts for kids who are born to opiate-addicted moms and get through their first weeks of life okay. Some but not all studies on the question have found those kids grow up with a higher risk of developmental problems, according to Patrick.

What is clear is that babies born in opiate withdrawal significantly drive up health care costs, especially for state Medicaid programs.

According to the new analysis, the average hospital stay for a newborn in withdrawal topped $50,000 in 2009 — with about 80 percent of that being paid by the government-funded insurance program for the poor.

That’s in part because those babies were kept in the hospital for an average of 16 days after being born — compared to just three days for other newborns, which cost an average of less than $10,000 to deliver.

The data come from discharge records for kids treated at more than 4,000 hospitals nationwide and statistically adjusted to represent the entire U.S. population.

Those records, which include all diagnoses made before a baby was sent home, showed that the number of infants born with symptoms of opiate withdrawal increased from one in 1,000 in the year 2000 to more than three in 1,000 in 2009.

That works out to about 13,500 newborns born in the U.S. in 2009 in withdrawal, the researchers reported in the Journal of the American Medical Association.

The study was published online Monday to coincide with a presentation at the Pediatric Academic Societies Annual Meeting in Boston.  more info here …http://www.reuters.com/article/2012/04/30/us-babies-painkiller-moms-idUSBRE83T17W20120430

Researchers who followed nearly 2,000 middle-aged women for 10 years found that those who had hysterectomies, with or without ovary removal, were as likely as women [...]]]> Women suddenly thrust into “surgical menopause” by hysterectomy don’t have more severe mood symptoms than women going through gradual, natural menopause, a new study suggests.

Researchers who followed nearly 2,000 middle-aged women for 10 years found that those who had hysterectomies, with or without ovary removal, were as likely as women who went through natural menopause to experience depression or anxiety — and for all women, those symptoms declined steadily within a few years.

“At least among women in midlife… mood symptoms don’t seem to be a worry to take into consideration when making treatment decisions around hysterectomy and oophorectomy,” said the study’s lead author Carolyn Gibson, a researcher in the Department of Psychology at the University of Pittsburgh.

Although past studies have shown a link between hysterectomy and risk for depression, Gibson and her fellow researchers say it’s still hard to tell whether the procedure is to blame.

Also unknown is whether the symptoms of surgically-induced menopause are any different from those of women who go through menopause naturally.

Gibson told Reuters Health the topic is important, because hysterectomies are very common.

About 600,000 women in the United States have their uterus removed during a hysterectomy every year, according to the U.S. Centers for Disease Control and Prevention.

The researchers say between 55 percent and 80 percent of women who undergo hysterectomy also have their ovaries removed — a procedure known as oophorectomy.

Because a woman’s ovaries generate estrogen, removing them induces menopause almost immediately.

Whether natural or induced, the change in a woman’s hormone levels leading up to menopause, and in the years immediately afterward, often contributes to a range of symptoms, from anxiety and depression to insomnia and hot flashes.

To see whether a quick transition to menopause through surgery changes women’s experience of the associated symptoms, Gibson’s team turned to a database containing information on women’s progression to, and through, the process.

They tracked about 2,000 women who were between 42 and 52 years old in 1996 and 1997, and were followed for more than ten years.

Over that period, 1,793 of the women went through menopause naturally, 76 had an elective hysterectomy and 101 had an elective hysterectomy and their ovaries removed.

All of the women were premenopausal at the beginning of the study and scored about the same on a scale that measures depression.

That scale goes from zero to 60 and, with higher scores representing more severe depression. A person with a score below 16 is not considered to be depressed.

For all three groups of women, depression scores decreased from the time they entered menopause to the end of the study period, and at about the same rates.

For those going through natural menopause, scores fell from 8.6 to 7.8. Those who had a hysterectomy saw their scores fall from 9.37 to 9.08, those who also had their ovaries removed went from 10.96 to 8.91.

Overall, the study shows depression symptoms in women who had a hysterectomy “declining in a very similar way as women who had a natural menopause,” said Ellen Freeman, a research professor of obstetrics and gynecology at the University of Pennsylvania School of Medicine.

Freeman, who was not involved with the new study, told Reuters Health that it’s important to know that the new study does not mean women will not be depressed after menopause — just that the symptoms do decrease, and at about the same rate among women in each group.

Gibson and her colleagues write in the journal Obstetrics & Gynecology that this suggests symptoms of depression and anxiety improve as women enter their postmenopausal years.

The authors note, however, that the results may not be applicable to the general population, such as those with a history of mood disorders.

SOURCE: bit.ly/Il6HmY Obstetrics & Gynecology, May 2012.

Within a year, on average, half of kids [...]]]> n a large new trial looking at ways to slow the progression of type 2 diabetes in children and teens, the addition of a second drug to the mainstay treatment metformin was only marginally more effective at controlling blood sugar than metformin alone.

Within a year, on average, half of kids on metformin and some 40 percent taking both metformin and rosiglitazone (Avandia) ended up having to resort to insulin injections to control their blood sugar, researchers reported Sunday at the annual meeting of the Pediatric Academic Societies in Boston and in the New England Journal of Medicine online.

“The results of the study were discouraging,” said Dr. David Allen from the University of Wisconsin School of Medicine and Public Health in an NEJM editorial. “These data imply that most youth with type 2 diabetes will require multiple oral agents or insulin therapy within a very few years after diagnosis.”

All 699 children included in the study had been diagnosed with type 2 diabetes two years or less before enrollment, so the rapid advance of about half to needing insulin marks an early start to a potential lifetime of complications and side effects — from the diabetes itself and the medications used to treat the disease.

Type 2 diabetes, the form usually associated with obesity, was once considered an “adult” disease, but is showing up in more and more teenagers, paralleling a rise in childhood obesity. And the condition is harder to treat in kids, experts say.

Type 2 diabetes “progresses more rapidly” in youth, according to Dr. Phil Zeitler from the University of Colorado, Denver, who worked on the new study.

He and his colleagues were surprised at how quickly many of the youngsters needed to switch from oral medications to taking daily insulin shots, Zeitler told Reuters Health.

Also, Zeitler said, the teens in the study appeared to have complications, including infections and hospitalization, more often than adults do.

All the children in the study were overweight or obese, and ranged in age from 10 to 17 years old.

Youngsters with diabetes are a difficult population to work with, Zeitler noted. Many of them don’t take their medications as instructed. And in the first place, to get type 2 diabetes before adulthood, “the toxicity of your lifestyle must be pretty severe,” Zeitler said.

That’s why all of the kids in the study got at least “basic lifestyle counseling,” he emphasized — for example, advice to stop drinking sugared sodas, eat less fast food, watch their diet in other healthy ways, take stairs instead of elevators and generally get more exercise.

Study enrollment began in July 2004 and follow-up continued through February 2011. All the kids in the study were taking metformin, a well-established diabetes drug, and a third were assigned to take the newer drug Avandia as well.

Another third of the kids were assigned a very intensive “lifestyle intervention,” that involved more assignments for kids to complete, more interaction with counselors, and close involvement of at least one parent, in addition to taking metformin.

The kids’ treatments were deemed failures if blood sugar and other signs pointed to their diabetes not being under control for a period of six months or more.

In the end, 52 percent of kids on metformin alone “failed” treatment, along with 39 percent of kids on metformin and Avandia and 47 percent of kids on metformin and lifestyle changes.

The median time it took for blood sugar control to be lost was just under a year.

The added benefit of Avandia was limited to girls, for reasons that are unclear, the researchers reported.

Also for unknown reasons, they noted, metformin alone was less effective for non-Hispanic black participants than other kids.

Surprisingly, kids on the combination of metformin and Avandia gained the most weight during the study, despite their slightly better rate of diabetes control. Kids in the lifestyle intervention group gained the least weight. more read….http://www.reuters.com/article/2012/04/30/us-diabetes-kids-idUSBRE83T17K20120430

The operation to remove the gland went well, but when it was later analyzed it turned out to have never contained cancerous cells, said spokesman Alfredo Scoccimaro.

“The original diagnosis has been modified,” he told a news conference. “The presence [...]]]> The government announced just after Christmas that the recently re-elected leader had thyroid cancer.

The operation to remove the gland went well, but when it was later analyzed it turned out to have never contained cancerous cells, said spokesman Alfredo Scoccimaro.

“The original diagnosis has been modified,” he told a news conference. “The presence of cancer cells was discarded.”

Fernandez was originally diagnosed with papillary carcinoma.

Buenos Aires-based thyroid cancer expert Eduardo Faure, who is not on the president’s medical team, said a small number of such cases turn out to be “false positives,” meaning that no cancer is present.

“The cells may originally appear to be cancer but in 2 percent of cases, after the operation, when a more thorough examination can be performed, it turns out they are not,” the doctor said in an interview.

“This result was always within the realm of possibility. It does not mean that the original diagnosis was mistaken.”

Several hundred Fernandez supporters had camped out near the hospital where she was treated, carrying banners that said “Strength Cristina.” A cheer went up from the crowd when Scoccimaro made the announcement.

The president, who won re-election with 54 percent of the vote in October, is popular among Argentines who agree with her generous welfare spending. Business leaders and farmers in the country’s key grains sector however say her state-centric interventions in the economy scare away investment.

Vice President Amado Boudou, the former economy minister and a loyal Fernandez ally, assumed the presidency this week during Fernandez’s scheduled 20-day leave of absence.

A skilled orator fond of glamorous clothes, high heels and make-up, Fernandez still wears black as she mourns her husband and closest adviser, former President Nestor Kirchner, who died in 2010.

Many thought his death spelled the end of the couple’s idiosyncratic blend of state intervention, nationalist rhetoric and the championing of human rights in grains exporting powerhouse Argentina, a major world supplier of soy and corn. source: www.reuters.com

Swiss researchers who [...]]]> When an elderly person’s chronic disease is impossible to cure, many doctors might assume that patient would chose to improve the quality of his or her remaining life rather than to extend it as is. Those doctors would be mistaken most of the time, according to a new study.

Swiss researchers who surveyed more than 500 elderly heart failure patients found three quarters wouldn’t trade a longer life with symptoms for a shorter life without them, and the severity of symptoms was not a good predictor of who would pick a measure of relief over more time.

“I was quite surprised by the results,” said lead author Dr. Hans-Peter Brunner-La Rocca, of University Hospital Basel in Switzerland.

“Often we think we know what is best for a patient, but this is often wrong,” he told Reuters Health in an email.

“When patients get to an age where the chance of dying in the near future becomes more evident, pure survival may be more important,” said Brunner-La Rocca, who is also affiliated with the Cardiovascular Research Institute at Maastricht University Medical Center in the Netherlands.

Heart failure is a chronic and incurable condition, in which the heart is too weak to pump enough blood to meet the body’s needs. It affects around six million people in the U.S., according to the Centers for Disease Control and Prevention.

Symptoms include shortness of breath, fatigue, weakness and swelling in the legs and feet, reducing a person’s ability to walk or exercise. Heart disease, high blood pressure or diabetes can weaken the heart muscle over time, which can lead to heart failure.

The researchers surveyed 555 heart failure patients, most in their seventies and eighties, asking a series of questions about end-of-life preferences. Then they repeated the survey after 12 months, and again after another six months.

At the start of the study, 74 percent of the respondents said they would not choose to live one more year in excellent health over living two more years in their current state. After a year had elapsed, 80 percent were unwilling to trade more time for symptom relief.

At 18 months, few had changed their minds. When asked about whether they wanted CPR in a crisis, about a third said they didn’t want to be resuscitated.

Even among people with “do not resuscitate” orders in their medical files, about a third said they in fact did want CPR. Dr. Eugene Storozynsky, who studies cardiology at the University of Rochester Medical Center, noted that the study participants represented a broad range of people with heart failure — from those with a just a few symptoms to those with many more severe problems.

Those with milder disease might not consider it bad enough to trade-off their remaining time.

“For these patients, it seems oral medications are still adequate enough to relieve their symptoms so they don’t need to be frequently hospitalized,” said Storozynsky, who was not part of the study.

Patients with end-stage heart failure require multiple hospitalizations in a short period of time due to their symptoms, he pointed out.

“Life expectancy may be six months or less without advanced therapies,” he told Reuters Health.

“Patients in this study were less bothered by their symptoms, so I would define them as less sick than those with end-stage heart failure.”

Participants in the study who were willing to trade more time for symptom relief were older, often female and had more heart failure symptoms, suggesting people may change how they manage their disease over time.

“We couldn’t find particular patterns to predict what individuals would want,” Brunner-La Rocca told Reuters Health.

“So it’s crucial to individually discuss these issues with the patient.” Storozynsky also thinks doctors should be upfront with patients.

“We should discuss all stages of heart failure to make them aware that at its end stage, their life will likely shorten,” he said.

“Not to scare them, but inform them and tailor our treatment to their wishes.” SOURCE: www.reuters.com/news/health

Analyzing data on more than 10,000 patients, University of Kansas researchers found that 70 percent were [...]]]> In people with low blood levels of vitamin D, boosting them with supplements more than halved a person’s risk of dying from any cause compared to someone who remained deficient, in a large new study.

Analyzing data on more than 10,000 patients, University of Kansas researchers found that 70 percent were deficient in vitamin D and they were at significantly higher risk for a variety of heart diseases.

D-deficiency also nearly doubled a person’s likelihood of dying, whereas correcting the deficiency with supplements lowered their risk of death by 60 percent.

“We expected to see that there was a relationship between heart disease and vitamin D deficiency; we were surprised at how strong it was,” Dr. James L. Vacek, a professor of cardiology at the University of Kansas Hospital and Medical Center, told Reuters Health.

“It was so much more profound than we expected.”

Vitamin D deficiency has been linked to a range of illnesses, but few studies have demonstrated the reverse — that supplements could prevent those outcomes.

Vacek and his team reviewed data from 10,899 adults whose vitamin D serum levels had been tested at the University of Kansas Hospital, and found that more than 70 percent of the patients were below 30 nanograms per milliliter, the level many experts consider sufficient for good health.

After taking into account the patients’ medical history, medications and other factors, the cardiologists found that people with deficient levels of vitamin D were more than twice as likely to have diabetes, 40 percent more likely to have high blood pressure and about 30 percent more likely to suffer from cardiomyopathy — a diseased heart muscle — as people without D deficiency.

Overall, those who were deficient in D had a three-fold higher likelihood of dying from any cause than those who weren’t deficient, the researchers reported in the American Journal of Cardiology. Moreover, when the team looked at people who took vitamin D supplements, their risk of death from any cause was about 60 percent lower than the rest of the patients, although the effect was strongest among those who were vitamin D deficient at the time they were tested.

The study does not prove that vitamin D is the cause of the effects seen — other factors, like disease, could be responsible both for the differences in health and the differences in vitamin D levels, for instance.

Previous research has indicated that many Americans don’t have sufficient levels of vitamin D, however. The latest National Health and Nutrition Examination Survey estimated that 25 percent to 57 percent of adults have insufficient levels of D, and other studies have suggested the number is as high as 70 percent.

Vacek said he believes so many people are deficient because we should get about 90 percent of our Vitamin D from the sun and only about 10 percent from our food. The human body makes vitamin D in response to skin exposure to sunlight.

Certain foods, like oily fish, eggs and enriched milk products are also good sources of D. A sufficient amount of Vitamin D absorption from the sun would require at least 20 minutes of full-body exposure each day in warmer seasons, and most people aren’t outside enough, Vacek said.

In the northern United States and throughout Canada, experts say the sun isn’t strong enough during the winter months to make sufficient vitamin D, even if the weather was warm enough to expose the skin for a long time.

It means that adults should consider getting their Vitamin D levels checked through a simple blood test, Vacek said, and take vitamin D supplements. Generally, Vacek recommends that adults take between 1,000 to 2,000 international units (IU) of Vitamin D each day.

“If you’re not deficient, Vitamin D is not a magic pill that will make you live longer,” Vacek said.

“Its benefit is in people who are deficient. If you’re low, it makes sense to be put on replacement therapy and have a follow-up a couple months later to make sure your levels come up.” SOURCE: www.reuters.com/news/health

Once again, eating a diet based on fish, legumes, vegetables and moderate amounts of alcohol is linked to lower chances of dying from a heart attack, stroke or other vascular “events,” according to a new study of New York City residents.

The mostly Hispanic and black study participants [...]]]>

Once again, eating a diet based on fish, legumes, vegetables and moderate amounts of alcohol is linked to lower chances of dying from a heart attack, stroke or other vascular “events,” according to a new study of New York City residents.

The mostly Hispanic and black study participants did not necessarily eat traditional foods from Mediterranean countries, but the closer their diets were to the spirit of Mediterranean eating — with plenty of fish, healthy fats like olive oil, whole grains and vegetables — the lower their risk of death from vascular problems including heart attacks.

“While it’s not the Mediterranean diet, it is comparing a healthier diet to a less healthy diet, and there was some improvement,” said Teresa Fung, a professor at Simmons College in Boston who was not involved in the study.

For nine years, Dr. Clinton Wright at the University of Miami and his colleagues followed more than 2,500 residents of northern Manhattan, a neighborhood with about 63 percent Hispanic residents, 20 percent African Americans and 15 percent whites. Information about the health benefits of a so-called Mediterranean diet in the black and Hispanic populations in the U.S. is lacking, Wright’s group notes in the American Journal of Clinical Nutrition.

Because both groups are burdened by high rates of heart disease, the team set out to study how much of a difference diet might make.

A little more than half of the study participants were Hispanic, while the other half was split roughly between non-Hispanic blacks and whites. All were over 40 years old when the study began.

At the outset, researchers asked participants about their health history, and ranked their eating habits along a nine-point scale: the higher the number, the closer the person’s diet was to the Mediterranean ideal, with lots of fish, vegetables, legumes, whole grains and vegetable oils and very little meat or animal fats.

The group then tracked how many people later experienced a stroke, heart attack or death related to a vascular problem like pulmonary embolism and aneurysm. More than 300 people in the study died from a vascular issue.

Each point higher that a person scored on the nine-point Mediterranean diet scale reduced the risk of vascular death by nine percent.

The study did not find that the diet had any effect on the risk of having a stroke, however. Among the 171 people who suffered a stroke, those at the high end of the diet scale were just as likely to have had one as those at the low end of the scale.

The researchers did detect slight protection from heart attack among those whose diets ranked in the top-four on the Mediterranean scale, but the finding could have been due to chance.

The results back up previous research that also reported benefits to heart health from eating a Mediterranean diet (see Reuters Health stories from March 7, 2011 and January 27, 2010).

The current study does not prove that diet is responsible for the benefits the researchers saw. But the Mediterranean diet is rich in elements like fiber and omega-three fatty acids, which could influence heart health, Wright said.

The evidence isn’t conclusive, he added, but overall, the Mediterranean diet appears to be good for people’s heart health.

“There’s very little evidence to suggest that it’s harmful compared to some other diets that we consider harmful, such as diets rich in red meat,” Wright said.

“So it seems like there isn’t much harm in it and there’s increasing evidence that it’s beneficial.”SOURCE: www.reuters.com/article/

A protein that helps transport cholesterol inside cells may be a key to developing drugs to treat Ebola, a rare but lethal virus for which there are no known treatments, U.S. researchers said.

Laboratory mice bred to produce low levels of this protein — known Niemann-Pick C1 — survived exposure to both Ebola, which causes a [...]]]>

A protein that helps transport cholesterol inside cells may be a key to developing drugs to treat Ebola, a rare but lethal virus for which there are no known treatments, U.S. researchers said.

Laboratory mice bred to produce low levels of this protein — known Niemann-Pick C1 — survived exposure to both Ebola, which causes a hemorrhagic fever, and its cousin, Marburg virus.

“This research identifies a critical cellular protein that the Ebola virus needs to cause infection and disease,” said Sean Whelan of Harvard Medical School, who worked on one of two studies published on Wednesday in the journal Nature.

“The discovery also improves chances that drugs can be developed that directly combat Ebola infections,” Whelan said in a statement.

Ebola is one of the most deadly infections known, killing 90 percent of people infected by it.

It first emerged in 1976 in villages along the Ebola River in the Sudan and the Democratic Republic of the Congo, and is usually fatal in humans and in other primates such as monkeys, gorillas and chimpanzees.

So far, there have been about two dozen Ebola outbreaks in Africa.

No one knows how the virus is spread, and there are no available vaccines or anti-viral drugs that fight the infections.

But the new research suggests the virus has a weakness in the form of a well-known protein called Niemann-Pick.

People who have two abnormal copies of this protein develop Niemann-Pick disease, in which cells of the spleen, liver and brain become clogged up with cholesterol.

KEY PATHWAY

But this same protein also appears to be the key pathway Ebola uses to get deep inside cells.

“What we showed is this virus needs this protein,” Kartik Chandran, of Albert Einstein College of Medicine in New York, said in a telephone interview.

“Mice that have less of this protein are very resistant to being killed by Ebola and the Marburg virus,” said Chandran, who worked with researchers at Harvard, the U.S. Army Medical Research Institute of Infectious Diseases and the Whitehead Institute for Biomedical Research.

Chandran’s work focused on the mechanism used by Ebola to gain access to cells.

But a compound he helped discover in 2005 as a young researcher working in the lab of James Cunningham at Harvard has shown promise in blocking the Niemann-Pick protein in human cells, according to a separate paper led by Cunningham and co-authored by Chandran.

“Essentially, they were able to show this compound can block infection by the virus,” Chandran said of Cunningham’s team.

The compound has not yet been tested in mice, and would still need to show it is effective in non-human primates.

Chandran said blocking this critical compound long term would likely cause illness.

People with Niemann-Pick disease have two abnormal copies of the gene that make this protein, but the mice used in Chandran’s lab only had one working copy of this gene, suggesting that simply reducing the amount of the Niemann-Pick protein may help protect people from the virus.

Besides, Chandran said, most outbreaks are short-lived, so treatment would be needed for only a short time.

The researchers are optimistic that this new understanding of how Ebola gets into cells may eventually lead to treatments. But he acknowledges it will take many years, and possibly even a decade, before treatments would be available for human use.source: www.reuters.com/article/