Sabtu, 31 Agustus 2013

Measles cases put Texas megachurch under scrutiny - Bryan

Measles cases put Texas megachurch under scrutiny - Bryan

The teachings of televangelist Kenneth Copeland and his family focusing on the virtues of trusting God to keep healthy are under scrutiny after a cluster of measles cases linked to his family's North Texas megachurch revealed many congregants hadn't been vaccinated against the highly contagious disease.

Kenneth Copeland Ministries has won supporters worldwide through television programs, crusades, conferences and prayer request networks. He was a pioneer of the prosperity gospel, which holds that believers are destined to flourish spiritually, physically and financially.

Although church officials were quick to act after the outbreak _ including hosting clinics in August where 220 people received immunization shots _ and have denied they are against medical care or vaccinations, people familiar with the ministry say there is a pervasive culture that believers should rely on God, not modern medicine, to keep them well.

"To get a vaccine would have been viewed by me and my friends and my peers as an act of fear _ that you doubted God would keep you safe, you doubted God would keep you healthy. We simply didn't do it," former church member Amy Arden told The Associated Press.

Health officials say 21 people were sickened with the measles after a person who contracted the virus overseas visited the 1,500-member Eagle Mountain International Church located on the vast grounds of Kenneth Copeland Ministries in Newark, about 20 miles north of Fort Worth.

Of the 21 people who contracted measles linked to the church, 16 were unvaccinated. The others may have had at least one vaccination, but had no documentation.

Symptoms of the measles, which is spread by coughing, sneezing and close personal contact with infected people, include a fever, cough and rash. Those infected are contagious from about four days before breaking out into the rash to four days after.

The Centers for Disease Control and Prevention recommends that children get two doses of the combined vaccine for measles, mumps and rubella, called the MMR. The first dose should be given when the child is 12 to 15 months old and the second at 4 to 6 years old.

During an August 2010 broadcast, Copeland expressed shock at the number of vaccinations recommended for his great-grandchild.

"I got to looking into that and some of it is criminal. ... You're not putting _ what is it Hepatitis B _ in an infant! That's crazy. That is a shot for a sexually transmitted disease. What? In a baby?" he said. "You don't take the word of the guy that's trying to give the shot about what's good and what isn't. You better go read the can or read the thing _ find out what's going on there and get the information on there because I'm telling you, it's very dangerous the things that are happening around us all the time."

His wife Gloria bragged during a conference that she and her husband don't need prescription drugs, adding that the Lord heals all diseases.

Robert Hayes, risk manager for the ministries, denied that the church's teachings ever have advised against immunizations and noted the facility includes a medical clinic staffed with a physician.

Ole Anthony, president of the Dallas-based religious watchdog group Trinity Foundation, said that while there might not be specific guidance on topics such as vaccinations, the views of the leadership are clear.

"The whole atmosphere is to encourage them to have faith, and it's no faith if they go to the doctor, that's the bottom line," Anthony said.

In a sermon posted online following the outbreak, Copeland's daughter, Terri Pearsons, who is a senior pastor at Eagle Mountain along with her husband, encouraged those who hadn't been vaccinated to have it done, but added that if "you've got this covered in your household by faith and it crosses your heart of faith, then don't go do it."

In a statement denying that she opposes vaccinations, she added the concerns they had had were "primarily with very young children who have a family history of autism and with bundling too many immunizations at one time."

A fear of the MMR vaccine can be traced to a now-discredited paper published in 1998 by British researcher Andrew Wakefield and colleagues that suggested a link between autism and the combined childhood vaccine for MMR. Repeated studies since have shown no connection, the paper was eventually rejected by the journal that published it and Britain's top medical board stripped Wakefield of the right to practice medicine.

"We do know how to effectively prevent measles. We do know that and so a choice not to do that, to put a child at risk is just an unsupportable, an unconscionable choice. And in addition, you put others at risk," said Dr. Paul Offit, chief of infectious diseases at the Children's Hospital of Philadelphia.

Arden, who attended church at Eagle Mountain from 1997 to 2003 and worked at the ministries for three years, said the distrust of vaccines was so pervasive that her daughter, who as an 11-month-old was up to date on her immunizations when they joined the church, didn't get any others until they left.

"We were terrified to have any sort of fear. And anything that wasn't faith in God was fear," said Arden, 35, who now lives in New York City.

Kristy Beach, 41, said that because of the ministry's teachings, her mother, Bonnie Parker, refused to see a doctor, even as her cancer advanced rapidly. After Parker died in 2004 at age 59, Beach found her mother's diaries, which detailed the words of Kenneth and Gloria Copeland she'd heard on television in her home in Winnsboro, La.

"If she went to a doctor, it was a sin," Beach said. "You didn't believe enough if you did. She just wrote: `God heal me. God heal me. God heal me.' "

Study shows men just as likely to be depressed as women

Study shows men just as likely to be depressed as women

Now researchers say that when these symptoms are factored into a diagnosis, the long-standing disparity between depression rates in men and women disappears.

That conclusion overturns long-accepted statistics indicating that, over their lifetimes, women are 70% more likely to have major depression than men. In fact, when its symptoms are properly recognized in men, major depression may be even more common in men than in women, according to a study published Wednesday by the journal JAMA Psychiatry.

The findings help unravel a mystery that has long puzzled mental health authorities: If men are so much less likely than women to be depressed, why are they four times more likely to commit suicide?

"When it comes to depression in men, to some extent we have blinders on," said Dr. Andrew Leuchter, a psychiatrist who studies depression at UCLA. "We have not been asking about and taking into account a range of symptoms that may be gender-specific."

Health policy researchers from the University of Michigan and Vanderbilt University set out to test the feasibility of two new checklists that might diagnose depression in men as well as women with greater accuracy.

In addition to familiar depression symptoms such as sadness, difficulty sleeping, feelings of guilt or worthlessness and loss of interest in pleasurable activities, the researchers expanded the list to include anger attacks, aggression or irritability, substance abuse, risk-taking behavior and hyperactivity. They devised two scales â€" one designed to be gender-neutral and one tuned toward the way the disease manifests itself in men.

The researchers tested these diagnostic criteria in a group of nearly 5,700 American adults who had been interviewed as part of a long-term study of mental health organized by researchers at Harvard Medical School; 41% of the participants were men.

The results of the analysis were striking.

When assessed using the "gender inclusive depression scale" that included widely recognized depressive symptoms such as sadness and hopelessness as well as symptoms commonly seen in men, 30.6% of men and 33.3% of women were found to have experienced a depressive episode at some point in their lives. In research terms, that gap between men and women was so narrow it may have been a statistical fluke.

And when the subjects were evaluated with the "male symptoms scale," 26.3% of men and 21.9% of women were said to have experienced a major depressive episode in their lifetimes. That difference was large enough that it could not be due to chance, the researchers reported.

"Everything we think we know about depression is a reflection of how we defined it to begin with," Leuchter said.

That bias, he added, may have fostered the perception that depression is predominantly a "woman's disease" â€" and that men don't need treatment for emotional suffering.

Sigmund Freud, the father of psychiatry, portrayed depression as rage turned inward. But for many men today, depression's rage appears not so much directed at oneself as it is spat outward â€" at spouses, co-workers and friends.

While women may not feel shame in acknowledging their sadness and sagging self-esteem, mental health experts find that depressed men often respond to such feelings with actions that look like their opposite: They bluster and bully. They throw themselves into harm's way. They numb themselves with sex, drugs and endless workdays.

If the emotional pain of many men is to be understood for what it is, depression's definition should be expanded to include these "externalizing" symptoms â€" the opposite of "internalizing" symptoms that have long defined depression, some mental health professionals argue.

"These findings could lead to important changes in the way depression is conceptualized and measured," the study authors concluded.

If psychiatrists update their official diagnostic criteria to reflect these gender differences, that would be only a first step, Leuchter said.

Doctors, including primary care physicians who now diagnose most depression, would have to be educated to look for an expanded set of symptoms, he said. Researchers would not only need to understand how seemingly separate diseases such as substance abuse and depression relate to each other, they would also need to assess whether the treatments currently available â€" antidepressants and talk therapy â€" would help men with these symptoms, he said.

For men as well as women, the checklists now in wide use to diagnose depression may fail to capture the experience and language of the emotional distress they feel, said study leader Lisa Martin, a health policy studies professor at the University of Michigan.

"Word choice matters," she said.

melissa.healy@latimes.com

Jumat, 30 Agustus 2013

Online tools may boost breast cancer patients' mood

Online tools may boost breast cancer patients' mood

NEW YORK | Fri Aug 30, 2013 9:50am EDT

NEW YORK (Reuters Health) - Women with breast cancer who created a personal website about their health reported feeling less depressed, more positive and having a greater appreciation for life in a small new study.

Though cancer patients have long benefited from support groups made up of fellow patients and survivors, researchers said, they may still have trouble talking about their experiences with family and friends - who may also feel uncomfortable broaching the subject.

The websites in this study were especially helpful for women to "be able to truly tell their story, express emotions and communicate with others without having to repeat information about their diagnosis and treatment," said lead author and psychologist Annette Stanton of the University of California at Los Angeles.

The study is the first to use a randomized controlled trial to evaluate online intervention tools and their influence on patient moods, Stanton told Reuters Health. Popular sites like CaringBridge.org and MyLifeLine.org offer similar tools, "but, to our knowledge, none of those websites have been tested for their effects," she said.

For their study, Stanton and her colleagues recruited 88 women from BreastLink, a network of cancer treatment centers in Southern California. The women ranged in age from 28 to 76 years old and roughly half were randomly assigned to create a personal website through a program called "Project Connect Online." The rest were put on a waiting list and given the same opportunity after the six-month study ended.

Participants in the group that created websites during the study began by attending a single three-hour workshop to build their Wordpress.org-based sites. They also completed standard mood assessment questionnaires three times: at the start of the study, and again at one month and six months after creating their sites.

During the first month after creating the site, participants spent an average of three hours adding materials and interacting with their project online. The site included a blog with personal photos, a "How You Ca n Help" page and a section directing visitors to outside information links.

At one and six months, the women who built websites reported feeling less depressed and more positive, compared to the group on the waiting list. But there was no link between having a personal website and the strength of relationships with family and friends, nor did the activity seem to ward off intrusive, cancer-related thoughts.

And the positive changes in mood and attitude were most noticeable among women undergoing cancer treatment during the study period, compared to women who had already completed treatment, the researchers report in the Journal of Clinical Oncology.

"It's a small sample size and it needs to be confirmed and reproduced," said study co-author Dr. James Waisman, a breast cancer oncologist at the City of Hope National Medical Center in Duarte, California. The study is nevertheless encouraging, Waisman said.

Yan Hong, a health behaviorist at Texas AM University Health Science Center in College Station called the results compelling. "Scientists have been excited about online intervention tools for a long time," she told Reuters Health.

Hong, who was not involved in the current study, recently published a review of previous research that found no strong links between online tools and improved mental health.

But she noted that the data she analyzed were only as recent as the early 2000s. None of the studies examined the potential benefits to patients of sharing their experiences through social media like Facebook or Twitter.

Most studies looking at Internet interventions have focused on a narrow part of the population that has access to the Internet, Hong said. This means the results are difficult to apply to the public outside the study.

Between 15 and 25 percent of cancer patients suffer from depressi on, according to the National Cancer Institute.

As patients get sicker and lose the ability to go out in public, online intervention tools could come in handy, Waisman said.

"This is a way they can mobilize support - through their computer and their website," he said.

SOURCE: bit.ly/1fffVzj Journal of Clinical Oncology, online August 12, 2013.

Kamis, 29 Agustus 2013

Illinois ranks low for HPV vaccine

Illinois ranks low for HPV vaccine

While public health officials have been recommending since 2006 that preteen girls be vaccinated against the sexually transmitted human papillomavirus, the percentage of teen girls in Illinois who received the prescribed dosage plunged last year, according to recently released federal estimates.

What's more, the state in 2012 ranked 48th among all states, ahead of only Arkansas and Mississippi, in the percentage of teen girls who have received the three HPV vaccine doses, according to those estimates.

That concerns health officials, who say low vaccination rates put the health of the next generation at risk.

"We really need to start recognizing and promoting the value of this lifesaving vaccine," said Julie Morita, medical director of the Chicago Department of Public Health's immunization program.

HPV is the most common sexually transmitted infection and in some cases can cause cervical, vaginal, penile or other cancers, according to the U.S. Centers for Disease Control and Prevention.

The CDC and other health experts say doctors should be more proactive in promoting HPV vaccinations, which are also recommended for boys, during the same office visits at which youngsters get immunized against tetanus, meningitis and other diseases.

"If a patient's there with their daughter because their throat hurts, it's hard to talk about, 'Oh by the way, you should get this vaccine,'" said Kai Tao, vice president of clinical operations who oversees 17 health centers for Planned Parenthood of Illinois. "But that's exactly what we should be doing."

Some parents are putting off HPV shots for their tween children, or deciding against them altogether, because it's difficult for them to see their children as sexually active and the primary way to contract HPV is through sexual intercourse.

But the vaccine is insurance for the future, doctors say. "You don't want to wait until you try and figure out when a young person is going to have sex," said Gregory Zimet, an Indiana University School of Medicine professor. "That's true with every vaccine, get them vaccinated before they're exposed."

While the vaccine doesn't eliminate the need for regular exams for sexually active people, it does protect them from some of the most common types of HPV that lead to disease and cancer, doctors said.

The CDC's recently released data show that only an estimated 21.1 percent of girls ages 13 to 17 in Illinois got the recommended three doses in 2012, compared with an estimated 34 percent in 2011.

The arrow pointed the other way in Chicago, however, where an estimated 37.8 percent of teen girls had three shots in 2012, up from 24.7 percent in 2011.

The national number sank slightly, to 33.4 percent last year from an estimated 34.8 percent in 2011.

Illinois law requires public heath departments to provide girls entering sixth grade and their parents with written information about the link between HPV and cervical cancer, and about the availability of the HPV vaccine. Since that law was passed in 2007, the vaccine has been recommended for boys as well.

Last year about 21 percent of boys ages 13 to 17 nationwide got at least one dose of the vaccine, according to the CDC. In Illinois, that figure was 24.3 percent.

Legislators in states including Illinois have proposed unsuccessful legislation that would make the HPV vaccine one of the mandatory shots for school attendance, according to the National Conference of State Legislatures.

Most insurance companies cover costs for the vaccine, and a federal program provides the vaccine for free for children who are uninsured or on Medicaid, Chicago's Morita said.

While access may not be a barrier, not all parents agree about when, or even if, the vaccine should be given to their children.

Conversations about the vaccine can be uncomfortable for some families, said Dr. Debra Schwartzers, a pediatrician who works for the DuPage Medical Group in Lombard and regularly brings up the vaccine to parents with teens.

Parents sometimes feel like approving the vaccine for their children is like giving "my child a license to have sex," Schwartzers said.

Men and women equally depressed, study shows

Men and women equally depressed, study shows

Featured Article
Main Category: Depression
Also Included In: Mental Health
Article Date: 29 Aug 2013 - 0:00 PDT

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Around the world, women are typically diagnosed with depression twice as often as men. But a recent study published in JAMA Psychiatry looks at these disparities in a new way by considering alternative symptoms of depression typically attributed to men.

The researchers, led by Lisa A. Martin, Ph.D., analyzed data from a national mental health survey of 3,310 women and 2,382 men while also looking for alternative symptoms. They wanted to observe whether the sex differences in depression rates would disappear when these alternative symptoms were considered alongside more conventional ones.

Some of the alternative "male-type" symptoms included anger attacks, aggression, substance abuse and risk taking.

Results show that when both traditional and alternative symptoms are accounted for, men and women meet the criteria for depression in equal measures, with 30.6% of men and 33.3% of the women in the study classified as depressed.

The study authors note that most of the research exploring the sex differences in depression has focused on reasons for why women have a greater risk for developing it. But Lisa A. Martin says that "when men are depressed, they may experience symptoms that are different than what is included in current diagnostic criteria."

Relying on men's disclosure of traditional symptoms, note the researchers, could lead to men who are not properly diagnosed with depression. They say that medical professionals should contemplate other clues when diagnosing depression in men.

Future depression diagnosis

According to the study, depression affects around 16% of the US population each year, which is just over 32 million people. Not just costly, the illness can be debilitating for those affected by it.

Though this is the first study to analyze male-type symptoms of depression in light of sex differences, the researchers note that future studies should try to understand "how masculinity and femininity influence depression rates rather than relying on sex alone as an indicator."

Because the depression criteria today could be biased toward identifying symptoms that appear more frequently in women, researchers say that further study is needed to clarify the symptoms most associated with male depression.

They do note, however, that their findings show male-type symptoms of depression are also common in women. As a result, asking both men and women questions about irritability, anger and substance abuse is equally important.

The authors conclude the study by writing that "the results of this work have the potential to bring significant advances to the field in terms of the perception and measurement of depression."

Written by Marie Ellis


Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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Rabu, 28 Agustus 2013

Scientists find genetic clue which could unlock the secret of reversing age ...

Scientists find genetic clue which could unlock the secret of reversing age ...

  • New evidence suggests age-related memory loss is a distinct condition from pre-Alzheimer's
  • Certain gene in the brain's memory center stops working properly in older people

By Daily Mail Reporter

|


Scientists have made a major breakthrough in determining the cause of age-related memory loss, which they hope will herald the development of a new drug to reverse the process.

A report released yesterday offers strong evidence that age-related memory loss really is a distinct condition from pre-Alzheimer's â€" and might eventually be treatable.

Researchers at Columbia University Medical Center examined brains, young and old ones, donated from people who died without signs of neurologic disease.

Scientists believe they have pinpointed the cause of memory loss offering a breakthrough that could lead to the development of drugs to reverse the process

Scientists believe they have pinpointed the cause of memory loss offering a breakthrough that could lead to the development of drugs to reverse the process

They discovered that a certain gene in a specific part of the hippocampus, the brain's memory center, stops working properly in older people. It produces less of a key protein.

That section of the brain, called the dentate gyrus, has long been suspected of being especially vulnerable to aging. Importantly, it's a different neural neighborhood than where Alzheimer's begins to form.

But it's circumstantial evidence that having less of that protein, named RbAp48, affects memory loss in older adults. So the researchers took a closer look at mice, which become forgetful as they age in much the same way that people do.

Sure enough, cutting levels of the protein made healthy young rodents lose their way in mazes and perform worse on other memory tasks just like old mice naturally do.

More intriguing, the memory loss was reversible: Boosting the protein made forgetful old mice as sharp as the youngsters again, the researchers reported in the journal Science Translational Medicine.

'It's the best evidence so far' that age-related memory loss isn't the same as early Alzheimer's, said Nobel laureate Dr. Eric Kandel, who led the Columbia University team.And since some people make it to 100 without showing much of a cognitive slowdown, the work begs another question: 'Is that normal aging, or is it a deterioration that we're allowing to occur?' Kandel said.

'As we want to live longer and stay engaged in a cognitively complex world, I think even mild age-related memory decline is meaningful,' added Columbia neurologist Dr. Scott Small, a senior author of the study. 'It opens up a whole avenue of investigation to now try to identify interventions.'

Clue: A certain gene in a specific part of the hippocampus, the brain's memory center, was found to stop working properly in older people

Clue: A certain gene in a specific part of the hippocampus, the brain's memory center, was found to stop working properly in older people

This is early-stage research that will require years of additional work to confirm, cautioned Dr. Molly Wagster of the National Institute on Aging, who wasn't involved with the report.

But Wagster said the findings add to a growing body of evidence suggesting 'that we're not all on the road to Alzheimer's disease' after we pass a certain age.

For example, other researchers have found that connections between neurons in other parts of the brain weaken with normal aging, making it harder but not impossible to retrieve memories. In contrast, Alzheimer's kills neurons.

How does Wednesday's research fit? Many pathways make up a smoothly functioning memory, and that protein plays a role in turning a short-term memory â€" like where you left those car keys â€" into a longer-term one, Kandel explained.

Some good news: Scientists already know that exercise makes the dentate gyrus â€" that age-targeted spot in the hippocampus â€" function better, Smal l said. He's also studying if nutrition might make a difference.

Broccoli may help prevent osteoarthritis

Broccoli may help prevent osteoarthritis

Here’s a new reason to eat your vegetables: It may help you have healthier joints as you age. A new study, published in the journal Arthritis and Rheumatism, finds that a compound called sulforaphane can help fight osteoarthritis, the most common form of arthritis.  And that compound is released when eating broccoli, brussel sprouts, cauliflower, kale, cabbage and bok choy.

The study, from the University of East Anglia, is significant in that it’s the first of its kind to demonstrate the relationship between sulforaphane and joint health. The goal of the study was to find out how much sulforaphane entered joints when vegetables were consumed and what effect they would have.

Researchers performed a relatively small trial, about which lead researcher Ian Clark, professor of musculoskeletal biology at UEA, said, “The results from this study are very promising. We have shown that this works in the three laboratory models we have tr ied, in cartilage cells, tissue and mice.”

UEA researchers are planning another trial, this time in 40 osteoarthritis patients who are due to have joint replacement surgery. Half of the patients will be fed “super broccoli,” with extra sulforaphane, two weeks before surgery. Researchers will compare patients post-surgery to see if they can detect sulforaphane in the replaced joints and whether it affected joint metabolism.

NEXT: Marijuana for teens can enhace additive behavior

Selasa, 27 Agustus 2013

Sarah Murnaghan, 11, is home after controversial lung transplant

Sarah Murnaghan, 11, is home after controversial lung transplant

For most 11-year-old girls, that might be an everyday event. But for Sarah, who spent months in the hospital and received new lungs only after her family filed a lawsuit, it was extraordinary.

Sarah, whose lungs were ravaged by cystic fibrosis, received adult lungs because of the court challenge and, when they failed, another set. Her case sparked a national debate about the way organ donations are allocated.

"Sarah’s looking forward to being a regular little kid," said Janet Murnaghan, her mother, at a news conference in front of the family’s Newtown Square, Pa., home Tuesday afternoon. "She’s doing fantastic, and this is really the beginning of the next chapter."

Sarah, who celebrated her 11th birthday in the hospital this month, sat in an armchair on the front steps, which were festooned with balloons and banners that read, "Welcome home Sarah!" Dressed in pink from head to toe, she waved weakly. When reporters asked how she was feeling, she responded quietly, "So-so."

Janet and Fran Murnaghan say Sarah already has been playing with her siblings and will begin the fifth grade next week, learning from home.

"We’re looking forward to Sarah having a nice long life, going to college, getting married, having a family and doing everything we dream for our other kids," said Janet Murnaghan, who added that her daughter used to love skating and horseback riding.

Sarah no longer needs oxygen, but still needs a machine to help her muscles breathe. She also needs a walker.

Earlier this summer, Sarah's own lungs were failing and she was near death.

Because of national rules governing the allocation of organ donations, Sarah was a long way down the waiting list to receive adult lungs that might fit her body. 

Under those rules, children under age 12 are first in line to receive organs from their own age group, but those lungs are in short supply. She could only receive organs from the larger adult or adolescent donor pools if no one in those age groups could use them, a rare occurrence. Children ages 12 to 17 also can compete in the adult donor system, which is based on a formula that takes into account the severity of the patient’s condition and the likelihood that the transplant will be a success.

When the Murnaghans were told their daughter was ineligible for the adult donor list, they sued, calling the policy age discrimination. In June, a federal judge ordered that Sarah be allowed to compete on an equal basis for adult lungs.

The first transplant failed and her family feared she would die. But her condition stabilized after a second transplant.

Federal transplant officials have taken issue with what they say is the courts’ interference in a carefully balanced national donor system.

The United Network for Organ Sharing, a nonprofit that oversees the national transplant system for the federal government, elected to allow hospitals to petition a national board on a case-by-case basis while the children's rules are reviewed over the next year. 

The Murnaghans say they will keep campaigning to change the rules.

"We’re not going to let go of this," Janet Murnaghan said.

As Sarah sat on the steps during the news conference, she wore a small gold medal around her neck. It was engraved: "To Sarah, for never giving up. We are so proud. With love, Mom and Dad."

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christine.maiduc@latimes.com

Twitter: @cmaiduc

Report: Underage Tobacco Sales at Record Lows

Report: Underage Tobacco Sales at Record Lows

Associated Press

New statistics show that the sale of tobacco to minors in the U.S. were held near all-time lows last year under a federal-state inspection program intended to curb underage usage.

The violation rate of tobacco sales to underage youth at retailers nationwide has fallen from about 40 percent in 1997 to 9.1 percent in the last fiscal year, according to a Substance Abuse and Mental Health Administration report released Tuesday. The rate, which reached an all-time low of 8.5 percent in 2011, is based on the results of random, unannounced inspections conducted at stores to see whether they'd sell tobacco products to a customer under the age of 18.

A U.S. Surgeon General's report issued last year found that more needs to be done to prevent young Americans from using tobacco, including stricter smoking bans and higher taxes on tobacco products. According to that report, almost one in five high school-aged children smokes. That's down from earlier decades, but the rate of decline has slowed. It also said that more than 80 percent of smokers begin by age 18 and 99 percent of adult smokers in the U.S. start by age 26.

The inspection program, named for late U.S. Rep. Mike Synar of Oklahoma, is a federal mandate requiring each state to document that the rate of tobacco sales to minors is no more than 20 percent at the risk losing millions in federal funds for alcohol and other drug abuse prevention and treatment services.

Frances Harding, director of the federal agency's Center for Substance Abuse, said that while the program has made "remarkable strides," far more needs to be done to curb underage tobacco use.

In the last fiscal year, 33 states and Washington, D.C., reported a retailer violation rate below 10 percent, according to the Tuesday report. It was the seventh time that no state was found to be out of compliance. Maine reported the lowest rate of 1.8 percent, and Oregon reported the highest rate at 17.9 percent.

The latest federal data shows that about 14 percent of minors reported buying their own cigarettes in stores in 2011, down from 19 percent a decade earlier, suggesting that children may instead be getting their cigarettes and tobacco products from places other than convenience stores or gas stations.

â€"â€"â€"

Michael Felberbaum can be reached at http://www.twitter.com/MLFelberbaum.

Senin, 26 Agustus 2013

Measles outbreak tied to Texas megachurch sickens 21

Measles outbreak tied to Texas megachurch sickens 21

vaccination

1 hour ago

An outbreak of measles tied to a Texas megachurch where ministers have questioned vaccination has sickened at least 21 people, including a 4-month-old infant -- and it’s expected to grow, state and federal health officials said.

“There’s likely a lot more susceptible people,” said Dr. Jane Seward, the deputy director for the viral diseases division at the Centers for Disease Control and Prevention.

Sixteen people -- nine children and seven adults -- ranging in age from 4 months to 44 years had come down with the highly contagious virus in Tarrant County, Texas, as of Monday. Another five cases are part of the outbreak in nearby Denton County.

All of the cases are linked to the Eagle Mountain International Church in Newark, Texas, where a visitor who’d traveled to Indonesia became infected with measles â€" and then returned to the U.S., spreading it to the largely unvaccinated chur ch community, said Russell Jones, the Texas state epidemiologist.

“We have a pocket of people that weren’t immunized,” said Jones, noting that vaccination rates typically hover above the 98 percent range in his county.

Infections spread to the congregation, the staff and a day care center at Eagle Mountain International.

measles

The ill people were all linked to the church that is a division of Kenneth Copeland Ministries. That group advocates faith-healing and advises people to “first seek the Wisdom of God” and then appropriate medical attention in matters of health, according to an online statement.

Terri Pearsons, a senior pastor of Eagle Mountain International Church and Copeland’s daughter, previously said she had concerns about a possible ties between early childhood vaccines and autism, a p osition that has been refuted by health officials.

In the wake of the measles outbreak, however, Pearsons has urged followers to get vaccinated and the church has held several vaccination clinics, according to its website. Health officials said the church administration has been very cooperative in the outbreak investigation. Pearsons did not return an email from NBC News seeking comment. 

“We continue to follow up on pending and confirmed cases to help in any way we can to keep the outbreak contained,” a church statement said. “We ask that others join us in prayers over this outbreak.”

Health authorities notified the church of the first cases on Aug. 14; Texas state health officials issued a warning about the outbreak on Aug. 16. In the meantime, hundreds, perhaps more than 1,000 contacts could have been affected by potentially infected people, Seward said.

“In this community, these cases so far are all in people who refused vaccination for themselves and their children,” she added.

Of the 16 cases in Tarrant County, 11 did not have any measles vaccination. The others may have had at least one measles vaccination, but they couldn’t produce documentation, county officials said.

The outbreak raises to 159 the total number of confirmed measles cases in the U.S. this year. The disease that once killed 500 people a year in the U.S. and hospitalized 48,000 had been considered eradicated after a vaccine introduced in 1963. Cases now show up typically when an unvaccinated person contracts the disease abroad and spreads it upon return to the U.S.

Five previous cases in Texas this year were far higher than typical years, but don’t appear to be related to the current outbreak, state officials said.

Measles is so contagious that 90 percent of people who are not immune to the disease or vaccinated against it will get sick, health officials warned. It is a respiratory disease spread by sneezing or coughing. The virus can live in the air or on infected surfaces for up to two hours. Symptoms include fever, cough, runny nose and sore throat, plus a characteristic red rash that starts on the face or hairline and spreads to the rest of the body. It can take eight days to two weeks after exposure before an infected person develops symptoms.

Health officials recommend that children receive a Measles/Mumps/Rubella vaccine at age 12 months and again at 4 to 6 years. Unless adults have previously had measles or are immunized, health officials say they should be vaccinated.

“We just want people to be aware and well-informed about the risks of the disease, especially when they travel abroad,” Seward said. 

JoNel Aleccia is a senior health reporter with NBC News. Reach her on Twitter at @JoNel_A leccia or send her an email. 

USPSTF: Primary Care Docs Can Curb Kids' Smoking

USPSTF: Primary Care Docs Can Curb Kids' Smoking

Action Points

Primary care providers can offer "simple, economical, and effective interventions" to help prevent tobacco use among children and teens, according to an updated recommendation from the U.S. Preventive Services Task Force (USPSTF).

The intensity of these interventions can be wide ranging -- from mailing an information packet to patients and their families to 15 hours of in-person group counseling -- and still be effective, according to Virginia Moyer, MD, of Baylor College of Medicine in Houston, who wrote on behalf of the USPSTF.

For the report, the USPSTF reviewed evidence on the effectiveness of primary care interventions on the rates of initiation or cessation of tob acco use in children and adolescents and on health outcomes, Moyer explained in a special article in Pediatrics.

The new evidence "has shown that primary care providers can provide simple, economical, and effective interventions to help prevent tobacco use among children and teens," according to a statement accompanying the report. "Although most serious and life-threatening effects from smoking show up in adults, it is important for children and adolescents to understand that young smokers can suffer from impaired lung growth, early onset of lung deterioration, and respiratory and asthma-related symptoms.""

In 2009, 8.2% of middle school students and 23.9% of high school students reported current use of any tobacco products. Although rates of tobacco use had been on the decline from 2000 to 2011, U.S. Surgeon General Regina Benjamin, MD, declared teen smoking an "epidemic" in March 2012.

Additionally, a study published in BMJ Open showed that, among German teens, smoking advertisement exposure was associated with increased risk of starting or continuing to smoke.

"One important note these guidelines raise is that nearly half a million deaths each year are caused by tobacco," said Harold Farber, MD, MSPH, of Texas Children's Hospital in Houston.

"If that many people were killed in airplane accidents or terrorist activities, we'd be up in arms over it. But somehow, because those deaths are cause by tobacco, we're complacent," he told MedPage Today, adding that parents, researchers, politicians, and practitioners "really need to start getting a handle on how important control of this epidemic is."

An earlier USPSTF recommendation from 2003 "concluded that the evidence was insufficient to recommend for or against routine screening for tobacco use or interventions to prevent and treat tobacco use and dependence in children or adolescents."

However, the new recommendation offer a number of validated interventions for both prevention and cessation in this population.

In preventing tobacco use, one intervention included an information document for children and their families, as well as a 28-minute video, and two follow-up phone calls to offer counseling on the mailed items.

A second intervention involved the creation of a "tobacco-free office and giving patients a series of anti-tobacco messages on preprinted 'prescription' forms."

Another more intense intervention required the youth and at least one parent to participate in seven group and family sessions over 7 weeks, with each session lasing 2 to 2.5 hours, along with take-home workbooks with activities. This intervention was aimed at preventing universal substance abuse and behavioral problems.

Messages delivered in the various interventions were similar and most focused on attitudes a nd knowledge about smoking, consequences of smoking, influences from a social environment, tobacco marketing awareness, skills to decline cigarettes, and parental attitudes and beliefs about smoking, as well as parent-child communication.

"Even very minimal interventions... had substantial effects on reducing smoking initiation," according to the update.

Less research was available on cessation or use reduction programs relevant to primary care. However, programs through community and school outreach were effective in trials exploring those interventions. The USPSTF also cautioned that no medications are currently approved to treat adolescent and nicotine dependence in children and adolescents.

Other interventions the task force supported included cellular phone-based cessation programs based on successes in adult populations; interventions that raise the cost of tobacco products; mass media campaigns against smoking; and community efforts to support strong er laws and enforcement against tobacco products and sales of them to minors.

Finally, the group looked at potential harms from interventions and found that one potential drawback was the initiation of smoking, with some trials reporting higher absolute prevalence of smoking in the intervention group compared with the control group at follow-up. But no trials reported a statistically significant difference between the groups.

The update also directed healthcare professionals to seek tools online, such as those available through the CDC cessation program and the U.S. Department of Health and Human Services, and to consult parents about their tobacco use to avoid "do as I say, not as I do" dilemmas.

Moyer reported no conflicts of interest.


Primary source: Pediatrics
Source reference: Moyer VA, et al "Primary care interventions to prevent tobacco use in children and adolescents: U.S. Preventive Services Task Force recommendation statement" Pediatrics 2013; 132: 560-565; DOI: 10.1542/peds.2013-2079.

Cole Petrochko

Staff Writer

open bio

Minggu, 25 Agustus 2013

Cocaine 'rapidly changes the brain'

Cocaine 'rapidly changes the brain'

Brain cellsThe researchers looked for tiny protrusions from brain cells called dendritic spines

Taking cocaine can change the structure of the brain within hours in what could be the first steps of drug addiction, according to US researchers.

Animal tests, reported in the journal Nature Neuroscience, showed new structures linked to learning and memory began to grow soon after the drug was taken.

Mice with the most brain changes showed a greater preference for cocaine.

Experts described it as the brain "learning addiction".

The team at University of California, Berkeley and UC San Francisco looked for tiny protrusions from brain cells called dendritic spines. They are heavily implicated in memory formation.

Cocaine hunting

The place or environment that drugs are taken plays an important role in addiction.

Continue reading the main story

“Start Quote

This study gives us a solid understanding of how addiction occurs - it shows us how addiction is learned by the brain”

End Quote Dr Gerome Breen Institute of Psychiatry

In the experiments, the mice were allowed to explore freely two very different chambers - each with a different smell and surface texture.

Once they had picked a favourite they were injected with cocaine in the other chamber.

A type of laser microscopy was used to look inside the brains of living mice to hunt for the dendritic spines.

More new spines were produced when the mice were injected with cocaine than with water, suggesting new memories being formed around drug use.

The difference could be detected two hours after the first dose.

Researcher Linda Wilbrecht, assistant professor of psychology and neuroscience at UC Berkeley, said: "Our images provide clear evidence that cocaine induces rapid gains in new spines, and the more spines the mice gain, the more they show they learned about the drug.

"This gives us a possible mechanism for how drug use fuels further drug-seeking behaviour.

"These drug-induced changes in the brain may explain how drug-related cues come to dominate decision making in a human drug user."

Commenting on the research, Dr Gerome Breen, from the Institute of Psychiatry at King's College London, told the BBC: "Dendritic spine development is particularly important in learning and memory.

"This study gives us a solid understanding of how addiction occurs - it shows us how addiction is learned by the brain.

"But it is not immediately apparent how useful this would be in developing a therapy."

Sabtu, 24 Agustus 2013

Porn actress' positive HIV test roils adult entertainment world

Porn actress' positive HIV test roils adult entertainment world

The Free Speech Coalition, a Canoga Park-based trade organization for the adult film industry, said Thursday that a 28-year-old actress who uses the screen name Cameron Bay, tested conclusively positive for HIV.

The coalition had issued the moratorium a day earlier, after preliminary test results came up positive.

While the industry association maintained there was no evidence that Bay had contracted the virus on set, the scare added fuel to an ongoing legal battle over a Los Angeles County measure passed by voters last year requiring porn actors to wear condoms at work.

Mark Schechter, owner of Adult Talent Managers L.A., which represents Bay, told the Los Angeles Times that the actress went in for her regular screening for sexually transmitted diseases on Monday and the results came back inconclusive. She had a second test Tuesday with a new blood sample. Preliminary results came back Wednesday as potentially positive for HIV.

The Free Speech Coalition said Thursday that separate tests by Cutting Edge Testing and Talent Testing Services confirmed the result.

Bay's last test prior to Monday -- which was negative -- took place July 27, Schechter said, and she had done shoots since.

Schechter said Bay was “distraught,” but was cooperating with medical personnel to make sure her partners were notified as quickly as possible.

“As difficult as this news is for me today, I am hopeful that no other performers have been affected,” Bay said in a statement. “I plan on doing everything possible to assist the medical professionals and my fellow performers. Following that, my long-term plan is to take care of myself and my health.”

A positive HIV test can be a double blow in that it leaves an adult performer out of a job while faced with costly medical treatment.

“There’s no health insurance, there’s no union, there really isn’t a safety net,” said Aurora Snow, a recently retired adult film actress. “I feel really bad for her. It’s got to be really tough to get that kind of news.”

Officials with the county’s department of public health confirmed that the agency had been notified of the test result, as required by law, but did not respond to a query whether they were conducting any follow-up investigation to see if the condom mandate had been violated.

A spokesman for Cal/OSHA, the state agency overseeing workplace safety issues, said the agency was gathering information about the case but had not opened a formal investigation.

The most recent industry moratorium related to a sexually transmitted disease was issued in August 2012 as a result of a syphilis outbreak.

A previous HIV scare that shut down adult film production in 2011 turned out to be a false alarm. After a weeklong filming moratorium, the performer involved was retested, with a negative result.

Before that, performer Derrick Burts tested positive in 2010. Burts went on to become an advocate of requiring condom use in porn productions. He said Friday that he felt sympathy for Bay and commended her for coming forward publicly.

But he had harsh words for the industry. The Free Speech Coalition said there was “no evidence whatsoever” that Bay had contracted the infection on set -- a statement Burts said was “jumping the gun” because testing of other performers was ongoing.

“To me, what that says is they care more about saving face,” Burts said. “They care more about the politics, not the performer.”

The Free Speech Coalition said it was working with a doctor affiliated with Adult Production Health and Safety Services to contact and treat any other performers who might have been exposed. The coalition said the moratorium would remain in place until all of Bay’s sexual partners have been tested and cleared.

Because of the rigorous APHSS protocols, the situation was accessed quickly and â€" most importantly â€" action was taken to ensure the protocols were followed,” coalition Chief Executive Diane Duke said.

Jumat, 23 Agustus 2013

For nearly 1 in 5 Americans, BMI may tell the wrong story

For nearly 1 in 5 Americans, BMI may tell the wrong story

Wrong, say a pair of University of Pennsylvania physicians and obesity researchers who are calling for better ways to assess individual health prospects than the body mass index, or BMI.

The BMI--a simple calculation that can be done with a scale and a ruler--is cheap, simple and allows comparisons of broad populations across years, cultures and continents. Since it was invented by Belgian mathematician Adolphe Quetelet in 1832, it has been the basis for research that has pointed overwhelmingly in one direction: When the formula for BMI (weight in kilograms divided by height in meters squared) yields the number 30 or higher, the demarcation line for obesity, the risk of cardiovascular disease, Type 2 diabetes and certain cancers goes up--sometimes dramatically--compared with when that number falls below 25.

And that is statistically true for whole populations of people. But as a measure of personal health, a wealth of recent research has underscored that the BMI can be a pretty poor predictor.

For some with a BMI over 30, a welter of recent studies suggests obesity may confer some health benefits--a mystery widely referred to as the "obesity paradox." Other new studies have shown that when some lean people develop diseases typically associated with obesity--such as Type 2 diabetes or cardiovascular disease--they're more likely to die than if they had been fat with the same diseases.

Add to that that weight status and metabolic health are imperfectly correlated, and the picture becomes perplexing and surprising: The proportion of obese adults who are metabolically unhealthy is high: 21%, or roughly 50.4 million Americans who should unambiguously worry physicians and public health authorities. But 8% of normal-weight adults are metabolically unhealthy. And if the latest research is borne out, that's another 19.2 million that physicians and public health authorities should be fretting about (but who currently do not raise alarms).

Meanwhile, research shows that 10% of the nation's obese adults are metabolically healthy. That may not sound like much. But it does translate into 24 million Americans who are chubby but not in danger of dying early, and yet who are relentlessly harangued by employers, insurers, public health authorities and, yes, health and medicine reporters to lose weight (or else!).

Those numbers, says Dr. Mitchell Lazar, should give actuarial experts (not to mention public health authorities and physicians) pause: They think the BMI tells them who will die early and who will live long and prosper.

But people, Lazar said, may carry excess weight for a variety of reasons--genetic, behavioral, psychological, social--and they may be healthy or unhealthy, die early or live long, for a different constellation of reasons. And there is already growing evidence that certain forms of fatness--that which clusters around the middle rather than around the arms, bottom and legs, for instance--are more predictive of trouble ahead. BMI captures such distinctions quite imperfectly, Lazar said in an interview.

Lazar and Dr. Rexford Ahima, a University of Pennsylvania endocrinologist and obesity expert, write that "there is an urgent need for accurate, practical, and affordable tools for assessing body composition, adipose hormones, myokines, cytokines and other biomarkers as predictive tools" that would let physicians separate the fat-but-fit from those in danger, and to identify the trim ones who look healthy but are actually at risk of illness and early death.

US defends study of blood transfusions for premature babies

US defends study of blood transfusions for premature babies

Fri Aug 23, 2013 1:28pm EDT

(Reuters) - A government-supported study of blood transfusion levels in premature infants adheres to the highest ethical and clinical standards, the National Institutes of Health said this week in response to advocacy group Public Citizen, which has called for the study to be stopped.

The Transfusion of Premature (TOP) trial aims to determine the best way to treat anemia in premature babies, most of whom will need blood transfusions during their care.

Public Citizen, in a letter sent on Thursday to U.S. Health and Human Services Secretary Kathleen Sebelius, said the clinical trial exposes the infants to risks without fully informing their parents.

The NIH said it is committed to ensuring that prospective research participants - and the people who speak for and love them - are given clear complete, and accurate information about the risks and benefits of participating in research.

The NIH said in an emailed statement that all consent forms have been reviewed and approved by the Institutional Review Boards (IRB) at the research institutions conducting the study, but the agency did not respond to the specific concerns raised by Public Citizen.

The group said tha t of 17 IRB-approved consent forms it had obtained, only one mentions the foreseeable risk of death or disability, five say the research poses no risk and 16 equate the risks of the research to the risks of routine medical care.

The trial randomly assigns half of the infants in the study to receive transfusions at a high hemoglobin level and half at a low hemoglobin level. Hemoglobin are the red blood cells that carry oxygen throughout the body.

Public Citizen said the best available evidence suggests a restrictive transfusion strategy is more likely to cause neurological injury or other harm to extremely premature infants, and the trial exposes more than 900 infants to the inferior treatment.

Earlier this year, Public Citizen called for an investigation into an NIH-funded study from 2005 to 2009 that was designed to test the effectiveness of different oxygen levels in the treatment of very premature infants. Public Ci tizen said that study exposed infants to an increased risk of blindness, brain injury and death, without properly disclosing the information to parents.

(Reporting By Deena Beasley; Editing by Kenneth Barry)

Kamis, 22 Agustus 2013

Mers: Deadly coronavirus found in tomb bat

Mers: Deadly coronavirus found in tomb bat

Egyptian tomb batThe sample was found in a faecal sample taken from an Egyptian tomb bat

The deadly Mers coronavirus has been isolated in a bat in Saudi Arabia, scientists report.

The virus was detected in a faecal sample taken from an Egyptian tomb bat, collected close to the home of the first known Mers victim.

The research is published in the journal Emerging Infectious Diseases.

But while scientists found a genetic match, they think it is unlikely that bats are responsible for passing the virus to humans.

Instead they think the virus is spreading from the winged mammals to other animals before it is reaching people.

Another piece of research was recently published in the journal Lancet Infectious Diseases, which suggested that this intermediary animal could be the dromedary camel.

However, only antibodies - the proteins produced to fight infections - were detected in camels, rather than the virus itself, and more work needs to be done to confirm this finding.

'Identical sequence'

The Mers coronavirus first emerged in the Middle East last year.

Continue reading the main story

“Start Quote

In this case we have a virus in an animal that is identical in sequence to the virus found in the first human case”

End Quote Dr Ian Lipkin Columbia University

So far, there have been 94 confirmed cases and 47 deaths.

While the virus has been spreading between humans, most cases are thought to have been caused by contact with an animal.

But scientists have struggled to work out which one.

In October 2012 and April 2013, researchers collected samples taken from different bat species found close to the home of the first known victim of Mers.

These were sent to Columbia University in New York. However, the first batch was opened at US customs, and thawed to room temperature. The April batch arrived intact.

Of the 1,000 samples collected, only one taken from the Egyptian tomb bat contained any signs of the virus.

Dr Ian Lipkin, director of the Center for Infection and Immunity from Columbia University and a co-author of the study, said: "In this case we have a virus in an animal that is identical in sequence to the virus found in the first human case."

Narrowing hunt

Dromedary camelResearchers are now looking to see if camels and other animals are involved in spreading the virus

The finding suggests that bats could be the origin of the disease, but scientists are looking for another animal that is involved in its spread. Samples taken from camels, sheep, goats and cattle are now being analysed.

Commenting on the research, Prof Jonathan Ball, a virologist from the University of Nottingham, said: "We have long suspected that bats are likely to be the original source of Mers. They've been around for millions of years and have picked up a lot of viruses on the way - bats are a source of lots of human virus infections, like Ebola, henipahvirus, rabies and Sars.

"But there are still some crucial unknowns. They sequenced a very small part of the virus genome - and a highly conserved part at that. We would need to see more extensive analysis involving other more variable genes before we can definitively say the viruses are related.

"Even if this proves to be the case, bats are unlikely to be the source of the continuing Mers outbreaks. Humans and bats just don't interact very much. It's much more likely that an intermediate animal is involved - and finding out what this animal is is key if we are to eradicate this virus before it becomes a bigger problem."

Prof Ian Jones from the University of Reading added: "The surprising overall message is that the bats of (Saudi Arabia) are not awash in the virus, quite the opposite as only one example was found and that appeared to be incomplete.

"The main reservoir for this virus and how it gets to infect people remains unclear at this stage."

Circumcision rates declining, especially in Western states

Circumcision rates declining, especially in Western states

Fewer American parents are having their newborn sons circumcised, according to a new report from the Centers for Disease Control and Prevention (CDC). The largest decline comes in Western states.

In 1979, about two-thirds of boys in Western states got circumcised in the hospital shortly after birth, nearly equal to the nationwide rate at that time of 65 percent. By 2010, the CDC reports, the numbers out West had dropped to 40 percent while the nationwide rate was 58 percent. It hasn't been a steady decline -- the national rate in 2010 was actually slightly higher than 2007, when only 55 percent of newborn boys were circumcised.

The report comes from the National Center for Health Statistics, a division of the CDC.

The decision to circumcise is often weighed against religious an d cultural beliefs. Opponents say it is a cruel procedure to inflict upon a child who cannot consent. In its mission statement, the non-profit anti-circumcision movement, Intact America, says that it seeks to "protect babies and children from circumcision and all other forms of medically unnecessary genital alteration, whether carried out for cultural conformity or profit, in medical or non-medical settings."

In 2011, a male circumcision ban almost made the November ballot in San Francisco. A judge later ruled that the issue should be a state decision, rather than decided in a city election.

There is a range of potential reasons behind the decline, including mixed messaging on the health benefits. Several insurance companies have also stopped covering circumcision. In Arizona, California, Oregon and Washington, Medicaid does not cover the procedure. The report also looked only at hospital circumcision rates, and some newborns may be getting the procedure elsewhere.

The mixed messaging in part has come from the top children's medical society, the American Academy of Pediatrics, which has see-sawed its stance over the last 40 years.

In the 1970s, the organization said there is no medical reason to have a baby circumcised. By the '80s, it said there could be medical benefits. The next decade, in 1999, it was back to saying there wasn't sufficient evidence to recommend the procedure.

Then, last year, the AAP released a statement saying "the medical benefits of circumcision outweigh the risks." It recommended that insurance companies should cover its costs.

"In 1999, there was some data suggesting that there were some small medical benefits to circumcision but, at the time, there was not a compelling medical reason to recommend circumcision. So the previous policy didn't argue for or against circumcision," Dr. Douglas S. Diekema, a member of the circumcision task force behind the new statement, said last August. "However, now there is much stronger evidence about protective medical benefits associated with circumcision, so the tone of this policy statement has changed."

Some of the cited benefits included risk reductions for male urinary tract infections, especially in the first year of life, and a lower risk of cancer and heterosexual acquisition of HIV and other sexually transmitted diseases.

Still, the AAP said that in the end, the benefits were not great enough to recommend the procedure routinely, and the decision should be made by parents and doctors.

Risks of circumcision include complications like bleeding and infection, and there have bee n reports of decreases in sensitivity and declines in sexual satisfaction, according to the CDC.

Regionally, about two-thirds of Midwest boys are circumcised, according to the new report. In the Northeast, the rates varied within the 60-percent range from 1979 to 2010. In the South, the rates peaked in 1998 before a slight but steady decline.

"The overall modest rate of decline reflects that parents are more thoughtful about circumcision now than they were a decade or two ago when circumcision was a given," Dr. Thomas McInerny, president of the American Academy of Pediatrics, told NPR. "I don't think that anyone has surveyed parents by U.S. regions to determine why there are significant regional differences, so I can't tell you why this variation exists ."

Rabu, 21 Agustus 2013

Players' brain study finds 2 main symptom patterns

Players' brain study finds 2 main symptom patterns

CHICAGO â€" Early signs of a destructive brain disease linked with head blows might include mood changes in younger athletes and mental decline at older ages, a small study of deceased former players suggests.

The researchers think the disease could involve two distinct patterns of symptoms, although the study doesn't prove that the behavior reported by families was caused by the brain disease, which was found after the athletes died.

The study is the largest report on a series of cases involving autopsy-confirmed chronic traumatic encephalopathy, or CTE, said lead author Robert Stern, a neurology professor at Boston University's medical school. It involved 36 former athletes â€" mostly professional football players â€" who'd experienced repeated head blows. Their brains were donated for research by their families.

The results were published online Wednesday in the journal Neurology. Results were based on brain imaging after death, medical records and family interviews. Players involved were all men, aged 17 to 98. Six died from suicide.

In younger players, mood and behavior changes, including depression and explosive tempers, began appearing at an average age of 35, long before mental decline. But in older players, mental decline, starting around age 59, was the first symptom.

Overall, 22 players first developed mood or behavior changes and 11 initially had memory problems or other mental decline. Three players had no symptoms.

The results echo research in former boxers with "punch drunk" symptoms, but that evidence didn't include brain imaging, Stern said.

He said he hopes the study will help lead to ways of diagnosing CTE before death and treating the disease.

The researchers acknowledged the study's limitations, including the small size and lack of a comparison group of former players without the disease. Larger studies might reveal other distinct patterns of symptoms, they said.

Little is known about CTE and its causes, but repeated head injuries including concussions are thought to be a risk factor. The disease process is thought to begin long before symptoms appear and involves an increasing buildup of abnormal proteins in the brain.

But Stern said, "there's no way to ever make a link directly between symptoms" and brain disease found after death.

Jeffrey Kutcher, director of a University of Michigan sports neurology program, echoed that comment and said the study athletes' symptoms could have been caused by something other than CTE, including depression, medication use, sleep deprivation, or normal aging.

Several former NFL stars have been diagnosed with the disease after death in recent years, including Junior Seau, Dave Duerson and Ray Easterling, who all had troubling symptoms and committed suicide.

Thousands of former players have sued the NFL, claiming the league withheld information about damaging effects of repeated head blows and concussions.

"The bottom line is, there's very little direct evidence of chronic effects of head trauma," Kutcher said. "As a neurologist, I know that brains don't like to experience" repeated head blows. "On the other side, I know that the majority of people who experience these forces do not have life-altering clinical outcomes."

A recent National Institutes of Health report said big questions remain for CTE research, including how prevalent it is; do genes make some people more vulnerable to it and how can it be diagnosed before death.

Copyright 2013 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

'Biological signal' of suicide risk found in blood

'Biological signal' of suicide risk found in blood

Featured Article
Academic Journal
Main Category: Mental Health
Also Included In: Depression;  Psychology / Psychiatry;  Medical Devices / Diagnostics
Article Date: 21 Aug 2013 - 8:00 PDT

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Researchers have discovered a series of RNA biomarkers in blood that could be used to develop a test to predict the risk of a person committing suicide.

The research, published in the journal Molecular Psychiatry, analyzed a large group of male patients from four cohort studies over a three-year period. All patients were diagnosed with bipolar disorder.

Psychiatrists and other researchers from the Indiana University School of Medicine conducted a series of interviews with the patients.

There was one interview at the baseline of the study, followed by up to three testing visits - when blood was also taken from the patients, every three and six months.

Each testing visit involved the patients being given a psychiatric score using the "Hamilton Rating Scale for Depression-17." This scale includes a rating for suicidal ideation (SI) to determine level of suicidal feeling. Blood was then taken from the subjects of the study.

The researchers analyzed the blood of participants who reported a dramatic shift from feeling no suicidal thoughts at all, to strong suicidal ideation.

Results of the analysis revealed significant gene differences between the patients who experienced high states of suicidal thinking and the people with low states of suicidal feeling.

'SAT1 biomarker' for suicide

The researchers say they found that the marker SAT1, alongside a series of others, was a strong "biological signal" associated with suicidal thoughts.

In support of their findings, the researchers analyzed blood samples taken from suicide victims from a local coroners office. The blood samples revealed that some of the same markers were elevated.

The researchers then analyzed blood test results from two other groups of patients. They found that high blood levels of these specific biomarkers were linked with future suicide-related hospitalizations, and hospitalizations that took place before the blood tests.

Dr. Alexander Niculescu, associate professor of psychiatry and medical neuroscience at the Indiana University School of Medicine, says:

"Suicide is a big problem in psychiatry. It is a big problem in the civilian realm, it is a big problem in the military realm and there are no objective markers.

There are people who will not reveal they are having suicidal thoughts when you ask them, who then commit it and there's nothing you can do about it. We need better ways to identify, intervene and prevent these tragic cases."

Dr. Niculescu talks more in a UI School of Medicine YouTube film:

According to CDC statistics on self-inflicted injury and suicide, in 2010 there were:

  • 713,000 emergency department visits for self-inflicted injury
  • 38,364 suicidal deaths.

"Suicide is complex. In addition to psychiatric and addiction issues that make people more vulnerable, there are existential issues related to lack of satisfaction with one's life, lack of hope for the future, not feeling needed, and cultural factors that make suicide seem like an option," says Dr. Niculescu.

'Further research needed' on females

The researchers note that although they are confident that these biomarkers could be used for future blood tests to detect suicide risk, the subjects in the study were all male.

lab test
The researchers are confident their findings could lead to a lab blood test for suicide risk but want to study biomarkers in females too.

"There could be gender differences. We would also like to conduct more extensive, normative studies, in the population at large," says Dr. Niculescu.

They would also like to conduct further research within other groups, such as those who have less impulsive, and more planned or deliberate suicide ideation.

"These seem to be good markers for suicidal behavior in males who have bipolar mood disorders or males in the general population who commit impulsive violent suicide," adds Dr. Niculescu.

"In the future we want to study and assemble clinical and socio-demographic risk factors, along with our blood tests, to increase our ability to predict risk."

In conclusion, the researchers add that they hope these biomarkers, along with other tools under their development - including neuropsychological tests and socio-demographic checklists - will help identify those who are at risk of suicide, and lead to intervention, counseling, and the saving of lives.

Written by Honor Whiteman

Various charitable organizations offer support for people feeling suicidal:

Befrienders Worldwide is a network of 169 emotional support centres in 29 countries.

Samaritans USA has local branches and a toll-free number: 1-800-273-TALK.

Samaritans in the UK offers a similar service there, where people would call 08457 90 90 90.


Copyright: Medical News Today
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MediLexicon International Ltd
Bexhill-on-Sea, United Kingdom
MediLexicon International Ltd © 2004-2013 All rights reserved.
MNT (logo) is the registered trade mark of MediLexicon Int. Limited.