martes, 31 de julio de 2012

Smoking Tied to Risk for Hepatitis Return After Liver Transplant: MedlinePlus

Smoking Tied to Risk for Hepatitis Return After Liver Transplant: MedlinePlus

MedlinePlus Logo

Smoking Tied to Risk for Hepatitis Return After Liver Transplant

Study findings indicate even ex-smokers were more likely to be re-infected within 1 year
(*this news item will not be available after 10/25/2012)

By Robert Preidt
Friday, July 27, 2012 HealthDay Logo
HealthDay news image
Related MedlinePlus Pages
FRIDAY, July 27 (HealthDay News) -- Current or previous smoking may increase the risk of hepatitis reinfection in people who have a liver transplant due to viral hepatitis, a new study suggests.
This may be because tobacco in cigarettes lowers their immune system response, according to Dr. Mamatha Bhat, of McGill University in Montreal, and colleagues.
For the study, the investigators analyzed data from 444 transplants conducted at the McGill University Health Center between 1990 and 2004.
They found that the average "viral hepatitis-free survival time" was less than one year for smokers and more than four years for nonsmokers.
The study was published in the July issue of the journal Liver Transplantation.
"Our findings suggest that recurrence of viral hepatitis may be more frequent among liver transplant recipients who are active or former smokers," Bhat said in a journal news release. Encouraging patients to quit smoking after their transplant may improve their outcomes, she added.
The study results do not mean that smokers should be denied liver transplants, but suggest that doctors need to be more vigilant in monitoring for complications in patients who smoke.
"Organs available for transplantation are scarce, with livers particularly in short supply," Bhat said. "Transplant centers need to take an active role in identifying and minimizing risks to the success of liver transplantation."
While the study uncovered an association between smoking and the recurrence of viral hepatitis in liver transplant patients, it did not prove a cause-and-effect relationship.
SOURCE: Liver Transplantation, news release, July 12, 2012
HealthDay

More Health News on:
Liver Transplantation
Smoking

Weight Control Can Cut Women's Diabetes Risk, Study Shows: MedlinePlus

Weight Control Can Cut Women's Diabetes Risk, Study Shows: MedlinePlus

MedlinePlus Logo

Weight Control Can Cut Women's Diabetes Risk, Study Shows

Exercise and healthy diet paid off regardless of race
(*this news item will not be available after 10/25/2012)

By Robert Preidt
Friday, July 27, 2012 HealthDay Logo
HealthDay news image
Related MedlinePlus Pages
FRIDAY, July 27 (HealthDay News) -- Weight control through diet and exercise can prevent most cases of type 2 diabetes in American women over age 50, a new study finds.
Researchers from the University of Massachusetts Medical School in Worcester, Mass., analyzed data from more than 150,000 postmenopausal women who were followed for more than 10 years. Hispanics and Asians were about twice as likely as whites to develop diabetes; blacks were two to three times as likely.
Those differences were largely due to modifiable lifestyle factors such as diet, physical activity and smoking, the researchers said.
The study also found that a large reduction in diabetes risk among women would occur in all four racial and ethnic groups if they maintained a healthy body weight, ate a healthy diet and were physically active.
Maintaining a body-mass index (BMI) of less than 25 appeared to be particularly important in reducing diabetes risk. BMI is a measure of body fat based on height and weight.
"Our work shows that among numerous races [and] ethnicities, the women with both high body-mass index and low levels of physical activity are far more likely to develop diabetes," primary investigator Dr. Yunsheng Ma said in a medical school news release. "A healthier diet and adequate levels of physical activity significantly lower that risk for most women."
The study was published July 23 in the journal Diabetes Care.
Type 2 diabetes, the more common type, means the body doesn't produce or properly use the hormone insulin, which is needed to convert food into energy. Untreated, type 2 diabetes can cause damage to the heart, eyes, kidneys and other organs.
SOURCE: University of Massachusetts Medical School, news release, July 23, 2012
HealthDay

More Health News on:
Diabetes
Weight Control
Women's Health

Death certificates may not tell the whole story: MedlinePlus

Death certificates may not tell the whole story: MedlinePlus

MedlinePlus Logo

Death certificates may not tell the whole story

(*this news item will not be available after 10/25/2012)

Friday, July 27, 2012 Reuters Health Information Logo
Related MedlinePlus Pages
By Natasja Sheriff
NEW YORK (Reuters Health) - Dementia may be overlooked as one of the biggest contributors to death in the U.S., thanks to oversimplistic death certificates, says a new study.
While the Centers for Disease Control and Prevention (CDC) attributed only three percent of recent deaths to dementia, the condition contributed to 13 percent of deaths among the population the researchers studied.
"We were actually surprised at what we found," Dr. Mary Tinetti, who led the study at Yale University, told Reuters Health. "Dementia was the second most common contributor to death, which is a much higher proportion than when only a single cause of death is considered."
When doctors in the U.S. fill out death certificates, they follow World Health Organization guidelines to decide how a person died, and then record just one underlying reason for death.
That may make sense for young people who die, said Tinetti, but attributing death to just a single disease isn't accurate for older adults.
"The vast majority of older adults have two, three, four or even five chronic diseases," said Tinetti, whose team published their report in the Journal of the American Geriatrics Society.
For the new study, Tinetti and her colleagues looked at treatment claims submitted for 22,890 Medicare beneficiaries and found 97 chronic diseases and acute problems.
During the 41-month study, 2,245 people died; two-thirds of those were over 80 years old.
When researchers looked at Medicare claims for those people who died, they found that fifteen diseases had contributed to 70 percent of deaths. Heart failure was involved in 20 percent of deaths, making it the most common contributor. Dementia contributed to 13 percent of deaths.
Lung diseases, such as bronchitis, asthma and emphysema, were found in 12.4 percent of deaths and pneumonia in 5.3 percent of deaths. Cancer contributed to just 5.6 percent of deaths.
Mortality data from death certificates are published by the CDC and widely used to guide health policy and healthcare research.
Tinetti and her colleagues found that the main contributors to death in older adults are similar to those listed by the CDC, but there were important exceptions: the CDC attributed only three percent of deaths to dementia in 2004, while cancer accounted for 22 percent of deaths.
Diabetes, the sixth most important cause of death on the CDC list, was absent from the Yale team's list. In their report, the researchers say that's most likely due to the close association between diabetes and other conditions like heart and kidney diseases.
Researchers couldn't get access to death certificates for the people who died during the study, so the official causes of death couldn't be compared to the claims-based findings.
A MORE ACCURATE APPROACH?
In their report, the researchers point to a need for a more accurate method of measuring how different diseases contribute to death to establish public health, clinical and research priorities for an aging population.
But Tinetti thinks that change is unlikely to come any time soon.
"It would probably take a lot of time and lot of people to decide that the current approach doesn't work and that we need to change it. But at least this starts people thinking that we need to do this differently," she said.
Dr. James Burke, who has studied multiple causes of death at the University of Michigan, agreed.
"It would require a huge amount of resources to use that data more meaningfully, and it would depend on the investment society wants to make," Burke told Reuters Health.
SOURCE: http://bit.ly/OpqZ0u Journal of the American Geriatrics Society, online June 26, 2012.
Reuters Health

More Health News on:
Dementia
Health Statistics

Ex-smokers have higher risks for bowel diseases: MedlinePlus

Ex-smokers have higher risks for bowel diseases: MedlinePlus

MedlinePlus Logo

Ex-smokers have higher risks for bowel diseases

(*this news item will not be available after 10/25/2012)

Friday, July 27, 2012 Reuters Health Information Logo
Related MedlinePlus Pages
By Kerry Grens
NEW YORK (Reuters Health) - Compared to people who've never smoked, former smokers have a higher risk of developing two inflammatory bowel diseases, Crohn's disease and ulcerative colitis, according to a new study.
"The increased risk of ulcerative colitis following smoking cessation persisted even two decades after cessation," said Dr. Leslie Higuchi, the lead author of the study and a researcher at Children's Hospital Boston and Harvard Medical School.
Following up on earlier shorter-term studies of the subject, Higuchi and her team collected information from nearly 230,000 female nurses who were surveyed about their behavior and health status from 1976 and 1989.
Over time, Higuchi and her colleagues found, 144 out of about 124,000 never-smokers developed Crohn's disease, while 117 out of 51,000 ex-smokers and 75 out of 53,500 smokers also developed the autoimmune disease.
After taking into account other risk factors, such as age, weight and hormone therapy use, they determined that smokers were 90 percent more likely to develop Crohn's than women who never smoked and ex-smokers were 35 percent more likely.
The more people smoked, the higher their risk.
For instance, women who had smoked a pack a day for 10 to 25 years were 1.7 times as likely to develop Crohn's as someone who never smoked, while women who smoked a pack a day for more than 25 years were 2.3 times as likely.
The researchers found that smoking was also tied to ulcerative colitis, an inflammation of the colon that can cause pain, diarrhea and bleeding.
Higuchi's group found that 190 non-smokers, 167 former smokers and 43 current smokers developed colitis during the study period.
The picture became more complicated when the researchers compared ex-smokers to current smokers, as quitters actually had a 50 percent higher risk of colitis than people who continued the habit.
Current smokers had the same risk as the women who never smoked, something that has been shown in other studies.
ANYTHING NEW?
The study does not show that smoking is the cause of the increased risks. "The mechanisms aren't clear" as to why smoking is linked to these diseases, and in such different ways, said Higuchi.
"None of this is new at all. Zero," said Dr. Stephen Hanauer, a professor at the University of Chicago Medicine, who was not involved in this study.
What is new, Higuchi said, is that she was able to track the ex-smokers in her study for more than 20 years. Even at that point, there was still an "increased risk of ulcerative colitis 20 years out, compared to current smokers in this study," Higuchi told Reuters Health.
The risk did appear to fade over time, however.
Within two to five years of quitting, women were three times as likely to develop colitis as women who continued to smoke.
But more than 20 years after giving up cigarettes, women were just a little more than one-and-a-half times more likely to get colitis.
Because of the higher risk of colitis found among ex-smokers, some studies have looked into using nicotine or cigarettes as a way to treat patients with colitis.
For rare cases in which former smokers have severe colitis that does not respond to other treatments, Hanauer said resuming low levels of smoking might be useful.
But Hanauer and Higuchi said that the health risks of smoking are too great to advocate that people should use cigarettes as a way to lower their risk of ulcerative colitis.
"The big message still is there is an environmental factor that impacts on autoimmune-type diseases...and researchers are looking at the ingredients (in cigarette smoke) to identify how and why they impact on inflammation," Hanauer told Reuters Health.
SOURCE: http://bit.ly/MuaQ9W The American Journal of Gastroenterology, online July 10, 2012.
Reuters Health

Only 1 in 4 Americans With HIV Has Virus Under Control: CDC: MedlinePlus

Only 1 in 4 Americans With HIV Has Virus Under Control: CDC: MedlinePlus

MedlinePlus Logo

Only 1 in 4 Americans With HIV Has Virus Under Control: CDC

Blacks, younger patients least likely to have ongoing care
(*this news item will not be available after 10/25/2012)

Friday, July 27, 2012 HealthDay Logo
HealthDay news image
Related MedlinePlus Pages
FRIDAY, July 27 (HealthDay News) -- Among the 1.1 million Americans living with HIV, just one in four has the virus under control, U.S. health researchers say.
In a report presented Friday at the International AIDS Conference in Washington, D.C., researchers from the U.S. Centers for Disease Control and Prevention said the problem applies to patients of all ages, races and ethnic groups, but especially to young people and blacks.
"This is the first time that we have ever looked at the outcome of continuum of care across all patient groups," said CDC epidemiologist Irene Hall. "And what we found is that, overall, too few people with HIV have viral suppression." People with viral load suppression are healthy and less likely to transmit the virus to others.
"Only if we get everyone under regular care for HIV/AIDS can we recognize the full benefits of treatment and prevention," said Hall, chief of the HIV incidence and case surveillance branch in the CDC division of HIV/AIDS prevention.
For the report, Hall and her colleagues pored through 2009 data collected by the CDC, which included rates of HIV testing, patient participation in the health care system, continuity of care for HIV, treatment prescribed, and the patient's viral load status in terms of suppression.
Overall, about 82 percent of all those infected with HIV know their status, meaning that more than 200,000 Americans now infected with HIV are not aware of their condition.
Two-thirds of the nation's HIV patients do have some relationship with a care provider, the report indicates, and more than one-third (37 percent) receive continuous HIV care, while one-third are treated with antiretroviral therapy.
But just over one-third of black patients were found to have ongoing care, compared with 37 percent to 38 percent of Latinos and whites. Similarly, just a little over one in five black patients was found to have viral load suppression, compared with 26 percent of Latinos and 30 percent of whites.
Blacks infected with HIV were the least likely to find out they were infected in the first place and the least likely to get any care for HIV, Hall added.
Younger HIV patients were also much less likely than older patients to know their HIV status and to obtain routine care, Hall said.
Suppression rates were also poorer among younger patients, with just 15 percent of those aged 25 to 34 having their virus under control compared with 36 percent among those aged 55 to 64.
No significant differences were seen between males and females in terms of diagnosis, treatment or disease control.
For now, the report authors can only theorize about what lies behind these differences in HIV care.
"Our study did not look at the reasons for why people are not in care, or are not prescribed [antiretroviral therapy] or don't have viral suppression," Hall noted. "But in general we do know there are differences in access to care and in insurance status. There is also a stigma associated with [HIV], and some people might distrust the medical system."
As for young people, they may not feel at risk and may not go to the doctor as often, she added.
"The treatment options certainly are much better today than in the past, but it is still a very serious disease," she said. "And it's very important that people know their status and that people who are infected get regular care."
This is not only so they can have optimum health, she said, but also "because if we want a national strategy for prevention we do need to have people with a suppressed viral load and in care so we can stop transmission of the virus."
Chris Collins, vice president and director of public policy at the American Foundation for AIDS Research (amfAR) in Washington, D.C., said that the CDC report "sounds consistent" with previous assessments of the current HIV picture across the country.
"One in five are living with HIV and don't know it," he noted. "And many other people are estranged from the health system. They don't think they can get quality care or don't have access, and we haven't done enough outreach."
Complacency about AIDS is an obstacle to ending the disease in America, said Collins. "The science is telling us that we have the opportunity to begin to end this epidemic in America," he said. "But Americans have to realize that while we have drugs that can save lives, we have failed to get them to half of the people that need them."
SOURCES: Irene Hall, Ph.D., MpH, epidemiologist and chief, HIV incidence and case surveillance branch, division of HIV/AIDS Prevention, U.S. Centers for Disease Control and Prevention, Atlanta; Chris Collins, vice president and director, public policy, amfAR, Washington D.C.; July 27, 2012, presentation, International AIDS Conference, Washington, D.C.
HealthDay

More Health News on:
HIV/AIDS
Living with HIV/AIDS

Women May Fare Worse Than Men After Stroke: MedlinePlus

Women May Fare Worse Than Men After Stroke: MedlinePlus

MedlinePlus Logo

Women May Fare Worse Than Men After Stroke

Female patients report more problems with their physical and emotional health, study finds
(*this news item will not be available after 10/25/2012)

By Robert Preidt
Friday, July 27, 2012 HealthDay Logo
HealthDay news image
Related MedlinePlus Pages
FRIDAY, July 27 (HealthDay News) -- Women have a poorer quality of life after a stroke or a ministroke than men, according to Swedish researchers.
In the study, 379 stroke patients and 117 transient ischemic attack (TIA), or ministroke, patients answered a quality-of-life survey that measured physical, emotional and social aspects of their health. Ministrokes are brief blockages of the blood supply cause temporary stroke symptoms.
Female stroke patients had much lower scores than men in five of six aspects of quality of life: emotion, sleep, energy, pain and mobility, the researchers reported in the August issue of the Journal of Clinical Nursing.
In terms of specific issues, women were more likely than men to report problems with housekeeping (56 percent versus 36 percent) after a stroke. Men were more likely than women to report issues with sex (34 percent versus 19 percent).
Female ministroke patients were much more likely than men to be affected in all aspects of quality of life. Specifically, women were more likely than men to feel the effects from their ministroke in the following areas: housekeeping (48 percent versus 20 percent, respectively); family (13 percent versus 0 percent, respectively); and leisure time activities (42 percent versus 23 percent, respectively).
The researchers also found that male stroke patients were much more affected in certain areas of quality of life than male ministroke patients (emotional, energy, social) but there were no significant differences between female stroke and ministroke patients.
"Our study shows that female stroke patients are more affected than male stroke patients when it comes to quality of life," study co-author Dr. Ann Charlotte Laska, of Danderyd Hospital in Stockholm, said in a journal news release. "It also shows that female [ministroke] patients are as badly affected when it comes to quality of life as female stroke patients and need the same level of support after they are discharged from hospital."
SOURCE: Journal of Clinical Nursing, news release, July 25, 2012
HealthDay

More Health News on:
Stroke
Stroke Rehabilitation

The Care and Feeding of Olympic Athletes: MedlinePlus

The Care and Feeding of Olympic Athletes: MedlinePlus

MedlinePlus Logo

The Care and Feeding of Olympic Athletes

Right combination of food and fluid can be critical to success
(*this news item will not be available after 10/25/2012)

Friday, July 27, 2012 HealthDay Logo
HealthDay news image
Related MedlinePlus Pages
FRIDAY, July 27 (HealthDay News) -- It seems there's virtually no end to the power and stamina of Olympic athletes, which is due in part to the detailed guidance they get from experts about the right amount and type of food they need.
So what do Olympic athletes eat? A lot.
On average, they need to consume between 8,000 and 10,000 calories a day, compared to just 2,000 to 2,800 calories a day for the average moderately active man, according to the Academy of Nutrition and Dietetics.
The science of fueling athletes for elite sports goes way beyond caloric intake to include percentages of carbohydrates versus proteins, quantities of fluid and the timing of meals and snacks.
"There is a huge range of different needs, depending on the event and how much speed, endurance and strength the athlete needs," said Dr. Christine Gerbstadt, a registered dietician and anesthesiologist in Gaithersburg, Md.
The advice athletes get has changed a lot in the past 20 years, Gerbstadt said. "You used to see an NFL football team sit down to a huge steak dinner before a game," she said. "No more."
Instead, the new approach is designed to feed athletes not just a combination of foods they need prior to an event, but to ensure that they ingest the right nutrients to help repair their muscles for the next competition, Gerbstadt said.
There are three phases to consider when planning the nutritional needs of athletes, Gerbstadt explained. An hour or two before an event, the Olympians should have an easily digestible light meal -- ideally oatmeal and a banana with milk or yogurt. An hour or so before the competition, they also need 16 ounces of water.
Hydration is a big issue, said Amy Jamieson-Petonic, a registered dietician and director of wellness coaching for the Cleveland Clinic.
"Athletes can lose 2 percent to 3 percent of their body weight from dehydration, which can negatively impact their aerobic performance," she said.
Trainers and coaches regularly check their athletes' specific gravity and osmolality (measures of dehydration), she added.
Some sports are more likely to lead to dehydration than others, Jamieson said. Swimmers typically are at high risk for the condition because they typically can't grab a sip of water in the middle of the event.
If an athlete's event is an hour long or less, they shouldn't drink water during the competition, Gerbstadt said. If it's more than an hour, the amount of water they should drink depends on the temperature, humidity and how much they actually perspire.
Gerbstadt recommends drinking 16 ounces of water, juice or a sports drink anywhere from every 15 minutes to every hour, depending on the individual's needs.
"They shouldn't go overboard on the fluids," she said. "It's actually better to be under-hydrating than taking in too much fluid."
After the event, in the "recovery" phase, the goal is to help the athletes' bodies bounce back quickly. The average Olympian burns about 800 calories an hour, but that can be replaced gradually over four to eight hours, Gerbstadt said.
She advises athletes to eat a quick recovery snack as soon after the competition as they can -- preferably 20 to 30 grams of protein and carbohydrates.
"A fruit smoothie with protein powder would be ideal, or a turkey sandwich is great," she said. "Without the immediate snack, there will be a prolonged recovery time of broken-down muscle fibers."
For most Olympic athletes, one of the hardest aspects of nutrition is finding the time to consume all the calories they need, said Jamieson-Petonic.
"They're training so hard, they have to literally plan to eat and drink multiple times a day," she said. "Because their nutrient needs are so high, they have to schedule meals and snacks very carefully."
The guidance that nutritionists offer Olympic athletes is also highly individualized, going beyond their sport to their particular preferences. "Everybody's got something a little different in their sports bottle," Gerbstadt said.
Although most people will never experience the athletic demands Olympians face, there are some important lessons from the nutrition experts for everyone who exercises:
  • If you wonder whether you get enough hydration when you exercise, try weighing yourself first thing in the morning and then again right after your workout. The decrease in weight will represent the amount of fluid you lost, Jamieson-Petonic said. You'll need to replace every pound you lost with 24 ounces of fluid, she added.
  • Concerned you might be dehydrated? It will probably be evident through your performance. "You feel like you just can't go on, your body can't do what it's used to doing," Jamieson-Petonic said. "You can walk but you can't run."
  • Don't roll out of bed and go straight to a 5K run without some breakfast, Gerbstadt said. "Be sure to get some carbohydrates, lean protein and fluid on board before you go."
SOURCES: Christine Gerbstadt, M.D., R.D., Gaithersburg, Md.; Amy Jamieson-Petonic, R.D., director, wellness coaching, Cleveland Clinic, Ohio; July 17, 2012, news release, Academy of Nutrition and Dietetics, Chicago
HealthDay