Study links 911 stress to heart disease
Tue, 08 Jan 2008 00:19:56 GMTBy AMY WESTFELDT, Associated Press Writer
NEW YORK - Americans who said they became anxious and stressed after the Sept. 11 terrorist attacks — some just from watching the collapse of the twin towers on television — reported higher rates of heart disease up to three years later, researchers said.
While several studies have found high rates of post-traumatic stress disorder and anxiety in first responders or attack survivors, most of the nearly 2,000 people randomly selected nationwide for the study had no direct connection to Sept. 11.
The research showed that before Sept. 11, about 22 percent of the participants reported they had heart ailments. Three years after the attacks, about 31 percent of them said they had developed heart problems.
People who said they were acutely stressed by the attacks were more than twice as likely to have high blood pressure one year after the attacks, and more than three times as likely to have heart problems two years after the attacks, according to the study reported in January's issue of the journal Archives of General Psychiatry.
The findings document the physical consequences of stress, especially from watching upsetting events on television, said lead researcher Alison Holman of the University of California-Irvine. About two-thirds of the participants watched the Sept. 11 attacks on live television.
"Seeing something as stressful as that on television is a very important thing to consider," Holman said. "You don't necessarily have to be in the towers or in the Pentagon to be at risk for other problems."
The study reported the increased heart disease rates even after taking into account other factors that could cause similar ailments, such as smoking and diabetes.
Steven Woloshin, a physician at the VA Medical Center in White River Junction, Vt., said the findings were problematic because people who report their own medical problems may exaggerate them. He said the study's participants are more likely to develop heart problems as they age.
"I don't think they've proven anything," he said. "There are millions of things that cause heart problems."
Holman and her colleagues used online surveys for their research; the participants were not examined or interviewed beyond the surveys. Most had completed a health survey before the Sept. 11 attacks.
The researchers asked participants whether they experienced anxiety, had flashbacks or worried about terrorism after the Sept. 11 attacks
During follow-up surveys for three years after the attacks, participants were asked whether doctors had diagnosed them, for either the first time or with worsening cases, of high blood pressure, irregular heartbeats and other heart problems.
Psychologist Tom Demaria, who directs a center for bereaved Sept. 11 families at South Nassau Communities Hospital on Long Island, said he helped to counsel a group of about 20,000 people, most of whom didn't live in New York City, in the months after the attacks. They frequently spoke of panic attacks with increased heart rates and tightness in their chests, he said.
"A lot of people reported a lot of phobic reactions. They didn't want to go on bridges, planes. The whole word I kept hearing was ambushed back then," Demaria said.
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On the Net:
Archives of General Psychiatry: http://archpsyc.ama-assn.org
California autism cases continue to grow
Mon, 07 Jan 2008 23:39:50 GMTBy ALICIA CHANG, AP Science Writer
LOS ANGELES - Autism cases in California continued to climb even after a mercury-based vaccine preservative that some people blame for the neurological disorder was removed from routine childhood shots, a new study found.
Researchers from the state Department of Public Health found the autism rate in children rose continuously during the 12-year study period from 1995 to 2007. The preservative thimerosal hasn't been used in childhood vaccines since 2001, but is used in some flu shots.
Doctors say the latest study adds to existing evidence refuting a link between thimerosal exposure and autism risk and should reassure parents that the disorder is not caused by vaccinations. If there was a risk, they said, autism rates should have dropped between 2004 and 2007.
The findings show "no evidence of mercury poisoning in autism" since there was no decline in autism rates even after the elimination of thimerosal, said Dr. Eric Fombonne, an autism researcher at Montreal Children's Hospital who had no role in the research.
Some advocacy groups blame thimerosal for the impaired social interaction typical of autism. Nearly 5,000 claims alleging a vaccine-autism link have been lodged with the federal government, which is deciding whether victims should receive compensation from a government fund.
Dr. Daniel Geschwind, a neurologist at the David Geffen School of Medicine at the University of California, Los Angeles, said the focus now should be on exploring the causes of autism such as possible genetic links.
"Something else must be at play and we need to know what that is if we're really serious about preventing autism," said Geschwind, who had no connection with the study.
For their study, California public health officials calculated the autism rate by analyzing a database of state-funded centers that care for people with autism and other developmental disorders.
They found the prevalence of autism in children aged 3 to 12 increased throughout the study period. For example, 0.3 per 1,000 children born in 1993 had autism at age 3 compared with 1.3 per 1,000 children born in 2003. Similar trends were found in other age groups.
"These time trends are inconsistent with the hypothesis that thimerosal exposure is a primary cause of autism in California," the researchers wrote.
Results were published in January's issue of the journal Archives of General Psychiatry. The study did not explore why there was an increase in autism cases.
Federal statistics show about one in 150 children in the United States have autism, higher than previous estimates. Researchers say it's unclear if the increase is due to changes in how the disorder is classified or whether it's an actual spike.
Autism is characterized by impaired social interaction and communication skills. There is no cure, but early therapy can lessen the severity.
Geraldine Dawson, the chief science officer for the advocacy group Autism Speaks, called the California research "a very important study," and said all possible causes — genetic and environmental — need to be explored aggressively.
"The bulk of the evidence thus far suggests that mercury is not involved, but I think parents still have many questions," said Dawson. "I think until parents are satisfied, we need to continue to examine the question."
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On the Net:
Archives of General Psychiatry: http://archpsyc.ama-assn.org
CDC autism page: http://www.cdc.gov/ncbddd/autism/index.htm
Girls who feel unpopular may gain weight
Mon, 07 Jan 2008 23:33:31 GMTBy CARLA K. JOHNSON, Associated Press Writer
CHICAGO - Where a teenage girl sees herself on her school's social ladder may sway her future weight, a study of more than 4,000 girls finds. Those who believed they were unpopular gained more weight over a two-year period than girls who viewed themselves as more popular. Researchers said the study showed how a girl's view of her social status has broader health consequences.
The girls in the study were still growing — their average age was 15 — and all of them gained some weight. However, those who rated themselves low in popularity were 69 percent more likely than other girls to increase their body mass index by two units, the equivalent of gaining about 11 excess pounds.
Girls who put themselves on the higher rungs of popularity also gained some excess weight, but less — about 6 1/2 pounds.
Both groups, on average, fell within ranges considered normal. But a gain of two BMI units over two years is more than the typical weight gain for adolescent girls, the researchers said.
"How girls feel about themselves should be part of all obesity prevention strategies," said the study's lead author, Adina Lemeshow, who began the study as a Harvard School of Public Health graduate student. She now works at the New York City Department of Health and Mental Hygiene.
The research, appearing in January's Archives of Pediatrics & Adolescent Medicine, used data from an ongoing study used frequently by scientists studying childhood obesity.
Weight and height data were reported by the girls themselves rather than getting weighed and measured by doctors; that's a weakness in the study that the researchers acknowledged.
The researchers took into account the girls' weight and BMI at the start of the study, along with their diet, household income, race/ethnicity and whether they'd reached puberty — and still found the link.
In the study, perceived popularity was measured in 1999 by how the girls reacted to a question next to a picture of a 10-rung ladder: "At the top of the ladder are the people in your school with the most respect and the highest standing. At the bottom are the people who no one respects and no one wants to hang around with. Where would you place yourself on the ladder?"
The researchers put the girls into two groups: the 4,264 who said they were on rung 5 or above, and the 182 who said they were on rung 4 or below. The weight gain link was based on those two groups.
Clea McNeely of Johns Hopkins Bloomberg School of Public Health called the study strong. She said she wanted to know more about the 4 percent of girls who rated themselves below average in popularity, particularly whether they already were gaining weight faster before they rated themselves as unpopular.
"The reason this paper is so important is it has broader implications beyond weight gain," said McNeely, who was not involved in the research but wrote an accompanying editorial. "Subjective social status is not just an uncomfortable experience you grow out of, but can have important health consequences."
Experts know little about how to intervene in teenagers' peer groups to improve health, McNeely said, but when adults set standards in schools, students treat one another with more respect.
Teenagers may give grown-ups "bored looks," she said, but "adults are still the most important influential figures in their lives."
The study was supported by a grant from the National Institutes of Health.
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On the Net:
Archives: http://www.archpediatrics.com
Snoring It could be sleep apnea
Mon, 07 Jan 2008 23:33:08 GMTBy LAURAN NEERGAARD, AP Medical Writer
WASHINGTON - Loud snoring doesn't just annoy your spouse. It could signal dangerous sleep apnea, yet millions go undiagnosed.
A government move may help change that: Medicare is poised to allow at-home testing for sleep apnea — letting people snooze in their own beds instead of spending the night in a sleep laboratory.
It's a controversial proposal, but potentially a far-reaching one. Some 18 million Americans are estimated to suffer from sleep apnea, yet specialists think fewer than half know it.
"It's been awkward and inconvenient and expensive to get a sleep test, and now that should be improved," says Dr. Terence Davidson of the University of California, San Diego, a longtime proponent of home-testing.
Today, Medicare pays for sleep apnea treatment — called CPAP, a mask that blows air through the nose while sleeping — only for seniors diagnosed in a sleep lab. Last month, Medicare proposed covering those diagnosed with cheaper home tests, too. The public may comment on the proposal until next week; final approval is expected in March.
While sleep apnea is a problem for seniors, it is most common in middle-aged men. But private insurers now reluctant to cover home apnea testing are expected to follow the government's lead, thus easing access for all ages.
Sleep apnea doesn't just deprive family members of their own zzzz's. Sufferers actually quit breathing for 30 seconds or so at a time, as their throat muscles temporarily collapse. They jerk awake to gasp in air, sometimes more than 15 times an hour. They're fatigued the next day because their brains never got enough deep sleep.
Severe apnea increases the chance of a car crash sevenfold. Research from UCSD suggests 1,400 deaths each year are caused by drivers with sleep apnea.
Worse, sleep apnea stresses the body in ways that also increase risk of high blood pressure, heart attack, stroke and diabetes.
Not every apnea patient is a bad snorer, and a low rumble may not be cause for concern. But sleep apnea's trademark is bad snoring, the snorting, choking kind. Other risk factors: Being overweight, having small airways, and apnea in the family.
Yet patients don't remember the nightly breathing struggle, and often don't see a doctor unless a family member complains about snoring — or until daytime sleepiness gets so bad they can't function.
Only then comes the test debate.
There are dozens of sleep disorders. A night slumbering in a sleep lab, hooked to monitors that measure both breathing and brain waves while health workers watch, has long been the standard for telling who has sleep apnea or another disorder.
But this lab-based polysomnography, or PSG, can cost $1,500. And while access has improved, there are swaths of the country where reaching a sleep lab can mean a few hundred miles' drive.
For about $500, home tests use primarily breathing monitors to detect only sleep apnea, not other disorders. Hook it up at bedtime, and a doctor checks the recordings later.
A home test can miss apnea, because it won't signal if someone never fell into that deep REM sleep where breathing is most likely to falter, says Dr. Thomas Gravelyn of the Saint Joseph Mercy Hospital sleep center in Ann Arbor, Mich., who opposes the Medicare change.
"You have this good feeling that everything was taken care of, when in fact it wasn't," he says.
"It certainly is possible to diagnose severe apnea at home," adds Dr. Joyce Walsleben, chief of New York University's sleep center. "What if it isn't severe? Are you willing to say it doesn't exist at all if you get a negative study?"
Still, a Canadian study published last year randomly assigned suspected apnea sufferers to either a sleep lab or home testing, and found they worked equally well.
Last month, the American Academy of Sleep Medicine, which represents sleep centers, changed its position to say home tests can help certain high-risk patients — but should be administered by sleep specialists.
Medicare's proposal wouldn't limit which doctors offer home tests. The American Academy of Otolaryngology, head-and-neck surgeons, requested the change.
In fact, Medicare concluded a sleep-lab test isn't perfect, either — and thus proposed that all patients get a 12-week trial of CPAP treatment. Only if their doctors certify they're being helped would treatment continue.
That's important, because about half of apnea patients prescribed CPAP struggle to use it, says Dr. Charles Atwood of the University of Pittsburgh Medical Center, a home-test proponent. What he calls tricks of the trade — trying differently shaped masks, adjusting the air pressure, adding a humidifier to moisten nostrils — early could keep more of them in care.
Consider Raymond Miles, 57, diagnosed with a sleep-lab study a few years ago. While he felt better with CPAP treatment, Miles quit it in frustration when he couldn't get help maintaining it.
Two weeks ago, nudged by his wife, Miles underwent a home test with a different doctor to see if it's time to try care again.
"There's a different level of comfort being at home," Miles says of the testing.
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EDITOR's NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
To comment on the Medicare proposal: http://www.cms.hhs.gov/mcd/viewtrackingsheet.asp?from2viewtrackingsheet.asp
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Weighty Mo. man wins custody of child
Mon, 07 Jan 2008 23:23:41 GMTBy ANDALE GROSS, Associated Press Writer
KANSAS CITY, Mo. - A man who claimed his obesity kept him from being allowed to adopt a baby will be allowed custody of the child while he and his wife move forward with adoption, a judge ruled Monday.
Gary Stocklaufer and his wife, Cindy, were awarded custody of the 8-month-old boy at a hearing before Circuit Court Judge John R. O'Malley. The child has been in the custody of another couple, who also have been trying to adopt him.
The Stocklaufers' case gained national attention after the couple said they were denied a petition to adopt the child because of Gary Stocklaufer's weight; he had weighed 550 pounds. He underwent gastric bypass surgery in August and has lost about 200 pounds.
Last month, O'Malley gave the Stocklaufers temporary custody of the child, named Max, and said the decision by another judge to remove the boy from their home over the summer had nothing to do with Gary Stocklaufer's weight. The judge said it was because the couple did not follow proper procedures when moving the child into Missouri from another state.
In his ruling Monday, O'Malley said it is "in the child's best interest" that the Stocklaufers "be permitted to adopt him."
The judge ordered the other couple to transfer the child Monday at a private location that the two families agreed on. The Stocklaufers can "proceed to pursue an adoption of the child when sufficient time has passed," O'Malley said.
"Obviously, my clients are very happy," said Gerald McGonagle, the Stocklaufers' attorney. "They fought long and hard."
Baby Max, who is from Arlington, Texas, and is related to the Stocklaufers, was 4 months old when he was taken from the couple in July. The baby had lived with the Stocklaufers since he was a week old.
"I just am thankful that my client — the minor child — had the opportunity for two different families to adopt him," said Sheri Simpkins, guardian ad litem for the case. "There are a lot of children available for adoption. This is a unique situation where the child had two loving families that wanted him."
France seizes 224000 fake antiimpotence pills
Mon, 07 Jan 2008 17:31:30 GMTPARIS - French customs officials have intercepted a shipment of 224,000 fake Viagra and Cialis anti-impotence pills worth 2.4 million euros , the Budget Ministry said on Monday.
The copies of the best-selling drugs were found on December 18 during a search at the French capital's main air hub at Roissy, in a freight cargo on its way to Brazil from India.
"Branded Powergra and Erectalis, each box contained, in fact, four tablets in the characteristic shape and color of Viagra or Cialis pills," Budget Minister Eric Werth's office, which is also in charge of customs, said in a statement.
"The companies Pfizer and Eli Lilly, which respectively own the Viagra and Cialis brands, quickly confirmed the counterfeit nature of these products and the 224,000 pills were seized," Werth's office added.
China experts identify drug addiction genes
Tue, 08 Jan 2008 06:50:32 GMTHONG KONG - Scientists in China have identified about 400 genes that appear to make some people more easily addicted to drugs, opening the way for more effective therapies and addiction control.
Experts believe genetic factors account for up to 60 percent of a person's vulnerability to drug addiction, with environmental factors accounting for the remainder.
The researchers focused on four addictive substances -- cocaine, opiate, alcohol and nicotine -- and mapped out five main routes, or "molecular pathways," that lead to addiction, they wrote in the journal PLoS Computational Biology.
Figuring out pathways are important in the study of complex diseases as they narrow down the genes and proteins involved. In diseases such as cancer, pathways help doctors make more accurate diagnoses and predictions of the course of the disease.
For drug addiction, the researchers said: "These common pathways may underlie shared rewarding and response mechanisms and may be targets for effective treatments for a wide range of addictive disorders."
The researchers trawled through more than 1,000 peer-reviewed medical publications that linked genes and chromosome regions to drug addiction over the past 30 years and assembled a list of 1,500 addiction-related genes.
Some of these genes turned up more frequently than others in the pathways and scientists narrowed the list to 396.
Health Tip Help Ease Growing Pains
Tue, 08 Jan 2008 04:47:10 GMT- Growing pains are common pains that occur in children between the ages of 3 and 5, and 8 and 12. They occur most often in the legs, and may be most frequent after strenuous play or exercise.
The American Academy of Family Physicians offers these suggestions to help ease growing pains in children:
- Try an over-the-counter pain reliever such as acetaminophen or ibuprofen. Don't ever give children aspirin.
- Gently stretch aching leg muscles.
- Place a heating pad over the sore legs.
- Massage the child's legs where they hurt.
Health Tip Stay Safe on the Stairs
Tue, 08 Jan 2008 04:47:11 GMT- It's relatively easy for seniors to slip on stairs and hurt themselves, so it's important to take precautions to prevent falls.
Here are some suggestions, courtesy of the American Academy of Orthopaedic Surgeons:
- Install light switches at both the top and bottom of stairs, or add motion-sensitive lights to the area.
- Make sure the entire stairway is well lit, and keep a flashlight in a drawer nearby.
- Put up a handrail on each side of the stairs.
- Keep stairs free of clutter and objects.
- For wood stairs, add a non-slip surface. For carpeted stairs, avoid dark or very thick carpeting that may be difficult to see.
- Keep boards or carpeting on stairs in good shape and tightly secured.
Fatherhood Tied to Higher Prostate Cancer Risk
Tue, 08 Jan 2008 04:47:09 GMTBy Ed Edelson
HealthDay Reporter
MONDAY, Jan. 7 -- Men who father children may be at higher risk of prostate cancer compared to those who forego the life experience, a Danish study suggests.
The large-scale study looked at all men born in Denmark between 1935 and 1988. It found that childless men had a 17 percent lower incidence of prostate cancer than fathers did.
The reasons why remain unclear.
"It is not possible from the current data to point out what factors associated with childlessness, whether biologic, environmental, social or behavioral, were responsible for the observed reduction in prostate cancer risk," wrote researchers at the Statens Serum Institut, in Copenhagen.
The study is published in the Jan. 7 online edition of Cancer, and will appear in the journal's Feb. 15 print edition.
The findings echo those of a prior Scandinavian study, published in 2005, which looked at more than 48,800 cases of prostate cancer. That report also found a 17 percent lower incidence of prostate cancer among childless men.
In neither of the two studies did the gender of the children fathered affect the man's risk of prostate cancer. However, one large-scale study conducted several years ago in Israel found that the malignancy was 40 percent more common among men with no sons.
Dr. Susan Harlap, now a professor of epidemiology at New York University, led that Israeli study. She said the differing results reflect the complex factors, genetic and otherwise, that underlie prostate cancer risk throughout the world.
"The incidence of prostate cancer is different in Israeli Jews than in northwestern Europeans," Harlap said. "It may be a different disease, and there may be a different set of causes. We do know there are genetic causes of prostate cancer, and there could be different sets of genes in Israeli Jews than in northwestern Europeans."
A relationship between prostate cancer risk and having no sons would point to a mutation in the Y chromosome, which determines the male sex of a child. But there are complexities to such a relationship, Harlap noted.
"If the effect is due to Y chromosomes, they are quite specific to ethnic groups," she said. "Israeli Jews are different from Danes and Swedes."
The complexity of the issue is also illustrated by the different findings of the two Scandinavian studies about fatherhood and risk. The new Danish report finds that "among fathers, a significant trend was observed of gradually reduced prostate cancer with increasing number of children" -- in other words, fatherhood was linked to an increased risk for prostate cancer, but fathering more children begins to bring that risk down again. In contrast, the earlier study found "no further change in risk associated with fathering of more than two children."
Dr. Otis Brawley, chief medical officer of the American Cancer Society, was less than impressed by the Copenhagen findings, however. Despite the large numbers, the result was "just barely statistically significant," Brawley said, and could be the result of pure chance.
In a study of this kind, he said, "you occasionally get something that is statistically significant but is not really significant biologically."
In any case, men shouldn't make decisions on fatherhood based on the study results, Brawley stressed. "I would never suggest to men that their wives not get pregnant so they don't get prostate cancer," he said. "Lack of fatherhood is not a strong preventive of prostate cancer."
Any relationship that does exist is probably very weak, Brawley said. "If there is a real correlation, I would like to know what the true cause is," he said. "I suspect we will never know."
More information
There's more on prostate cancer at the American Cancer Society.
