Most antibiotics prescribed for sore throat unneeded

Most Americans with a sore throat are prescribed antibiotics even though just a fraction stand to benefit from them, a new study shows.

Researchers said only about 10 percent of adults with sore throats have strep throat, which is caused by bacteria that could be killed by antibiotics.

Almost all other sore throats are caused by viruses. In those cases, “an antibiotic is not going to help you and it has a very real chance of hurting you,” Dr. Jeffrey Linder, who worked on the study at Brigham and Women’s Hospital in Boston, said.

Although serious side effects are rare, he said antibiotics can cause diarrhea or yeast infections and interact with other medicines. Overuse of the drugs also makes bacteria resistant to them – which means future infections could be harder to treat.

For their study, Linder and his colleague Dr. Michael Barnett analyzed data on 8,200 U.S. primary care and emergency room visits for sore throats between 1997 and 2010.

They found doctors prescribed an antibiotic at 60 percent of those visits, with no change in that rate during the study period, according to findings published in JAMA Internal Medicine.

What did change is that a greater proportion of prescriptions were for new, expensive antibiotics in recent years – even though penicillin works just fine against strep throat, Linder told Reuters Health.

His team’s findings were presented Thursday at IDWeek 2013 in San Francisco.

The researchers noted that they didn’t have data on each patient’s diagnosis, so they couldn’t know exactly when antibiotics were appropriate.

Linder said ideally, doctors should use a few key symptoms to figure out which patients should be tested for strep throat. Patients are more likely to have strep if they have a fever, swollen lymph nodes, white spots on the tonsils or swollen tonsils and no cough.

But the test is often used “pretty indiscriminately,” or people are given antibiotics without even being tested for strep, Linder said.

Dr. Ralph Gonzales, who has studied antibiotic prescribing at the University of California, San Francisco, said the results weren’t all bad news, necessarily.

The proportion of people visiting their primary care doctor for a sore throat – rather than any other complaint – dropped from almost 8 percent to about 4 percent during the study period, he noted.

He said fewer total visits for sore throats means fewer antibiotics are being prescribed – even if most people with achy throats still get the drugs.

“At least from a public health perspective, we’re having a lower impact on resistance,” Gonzales, who wasn’t involved in the new research, told Reuters Health.

Dr. Paul Little, a professor of primary care research at the University of Southampton in the UK, said people can avoid getting unneeded antibiotics by not going to the doctor for a run-of-the-mill sore throat.

“The truth is, nasty things are really pretty uncommon,” Little, who also didn’t participate in the study, told Reuters Health. “What you need to do is manage your symptoms,” he said, such as with over-the-counter pain relievers and plenty of fluids.

“The vast, vast majority of these are going to get better on their own,” Linder agreed.

Still, Little said, “If you’re worried about it and you’re very unwell … then I think it is worth it to see a doctor and have a (strep) test.”

Source:

Japan’s Fukushima : nuclear plant leaked toxic water

The operator of Japan’s crippled Fukushima nuclear plant said on Thursday another tank holding highly contaminated water overflowed, probably sending the liquid into the Pacific Ocean, in the second such breach in less than two months.

Recent site mishaps have returned Tokyo Electric Power Co, or Tepco, to the spotlight, calling into question its ability to execute a complex cleanup that could last decades. The company has vowed to monitor the tanks more closely and improve its water management.

Amid mounting international alarm, Japan’s government stepped in last month and said it would fund efforts to improvement water management at the plant.

The latest leaks show Tepco’s efforts to improve its handling of the contaminated water are not sufficient, Japan’s top government spokesman, Yoshihide Suga, told reporters on Thursday. The government will take steps to deal with the water, he said, adding that he thought the situation was under control.

Tepco has been relying on hastily built tanks to hold excess cooling water flushed over damaged reactors at the Fukushima Daiichi site, where three units suffered nuclear meltdowns and hydrogen explosions after a March 2011 earthquake and tsunami.

Tepco said the water that leaked contained 200,000 becquerels per liter of beta-emitting radioactive isotopes, including strontium 90. The legal limit for strontium 90 is 30 becquerels per liter.

The breach was discovered in a tank holding area away from where 300 metric tons (1 metric ton = 1.1023 tons) of toxic water escaped in August.

About 430 liters (113 gallons) of water spilled over a period of as much as 12 hours after a worker misjudged how much could be held by the tank, which is tilting because of an uneven location, Tepco spokesman Masayuki Ono told reporters.

The company is filling tanks to the brim as it does not have the capacity to accommodate the buildup of contaminated water, Ono said, adding that the water is likely to have flowed into a trench leading to the Pacific Ocean, about 300 m (330 yards) from the tank.

It is also pumping out accumulated rainwater in tank holding areas.

After repeated denials, Tepco admitted in July that contaminated water was flowing into the Pacific Ocean from the wrecked reactor buildings at Fukushima.

Measurable radiation from water leaking from the facility is mostly confined to the harbor around the plant, officials have said, and is not an environmental threat to other countries as the radiation will be diluted by the sea.

Tepco has been pumping hundreds of metric tons of water a day over the Fukushima reactors to keep them cool and storing the radioactive wastewater in tanks above ground.

It has also found high levels of radiation just above the ground near other tanks, suggesting widespread structural problems with the tanks.

Source:

ICU patients often suffer long-term brain impairment

Imagine entering the intensive care unit with one illness like pneumonia – and then leaving with an entirely different debilitating health condition affecting your memory, organizational skills and overall quality of life

It turns out that long-term brain dysfunction is a reality that many patients must face after a stay in the intensive care unit (ICU), according to a new study  from Vanderbilt University Medical Center published in the New England Journal of Medicine.  

“As survival has increased from critical illness based on modern medical therapies, we see a lot of patients coming back with memory problems, problems doing day-to-day activities,” study author Dr. Pratik Pandharipande, a professor of anesthesiology and critical care at Vanderbilt University Medical Center, told FoxNews.com. “Patients are telling us just getting us thorough the ICU and being a survivor is not good enough. They say, ‘We want to be back to where we were before we were in the ICU.’”

In an effort to improve quality of life for ICU patients post-treatment, Pandharipande and his team set out to discover what was happening in the ICU that was causing patients to experience such high rates of debilitating cognitive impairment.

Researchers analyzed 821 patients who had been admitted to the ICU with respiratory failure, cardiogenic shock or sepsis. Overall, they discovered that three months after leaving the ICU, 26 percent of patients had cognitive impairment symptoms similar to those seen in early Alzheimer’s disease, and 40 percent of patients had levels of cognitive impairment comparable to those seen in concussion victims.

Additionally, these effects were still visible months later. A year after their initial hospital stay, 24 percent of the patients still demonstrated levels of cognitive impairment similar to Alzheimer’s disease and 34 percent were still experiencing concussion-like levels of impairment.

“Even patients below 50 years of age had significant cognitive impairment,” Pandharipande said. “Another significant finding was whether you had prior disease or not, you still had this risk.”

In seeking an explanation, Pandharipande and his colleagues focused on delirium – a condition commonly seen in the ICU and characterized by brain dysfunction leading to confusion, fluctuating mental status or decreased levels of consciousness.

“There are early studies looking at what delirium does to the brain, and what people have found is that patients who have longer durations of delirium have more brain atrophy, more inflammation…and this could potentially be the connection between delirium and long term cognitive impairment,” Pandharipande said.

The researcher’s suspicions proved correct. They ultimately discovered that the longer patients experienced symptoms of delirium in the ICU, the worse their cognitive impairment after their stay.

“A number of studies have shown in recent years that delirium is not an innocent bystander of ICU care but is a real issue associated with worse outcomes, longer time in the ICU, on ventilation, even a predictor of mortality,” Pandharipande  said. “And now, if you survive, it’s a predictor of cognitive impairment.”

Pandharipande and his colleagues are now exploring methods to reduce the duration of delirium in ICU patients.

“A couple of things that have already been studied and have an impact are reducing sedative exposure…and having patients alert and getting them mobilized faster out of ICU beds,” Pandharipande said. “Sitting, walking – all have been shown to reduce duration of delirium.”

The team hopes their research will also encourage physicians to offer patients cognitive rehabilitation in addition to the physical rehabilitation that is typically prescribed after a serious illness.

“We hope to bring awareness to this problem so…when patients start complaining early in recovery period, it’s not blown off, but people actually try to get them involved in therapy programs,” Pandharipande said.

Source: http://www.allvoices.com

6 ways to reduce Alzheimer’s risk

For many years, we’ve been told that there’s little we can do to prevent Alzheimer’s disease and other types of dementia but hope for the best and wait for a pharmaceutical cure. But the truth is you can reduce your risk by eating right, exercising, staying mentally and socially active, and keeping stress in check. By leading a brain-healthy lifestyle, you may be able to prevent Alzheimer’s symptoms and slow down, or even reverse, the process of deterioration.

Lifestyle choices can protect your brain

Researchers across the world are racing towards a cure for Alzheimer’s disease. But as prevalence rates climb, their focus has broadened from treatment to prevention strategies. What they’ve discovered is that it may be possible to prevent or delay the symptoms of Alzheimer’s disease and other dementias through a combination of healthful habits. While Alzheimer’s disease accounts for 50 percent of dementia cases, vascular dementia accounts for up to 40 percent in older adults, and there is much you can do to prevent this type of dementia.

It’s never too early to start boosting your brain reserves, but whatever your age, there are steps you can take to keep your brain healthy.

The 6 pillars of a brain-healthy lifestyle

The health of your brain, like the health of your body, depends on many factors.

While some factors, such as your genes, are out of your control, many powerful lifestyle factors are within your sphere of influence.

The six pillars of a brain-healthy lifestyle are:

1.         Regular exercise

2.         Healthy diet

3.         Mental stimulation

4.         Quality sleep

5.         Stress management

6.         An active social life

The more you strengthen each of the six pillars in your daily life, the healthier and hardier your brain will be. When you lead a brain-healthy lifestyle, your brain will stay working stronger…longer.

1: Regular exercise

According to the Alzheimer’s Research & Prevention Foundation, physical exercise reduces your risk of developing Alzheimer’s disease by 50 percent.

Regular exercise can also slow further deterioration in those who have already started to develop cognitive problems.

If you’ve been inactive for a while, starting an exercise program can be intimidating. But you don’t have to take up jogging or sign up for a gym membership. Look for small ways to add more movement into your day. Park at the far end of the parking lot, take the stairs, carry your own groceries, or walk around the block or pace while talking on your cell phone.

Tips for getting started and sticking with your exercise plan:

  • Aim for at least 30 minutes of aerobic exercise five times per week. Try walking, swimming, or any other activity that gets your heart rate up. Even routine activities such as gardening, cleaning, or doing laundry count as exercise.
  • Build muscle to pump up your brain. Moderate  evels of weight and resistance training not only increase muscle mass, they help you maintain brain health. Combining aerobics and strength training is better than either activity alone. For those over 65, adding 2-3 strength sessions to your weekly routine may cut your risk of Alzheimer’s in half.
  • Include balance and coordination exercises. Head injuries from falls are an increasing risk as you grow older, which in turn increase your risk for Alzheimer’s disease and dementia. Balance and coordination exercises can help you stay agile and avoid spills. Try yoga, Tai Chi, or exercises using balance discs or balance balls.
  • Stick with it for a month. It takes approximately 28 days for a new routine to become habit. Once you’re over this hump, keeping up your exercise routine will feel natural. In the meantime, write realistic goals on a workout calendar and post it on the fridge. Build in frequent rewards, and within no time, the feel-good endorphins from regular exercise will help you forget the remote…and head out the door.
  • Protect your head. Studies suggest that head trauma at any point in life significantly increases your risk of Alzheimer’s disease. This includes repeated hits in sports activities such as football, soccer, and boxing, or one-time injuries from a bicycle, skating, or motorcycle accident. Protect your brain by wearing properly fitting sports helmets, buckling your seatbelt, and trip-proofing your environment. Avoid activities that compete for your attention—like talking on your cell while driving. A moment’s distraction can lead to a brain-injuring thud!

 

2: Healthy diet

Eat to protect glial cells.

Researchers believe that glial cells may help remove debris and toxins from the brain that can contribute to Alzheimer’s disease. Consuming foods such as ginger, green tea, fatty fish, soy products, blueberries, and other dark berries may protect these important cells from damage.

Just like the rest of your body, your brain needs a nutritious diet to operate at its best. Focus on eating plenty of fresh fruit and vegetables, lean protein, and healthy fats.

Eating habits that reduce inflammation and provide a steady supply of fuel are best. These food tips will keep you protected:

  • Follow a Mediterranean diet. Eating a heart-healthy Mediterranean diet rich in fish, nuts, whole grains, olive oil, and abundant fresh produce. Treat yourself to the occasional glass of red wine and square of dark chocolate.
  • Avoid trans fats and saturated fats. Reduce your consumption by avoiding full-fat dairy products, red meat, fast food, fried foods, and packaged and processed foods.
  • Eat a heart-healthy diet. What’s good for the heart is also good for the brain, so by reducing your risk of heart disease, you also lower your risk of Alzheimer’s disease.
  • Get plenty of omega-3 fats. Evidence suggests that omega-3 fatty acids may help prevent Alzheimer’s disease and dementia. Food sources include cold-water fish such as salmon, tuna, trout, mackerel, and sardines. You can also supplement with fish oil.
  • Eat 4-6 small meals throughout the day, rather than 3 large meals. Eating at regular intervals helps to maintain consistent blood sugar levels. Also avoid refined carbohydrates high in sugar and white flour, which rapidly spike glucose levels and inflame your brain.
  • Eat across the rainbow. Emphasize fruits and vegetables across the color spectrum to maximize protective antioxidants and vitamins. Daily servings of berries and green leafy vegetables should be part of your brain-protective regimen.
  • Enjoy daily cups of tea. Regular consumption of green tea may enhance memory and mental alertness and slow brain aging. White and oolong teas are also particularly brain healthy. Drinking 2-4 cups daily has proven benefits. Although not as powerful as tea, coffee also confers brain benefits.

Give up smoking and drink in moderation

Smoking and heavy drinking are two of the most preventable risk factors for Alzheimer’s disease. Not only does smoking increase the odds for those over 65 by nearly 79 percent, researchers at Miami’s Mt. Sinai Medical Center warn that a combination of these two behaviors reduces the age of Alzheimer’s onset by six to seven years.

When you stop smoking, the brain benefits from improved circulation almost immediately, no matter your age. However, brain changes from alcohol abuse can only be reversed in their early stages.

What about supplements?

Folic acid, vitamin B12, vitamin D, magnesium, and fish oil are believed to preserve and improve brain health. Studies of vitamin E, ginkgo biloba, coenzyme Q10, and turmeric have yielded less conclusive results, but may also be beneficial in the prevention or delay of Alzheimer’s and dementia symptoms.

Talk to your doctor about medication interactions, and review current literature to make a personal decision about the costs and benefits of dietary supplements.

3: Mental stimulation

Those who continue learning new things throughout life and challenging their brains are less likely to develop Alzheimer’s disease and dementia, so make it a point to stay mentally active. In essence, you need to “use it or lose it.”

Activities involving multiple tasks or requiring communication, interaction, and organization offer the greatest protection. Set aside time each day to stimulate your brain. Cross-training with these brain-boosting activities will help keep you mentally sharp:

  • Learn something new. Study a foreign language, learn sign language, practice a musical instrument, read the newspaper or a good book, or take up a new hobby. The greater the novelty and challenge, the larger the deposit in your brain reserves.
  • Practice memorization. Start with something short, progressing to something a little more involved, such as the 50 U.S. state capitals. Create rhymes and patterns to strengthen your memory connections.
  • Enjoy strategy games, puzzles, and riddles. Brain teasers and strategy games provide a great mental workout and build your capacity to form and retain cognitive associations. Do a crossword puzzle, play board games or cards, or work word and number games, such as Scrabble or Sudoku.
  • Practice the 5 W’s. Observe and report like a crime detective. Keep a “Who, What, Where, When, and Why” list of your daily experiences. Capturing visual details keeps your neurons firing.
  • Follow the road less traveled. Take a new route, eat with your non-dominant hand, rearrange your computer file system. Vary your habits regularly to create new brain pathways.

4: Quality sleep

Your brain needs regular, restful sleep in order to function at optimum capacity. Sleep deprivation not only leaves you cranky and tired, but impairs your ability to think, problem-solve, and process, store, and recall information. Deep, dreamy sleep is critical for memory formation and retention. If nightly sleep deprivation is slowing your thinking and affecting your mood, you may be at greater risk of developing symptoms of Alzheimer’s disease. The vast majority of adults need at least 8 hours of sleep per night. Any less, and productivity and creativity suffers.

Tips to help you combat insomnia and catch up on your Z’s

  • Establish a regular sleep schedule. Going to bed and getting up at the same time reinforces your natural circadian rhythms. Your brain’s clock responds to regularity.
  • Be smart about napping. While taking a nap can be a great way to recharge, especially for older adults, it can make insomnia worse. If insomnia is a problem for you, consider eliminating napping. If you must nap, do it in the early afternoon, and limit it to thirty minutes.
  • Set the mood. Reserve your bed for sleep and sex, and ban television and computers from the bedroom (both are stimulating and may lead to difficulties falling asleep).
  • Create a relaxing bedtime ritual. Take a hot bath, do some light stretches, write in your journal, or dim the lights. As it becomes habit, your nightly ritual will send a powerful signal to your brain that it’s time for deep restorative sleep.
  • Quiet your inner chatter. When stress, anxiety, or negative internal dialogues keep you awake, get out of bed. Try reading or relaxing in another room for twenty minutes then hop back in.

5: Stress management

Stress that is chronic or severe takes a heavy toll on the brain, leading to shrinkage in a key memory area of the brain known as the hippocampus, hampering nerve cell growth, and increasing your risk of Alzheimer’s disease and dementia. Yet simple daily tools can minimize its harmful effects.

Get your stress levels in check with these proven techniques

  • Breathe! Stress alters your breathing rate and impacts oxygen levels in the brain. Quiet your stress response with deep, abdominal breathing. Restorative breathing is powerful, simple, and free!
  • Schedule daily relaxation activities. Keeping stress under control requires regular effort. Make relaxation a priority, whether it’s a walk in the park, playtime with your dog, yoga, or a soothing bath.
  • Nourish inner peace. Most scientists acknowledge a strong mind-body connection, and various studies associate spirituality with better brain health. Regular meditation, prayer, reflection, and religious practice may immunize you against the damaging effects of stress.

6: An active social life

Human beings are highly social creatures. We don’t thrive in isolation, and neither do our brains. Studies show that the more connected we are, the better we fare on tests of memory and cognition. Staying socially active may even protect against Alzheimer’s disease and dementia, so make your social life a priority.

Oftentimes, we become more isolated as we get older, but there are many ways to keep your support system strong and develop new relationships:

  • Volunteer
  • Join a club or social group
  • Visit your local community center or senior center
  • Take group classes (such as at the gym or a community college)

Source:

Direct Link Between Obesity And Pancreatic Cancer Discovered

Pancreatic cancer is cancer of the pancreas. The pancreas is a glandular organ in the digestive system and endocrine system that produces several important hormones including insulin, glucagon, somatostatin, and pancreatic polypeptide and that secretes pancreatic juice containing digestive enzymes. The survival rate for pancreatic cancer is less than 14 percent, usually around three to five percent after five years.

A link between obesity and pancreatic cancer had previously been posited but had never been confirmed. The inflammation and insulin resistance associated with obesity are thought to increase an obese person’s risk of developing deadly pancreatic cancer.

A new study published in the Cancer Prevention Journal is the first to show a direct causal link between obesity and pancreatic cancer risk in an animal model.

Researchers at the David Geffen School of Medicine at UCLA created a state-of-the-art mouse model that resembles important clinical features of human obesity such as weight gain and metabolic disturbances. The researchers fattened mice with high-calorie, high-fat diets to the point of obesity.

Mice fed normal diets had mostly normal pancreases.

However, when fed the high-calorie, high-fat diets, the mice PanIN lesions and had fewer overall healthy pancreases. PanIN lesions, or pancreatic intraepithelial neoplasia lesions, are the most common precursor lesions on the pancreas before pancreatic cancer. In addition to the development of PanIN lesions, a common precursor to pancreatic cancer, the mice on the unhealthy diets also gained significantly more weight and had abnormalities of their metabolism,, increased insulin levels, and marked pancreatic tissue inflammation.

As Dr. Guido Eibl, a professor-in-residence in the department of surgery at David Geffen School of Medicine, explains:

“The development of these lesions in mice is very similar to what happens in humans. These lesions take a long time to develop into cancer, so there is enough time for cancer preventive strategies, such as changing to a lower fat, lower calorie diet, to have a positive effect.”

The results of the study directly link obesity and pancreatic cancer risk. High-fat, high-calorie diets that often lead to obesity increase a person’s risk of developing deadly pancreatic cancer. Switching to a lower-fat, lower-calorie diet may mitigate the negative effects of obesity on pancreatic cancer.

Source: http://www.inquisitr.com

Cats may be key to HIV vaccine

There have been numerous studies showing how dogs can benefit human health, by sniffing out cancer, for example. Now it is time for cats to shine, as researchers say they may hold the key to a human immunodeficiency virus (HIV) vaccine.

Researchers from the University of Florida and the University of California, San Francisco, have discovered that blood from patients infected with HIV shows an immune response against a feline AIDS virus protein.

Janet Yamamoto, professor of retroviral immunology at the College of Veterinary Medicine at the University of Florida and corresponding study author, told Medical News Today:

“Since FIV (feline immunodeficiency virus) and HIV-1 are distant cousins and their sequences are similar, we used the T cells from HIV positive human subjects to see if they can react and induce anti-HIV activity to small regions of FIV protein, which lead to the current story.”

The team’s findings are published in the Journal of Virology.

New vaccine-development strategy for HIV

The researchers say they are working on a T cell-based HIV vaccine that is able to activate an immune response in T cells from individuals against the feline acquired immunodeficiency syndrome (AIDS) virus.

T peptides are small pieces of protein that are crucial in this process, as they trigger the body’s T cells to distinguish viral peptides on infected cells and attack them.

However, Prof. Yamamoto says that not all HIV peptides are able to work as vaccine components. Some enhance HIV infection or have no effect, while others have anti-HIV activities that become lost if the virus changes or mutates to avoid immunity.

Previous studies have shown that when combining various whole HIV proteins to create vaccine components, the results have not been strong enough to create a commercial vaccine.

But the researchers believe that the feline AIDS virus could be used to discover areas of the human AIDS virus, and this could lead to a new vaccine-development strategy for HIV.

“We had difficulty in identifying ways to select regions on HIV-1 for HIV-1 vaccine. Our work shows how to select the viral regions for HIV-1 vaccine. The regions on FIV or their counterpart on HIV-1 that have anti-HIV T cell activities can be used as a component for human HIV-1 vaccine,” says Prof. Yamamoto.

FIV triggers T cells to kill HIV

To reach their findings, they acquired the T cells of patients who were infected with HIV. The T cells were isolated and incubated with different peptides that the researchers say are crucial for survival of both the human and feline AIDS viruses.

On comparing the reactions of the feline immunodeficiency virus (FIV) peptides with the reactions of the HIV peptides, the researchers discovered one particular peptide region on FIV that triggered patients’ T cells to kill HIV.

They found that the feline viral region by human cells seems to be “evolutionarily conserved.” This means it is present in many viruses similar to AIDS across animal species.

This feline viral region must be crucial, the researchers note, as it is unable to mutate in order for the virus to survive.

Prof. Yamamoto notes that so far, there have been no T cell-based vaccines used to prevent any viral diseases:

Dr. Jay A. Levy, professor of medicine at the University of California, San Francisco, and study author, stresses that their findings do not mean that the feline AIDS virus infects humans.

“Rather,” he adds, “the cat virus resembles the human virus sufficiently so that this cross-reaction can be observed.”

Prof. Yamamoto told Medical News Today that more of these cross-reactive regions on FIV need to be observed, as well as regions on the monkey AIDS virus

Source: http://www.medicalnewstoday.com/articles/266911.php

After melanoma, people head back to the sun: study

People with the most dangerous type of skin cancer tend to stay out of the sun and wear extra sunscreen the year after being diagnosed. But a new small study suggests those precautions don’t last.

Two to three years after being diagnosed with melanoma, people spent as many days in the sun and were exposed to at least as much UV radiation as their peers without the disease, researchers found.

“Something tells us that they relax more when time passes by after diagnosis,” Dr. Luise Idorn, the study’s lead author from Bispebjerg Hospital in Copenhagen, Denmark, said.

“We think they just regress back to old habits.”

Rates of melanoma have been rising in the United States, according to the American Cancer Society. It predicts over 76,000 new melanomas will be diagnosed in 2013.

People who have had melanoma have a higher than average chance of getting it again. But that risk can be reduced if they cover up and stay out of the sun, Idorn told Reuters Health.

To see how well patients protect themselves, she and her colleagues tracked 20 people during the three summers after they were diagnosed with melanoma.

They compared those patients to another 20 melanoma-free people who mirrored the patients in their age, gender and skin type.

All study participants recorded the time they spent in the sun and use of sunscreen in daily diaries. They also wore watches that measured UV radiation exposure.

During the first summer after patients were diagnosed with melanoma, they spent fewer days in the sun without sunscreen than people in the comparison group, the researchers found.

However, patients’ daily UV radiation dose rose by 25 percent from the first summer to the second, and increased again in the third summer. People without melanoma, on the other hand, were exposed to similar levels of radiation across all three years.

UV exposure tended to be higher among patients than people without skin cancer by the third summer. But that difference was small and could have been due to chance, Idorn and her colleagues reported Wednesday in JAMA Dermatology.

Half of the cancer-free group and 60 percent of people with melanoma reported getting sunburned at least once during the study period, they added.

“I would have thought that a diagnosis of melanoma would change their behavior. This study indicates they may be more cautious, but only the first year after diagnosis,” Idorn said.

“It’s disturbing results that these patients who are really at quite high risk of a second melanoma are not reducing their sun exposure,” Brenda Cartmel, from the Yale School of Public Health in New Haven, Connecticut, said.

“This is surprising,” added Cartmel, who has studied people’s behavior after a skin cancer diagnosis but wasn’t involved in the new study.

The researchers noted that their study was small and did not include information on sun exposure from before participants developed melanoma.

“It may be more difficult than we realize for people who really enjoy the sun to stay out of it,” Idorn said. “It may be a habit or a way of living that is difficult to abstain from, even after a cancer diagnosis.”

Dermatologist Dr. Brundha Balaraman from Washington University School of Medicine in St. Louis said she found the results “not entirely surprising” because skin cancer is more common among people who spend lots of time in the sun to begin with.

“It would be interesting to assess sun behaviors before and after the diagnosis of melanoma to determine whether a patient improves from his personal baseline,” Balaraman, who also didn’t participate in the new research, told Reuters Health in an email.

According to Idorn, there’s a need for more studies, including focus groups of people with melanoma, to figure out how doctors can help patients reduce their time in the sun.

Cartmel told Reuters Health she and her colleagues are working on those types of studies now.

“I don’t think what we are going to advise people to do is going to be different,” she said. “I just think somehow we need to get that message over maybe in a different way.”

Source: http://uswebdaily.com/news2/after-melanoma-people-head-back-to-the-sun-study

Acupuncture is good for depression: study

People with depression may benefit as much from acupuncture as they do from counseling, suggests a new study.

Researchers found one in three patients were no longer depressed after three months of acupuncture or counseling, compared to one in five who received neither treatment.

“For people who have depression, who have tried various medical options, who are still not getting the benefit they want, they should try acupuncture or counseling as options that are now known to be clinically effective,” said Hugh MacPherson, the study’s lead author from the University of York in the UK.

Previous studies looking at whether acupuncture helps ease depression have been inconclusive. Those studies were also small and didn’t compare acupuncture to other treatment options.

“What’s more important for the patient is does it work in practice and that is the question we were asking,” MacPherson said.

For their study, he and his colleagues recruited 755 people with moderate or severe depression. The researchers split participants into three groups: 302 were randomly assigned to receive 12 weekly acupuncture sessions, another 302 received weekly counseling sessions and 151 received usual care only.

About 70 percent of people had taken antidepressants in the three months before the study and about half reported taking pain medications. People did not have to stop taking their medicine to participate in the study.

At the outset, participants had an average depression score of 16 on a scale from 0 to 27, with higher scores symbolizing more severe depression. A 16 is considered moderately severe depression.

After three months, people assigned to the acupuncture group had an average score of about 9 – on the higher end of the mild depression category. Scores fell to 11 among members of the counseling group and about 13 in the usual care group, both considered moderate depression.

Participants who received acupuncture or counseling saw larger improvements over three months than those who had neither treatment. Those benefits remained for an additional three months after the treatments stopped.

However, any differences between acupuncture and counseling could have been due to chance, the researchers reported Tuesday in PLOS Medicine.

They found doctors would need to treat seven people using acupuncture and 10 people with counseling for one person to no longer be depressed.

“What this says is if you don’t get completely better, there are other options,” Dr. Philip Muskin, a psychiatrist at Columbia University Medical Center in New York, told Reuters Health.

“One option would be to take a different medication, but by this study these would be valid options,” said Muskin, who was not involved with the new research.

He cautioned, however, that counseling and acupuncture are not replacements for medication. The majority of study participants were still taking antidepressants at the end of the three months.

Muskin said the study also doesn’t show what types of patients respond best to acupuncture or counseling.

“What I can’t tell from this study is who’s who. Not everybody got better,” he said.

MacPherson said it’s best to ask patients for their treatment preference.

“If you talk to people, they would almost always have a leaning one way or the other,” he said.

Acupuncture is only covered by health insurance in the UK for chronic pain, MacPherson said. In the U.S., some plans also cover acupuncture for pain or nausea.

According to online information from the Mayo Clinic, the risks of acupuncture are low if people hire competent and certified practitioners. Complications can include soreness, organ injury and infections.

“Cleary acupuncture is a new option,” MacPherson said. “This is the first evidence that acupuncture really helps.”

 Source: medindia

 

Doing yoga during menopause may help insomnia

Taking a 12-week yoga class and practicing at home has been linked to less insomnia – but not to fewer or less bothersome hot flashes or night sweats, according to scientists.

Lead author Katherine Newton, PhD, a senior investigator at Group Health Research Institute, said that many women suffer from insomnia during menopause, and it`s good to know that yoga may help them.

MsFLASH (Menopause Strategies: Finding Lasting Answers for Symptoms and Health) Network randomized controlled trial tried to see if three more “natural” approaches – yoga, exercise, or fish oil – may help ease these menopause symptoms.

The study assigned 249 healthy, previously sedentary women at multiple sites, including Group Health, to do yoga, a moderate aerobic exercise program, or neither – and to take an omega-3 fatty acid supplement or a placebo.
Exercise seemed linked to slightly improved sleep and less insomnia and depression, and yoga also was linked to better sleep quality and less depression – but these effects were not statistically significant.

The omega-3 supplement was not linked to any improvement in hot flashes, night sweats, sleep, or mood.

The findings have been published online in Menopause.

Source: Zee News

Urgent action’ needed on child TB

Global health agencies have launched an action plan to reduce child deaths from tuberculosis (TB).

A report led by the World Health Organization says 74,000 lives could be saved each year through better diagnosis and treatment.

Funds of $120m (£74m) a year could have a major impact on children’s lives, including among those infected with both TB and HIV, say experts.

The action plan was unveiled in Washington on Tuesday.

Stakeholders include the WHO, Unicef, the Stop TB Partnership and a number of global TB agencies.

The steps outlined in this roadmap are simple and low-cost. We owe it to the children of the world to put this plan into action”

Dr Lucica Ditiu Stop TB Partnership

The Roadmap for Childhood TB: Toward Zero Deaths builds on the latest knowledge of the disease and highlights actions to prevent child deaths.

Each day almost 200 children under the age of 15 die from tuberculosis, while more than half a million fall ill every year, it says.

“Any child who dies from TB is one child too many,” said Dr Mario Raviglione, Global Tuberculosis Program director at WHO.

“TB is preventable and treatable, and this roadmap focuses on immediate actions governments and partners can take to stop children dying.”

The report says there is an urgent need to focus on children. Diagnostic tests and child-friendly drug formulations are lacking, and there is a need for better screening and awareness, it says.

“To get to zero TB deaths, we must focus on the most vulnerable groups and children are the most vulnerable of all,” said Dr Lucica Ditiu, executive secretary of the Stop TB Partnership.

“The steps outlined in this roadmap are simple and low-cost. We owe it to the children of the world to put this plan into action.”

Contagious infection

Tuberculosis is a contagious infection that mainly affects the lungs, but may spread to other parts of the body.

If not treated, it can damage the lungs to such an extent that a person cannot breathe properly.

Sometimes, people do not experience any symptoms for many months or even years after being infected.

TB can be treated with antibiotics but is sometimes fatal.

Source: http://www.medicalwebtimes.com/read/urgent_action_needed_on_child_tb/