Fewer U.S. Med Students Choose Psychiatry: Report

FRIDAY, March 30 (HealthDay News) -- The declining number of U.S. medical students who choose psychiatry as a specialty is cause for concern because there's already a shortage of psychiatrists, experts warn.

The overall downward trend has occurred for the past six years, according to a National Resident Matching Program report.

Medical schools need to provide more information and training to medical school students so they know psychiatry can be a profitable and rewarding career, the American Psychiatric Association (APA) said.

"In 2010, there was a slight increase in the number of seniors choosing psychiatry, but overall the trend has been downward," APA president Dr. John Oldham said in an association news release.

"We need to reach out to medical students in more effective ways than simply exposing them to a four-week clerkship on an inpatient unit, with no follow-up of the patients they have cared for," Oldham said. "Establishing and maintaining ongoing relationships with patients is one of the key factors that makes psychiatry such a fulfilling career."

Psychiatrists specialize in diagnosing, treating and preventing mental illness, including substance-abuse disorders.

The reasons for the decline in students choosing to pursue a career in psychiatry aren't well known, but there could be several factors, said Dr. James Scully Jr., the APA's medical director and CEO.

"This is a very exciting time for psychiatry, when we have more scientific developments in the field than ever before, but this means that the field is evolving in ways in which the outcome is unknown," Scully said in the news release. "It's a great time for young doctors to have an impact on what the future of psychiatry will look like."

There are about 50,000 psychiatrists in the United States -- too few to serve all the patients who need help, especially in rural areas, according to the APA. The group also noted that about half of currently practicing psychiatrists are over the age of 55, and many will soon retire.

More information

The American Psychiatric Association has more about being a psychiatrist.

Changes in Insurance Make ER Visits More Likely: Study

FRIDAY, March 30 (HealthDay News) -- People who have experienced recent changes in their health insurance status are more likely to use hospital emergency departments, a new study finds.

The use of emergency departments is an important indicator of access to care. People who have difficulty obtaining outpatient care often turn to emergency departments for medical care, said Dr. Adit Ginde, of the University of Colorado School of Medicine, and colleagues.

The researchers analyzed data from nearly 160,000 adults who took part in the 2004 to 2009 National Health Interview Study, and found that 21 percent of insured adults and 20 percent of uninsured adults had made at least one visit to an emergency department during the previous year.

Further analysis of the data revealed that nearly 30 percent of newly insured adults (those who were insured but lacked insurance at some point during the previous year) had at least one emergency department visit, compared with 20 percent of continuously insured adults.

The researchers also found that 26 percent of newly uninsured adults (those who were uninsured but had insurance at some point in the previous year) had at least one emergency department visit, compared with 19 percent of continuously uninsured adults.

"In conclusion, although adjusted

People Stir Up Millions of Bacteria When Entering a Room: Study

THURSDAY, March 29 (HealthDay News) -- Simply by entering a room, you can add up to 37 million bacteria to the air every hour, according to a new study.

Most of this airborne bacteria is left behind by previous occupants and stirred up from the floor when you enter, Yale University researchers said.

"We live in this microbial soup, and a big ingredient is our own microorganisms," principal investigator Jordan Peccia, an associate professor of environmental engineering, said in a Yale news release.

"Mostly people are re-suspending what's been deposited before. The floor dust turns out to be the major source of the bacteria that we breathe," he explained.

He and his colleagues measured and analyzed biological particles in a single, ground-floor university classroom over a period of eight days -- four days when the room was periodically occupied, and four days when it was continuously vacant. The windows and doors were kept closed for all eight days.

When people were in the room, there was a substantial increase in airborne concentrations of bacteria and fungus of various sizes. About 18 percent of fresh and previously deposited bacteria in the room came from people, as opposed to plants and other sources.

This type of research could help efforts to develop new ways of improving indoor air quality, said Peccia, adding that Americans spend more than 90 percent of their time indoors.

"All those infectious diseases we get, we get indoors," he noted.

The study was recently released online in advance of print publication in an upcoming issue of the journal Indoor Air.

More information

The American Lung Association has more about indoor air quality.

Depression has big impact on stroke, TIA survivors

March 29, 2012 Study Highlights:Depression is common among stroke and transient ischemic attack (TIA) survivors.Rates of depression were similar for stroke and TIA.The condition often goes unrecognized and under-treated.EMBARGOED UNTIL 3 pm CT/4 pm ET, Thursday, Mar. 29DALLAS, March 29, 2012 — Depression is more prevalent among stroke and transient ischemic attack survivors than in the general population, researchers reported in the American Heart Association’s journal Stroke. While most patients with stroke in the study had only mild disability, and only a fraction of those with TIAs had severe disability, depression rates were similar. “The similar rates of depression following stroke and TIA could be due to similarities in the rates of other medical conditions or to the direct effects of brain injury on the risk of depression, but more studies are needed,” said Nada El Husseini, M.D., M.H.S., an author of the study and a Stroke Fellow in the Department of Medicine, Division of Neurology, at Duke University Medical Center in Durham, N.C. Researchers, analyzing 1,450 adults with ischemic stroke (blockage of a blood vessel in the brain) and 397 with TIA, found:Three months after hospitalization, depression affected 17.9 percent of stroke patients and 14.4 percent of TIA patients.At 12 months, depression affected 16.4 percent of stroke patients and 12.8 percent of TIA patients.Nearly 70 percent of stroke and TIA patients with persistent depression still weren’t treated with antidepressant therapy at either the 3 or 12 month intervals.“Patients need to be open about their symptoms of depression and discuss them with their physicians so that they can work together to improve outcomes,” El Husseini said. “It is important for physicians to screen for depression on follow-up after both stroke and TIA.” Researchers defined depression using the Patient Health Questionnaire-8 (PHQ-8), which covers a range of depressive symptoms: loss of interest and pleasure in doing things; feelings of sadness, helplessness and hopelessness; insomnia or oversleeping; lack of energy; feelings of worthlessness; inability to concentrate; loss of appetite or overeating; and moving or speaking slowly. Patients who scored 10 or more on that questionnaire were considered depressed. Patients with stroke, who had persistent depression, tended to be younger, have greater stroke-related disability and couldn’t work at three months follow-up. “Physicians may need to be more vigilant in screening these patients because of their higher risk for long-term and persistent depression,” El Husseini said. The study participants were in the AVAIL (Adherence eValuation After Ischemic Stroke Longitudinal) Study and patients in hospitals participating in the American Heart Association’s Get With The Guidelines™-Stroke in 2006-08. The median age was 64 for stroke patients and 68 for TIA patients. About 44 percent of the stroke patients and 54 percent of the TIA patients were women. The majority of patients were white. AVAIL included a geographically national representative group of 106 hospitals. GWTG-Stroke puts the expertise of the American Stroke Association to work for hospital teams, helping to ensure that the care they provide to stroke patients is aligned with the latest scientific guidelines. Co-authors are Larry B. Goldstein, M.D.; Eric D. Peterson, M.D., M.H.S.; Xin Zhao, M.H.S.; Wenqin Pan, Ph.D.; Dai Wai M. Olson R.N., Ph.D.; Louise Zimmer, M.A., M.P.H.; John W. Williams Jr., M.D., M.H.S.; Cheryl Bushnell, M.D., M.H.S.; and Daniel T. Laskowitz, M.D. M.H.S. Author disclosures are on the manuscript. Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership provided unrestricted funds for AVAIL, which was conducted through collaboration with the American Heart Association. The Agency for Healthcare Research and Quality cooperative agreement also supported the AVAIL analyses.### Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at www. heart.org/corporatefunding. NR12 – 1051 (Stroke/El Husseini) Additional resources, including multimedia, are available on the right column of this link:http://newsroom.heart.org/pr/aha/_prv-depression-has-big-impact-on-stroke-231095.aspx Additional Resources:American Stroke AssociationGWTG - StrokeWhat is a TIA?Stroke Stats:Each year, 795 000 people experience a new or recurrent stroke. About 610,000 of these are first attacks and 185,000 are recurrent attacks.Mortality data from 2008 indicate that stroke accounted for one of every 18 deaths in the United States.On average, every 40 seconds, someone in the United States has a stroke.From 1998 to 2008, the stroke death rate fell 34.8 percent, and the actual number of stroke deaths declined 19.4 percent.For Media Inquiries, please call: (214) 706-1173Karen Astle: (214) 706-1392; karen.astle

911 Dispatchers May Suffer From Post-Traumatic Stress

THURSDAY, March 29 (HealthDay News) -- Answering 911 calls for help may cause emergency dispatchers to experience symptoms of post-traumatic stress disorder, or PTSD, a new study has found.

Even indirect exposure to traumatic events could lead to psychological disorders, whether a person personally knows the victims or not, according to a report published in the March issue of the Journal of Traumatic Stress.

"Post-traumatic psychological disorders are usually associated with frontline emergency workers, such as police officers, fire fighters or combat veterans," study author Dr. Michelle Lilly, assistant professor of psychology at Northern Illinois University in DeKalb, Ill., said in a journal news release.

"Usually, research considers links between disorders and how much emotional distress is experienced on the scene of a traumatic event," Lilly said. "However, this is the first study on emergency dispatchers, who experience the trauma indirectly."

In conducting the study, the researchers surveyed 171 emergency dispatchers currently working in 24 states across the United States. The dispatchers, who were primarily white women averaging 38 years old with more than 11 years of experience, were questioned about the type of calls they answer and the emotional distress they endured as a result of those calls. They also were asked to rate the types of calls that cause them the most distress and recall the worst call they ever received.

The unexpected injury or death of a child accounted for 16 percent of the calls dispatchers identified as their worst trauma. Nearly 13 percent of the worst calls identified were suicidal callers, about 10 percent were police-officer shootings and another 10 percent involved the unexpected death of an adult, the investigators found.

The study authors noted that the dispatchers experienced a high level of distress following an average of 32 percent of potentially traumatic calls. In addition, 3.5 percent of the dispatchers reported symptoms severe enough to be classified as PTSD.

These new findings may contribute to the debate over the definition of a "traumatic event," ahead of the publication of official guidelines next year, the news release noted.

"Our research is the first to reveal the extent of emotional distress experienced by emergency dispatchers while on duty," researcher Heather Pierce, a former 911 dispatcher, said in the news release. "The results show the need to provide these workers with prevention and intervention support as is currently provided for their frontline colleagues. This includes briefings and training in ways to handle emotional distress."

More information

The U.S. National Institute of Mental Health has more about PTSD.

Gaza: lack of fuel puts thousands of patients at risk

The International Committee of the Red Cross (ICRC) is preparing to supply the Ministry of Health in Gaza with 150,000 litres of diesel.

The fuel will help 13 public hospitals maintain essential health services for the next 10 days.

The organization delivered a similar amount of fuel for Gaza hospitals in February.

"More than a month has passed since the fuel and electricity crisis began. The current failure to ensure delivery of fuel and electricity could rapidly lead to interruptions in vital public services such as hospital care and water supply, putting the lives of thousands of patients in danger," said Juan-Pedro Schaerer, the head of the ICRC delegation for Israel and the occupied territories. "We have already warned that in the event of any such disruption, hospital operating theatres and specialist units, such as those providing intensive care, neonatal care and haemodialysis, would be especially hard hit."

Immediate action must be taken by all authorities concerned to prevent a further deterioration of the situation and find a lasting solution to the problem. The potential humanitarian consequences of a prolonged crisis should outweigh any political considerations.

For further information, please contact:
Cecilia Goin, ICRC Jerusalem, tel:

View the Original article

People With Autism May Be Better at Processing Information

MONDAY, March 26 (HealthDay News) -- People with autism have an enhanced ability to process information, which may explain the apparently higher-than-average percentage of people with autism who work in the information technology industry, British researchers say.

Along with this heightened capacity for processing information, people with autism are better able to detect information that is considered critical, according to the study, which appeared March 22 in the Journal of Abnormal Psychology.

Autism spectrum disorders include a range of neurodevelopmental disorders, all marked by difficulties with social and communication skills and repetitive behaviors.

People with autism have an increased ability to focus on certain tasks, but are also easily distracted by things such as flashing lights or particular sounds, it has been thought.

A University College London (UCL) researcher wondered if these conflicting characteristics might be due to a higher-than-normal ability to process information.

"Our work on perceptual capacity in the typical adult brain suggests a clear explanation for the unique cognitive profile that people with autism show," Nilli Lavie, a professor at the Institute of Cognitive Neuroscience at UCL, said in a Wellcome Trust news release.

"People who have higher perceptual capacity are able to process more information from a scene, but this may also include some irrelevant information that they may find harder to ignore," she said. "Our research suggests autism does not involve a distractibility deficit but rather an information-processing advantage."

Lavie and her colleagues tested the theory by giving 16 adults with autism and 16 adults without autism a task designed to assess their "perceptual load capacity." Both groups were successful at the task in the easier initial stages, but the adults with autism significantly outperformed those without autism as the task became more difficult.

"Our study confirms our hypothesis that people with autism have higher perceptual capacity compared to the typical population," Lavie said. "This can only be seen once the task becomes more demanding, with more information to process. In the more challenging task conditions, people with autism are able to perceive significantly more information than the typical adult."

Lavie said the findings may help explain why people with autism spectrum disorders, such as Asperger's syndrome, may excel in information technology and other careers that require intense concentration and the ability to process large amounts of information from a computer screen.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about autism.

Cardiac Cocktail Delivered by Paramedics May Save Lives

TUESDAY, March 27 (HealthDay News) -- Training paramedics to give probable heart attack patients a mixture of glucose, insulin and potassium may lessen the severity of a heart attack and save lives, new research suggests.

When someone suspects a heart attack and dials 911, the responding paramedics will quickly assess whether or not the person is in the throes of having a heart attack, or about to have one. Typically, paramedics will give aspirin to thin the blood and nitroglycerin for chest pain while transporting the patient to the hospital.

But the new study indicates that if paramedics administer the glucose/insulin/potassium solution right away, they can reduce the risk of cardiac arrest (when the heart suddenly stops beating) and death by 50 percent. This potentially lifesaving cocktail is readily available and costs just $50, the researchers noted.

"It can't stop a heart attack, but it can make it smaller and reduce the risk of cardiac arrest and death," said study author Dr. Harry P. Selker, executive director of the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center in Boston.

The findings were to be presented Tuesday at the American College of Cardiology annual meeting in Chicago, and published online simultaneously in the Journal of the American Medical Association.

The cardiac cocktail basically feeds the heart during a time when it would be starved of oxygen and nutrients, and keeps levels of dangerous free fatty acids in check, Selker explained.

Until now, the treatment had not been administered early enough in the course of a heart attack to make a difference in outcomes. But, "we did it in people's homes and while driving to the hospital," Selker said. And it worked.

In the trial, paramedics from 13 cities were trained to administer the solution after determining that an individual was likely having or about to have a heart attack. Overall, 911 people received either the solution or a placebo. People who received the solution immediately after being diagnosed with acute coronary syndrome -- which means a heart attack is in progress or imminent -- were 50 percent less likely to experience cardiac arrest or die compared to those who received the placebo. The results were even more pronounced for people with more severe ST-elevation heart attacks ( a pattern assessed via electrocardiogram). Among this group, immediate treatment with the solution resulted in a 60 percent reduction in risk for cardiac arrest or death.

The treatment did not prevent the heart attack from occurring, but may have lessened the damage that it caused. On average, 2 percent of the heart tissue was destroyed by the heart attack in people receiving the solution, compared with 10 percent in those who received the placebo.

Twenty-three percent of heart attacks in the study were later determined to be false alarms. This rate is lower than what is typically seen. In the study, paramedics used decision support tools to make the call. Administering the solution does not appear to cause any harm in people who are not having a heart attack, the authors said.

The researchers are following up with study participants at six and 12 months to see how they have fared in the longer term. "Larger trials should be done, but this therapy is inexpensive and can be used everywhere," Selker said.

Dr. Robert Glatter, an emergency medicine physician at Lenox Hill Hospital in New York City, expressed some caution. "This is very preliminary," he said. "This therapy has been around since the 1960s and never proved to be effective, so we must be very cautious in interpreting the new findings."

The solution is indeed inexpensive and widely applicable, but potential risks include infusion-related hyperglycemia (elevated blood sugar), hyperkalemia (elevated potassium) and fluid retention, he said.

More information

Learn more about heart attack risks at the U.S. National Heart, Lung, and Blood Institute.

Rearranging GI tract for obesity also improves diabetes

Bariatric surgery is gaining prevalence in the U.S., as more severely obese patients choose to go under the knife to improve their chances of losing excess weight. And since obese individuals are at a particularly high risk of type 2 diabetes, two new studies offer welcome news for patients who suffer from both obesity and diabetes: According to the study results, bariatric surgery may hold some impressive benefits for such patients, helping to reduce the toll of diabetes in addition to facilitating weight loss.

The two studies, published in The New England Journal of Medicine, evaluated the effects of combined medical therapy and bariatric surgery on obese patients with diabetes, as compared to regular or intensive medical care alone. In both cases, researchers found that patients fared significantly better with bariatric surgery than with medical care alone. In fact, many of these patients saw their diabetes go into remission.

For the first study, 60 severely obese patients with a BMI (body mass index — calculated as body weight divided by height squared) of at least 35, who had had type 2 diabetes for at least five years, were randomly assigned to receive one of two types of bariatric surgery or to undergo regular medical treatment. Obesity is defined as a BMI of 30 or more, and severe obesity as a BMI of 35 or greater. Two years later, none of the medical therapy patients had experienced diabetes remission, while between 75 and 95 percent of the bariatric surgery patients had complete diabetes remission. (It should, however, be noted that diabetes remission is not necessarily permanent, and the disease can recur if diet and weight change significantly.)     

The second study assessed 140 obese patients with diabetes who had a BMI between 27 and 43. Researchers randomized the participants to receive one of two forms of bariatric surgery or to receive intensive medical therapy. After a year of follow-up, only 12 percent of patients in the intensive medical therapy group had satisfactory blood glucose control, as compared to 37 and 42 percent in the two surgery groups.

The take-home message? “Bariatric surgery was a significant improvement over regular care, or even intensive medical therapy, for both weight loss, and for amelioration of type 2 diabetes” notes ACSH’s Dr. Ruth Kava.

An accompanying editorial in the journal, by Drs. Paul Zimmet and George Alberti, observes that there is still much to be learned about the long-term effects of surgery on these patients; both of these studies included small numbers of patients followed over only a short time period, and surgery itself has some risks. Yet in light of these findings, the editorial proposes that bariatric surgery “should not be seen as a last resort. Such procedures might well be considered earlier in the treatment of obese patients with type 2 diabetes.”

CT Scans Can Spot Heart Trouble Fast

MONDAY, March 26 (HealthDay News) -- Most people who go to the emergency room with chest pain aren't having a heart attack, but it can take hours or days to make a definitive diagnosis.

However, a new study finds that a special kind of CT scan given in the emergency room seems to identify a heart attack faster than traditional methods, so patients can be sent home safely sooner.

"You can go to an emergency department with chest pain, be concerned it might be a heart attack -- get a CT scan, like we do for everything else in the emergency department -- and we can say it's not your heart and you can go home, within a couple of hours," said researcher Dr. Judd Hollander, clinical research director of the department of emergency medicine at the University of Pennsylvania, in Philadelphia.

"We can now answer the questions faster, and let people go home sooner," he said.

Using the CT scan is faster, Hollander said, noting it can take 25 hours to get the results of blood tests that indicate whether a patient has had a heart attack.

"And an EKG only shows if you are having the big one," Hollander added. "So, if it's negative it doesn't tell you if you are having a smaller heart attack, and two-thirds of heart attacks will have an EKG that's not diagnostic."

For every 100 patients who go to an ER with chest pain, only 10 or 15 have cardiac disease, Hollander said. "The other 90 percent end up with nothing serious," he added.

In addition, ERs are busy and crowded, and this is a way to move patients out faster and increase the ability to see more patients sooner, he said.

The findings were to be presented Monday at the American College of Cardiology's annual meeting in Chicago. They will also be published simultaneously in the New England Journal of Medicine.

For the study, Hollander's team randomly assigned more than 1,300 patients with chest pain, but no previous history of heart disease or risk factors such as high blood pressure or diabetes, to CT scans or regular care.

The scans generate three-dimensional images of the heart and the blood vessels surrounding it, the researchers noted.

Among those with a normal scan, none died or had a heart attack within a month after being seen in the ER. In addition, more of these patients were sent home than those who received usual care -- about 50 percent versus 23 percent, the researchers found.

Those who received scans spent less time in the hospital and had heart problems diagnosed faster.

Scans are also cost-effective, Hollander said. The tests, which are like a standard CT scan, cost about $1,500. Patients who have a normal scan can be sent home within a few hours. A patient who is admitted to the hospital can run up bills of more than $4,000 for stress tests and monitoring alone, the researchers noted.

Chest pain is one of the most common reasons people go to the emergency room in the United States, accounting for as many as 8 million visits each year, at a cost of several billion dollars, they noted.

Many patients with chest pain are suffering from anxiety, pneumonia or indigestion that can cause the same symptoms as a heart attack, the researchers explained. Yet, more than half of patients with chest pain are admitted to the hospital for observation or testing such as cardiac catheterization or a stress test.

Commenting on the study, Dr. Gregg Fonarow, director of the Ahmanson-UCLA Cardiomyopathy Center and co-director of the UCLA Preventative Cardiology Program, said that "there are 8 million men and women that present to emergency medical centers with chest pain each year."

There has been great interest in developing strategies to more efficiently evaluate these patients and identify which ones can be safely discharged, he said.

The trial demonstrated that these scans may be useful to screen low- to moderate-risk patients, Fonarow said.

"However, further studies are needed to evaluate the cost-effectiveness of this strategy and how it compares to protocols using high-sensitivity troponin tests," he added.

A troponin test measures the levels of one of two proteins, troponin T or troponin I, in blood, Fonarow explained. These proteins are released when the heart has been damaged, such as during a heart attack. However, this test is usually repeated over 12 to 16 hours, so the results do not come back as quickly as a CT scan.

More information

For more on heart attacks, visit the American Heart Association.

Teen Girl Drivers Likelier to Use Electronic Devices: Study

MONDAY, March 26 (HealthDay News) --Teen girls are twice as likely as boys to use cellphones and other electronic devices while driving, according to researchers who analyzed in-car video clips of American teen drivers' behavior.

Electronic devices were the most common type of distracted driving behavior for both genders, but there were a number of other types of distractions, found the study released Monday by the AAA Foundation for Traffic Safety.

The video clips were from unsupervised teen drivers in 50 North Carolina families.

"Cellphones, texting, personal grooming, and reaching for things in the car were among the most common distracting activities found when cameras were put in new teen drivers' cars," President and CEO Peter Kissinger said in a foundation news release.

"This new study provides the best view we've had about how and when teens engage in distracted driving behaviors believed to contribute to making car crashes the leading cause of death for teenagers," he added.

The use of electronic devices was the leading cause of distracted driving behaviors in 7 percent of all the video clips analyzed by the researchers. Other types of distractions were noted in 15 percent of the video clips. The most common were adjusting controls, personal grooming and eating or drinking.

Older teens were more likely to engage in distracting behaviors while driving, which suggests that these behaviors increase as teens get more comfortable behind the wheel, the researchers said.

Along with being twice as likely as male teens to use an electronic device while driving, teen girls were nearly 10 percent more likely to engage in other distracted behaviors. Girls were nearly 50 percent more likely than boys to be reaching for an object and nearly 25 percent more likely to be eating and drinking.

Male teens were about twice as likely as female teens to turn around in their seats while driving and were also more likely to communicate with people outside of the car.

The study also found that loud conversation and horseplay were far more common when teen drivers had a group of friends in the car rather than just one friend.

The risk of teen drivers taking their eyes off the road was three times higher when they used electronic devices and 2.5 times higher when they engaged in other distracting behaviors.

Teen drivers using electronic devices took their eyes off the road for an average of one second longer than those who didn't use the devices.

"A second may not seem like much, but at 65 mph a car travels the length of a basketball court in a single second," Kissinger said. "That extra second can mean the difference between managed risk and tragedy for any driver."

More information

The U.S. National Highway Traffic Safety Administration has more about distracted driving.

CT Scans Can Spot Heart Trouble Fast

MONDAY, March 26 (HealthDay News) -- Most people who go to the emergency room with chest pain aren't having a heart attack, but it can take hours or days to make a definitive diagnosis.

However, a new study finds that a special kind of CT scan given in the emergency room seems to identify a heart attack faster than traditional methods, so patients can be sent home safely sooner.

"You can go to an emergency department with chest pain, be concerned it might be a heart attack -- get a CT scan, like we do for everything else in the emergency department -- and we can say it's not your heart and you can go home, within a couple of hours," said researcher Dr. Judd Hollander, clinical research director of the department of emergency medicine at the University of Pennsylvania, in Philadelphia.

"We can now answer the questions faster, and let people go home sooner," he said.

Using the CT scan is faster, Hollander said, noting it can take 25 hours to get the results of blood tests that indicate whether a patient has had a heart attack.

"And an EKG only shows if you are having the big one," Hollander added. "So, if it's negative it doesn't tell you if you are having a smaller heart attack, and two-thirds of heart attacks will have an EKG that's not diagnostic."

For every 100 patients who go to an ER with chest pain, only 10 or 15 have cardiac disease, Hollander said. "The other 90 percent end up with nothing serious," he added.

In addition, ERs are busy and crowded, and this is a way to move patients out faster and increase the ability to see more patients sooner, he said.

The findings were to be presented Monday at the American College of Cardiology's annual meeting in Chicago. They will also be published simultaneously in the New England Journal of Medicine.

For the study, Hollander's team randomly assigned more than 1,300 patients with chest pain, but no previous history of heart disease or risk factors such as high blood pressure or diabetes, to CT scans or regular care.

The scans generate three-dimensional images of the heart and the blood vessels surrounding it, the researchers noted.

Among those with a normal scan, none died or had a heart attack within a month after being seen in the ER. In addition, more of these patients were sent home than those who received usual care -- about 50 percent versus 23 percent, the researchers found.

Those who received scans spent less time in the hospital and had heart problems diagnosed faster.

Scans are also cost-effective, Hollander said. The tests, which are like a standard CT scan, cost about $1,500. Patients who have a normal scan can be sent home within a few hours. A patient who is admitted to the hospital can run up bills of more than $4,000 for stress tests and monitoring alone, the researchers noted.

Chest pain is one of the most common reasons people go to the emergency room in the United States, accounting for as many as 8 million visits each year, at a cost of several billion dollars, they noted.

Many patients with chest pain are suffering from anxiety, pneumonia or indigestion that can cause the same symptoms as a heart attack, the researchers explained. Yet, more than half of patients with chest pain are admitted to the hospital for observation or testing such as cardiac catheterization or a stress test.

Commenting on the study, Dr. Gregg Fonarow, director of the Ahmanson-UCLA Cardiomyopathy Center and co-director of the UCLA Preventative Cardiology Program, said that "there are 8 million men and women that present to emergency medical centers with chest pain each year."

There has been great interest in developing strategies to more efficiently evaluate these patients and identify which ones can be safely discharged, he said.

The trial demonstrated that these scans may be useful to screen low- to moderate-risk patients, Fonarow said.

"However, further studies are needed to evaluate the cost-effectiveness of this strategy and how it compares to protocols using high-sensitivity troponin tests," he added.

A troponin test measures the levels of one of two proteins, troponin T or troponin I, in blood, Fonarow explained. These proteins are released when the heart has been damaged, such as during a heart attack. However, this test is usually repeated over 12 to 16 hours, so the results do not come back as quickly as a CT scan.

More information

For more on heart attacks, visit the American Heart Association.

Americans’ Heart Health Continues to Benefit from the Affordable Care Act

March 22, 2012 Washington, D.C., March 22, 2012 — American Heart Association CEO Nancy Brown issued the following comments today on the second anniversary of the Affordable Care Act, signed into law on March 23, 2010:  “As the Affordable Care Act (ACA) turns 2, the heart health of many Americans continues to benefit from the law’s improved coverage. The American Heart Association’s goal by 2020 is to improve the cardiovascular health of all Americans by 20 percent, and to reduce deaths from cardiovascular diseases and stroke by 20 percent. The ACA, along with the unique public-private partnership, “Million Hearts,” are both key to helping us attain these important goals. By 2030, 40.5 percent of the U.S. population is projected to have some form of cardiovascular disease, which will cost the nation’s healthcare system $1 trillion annually. We can avert this health and economic tragedy in the future if we practice strong prevention today. Prevention plays a critical role in conquering heart disease and stroke — the nation’s No. 1 and No. 4 killers — and in reducing the enormous costs associated with their treatment. If Americans can eliminate traditional risk factors such as obesity, high blood pressure and high cholesterol levels by the time they reach middle age, then they have a very low risk of ever having a heart attack or stroke. The Affordable Care Act is helping Americans improve, achieve and maintain ideal heart health through a greater focus on prevention. Last year, under the new law, 86 million Americans received at least one new free preventive service, including 32 million Medicare beneficiaries. Among Medicare beneficiaries, 20 million people were screened for high cholesterol in 2011.   The ACA also places an extraordinary emphasis on helping communities focus on prevention and wellness. The Million Hearts initiative, launched last fall, sets a goal of preventing 1 million heart attacks and strokes over the next five years by harnessing tools and resources made available by the ACA. For example, states and communities have already received $1.2 billion from the Prevention and Public Health Trust Fund to transform communities and help people live healthier lives through tobacco-free living, physical activity and healthy eating, and prevention and control of high blood pressure and high cholesterol. An estimated 7.3 million Americans who suffer from cardiovascular disease are uninsured and are often denied the coverage they need because of their medical conditions. But under the law’s Pre-Existing Condition Insurance Plan (PCIP), heart attack and stroke patients who have been uninsured for at least six months have been able to gain access to comprehensive insurance coverage. Of the 50,000 PCIP enrollees, an estimated 15 percent have heart disease, stroke or another form of cardiovascular disease. As the nation’s highest court takes up the Affordable Care Act, we hope the justices will remember that these broadly supported patient protections could be undermined if the law’s minimum coverage requirement is struck down. Without this requirement, the promise of guaranteed, affordable health insurance may never be realized by all Americans, including those with heart disease and stroke who desperately need it.” ### Contact: Retha Sherrod, (202) 785-7929retha.sherrod

American Heart Association Comment: Heart failure, transplants and LVADS

March 25, 2012 DALLAS – March 25, 2012 - Former Vice-President Dick Cheney, 71, had a heart transplant on Saturday, March 24.  According to the American Heart Association, donor hearts are distributed through the Organ Procurement and Transplantation Network of the U.S. government, which distributes organs based on the urgency of need, availability of organs and the location of the patient who is receiving the transplant, usually because of heart failure. Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood to meet the body’s needs for blood and oxygen. The heart muscle compensates by becoming enlarged and pumping faster to keep up with the body’s demand for blood. Eventually the heart and body just can't keep up, and the person experiences the fatigue, breathing problems or other symptoms that are called heart failure. Heart failure can involve the heart's left side, right side or both sides. However, it usually affects the left side first. A heart attack can damage the heart muscle, resulting in reduced ability to pump blood, which often leads to heart failure. Heart transplants are lifesaving procedures that were performed on 2,332 Americans in 2011. Of that number, 14 percent – 332 people -- were over the age of 65, according to the U.S. Department of Health and Human Services. Wait times for patients can vary from days to months to years depending on matching an appropriate donor heart with the patient. “Although most transplants are performed on younger people, patients over the age of 65 do receive transplants in the United States,” said Mariell Jessup, M.D., incoming president-elect of the American Heart Association, and a heart failure cardiologist at the University of Pennsylvania. According to reports, before his transplant Vice-President Cheney had a left ventricular assist device (LVAD) implanted, which augments the heart’s output using a mechanical pump. “Left-ventricular assist devices (LVADs) have provided us with a highly effective tool to help patients with advanced heart failure.  These devices have revolutionized how we treat patients who used to die before they could undergo a heart transplant.  After receiving one of these devices, patients can go home, get around and enjoy their life in relatively good health, although they might still have significant symptoms.  LVAD devices are most commonly employed as a bridge to transplantation, although in some patients they can be used alone.  Patients with LVAD devices may still have symptoms and continue a guarded prognosis,” said Jessup. While we can do much more than ever before in treating heart disease, it is vitally important for people to understand that heart disease can be prevented in many cases by a lifestyle that includes a healthy diet enough physical activity, avoidance of tobacco smoke and control of factors such as high blood pressure, high cholesterol, diabetes and overweight,” said Gordon Tomaselli, president of the American Heart Association, professor and director of the Johns Hopkins University School of Medicine’s Division of Cardiology. Additional resources: Implantable devices for heart failure -- LVADsCardiac procedures and surgeries, including transplantsHeart Failure The American Heart Association/American Stroke Association receives funding mostly from individuals. Foundations and corporations donate as well, and fund specific programs and events. Strict policies are enforced to prevent these relationships from influencing the association’s science content. Financial information for the American Heart Association, including a list of contributions from pharmaceutical companies and device manufacturers, is available at www.heart.org/corporatefunding. CONTACT:  Carrie Thacker at 214-924-0824 or carrie.thacker

Common Respiratory Virus Affecting Many Young Children

THURSDAY, March 22 (HealthDay News) -- Many pediatric hospital admissions involve a common virus that infects the lungs and airways and can lead to serious illness in young children and people with weakened immune systems, an expert says.

Respiratory syncytial virus (RSV) is a leading cause of bronchiolitis -- an inflammation of the small airways in the lungs -- in infants younger than a year old, according to the U.S. Centers for Disease Control and Prevention.

"This is an extremely contagious virus, so it can easily be spread from one child to another in a school or home setting. We continue to see a large amount of kids being admitted to the hospital this year due to RSV. Though it often peaks in winter, the virus may continue to affect communities through early spring," Dr. Rahul Bhatia, a pediatric intensive care unit physician at Loyola University Health System, said in a Loyola news release.

"Though younger children have a greater chance of being hospitalized due to the virus, any age group can be affected," Bhatia said.

There is no vaccine to protect against the virus. "RSV is easily spread by touching infected people and surfaces, so washing your child's and your own hands often is the best way to prevent it from being spread," Bhatia stated in the news release.

The symptoms of RSV may appear to be similar to those of the common cold, and may vary with age. Parents should call a doctor if a child with an apparent cold has the following symptoms: difficulty breathing, nasal flaring, decreased appetite or decreased urine output. Parents should go to the emergency room if their child has trouble breathing or is a dusky color, Bhatia advised.

"There are numerous viruses that can cause respiratory infections. The only way to know if it is RSV is to have testing done," Bhatia said. "RSV has been around for a while. It's nothing new, just every once in a while we see a spike in cases and this happens to be one of those years."

More information

The Nemours Foundation has more about respiratory syncytial virus.

Diarrhea and Vomiting Can Kill You

There are two big causes of truly dangerous infections that lead to gastroenteritis. Gastroenteritis is a medical term that simply means an inflammation inside the digestive system. Most gastroenteritis is caused by an infection and the two most common are Clostridium difficile (not so affectionately known as C.Diff in medical circles) and norovirus.

Vomiting and diarrhea are the two most common symptoms and problems associated with both of these infections. And, in both cases, death is a significant possibility. You can get seriously ill from secondary infections, tissue damage or dehydration.

Both of these gastric infections are spread from person to person through fecal matter, usually because the person with the infection didn't wash his or her hands well enough after using the restroom. Handwashing is the key to keeping your infection to yourself.

There isn't much you can do on your own to fix diarrhea and vomiting from gastroenteritis. It takes a healthcare professional to help you. There are things you can do to make it a little more tolerable, however. Read How to Stop Diarrhea and Nausea Treatment for tips on how to treat both conditions.

Gut Infections Are Growing Much More Lethal - NYTimes.com

Catch a stroke in time to save a mind

Timing is crucial in the treatment of most medical conditions — and none more so than acute stroke. In such cases, experts urge patients and doctors to heed a narrow window of 4.5 hours. This is the amount of time that can elapse between stroke onset and the administration of a clot-busting medication, such as tissue plasminogen activator (tPA), that can significantly reduce the risk of brain damage. Since the 1997 advent of tPA, medical experts have increased their efforts to get stroke victims to the hospital as soon as possible. Disappointingly, however, a recent paper in the journal Stroke reported that only 4 percent of stroke patients were receiving tPA — largely because they were arriving at the hospital too late.

Half of Stroke Victims Don't Call 911, Research Shows

FRIDAY, March 16 (HealthDay News) -- Slightly more than half of Americans with stroke symptoms call 911, a rate that hasn't changed since the mid-1990s, a new study finds.

The study highlights the need for more public education about stroke symptoms and the importance of early treatment, said the researchers from New York-Presbyterian Hospital/Weill Cornell Medical Center.

"People do not always recognize the seriousness of stroke symptoms, or instead of calling 911 they may call their primary-care physician for an appointment and lose valuable time as the damage becomes irreversible," study leader Dr. Hooman Kamel, a neurologist at New York-Presbyterian Hospital/Weill Cornell, said in a medical center news release.

The researchers examined data from more than 1,600 stroke cases collected by the National Hospital Ambulatory Medical Care Survey between 1997 and 2008.

The analysis revealed that just 51 percent of adults who were diagnosed with stroke at an emergency department arrived via ambulance, and that rate had not significantly changed during the 11-year study period.

The findings were published in a research letter in the March 14 issue of the Journal of the American Medical Association.

Recovery from stroke often is possible with early treatment, Kamel said.

"We have drugs and surgeries that can minimize brain damage from a stroke, but they can be used only within a few short hours," Kamel said in the release. "When stroke victims or bystanders quickly recognize the symptoms of a stroke and call 911, patients are more likely to arrive in time to receive these treatments."

Common warning signs of stroke include:

Sudden numbness or weakness in the face, arms or legs, especially on one side of the bodySudden confusionSudden trouble speaking or understandingSudden trouble seeing in one or both eyes Sudden trouble walking, dizziness, or loss of balance or coordination Sudden, severe headache with no known cause

You should call 911 if you or someone else experiences any of these symptoms, according to the U.S. National Institute of Neurological Disorders and Stroke.

More information

The American Academy of Family Physicians has more about stroke.

Anti-Smoking Efforts Saved 795,000 Lives Over 25 Years: Study

WEDNESDAY, March 14 (HealthDay News) -- Bans on smoking in public places, hikes in cigarette taxes and other efforts to get people to quit smoking prevented close to 800,000 deaths from lung cancer between 1975 and 2000 in the United States, a new study shows.

The findings, published online March 14 in the Journal of the National Cancer Institute, likely represent just the tip of the iceberg as lung cancer is only one of the diseases linked to tobacco smoke, experts say.

Researchers led by Dr. Suresh Moolgavkar, of the biostatistics and biomathematics program at the Fred Hutchinson Cancer Research Center in Seattle, developed a sophisticated model to estimate changes in U.S. smoking patterns resulting from tobacco-control efforts, and how these changes affected deaths from lung cancer between 1975 and 2000.

During that time, nearly 2.1 million lung cancer deaths occurred among men and about 1.05 million lung cancer deaths occurred among women. The researchers predicted that over 552,000 lung cancer deaths among men and 243,000 among women were averted by tobacco-control efforts.

While an impressive number, this is just one-third of the number of deaths that could have been averted had all U.S. cigarette smokers successfully quit smoking and no one else started after the watershed 1964 U.S. Surgeon General's report on the dangers of tobacco, the researchers calculated.

On the other hand, if smoking behaviors had not changed at all after the Surgeon General's report, an additional 795,000 people would have died of lung cancer.

"Quitting smoking most definitely reduces deaths from lung cancer. However, too many people continue to smoke," Moolgavkar said. "The most effective way to reduce the burden of lung cancer is to get smokers to quit and to prevent non-smokers from taking up smoking."

Another study author, Eric Feuer, chief of the Statistical Methodology and Applications Branch of the U.S. National Cancer Institute, said that Americans have come a long way, but can't afford to become complacent.

"We can't let our guard down and we really need to continue our efforts," Feuer said. Recent data from the Surgeon General's office showed that one in four U.S. high school seniors still smokes and three in four high school smokers continue to smoke as adults.

Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City, said that "the new study is good news and very persuasive. It shows us very conclusively that less smoking means fewer smoking-related deaths."

And it is more than lung cancer rates that are likely decreasing, Horovitz noted. "Smoking cessation would also reduce rates of heart attack, stroke and the lung disease, chronic obstructive pulmonary disease," he said. "The list goes on and on."

In an editorial accompanying the new findings, Thomas Glynn, director of cancer science and trends and international cancer control at the American Cancer Society, wrote: "The good news is that we have become more aggressive in our tobacco control efforts."

Many of the deaths averted occurred in 2000, suggesting that the efforts are picking up steam. Glynn noted that his own father died from lung cancer after smoking for decades and never met his granddaughter.

"He was not one of the 795,000, but seeing

Children in low-income neighborhood with special walking/bike trail exercised more

American Heart Association Meeting Report - Abstract P267 - Embargoed until 1 pm PT/4 pm ET March 15, 2012 This news brief contains new information provided by the study author. SAN DIEGO, March 15, 2012 — Children living in a neighborhood designed with a special bike trail were three times as likely as those in a traditional neighborhood to engage in vigorous physical activity, according to new research presented at the American Heart Association’s Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism 2012 Scientific Sessions. Researchers compared two low-income neighborhoods in Chattanooga, Tenn. One had a “new urbanist construction” that features a specially-designed, two-mile, extra-wide trail/sidewalk for biking and walking that winds from new public housing and single-family residences to a school, library, recreational facility, park and retail shops. The other area has traditional homes, public housing, a new school, park and an older, regular-width sidewalk. “There was more vigorous activity in the park and along the trail,” said Gregory W. Heath, D.H.Sc., M.P.H., the study’s lead author and assistant provost for research and engagement at the University of Tennessee at Chattanooga and the UT College of Medicine. “There was more jogging or bike riding, which makes sense because the urban trail was made for that.” In previous studies on this type of community feature, researchers focused mostly on suburban or upper-income neighborhoods, Heath said. “Infrastructural changes like these are expensive,” said Heath, who is also professor of health and human performance and medicine. “But quite frankly in the long run, they’re worth it.” Co-author is S. White-Woerner, B.S. Author disclosures are on the abstracts. The Middle Tennessee State University Center for Physical Activity and Health in Youth funded the study. ### Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position.  The association makes no representation or warranty as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing science content.  Revenues from pharmaceutical and device corporations are available at www.heart.org/corporatefunding. NR12-1048 (Epi/NPAM 2012/Heath) Note: Actual presentation is 5 p.m. PT/8 p.m. ET, Thursday, March 15, 2012. Additional resources are available on the right column of this link:http://newsroom.heart.org/pr/aha/children-in-low-income-neighborhood-230088.aspx Media Inquiries: (214) 706-1173Darcy Spitz: (212) 878-5940; Darcy.Spitz

Overweight, obese adults use electronic device to stick to diet, exercise

American Heart Association Meeting Report - Abstract 026- Embargoed until 1 pm PT/4 pm ET March 15, 2012 Study Highlights:Overweight and obese adults using an electronic device that provided daily messages did better at staying on diet and exercise programs.Those using the device were more successful in adhering to five treatment factors for weight loss.SAN DIEGO, March 15, 2012 — Overweight and obese adults who used an electronic diary program on a personal digital assistant did better at staying on diet and physical activity programs, researchers reported at the American Heart Association’s Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism 2012 Scientific Sessions. People using the device, which provided tailored dietary and exercise feedback messages, were more successful in adhering to five treatment factors for weight loss:attending group sessions;meeting daily calorie goals;meeting daily fat intake goals;reaching weekly exercise goals; andmonitoring eating and exercise.The SMART (Self-Monitoring and Recording with Technology) study included 210 overweight or obese adults, 84 percent women, 79 percent white, who used a paper diary, a handheld electronic device without feedback, or a handheld device that provided daily messages. Those using the electronic devices did significantly better than those using a paper diary for attendance, self-monitoring and energy and exercise goals. At six months, the group that received the daily feedback messages from their device had more than a 5 percent weight loss, but over time adherence declined and weight gain occurred. At 24 months, weight loss was similar across the three groups, but was slightly better in the group receiving feedback. “The results suggest that using an electronic diary improves treatment adherence,” said Lora E. Burke, Ph.D., study author and professor of nursing and epidemiology at the University of Pittsburgh in Pennsylvania. “Over time, participants’ adherence declined, particularly in the later phase as contact frequency declined and subsequently ended. Adherence in the paper diary group declined more than in the device groups.” Study participants recorded their exercise levels and daily food and beverage intakes. Devices displayed the consumed daily calories and fat grams next to targeted amounts. Users with devices providing feedback received messages on diet once a day and exercise every other day. Thirty-nine group sessions were offered in the first 18 months, followed by one “maintenance” session in the last six months. More frequent contact during the last half of the trial would have resulted in better adherence, Burke said. The study confirmed that reducing or withdrawing contact leads to weight regain. The technology used in the study has since been upgraded, but the concept is the same for smartphones and self-monitoring applications, said Burke, who is conducting a study using smartphones to monitor the triggers for relapses. Co-authors are Mindi Styn, Ph.D.; Molly Conroy, M.D.; Le Ye, Ph.D.; Karen Glanz, Ph.D.; Susan Sereika, Ph.D.; Mary Ann Sevick, Ph.D.; and Linda Ewing, Ph.D. Author disclosures are on the abstract. The National Institutes of Health funded the study. ### Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position.  The association makes no representation or warranty as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events.  The association has strict policies to prevent these relationships from influencing science content.  Revenues from pharmaceutical and device corporations are available at www.heart.org/corporatefunding. NR12-1042 (Epi/NPAM 2012/Burke) Note: Actual presentation is 3:30 p.m. PT/6:30 p.m. ET, Thursday March 15, 2012.  Additional resources are available on the right column of this link:http://newsroom.heart.org/pr/aha/_prv-overweight-obese-adults-use-electronic-230087.aspxMedia Inquiries: (214) 706-1173Darcy Spitz: (212) 878-5940; Darcy.Spitz

Anti-Smoking Efforts Saved 795,000 Lives Over 25 Years: Study

WEDNESDAY, March 14 (HealthDay News) -- Bans on smoking in public places, hikes in cigarette taxes and other efforts to get people to quit smoking prevented close to 800,000 deaths from lung cancer between 1975 and 2000 in the United States, a new study shows.

The findings, published online March 14 in the Journal of the National Cancer Institute, likely represent just the tip of the iceberg as lung cancer is only one of the diseases linked to tobacco smoke, experts say.

Researchers led by Dr. Suresh Moolgavkar, of the biostatistics and biomathematics program at the Fred Hutchinson Cancer Research Center in Seattle, developed a sophisticated model to estimate changes in U.S. smoking patterns resulting from tobacco-control efforts, and how these changes affected deaths from lung cancer between 1975 and 2000.

During that time, nearly 2.1 million lung cancer deaths occurred among men and about 1.05 million lung cancer deaths occurred among women. The researchers predicted that over 552,000 lung cancer deaths among men and 243,000 among women were averted by tobacco-control efforts.

While an impressive number, this is just one-third of the number of deaths that could have been averted had all U.S. cigarette smokers successfully quit smoking and no one else started after the watershed 1964 U.S. Surgeon General's report on the dangers of tobacco, the researchers calculated.

On the other hand, if smoking behaviors had not changed at all after the Surgeon General's report, an additional 795,000 people would have died of lung cancer.

"Quitting smoking most definitely reduces deaths from lung cancer. However, too many people continue to smoke," Moolgavkar said. "The most effective way to reduce the burden of lung cancer is to get smokers to quit and to prevent non-smokers from taking up smoking."

Another study author, Eric Feuer, chief of the Statistical Methodology and Applications Branch of the U.S. National Cancer Institute, said that Americans have come a long way, but can't afford to become complacent.

"We can't let our guard down and we really need to continue our efforts," Feuer said. Recent data from the Surgeon General's office showed that one in four U.S. high school seniors still smokes and three in four high school smokers continue to smoke as adults.

Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City, said that "the new study is good news and very persuasive. It shows us very conclusively that less smoking means fewer smoking-related deaths."

And it is more than lung cancer rates that are likely decreasing, Horovitz noted. "Smoking cessation would also reduce rates of heart attack, stroke and the lung disease, chronic obstructive pulmonary disease," he said. "The list goes on and on."

In an editorial accompanying the new findings, Thomas Glynn, director of cancer science and trends and international cancer control at the American Cancer Society, wrote: "The good news is that we have become more aggressive in our tobacco control efforts."

Many of the deaths averted occurred in 2000, suggesting that the efforts are picking up steam. Glynn noted that his own father died from lung cancer after smoking for decades and never met his granddaughter.

"He was not one of the 795,000, but seeing

Recent Rise Seen in Foodborne Diseases From Imports: CDC

WEDNESDAY, March 14 (HealthDay News) -- The number of foodborne disease outbreaks in the United States caused by imported food rose in recent years, according to a new federal government study.

Researchers at the U.S. Centers for Disease Control and Prevention reviewed outbreaks reported to the CDC's Foodborne Disease Outbreak Surveillance System between 2005 and 2010. During those five years there were 39 outbreaks and more than 2,300 illnesses linked to imported food from 15 countries.

Of those outbreaks, nearly half (17) occurred in 2009 and 2010.

The most common types of imported food associated with outbreaks were fish (17 outbreaks) and spices (six outbreaks, including five from fresh or dried peppers). Asia was the source of most of the imported food products that caused outbreaks (nearly 45 percent).

The study was scheduled for presentation Wednesday at the International Conference on Emerging Infectious Diseases, in Atlanta.

"It's too early to say if the recent numbers represent a trend, but CDC officials are analyzing information from 2011 and will continue to monitor for these outbreaks in the future," lead author Hannah Gould, an epidemiologist in CDC's division of foodborne, waterborne and environmental diseases, said in a news release from the American Society for Microbiology.

"As our food supply becomes more global, people are eating foods from all over the world, potentially exposing them to germs from all corners of the world, too," Gould noted. "We saw an increased number of outbreaks due to imported foods during recent years, and more types of foods from more countries causing outbreaks."

Between 1998 and 2007, annual U.S. food imports increased from $41 billion to $78 billion, and much of that growth was in fruit and vegetables, seafood and processed food products, according to a report by the Economic Research Service (ERS) of the U.S. Department of Agriculture.

Overall, about 16 percent of all food consumed in the United States is imported, including up to 85 percent of seafood and up to 60 percent of fresh produce, the ERS report said.

Gould said her study likely underestimates the actual number of outbreaks caused by imported food because the origins of many foods that cause outbreaks are not known or not reported.

"We need better -- and more -- information about what foods are causing outbreaks and where those foods are coming from," Gould said. "Knowing more about what is making people sick, will help focus prevention efforts on those foods that pose a higher risk of causing illness."

Research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. Centers for Disease Control and Prevention has more about foodborne illness.

Walking may lessen the influence of genes on obesity by half

American Heart Association Meeting Report - Abstract 004- Embargoed until 11 am PT/2 pm ET March 14, 2012 Study Highlights:People can cut the genetic effect of obesity in half by walking briskly for an hour a day.A sedentary lifestyle that includes watching TV for four hours a day can increase the effects of the genetic tendency to obesity by 50 percent.SAN DIEGO, March 14, 2012 — Watching too much TV can worsen your genetic tendency towards obesity, but you can cut the effect in half by walking briskly for an hour a day, researchers report at the American Heart Association’s Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism 2012 Scientific Sessions. “While previous studies have looked at how physical activity affects genetic predispositions, this is the first study that directly looked at the effect of the sedentary behavior of television watching on the body mass index (BMI) of individuals with a genetic predisposition to obesity,” said Qibin Qi, Ph.D., study author and a post doctorate research fellow in the Department of Nutrition at Harvard School of Public Health in Boston, Mass. “In our study, a brisk one-hour daily walk reduced the genetic influence towards obesity, measured by differences in BMI by half. On the other hand, a sedentary lifestyle marked by watching television four hours a day increased the genetic influence by 50 percent.” The study included 7,740 women and 4,564 men from the Nurses’ Health Study and Health Professionals Follow-up Study. Researchers collected data on physical activity and TV watching two years prior to assessing BMI. BMI is the ratio of weight in kilograms to square of height in meters; a score of 30 or more is obese. The researchers calculated a genetic predisposition score based on 32 established BMI-predisposing genetic variants. The effect of genes on obesity was measured by differences in BMI per point of the genetic predisposition score, corresponding to each BMI-increasing gene. Each BMI-increasing gene was associated with 0.13 kilograms/meter squared (kg/m2) in BMI. That effect was reduced in people in the highest level of physical activity compared to those in the lowest, 0.08 versus 0.15 kg/m2. The genetic effect on BMI was more pronounced in people who spent 40 hours a week watching television than those who spent an hour or less, 0.34 versus 0.08 kg/m2. The equivalent of brisk walking one hour a day was associated with a 0.06 kg/m2 reduction in the genetic effect on BMI and each two-hour-a-day increment in television watching was associated with 0.03 kg/m2 increase in genetic effect on BMI. Gene testing for obesity is not available to the general public yet, and Qi advised physicians to ask patients about a family history of obesity. The average American watches television about four to six hours a day, he said. How the function of these genes affect BMI isn’t clear, Qi said. “These genes were just identified in the past five years and the exact functions of the genetic variants are still unknown. Future studies will be needed to uncover the underlying mechanisms.” Co-authors are Yanping Li, Ph.D.; Andrea K. Chomistek, Sc.D.; Jae Hee Kang, Sc.D.; Gary Curhan, M.D., Sc.D.; Louis R. Pasquale, M.D.; Walter Willett, M.D.; Eric B. Rimm, Sc.D.; Frank B. Hu, M.D., Ph.D.; and Lu Qi, M.D., Ph.D. Author disclosures are on the abstract. The National Institutes of Health funded the study. ### Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position.  The association makes no representation or warranty as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events.  The association has strict policies to prevent these relationships from influencing science content.  Revenues from pharmaceutical and device corporations are available at www.heart.org/corporatefunding. NR12-1046 (Epi/NPAM 2012/Qi) Additional resources, including multimedia, are available on the right column of this link:http://newsroom.heart.org/pr/aha/_prv-walking-may-lessen-the-influence-230079.aspx Media Inquiries: (214) 706-1173 Darcy Spitz: (212) 878-5940; Darcy.Spitz

Doctors practicing healthy lifestyles more likely to preach it to patients

American Heart Association Meeting Report - Abstract P136 - Embargoed until 1 pm PT/4 pm ET March 14, 2012 SAN DIEGO, March 14, 2012—Physicians who have more healthy habits are more likely than doctors without such habits to recommend five important lifestyle modifications to patients, including eating healthy, limiting sodium, maintaining a healthy weight, limiting alcohol and being more physically active. In a survey of 1,000 physicians about their lifestyles and whether they recommend national guideline lifestyle modifications to patients with high blood pressure, researchers found:Four percent smoked at least once a week.Almost 39 percent ate the recommended five or more cups of fruits and vegetables a week.About 27 percent exercised five or more days a week.About 66 percent made all five lifestyle recommendations to patients.Doctors who exercised at least once a week or didn’t smoke were about twice as likely to recommend the five interventions.The study’s lead author is Olivia Y. Hung, M.D., Ph.D., Emory University School of Medicine, Atlanta, Ga., and Centers for Disease Control and Prevention. Co-authors are Nora L. Keenan, Ph.D. and Jing Fang, M.D. Author disclosures are on the manuscript. ### Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position.  The association makes no representation or warranty as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events.  The association has strict policies to prevent these relationships from influencing science content.  Revenues from pharmaceutical and device corporations are available at www.heart.org/corporatefunding. NR12-1043 (Epi/NPAM 2012/Hung) Note: Actual presentation is 5 p.m. PT/8 p.m.ET Wednesday, March 14, 2012. Additional resources are available on the right column of this link:http://newsroom.heart.org/pr/aha/_prv-doctors-practicing-healthy-lifestyles-230084.aspx Media Inquiries: (214) 706-1173Darcy Spitz: (212) 878-5940; Darcy.Spitz

Lack of sleep may increase calorie consumption

American Heart Association Meeting Report - Abstract MP030 - Embargoed until 1 pm PT/4 pm ET March 14, 2012 Study Highlights:People who were sleep deprived ate more than 500 additional calories per day.Chronic lack of sleep may contribute to obesity. SAN DIEGO, March 14, 2012 —If you don’t get enough sleep, you may also eat too much — and thus be more likely to become obese.That is the findings of researchers who presented their study at the American Heart Association’s Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism 2012 Scientific Sessions. “We tested whether lack of sleep altered the levels of the hormones leptin and ghrelin, increased the amount of food people ate, and affected energy burned through activity,” said Virend Somers, M.D., Ph.D., study author and professor of medicine and cardiovascular disease at the Mayo Clinic, Rochester, Minn.. Leptin and ghrelin are associated with appetite. The researchers studied 17 normal, healthy young men and women for eight nights, with half of the participants sleeping normally and half sleeping only two-thirds their normal time. Participants ate as much as they wanted during the study. Researchers found:The sleep deprived group, who slept one hour and 20 minutes less than the control group each day consumed an average 549 additional calories each day.  The amount of energy used for activity didn’t significantly change between groups, suggesting that those who slept less didn’t burn additional calories.Lack of sleep was associated with increased leptin levels and decreasing ghrelin — changes that were more likely a consequence, rather than a cause, of over-eating.“Sleep deprivation is a growing problem, with 28 percent of adults now reporting that they get six or fewer hours of sleep per night,” said Andrew D. Calvin, M.D., M.P.H., co-investigator, cardiology fellow and assistant professor of medicine at the Mayo Clinic. The researchers noted that while this study suggests sleep deprivation may be an important part and one preventable cause of weight gain and obesity, it was a small study conducted in a hospital’s clinical research unit. “Larger studies of people in their home environments would help confirm our findings,” Calvin said. Co-authors are Rickey E. Carter, Ph.D. and James A. Levine, M.D., Ph.D. Author disclosures are on the manuscript. The study was funded by the National Institutes of Health, Minnesota Obesity Center and the Mayo Clinic. ###Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position.  The association makes no representation or warranty as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events.  The association has strict policies to prevent these relationships from influencing science content.  Revenues from pharmaceutical and device corporations are available at www.heart.org/corporatefunding. NR12-1045 (Epi/NPAM 2012/Calvin) Note:  Actual presentation is 5 p.m. PT/8 p.m. ET, Wednesday, March 14, 2012.  Additional resources, including multimedia, are available on the right column of this link:http://newsroom.heart.org/pr/aha/_prv-lack-of-sleep-may-increase-calorie-230068.aspx Media Inquiries: (214) 706-1173Darcy Spitz: (212) 878-5940; Darcy.Spitz

People in neighborhoods with healthy features have better heart health

American Heart Association Meeting Report - Abstract 001 - Embargoed until 9:15 am PT/12:15 pm ET March 14, 2012 Study Highlights:Residents of neighborhoods with more healthy food stores, parks, trails and enjoyable walking environments were more likely to be in ideal cardiovascular health.People under 55, men, Caucasians and those with higher education also had better cardiovascular health.SAN DIEGO, March 14, 2012 — If you live in neighborhoods with access to grocery stores, healthy food, parks and a pleasant walking environment, you’re more likely to be in ideal cardiovascular health. That’s the finding of research reported at the American Heart Association’s Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism 2012 Scientific Sessions.  “The most significant neighborhood factors that lead to ideal health were access to recreational resources like parks and trails where people can walk in safety and comfort, and the availability of healthy foods,” said Erin Unger, study author and medical student at Northwestern University in Evanston, Ill. “These are some of the first findings showing that your neighborhood influences your overall cardiovascular health.” The study included 6,047 participants in the Multi-Ethnic Study of Atherosclerosis (MESA), with baseline measurements of cholesterol, body mass index, diet, physical activity, fasting glucose, blood pressure and smoking. Participants were determined as having poor, intermediate or ideal levels of seven risk factors and an overall score was determined that described their cardiovascular risk profile according to the American Heart Association’s definition of ideal cardiovascular health. Study participants with ideal cardiovascular health were more likely to be under age 55, male, Caucasian and highly educated, researchers said. Neighborhood characteristics included favorable food stores (grocery stores and fruit/vegetable markets), unfavorable food stores (fast food restaurants, liquor stores and convenience stores) recreational facilities and resources, census measures of socioeconomic status and residents’ ratings of aesthetic quality, walking environment, healthy food availability, safety and sense of community. “This study demonstrates the importance of where we live. Our neighborhood can play a significant role in our health,” Unger said. Physical activity in neighborhoods could be improved with community gardens, healthier school lunches, parks, lights and sidewalks, she said. Co-authors are Ana Diez-Roux, M.D., Ph.D.; Donald Lloyd-Jones, M.D.; Mahasin Mujahid, Ph.D.; Jennifer Nettleton, Ph.D.; Hongyan Ning, M.D., M.S. and Norrina Allen, Ph.D. Author disclosures are on the abstract. ###Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position.  The association makes no representation or warranty as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events.  The association has strict policies to prevent these relationships from influencing science content.  Revenues from pharmaceutical and device corporations are available at www.heart.org/corporatefunding. NR12-1047 (Epi/NPAM 2012/Unger) Additional resources, including multimedia, are available in the right column of this link:http://newsroom.heart.org/pr/aha/_prv-people-in-neighborhoods-with-healthy-230078.aspx  Media Inquiries: (214) 706-1173Darcy Spitz: (212) 878-5940; Darcy.Spitz

Sleep apnea treatment may protect against heart failure

March 13, 2012 Study Highlights:Sleep apnea can cause harmful structural and functional changes in the heart similar to those caused by chronic high blood pressure, but breathing treatment may prevent the changes.After six months of treatment with a continuous positive air pressure (CPAP) device during sleep, almost all of the abnormalities corrected to near-normal in the otherwise healthy sleep apnea patients.EMBARGOED UNTIL 3 pm CT/4 pm ET, Tuesday, Mar. 13DALLAS, March 13, 2012 — A nightly breathing treatment may do more than help people with obstructive sleep apnea get a good night’s rest — it may also help prevent heart failure.  In a study published in Circulation: Heart Failure, a journal of the American Heart Association, researchers in the U.K. discovered that moderate to severe obstructive sleep apnea (OSA) can cause changes in the heart’s shape and function, similar to the effects of hypertension. These changes include increased mass, thickening of the heart wall and reduced pumping ability. But, six months after continuous positive airway pressure (CPAP) treatment, the abnormalities returned to near-normal measurements in sleep apnea patients. “To the best of our knowledge, this is the first study to provide a comprehensive assessment of left ventricular structural and functional parameters using advanced echocardiograms in otherwise healthy apnea patients,” said Gregory Y. H. Lip, M.D., a researcher at the University of Birmingham Center for Cardiovascular Sciences in Birmingham, U.K. “Our findings imply that OSA could be crucial in the development of left ventricular diastolic dysfunction that can lead to heart failure and increased mortality if left untreated.” British researchers evaluated 40 patients with moderate to severe obstructive sleep apnea and compared the results with those obtained from 40 people with high blood pressure and 40 healthy people. The OSA patients had abnormal cardiac structure and performance changes typically associated with chronic high blood pressure, even though their blood pressure was only moderately elevated. While previous studies have suggested that OSA might be associated with structural and functional changes in the left ventricle, the new study used a better defined and controlled patient group, newer two- and three-dimensional echocardiograms and Doppler imaging of heart muscle tissue. “OSA patients may have cardiac abnormalities that often are undetected, but will improve with CPAP,” Lip said. “Patients also need to understand that OSA is not a benign disorder, but that their risk of heart problems can be easily treated with CPAP.” Physicians should question patients with hypertension and/or abnormal echocardiograms about snoring and other signs of sleep apnea, although asking their partners is usually more reliable, Lip said. The study wasn’t randomized or blinded, so observer bias can’t be ruled out. Also, the OSA patients tended to have a higher body mass index. A larger randomized trial may clarify the findings, Lip said. The National Sleep Foundation estimates that more than 18 million Americans have some form of OSA. Co-authors are: Mehmood Butt, M.R.C.P.; Girish Dwivedi, M.D., Ph.D.; Alena Shantsila, M.D., University of Birmingham Center for Cardiovascular Sciences; and Omer Khair, M.D., with the Department of Respiratory Medicine at City Hospital in Birmingham. Author disclosures and funding information are on the manuscript. ### Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at www.heart.org/corporatefunding. NR12 –1039 (Circ HF/Lip) Additional resources, including multimedia, are available on the right column of this link:http://newsroom.heart.org/pr/aha/_prv-sleep-apnea-treatment-may-protect-230160.aspx Additional Resources:Learn more about Sleep Apnea and Cardiovascular DiseaseWhat Is Heart Failure? (Downloadable PDF)For Media Inquiries: (214) 706-1173Bridgette McNeill: (214) 706-1135; bridgette.mcneill

Heat-Related Deaths on Rise for High School Football Players

TUESDAY, March 13 (HealthDay News) -- Heat-related deaths among high school and college football players in the United States nearly tripled between 1994 and 2009, according to a new study.

An average of nearly three players died each year during that time period -- up from about one death per year during the previous 15 years -- with six deaths occurring in Georgia alone, the most of any state.

The University of Georgia researchers analyzed weather conditions, along with information on all 58 athletes who died of hyperthermia (overheating) during football practice. Specifically, they examined the temperature, humidity and time of day of the incident, as well as the players' height, weight and position.

The study, published recently in the International Journal of Biometeorology, found that morning heat indexes were higher from 1994 to 2009 than they were in the preceding 15 years.

"In general, on days the deaths occurred, the temperature was hotter and the air more humid than normal local conditions," senior study author Andrew Grundstein, a climatologist and associate professor of geography at the University of Georgia, said in a university news release.

More than half of the players got sick on days when practice was held in the morning and ended before noon. Most of the deaths occurred in August, when many coaches intensified preseason training.

Researchers used wet bulb globe temperature, developed by the American College of Sports medicine, which takes into account air temperature, players' ability to be cooled through evaporation and the amount of solar radiation absorbed by players' skin. They also used the U.S. National Weather Service's heat index. The authors noted limitations to the study, however, such as that neither of these methods used to measure temperature account for the added heat caused by football pads and helmets.

"We all want a single magic number to indicate the heat threshold," Grundstein said. "But so many factors contribute to heat stress that it's impossible to draw the line at a single temperature."

The researchers said coaches should take the following steps to avoid heat illness among players:

Know the true temperature outdoors. Make sure players ramp up their workouts slowly over time so they can acclimate to outdoor temperatures. Remind trained staff members to watch for signs of hyperthermia among players. Have an emergency management plan in place to address heat-related illness immediately.

The researchers said body-mass index (BMI) -- a measure of body fat based on height and weight -- also could have played a role in the increase in player deaths. The study showed football players have gotten bigger since 1980, which could make them more susceptible to hyperthermia. Of the players who died, 86 percent were linemen, who tend to have a higher BMI than other players.

More information

The U.S. Centers for Disease Control and Prevention provides more information on how to prevent overheating.

Cooler Hands Might Boost Your Workout, Study Suggests

TUESDAY, March 13 (HealthDay News) -- Looking for a exercise edge, a way to stay faithful to regular workouts?

Try chilling out -- literally.

Cooling the palms of the hands while working out helped obese women exercise longer, reports researcher Stacy Sims, a research scientist and exercise physiologist at Stanford University School of Medicine.

She was to present her findings Tuesday at the American Heart Association's Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism scientific sessions in San Diego.

"If you think about adipose

One Antibiotic Appears to Ease Severe E. Coli Infection

TUESDAY, March 13 (HealthDay News) -- Patients suffering from a strain of E. coli that produces Shiga toxin, which can be deadly, appear to respond to the antibiotic azithromycin (Zithromax), according to German researchers.

Starting in May 2011, an outbreak of Shiga-toxin-producing E. coli infected nearly 4,000 people in Germany, more than 800 of whom had confirmed cases of hemolytic uremic syndrome (HUS), which causes red blood cells to break apart, resulting in kidney failure.

Current treatment discourages using antibiotics for Shiga-toxin-producing E. coli because it could increase the risk for HUS, the researchers note.

"The successful decolonization of long-term carriers of the German outbreak strain is an important finding, as the legal authorities in many countries restrict long-term carriers in their social or working life," said lead researcher Dr. Johannes Knobloch, of the institute of medical microbiology and hygiene at the University of Lubeck. "However, decolonization by azithromycin should be investigated in further studies for other E. coli strains."

E. coli can cause persistent diarrhea, and it can be spread by those infected through person-to-person contact.

The German outbreak was a mix of E. coli strains O157 and O104 (or enteroaggregative E. coli), both investigated in the new study, which was published in the March 14 issue of the Journal of the American Medical Association. "For the treatment of one strain -- enteroaggregative E. coli -- azithromycin is one of the antibiotics of choice," Knobloch said.

The study reports on 65 infected patients -- some with HUS -- who were followed for almost 40 days after showing initial symptoms. Among these patients, 22 were treated with azithromycin starting almost 12 days after their symptoms began; the others were not.

Knobloch's team found that there were significantly fewer carriers of E. coli among those who took azithromycin, compared to those who didn't.

Twenty-one days after starting treatment, nearly 32 percent of those taking azithromycin still carried the bacteria, compared with almost 84 percent of those not treated, they found.

After about one month, only 4.5 percent of those who received azithromycin still had the bacteria, compared with more than 81 percent of those who were not treated, and at 35 days none of the patients in the treated group had the bacteria.

In addition, all the treated patients remained bacteria-free after two weeks of antibiotic treatment, the researchers noted. However, 25 of the 43 untreated patients still carried the bacteria 42 days after their symptoms started.

Based on the successful use of azithromycin, it was decided to provide the drug to the 15 patients who still had symptoms.

After receiving azithromycin treatment, these patients no longer carried the bacteria. Moreover, there were no signs of HUS among any of the patients who took the antibiotic, the researchers said.

"This is a small study, but since other antibiotics activate the Shiga toxin, this is a revealing study," said Dr. Marc Siegel, an associate professor of medicine at New York University in New York City. "Azithromycin may well be the preferred antibiotic when you suspect an aggressive E. coli or a toxic E. coli."

Another expert, Hugh Pennington, emeritus professor of bacteriology at the University of Aberdeen in Scotland, is more cautious.

This finding is "not surprising, but relevance to E. coli O157 is far from certain," he said. The O157 strain of E. coli is particularly severe and also produces the Shiga toxin that often leads to hemolytic uremic syndrome.

"Neither does it help much regarding the issue of antibiotic use increasing the frequency of hemolytic uremic syndrome caused by E. coli O157," Pennington said. "The issue here, of course, is not whether antibiotics help after hemolytic uremic syndrome has developed, but whether they help to induce it. The jury is still out."

More information

For more about E. coli, visit the U.S. National Library of Medicine.

Spring Break Safety Tips to Keep Vacation Fun

SUNDAY, March 11 (HealthDay News) -- High school and college students around the country are gearing up for spring break, but getting hurt or sick on vacation can ruin the fun.

The American College of Emergency Physicians (ACEP) offers steps that students can take to prevent injuries and stay safe while traveling with their friends or family.

"Of course, if there's a medical emergency, a person should go to the nearest ER so we can treat them," said Dr. David Seaberg, ACEP president, in a news release. "But so many of the illnesses and injuries we see each year during spring break can easily be prevented with a little knowledge, preparation and common sense."

Before a spring break vacation, ACEP advised that every student should:

Apply sunscreen (SPF 15 or higher), and reapply throughout the day. And wear a hat and sunglasses outdoors. Drink plenty of water, particularly if you're in the sun or sweating a lot. Wear a life vest on boats. Stick close to friends and other people you trust, especially when swimming. Become familiar with your surroundings, including local emergency rooms. Get enough sleep to keep a clear head. Use condoms if you plan to be sexually active. Resist peer pressure to join in activities you know are questionable or dangerous. Pack your medications and proof of insurance.

ACEP also warned that during spring break, a student should NOT:

Take illegal drugs. Drink before swimming or drive a car or boat under the influence of alcohol. Drink alcohol if you're underage. Put yourself at risk for alcohol poisoning by binge drinking. Ignore your body's warning signs if you feel you are getting sick. Go to an isolated place with someone you do not know or trust.

"Spring break is a time to celebrate after the hard work you've done in the year," Seaberg said. "We want you to remember the fun memories from your vacation, not ones where you found yourself being treated in an emergency department because of something you could have prevented."

More information

The U.S. Centers for Disease Control and Prevention provides more tips on spring break health and safety.

Spring Break Safety Tips to Keep Vacation Fun

SUNDAY, March 11 (HealthDay News) -- High school and college students around the country are gearing up for spring break, but getting hurt or sick on vacation can ruin the fun.

The American College of Emergency Physicians (ACEP) offers steps that students can take to prevent injuries and stay safe while traveling with their friends or family.

"Of course, if there's a medical emergency, a person should go to the nearest ER so we can treat them," said Dr. David Seaberg, ACEP president, in a news release. "But so many of the illnesses and injuries we see each year during spring break can easily be prevented with a little knowledge, preparation and common sense."

Before a spring break vacation, ACEP advised that every student should:

Apply sunscreen (SPF 15 or higher), and reapply throughout the day. And wear a hat and sunglasses outdoors. Drink plenty of water, particularly if you're in the sun or sweating a lot. Wear a life vest on boats. Stick close to friends and other people you trust, especially when swimming. Become familiar with your surroundings, including local emergency rooms. Get enough sleep to keep a clear head. Use condoms if you plan to be sexually active. Resist peer pressure to join in activities you know are questionable or dangerous. Pack your medications and proof of insurance.

ACEP also warned that during spring break, a student should NOT:

Take illegal drugs. Drink before swimming or drive a car or boat under the influence of alcohol. Drink alcohol if you're underage. Put yourself at risk for alcohol poisoning by binge drinking. Ignore your body's warning signs if you feel you are getting sick. Go to an isolated place with someone you do not know or trust.

"Spring break is a time to celebrate after the hard work you've done in the year," Seaberg said. "We want you to remember the fun memories from your vacation, not ones where you found yourself being treated in an emergency department because of something you could have prevented."

More information

The U.S. Centers for Disease Control and Prevention provides more tips on spring break health and safety.

Indicators of the need for ICU admission following suicide bombing attacks

4 areas, and certain types of injuries such as facial and skull fractures, and peripheral vascular injury, can serve as surrogates of severe trauma and the need for ICU admission. Over-triage rates following SBA can be limited by a concerted, focused plan implemented by dedicated personnel and by the liberal utilization of imaging studies.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production. Advertisement

Drug Seems to Speed Recovery After Traumatic Brain Injury

WEDNESDAY, Feb. 29 (HealthDay News) -- A drug that's typically used to treat the flu and Parkinson's disease appears to speed recovery in traumatic brain injury patients, a new study indicates.

Traumatic brain injury (TBI) victims who weren't fully conscious and were discharged to rehabilitation facilities after hospitalization were given amantadine hydrochloride. The drug is already given "off-label" to such patients, but if and how much it helps has remained unclear.

While taking the drug, the patients given amantadine scored better on behavioral tests that measure how well the brain is functioning compared to a group of patients given a placebo, researchers report in the March 1 issue of The New England Journal of Medicine.

"Amantadine appeared to increase the rate of recovery compared to placebo. Patients got better faster while they were on the drug," said study co-author Joseph Giacino, director of rehabilitation neuropsychology at the Spaulding Rehabilitation Hospital, in Boston, and an associate professor in the department of physical medicine and rehabilitation at Harvard Medical School.

Study co-author Dr. John Whyte, director of the Moss Rehabilitation Research Institute at Albert Einstein Healthcare Network, in the Philadelphia area, said previous observational studies had suggested amantadine improved the rate of recovery. While the medicine is already commonly prescribed off-label to treat people suffering from prolonged disorders of consciousness, he said this is the first placebo-controlled trial of the drug in patients who were either in a vegetative state (wakeful but not aware) or a minimally conscious state (able to track with their eyes).

"There were many hypotheses out there about what this drug should do, but there was very little data to support or refute those hypotheses," Whyte explained.

For the study, 184 patients from 11 medical centers in three countries were enrolled. They had all suffered a TBI within the previous one to four months. Half received amantadine while the other half were given a placebo for the first four weeks of the six-week study. Both groups were followed up for two additional weeks, Whyte said.

The researchers used the Disability Rating Scale (DRS) to monitor patients' progress during the treatment and follow-up period. The test measures eye opening, verbal ability and motor response, among other functions, Giacino said.

"During the four-week treatment period, recovery was significantly faster in the amantadine group than the placebo group," said Giacino.

Whyte said during his 25-year career as a brain trauma rehabilitation physician there have been no groundbreaking treatments for these patients. TBI rehabilitation can take months, or years, and many patients do not have the health insurance or private funds to access good rehabilitative care, so a drug that could speed recovery would be a boon, he said.

The ability of patients in a vegetative state or those in the MCS "to access rehab has gotten less and less," Whyte said. "Many of these patients go straight to a nursing home or home with family." He noted that TBI remains the most common cause of death and disability in people between the ages of 15 and 30.

The new finding "is very exciting because we have a new tool to help improve these patients in their early outcome," said one expert, Dr. J. Javier Provencio, director of the Neurocritical Care Fellowship Program at the Cerebrovascular Center of the Cleveland Clinic Neurological Institute.

"The take-home message is that this medicine is promising for patients in a very certain setting. I think the results have to be taken very strictly and not extrapolated to other conditions," said Provencio.

He noted that the rate of improvement in the drug group slowed in weeks five and six. By the study's end, the overall improvement from baseline between the placebo group and the amantadine group was identical.

That means that, "it is still unclear whether the effects last," Provencio said. "In the study, by week six, the effect difference was getting smaller. I hope they follow these patients out to a year to see how they do."

Study co-author Giacino said they were surprised when they saw an immediate leveling off between the two groups in the final two weeks.

"But when I take a step back, it is even stronger evidence that this drug was doing something," he added.

Neurologist Dr. Daniel Labovitz, of Montefiore Medical Center in New York City, believes hope should remain in check despite the promising results. "It's not a home run. It's a small change and it was temporary, and I think that would be the message that has to come through."

Labovitz said the drug appears to be gently waking the patients. "If this trial holds up in larger, longer-term studies, maybe you can enhance the ability of