Experts Offer Tips To Lower Risk of West Nile

stay indoors, wear long clothes that cover your skin and use insect repellant. Eliminating standing water, such as that pooled in puddles or unused containers, can also help reduce mosquito breeding grounds and populations overall.

Stopping the mosquitoes’ spread helps in the long-run

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Experts Offer Tips to Cut Kids' Screen Time During Summer

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New lipid screening guidelines for children overly aggressive, experts say

ScienceDaily (July 23, 2012) — Recent guidelines recommending cholesterol tests for children fail to weigh health benefits against potential harms and costs, according to a new commentary authored by three physician-researchers at UCSF.

See Also:Health & MedicineChildren's HealthCholesterolDiet and Weight LossHealth PolicyHeart DiseaseDiseases and ConditionsReferenceLow density lipoproteinHigh density lipoproteinCholesterolGrowth hormone deficiency

Moreover, the recommendations are based on expert opinion, rather than solid evidence, the researchers said, which is especially problematic since the guidelines' authors disclosed extensive potential conflicts of interest.

The guidelines were written by a panel assembled by the National Heart, Lung and Blood Institute ( NHLBI) and published in Pediatrics, in November 2011. They also were endorsed by the American Academy of Pediatrics. The guidelines call for universal screening of all 9 to 11-year-old children with a non-fasting lipid panel, and targeted screening of 30 to 40 percent of 2 to 8-year-old and 12 to 16-year old children with two fasting lipid profiles. Previous recommendations called only for children considered at high risk of elevated levels to be screened with a simple non-fasting total cholesterol test.

The call for a dramatic increase in lipid screening has the potential to transform millions of healthy children into patients labeled with so-called dyslipidemia, or bad lipid levels in the blood, according to the commentary by Thomas Newman, MD, MPH, Mark Pletcher, MD, MPH and Stephen Hulley, MD, MPH, of the UCSF Department of Epidemiology and Biostatistics and e-published on July 23 in Pediatrics.

"The panel made no attempt to estimate the magnitude of the health benefits or harms of attaching this diagnosis at this young age," said Newman. "They acknowledged that costs are important, but then went ahead and made their recommendations without estimating what the cost would be. And it could be billions of dollars."

Some of the push to do more screening comes from concern about the obesity epidemic in U.S. children. But this concern should not lead to more laboratory testing, said Newman. "You don't need a blood test to tell who needs to lose weight. And recommending a healthier diet and exercise is something doctors can do for everybody, not just overweight kids," he said

The requirement of two fasting lipid panels in 30 to 40 percent of all 2 to 8-year olds and 12 to 16 -year- olds represents a particular burden to families, he said.

"Because these blood tests must be done while fasting, they can't be done at the time of regularly scheduled 'well child' visits like vaccinations can," said Newman. "This requires getting hungry young children to the doctor's office to be poked with needles on two additional occasions, generally weekday mornings. Families are going to ask their doctors, 'Is this really necessary?' The guidelines provide no strong evidence that it is."

The authors note that the panel chair and all members who drafted the lipid screening recommendations disclosed an "extensive assortment of financial relationships with companies making lipid lowering drugs and lipid testing instruments." Some of those relevant relationships include paid consultancies or advisory board memberships with pharmaceuticals that produce cholesterol-lowering drugs such as Merck, Pfizer, Astra Zeneca, Bristol-Myers Squibb, Roche and Sankyo.

"The panel states that they reviewed and graded the evidence objectively," said Newman. "But a recent Institute of Medicine report recommends that experts with conflicts of interest either be excluded from guideline panels, or, if their expertise is considered essential, should have non-voting, non-leadership, minority roles."

Evidence is needed to estimate health benefits, risks and costs of these proposed interventions, and experts without conflicts of interest are needed to help synthesize it, according to Newman. He said that "these recommendations fall so far short of this ideal that we hope they will trigger a re-examination of the process by which they were produced."

Newman and Hulley have no disclosures. Pletcher has NIH funding to support research on targeting of cholesterol-lowering medications to prevent cardiovascular disease.

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All HIV Patients Should Take Meds Early On, Experts Now Say

HealthDay – 1 hr 41 mins ago MONDAY, July 23 (HealthDay News) -- A new report recommends that physicians begin treating all HIV-positive adults with antiretroviral drugs instead of waiting, at least in countries where the therapy is easily accessible.

All HIV-positive patients should take the drugs, even if blood tests reveal that their immune system is healthy, according to the revised guidelines, which were presented Sunday at the International AIDS Conference in Washington D.C., and published in the July 25 issue of the Journal of the American Medical Association.

Over the last 25 years, antiretroviral drugs have become stronger, easier to tolerate and simpler to take, the authors of the report explained. "New trial data and drug regimens that have become available in the last two years warrant an update to guidelines for antiretroviral therapy in HIV-infected adults in resource-rich settings," Dr. Melanie Thompson and her 2012 International Antiviral Society-USA Panel colleagues said in the report.

While medications don't rid the body of HIV -- the virus that causes AIDS -- they can prevent the virus from replicating and have allowed millions of people to live for years with a greatly reduced threat of developing AIDS, experts have noted.

However, not every person infected with HIV takes the medications. In some cases, doctors prefer to wait until a patient's immune system begins to show signs that the virus is becoming stronger.

The reasons why doctors sometimes wait to prescribe antiretroviral medications may be because the drugs can cause side effects, and there's also the challenge that patients must keep taking them or take the risk that the virus will rebound.

Commenting on the report, Rowena Johnston, director of research with the Foundation for AIDS Research in New York City, explained, "We can't lose sight of the fact that this is a big commitment. Once you start, you can't stop."

The report recommends that initial treatment include two nucleoside reverse transcriptase inhibitors (tenofovir/emtricitabine

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All HIV Patients Should Take Meds Early On, Experts Now Say

HealthDay – 1 hr 41 mins ago MONDAY, July 23 (HealthDay News) -- A new report recommends that physicians begin treating all HIV-positive adults with antiretroviral drugs instead of waiting, at least in countries where the therapy is easily accessible.

All HIV-positive patients should take the drugs, even if blood tests reveal that their immune system is healthy, according to the revised guidelines, which were presented Sunday at the International AIDS Conference in Washington D.C., and published in the July 25 issue of the Journal of the American Medical Association.

Over the last 25 years, antiretroviral drugs have become stronger, easier to tolerate and simpler to take, the authors of the report explained. "New trial data and drug regimens that have become available in the last two years warrant an update to guidelines for antiretroviral therapy in HIV-infected adults in resource-rich settings," Dr. Melanie Thompson and her 2012 International Antiviral Society-USA Panel colleagues said in the report.

While medications don't rid the body of HIV -- the virus that causes AIDS -- they can prevent the virus from replicating and have allowed millions of people to live for years with a greatly reduced threat of developing AIDS, experts have noted.

However, not every person infected with HIV takes the medications. In some cases, doctors prefer to wait until a patient's immune system begins to show signs that the virus is becoming stronger.

The reasons why doctors sometimes wait to prescribe antiretroviral medications may be because the drugs can cause side effects, and there's also the challenge that patients must keep taking them or take the risk that the virus will rebound.

Commenting on the report, Rowena Johnston, director of research with the Foundation for AIDS Research in New York City, explained, "We can't lose sight of the fact that this is a big commitment. Once you start, you can't stop."

The report recommends that initial treatment include two nucleoside reverse transcriptase inhibitors (tenofovir/emtricitabine

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Keep Infants Out of Sun and Heat, Experts Warn

HealthDay – 23 hrs ago SATURDAY, July 7 (HealthDay News) -- Because infants are so much smaller than adults and lack the ability to sweat, heat and sun exposure pose specific risks for babies, experts say.

Fortunately, there are steps parents and caregivers can take to protect infants this summer, according to the U.S. Food and Drug Administration and the American Academy of Pediatrics. But one of the usual summertime recommendations, sunscreen, is not advised for children under 6 months old, they pointed out.

Dr. Hari Cheryl Sachs, a pediatrician with the FDA, said parents should avoid putting sunscreen on their infants. Sachs explained that young babies' skin is much thinner than that of adults and can absorb the active, chemical ingredients found in sunscreens more easily. She noted that because they have a relatively high surface-area to body-weight ratio, they are at greater risk for allergic reactions or inflammation from exposure to sunscreen.

"The best approach is to keep infants under 6 months out of the sun, and to avoid exposure to the sun in the hours between 10 a.m. and 2 p.m., when ultraviolet (UV) rays are most intense," Sachs said in an FDA news release.

If necessary, shade can be created by an umbrella or stroller canopy, Sachs pointed out. When there are no other options available, a small amount of sunscreen with a sun-protection factor of at least 15 can be applied to small areas of exposed skin, such as the cheeks and back of the hands. Applying a small amount of sunscreen to the baby's inner wrist first to test for sensitivity is a good idea, she noted.

Sachs and the American Academy of Pediatrics (AAP) offered additional tips to ensure infants are protected from sun exposure, including:

To prevent sunburns, dress infants in lightweight pants and shirts with long sleeves, as well as hats with brims that shade the ears and neck, advised the AAP. Sheer fabrics should be avoided because they could still result in a sunburn. Ensure babies are well hydrated. Offer them their usual feeding of breast milk or formula, said Sachs. Use a cooler to store the liquids if they will be out in the sun for more than a few minutes. Monitor babies for signs of sunburn or dehydration, including fussiness, redness, excessive crying and lack of urination. If sunscreen is applied to babies, steer clear of products containing the insect repellant DEET. Babies who become sunburned should be taken out of the sun immediately, and cold compresses should be applied to the affected areas.

More information

The American Academy of Pediatrics has more sun safety tips.

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Killer disease in Cambodia stumps experts

"A doctor checks a child at Kantha Bopha children's hospital in Phnom Penh. Medical experts are scrambling to respond to what the Cambodian health ministry and World Health Organization have labelled an "undiagnosed syndrome" that has claimed the lives of at least 56 boys and girls, mostly toddlers, since April" title

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Court's Verdict on Health-Care Reform Holds Surprises, Legal Experts Say

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Significant cardiovascular risk with Atkins-style diets, experts warn

ScienceDaily (June 27, 2012) — Women who regularly eat a low carbohydrate, high protein diet are at greater risk of cardiovascular disease (such as heart disease and stroke) than those who do not, a study just published on the British Medical Journal website suggests.

See Also:Health & MedicineDiet and Weight LossObesityNutritionHeart DiseaseCholesterolStroke PreventionLiving WellReferenceZone dietColostrumSouth Beach dietGlycemic index

Although the actual numbers are small (an extra 4-5 cases of cardiovascular disease per 10,000 women per year) the authors say that this is a 28% increase in the number of cases and that these results are worrying in a population of young women who may be exposed to these dietary patterns and face the excess risk for many years.

Low carbohydrate-high protein diets are frequently used for body weight control. Although they may be nutritionally acceptable if the protein is mainly of plant origin (e.g. nuts) and the reduction of carbohydrates applies mainly to simple and refined ones (i.e. unhealthy sweeteners, drinks and snacks), the general public do not always recognise and act on this guidance.

Studies on the long term consequences of these diets on cardiovascular health have generated inconsistent results. So a team of international authors carried out a study on just under 44,000 Swedish women aged between 30 and 49 years from 1991-92 (with an average follow-up of 15 years).

Women completed an extensive dietary and lifestyle questionnaire and diet was measured on the low carbohydrate-high protein (LCHP) score where a score of two would equal very high carbohydrate and low protein consumption through to 20 which would equal very low carbohydrate and high protein consumption.

Factors likely to influence the results were taken into account including smoking, alcohol use, diagnosis of hypertension, overall level of activity and saturated / unsaturated fat intake.

After these variables were included, results showed that 1270 cardiovascular events took place in the 43,396 women (55% ischaemic heart disease, 23% ischaemic stroke, 6% haemorrhagic stroke, 10% subarachnoid haemorrhage and 6% peripheral arterial disease) over 15 years.

The incidence of cardiovascular outcomes increased with an increasing LCHP score.

Unadjusted figures show that, compared with an LCHP score of six or less, cardiovascular diseases increased by 13% for women with a score from 7 to 9, to 23% for those with a score from 10 to 12, to 54% for those with a score from 13 to 15, and to 60% for those with a score of 16 or higher.

After adjusting for other cardiovascular risk factors, there was still a significant 5% increase in the likelihood of a cardiovascular event or death with every two point increase in the LCHP score. The 5% increase resulted from a daily decrease of 20g of carbohydrates (equivalent to a small bread roll) and a daily increase of 5g of protein (equivalent to one boiled egg).

In absolute terms, the adjusted figures represent an additional four to five cases of cardiovascular diseases per 10,000 women per year compared with those who did not regularly eat a low carbohydrate, high protein diet.

Increasing level of education and physical activity reduced the risk of cardiovascular disease whilst increasing levels of smoking increased the risk.

The authors conclude that LCHP diets "used on a regular basis and without consideration of the nature of carbohydrates or the source of proteins" are associated with cardiovascular risk. This study doesn't, however, address the questions concerning the possible benefit of short-term effects of LCHP diets that can be used to control weight or insulin resistance, which the authors say needs further investigation.

An accompanying editorial argues that the short term benefits of weight loss seem outweighed by longer term cardiovascular harms. Anna Floegel from the German Institute of Human Nutrition and Tobias Pischon from the Max Delbrück Center for Molecular Medicine in Germany, say that the discrepancy between conclusions from different types of studies in this field "need to be resolved before low carbohydrate-high protein diets can be safely recommended to patients."

In the meantime, they suggest that any benefits gained from these diets in the short-term "seem irrelevant in the face of increasing evidence of higher morbidity and mortality from cardiovascular diseases in the long term."

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Experts say science lacking on 9/11 and cancer

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Experts cast doubt on Sandusky's disorder defense

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Brave New World of Genetics Requires Safeguards, Experts Say

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Flesh-Eating Bacteria No Cause for Panic, Experts Say

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Efficient Disease Risk Prediction a Long Way Off, Experts Say

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Major overhaul of US life urged to cure obesity: experts

"Two overweight women walk at the 61st Montgomery County Agricultural Fair in 2009. Two-thirds of American adults are too fat, and a major overhaul of US policies -- from schools to restaurants to urban planning -- is needed to stem the epidemic, medical experts said. (AFP Photo/Tim Sloan)" title

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Glaucoma Need Not Steal Sight, Experts Say

HealthDay – 14 mins ago FRIDAY, April 20 (HealthDay News) -- Though glaucoma has been nicknamed the silent thief of sight, eye experts now say it generally doesn't have to be that way.

"For most people, if you treat early, you should have vision for a lifetime," said Dr. Mark Fromer, an ophthalmologist at Lenox Hill Hospital and medical director of the Fromer Eye Centers, both in New York City, and the eye surgeon director for the New York Rangers hockey team.

Glaucoma isn't just one disease but a group of conditions that cause damage to the optic nerve, which connects the eye to the brain. Left untreated, glaucoma can in fact cause blindness. And because the disease can progress for long periods undetected, experts stress that checkups and early detection are key to maintaining vision.

Most forms of glaucoma develop because of increased pressure in the eye, according to the Glaucoma Foundation. High eye pressure, also known as intraocular pressure, is the biggest risk factor for developing glaucoma. However, some people have what's called normal tension glaucoma, and they can have optic nerve damage even when eye pressure is normal.

"Some people are just more susceptible to optic nerve damage," Fromer noted.

The most common form of glaucoma is called primary open-angle glaucoma, he said. The angle referred to is where the cornea and the iris meet. Fluid normally drains through the angle. Sometimes, however, the fluid drains too slowly, which allows it to build up and increase the pressure in the eye. The increased pressure causes optic nerve damage, and, as the damage increases, so does peripheral vision loss.

If the angle narrows or closes completely, an acute form of glaucoma can develop. The pressure rises quickly and causes pain, blurred vision and halos around lights. This is a medical emergency that requires immediate treatment to save vision.

"If you develop severe pain in your eye, get seen right away at the ER," said Dr. Gregory Harmon, a New York City ophthalmologist who's chairman of the Glaucoma Foundation. "Without treatment, you can have a permanent loss of vision."

People who have a family history of glaucoma are more likely to develop glaucoma themselves. Harmon said that blacks and Hispanics have a four to five times higher risk for glaucoma than whites. Older people, especially those who are also developing cataracts, have an increased risk of glaucoma as well, according to Fromer. And those who take any type of steroid medication -- whether it's oral, inhaled or even a topical cream -- also face a higher risk for glaucoma, he noted.

The American Academy of Ophthalmology recommends that people older than 40 have a baseline eye exam and then discuss how often follow-up visits are necessary based on their particular glaucoma risk factors. After 65, testing is recommended every year or two.

The most commonly used test for glaucoma is called tonometry, which involves looking into a device that blows a small puff of air into your eye. Though it can be slightly startling, the test is painless. Another important tool for detecting glaucoma is the dilated eye exam, which Harmon said "allows us to look at the optic nerve and evaluate the optic nerve health."

If there's evidence of optic nerve damage, your eye doctor will probably conduct a visual field test as well. You'll be asked to click a button whenever you see flashes of light, which lets the doctor determine whether you've lost any peripheral vision.

If the doctor diagnoses glaucoma, treatment usually begins with eye drops that help lower pressure in the eyes. Eye drops can decrease fluid production, or they can help open the drainage ducts. There are also oral medications that can be used, according to Harmon. Eye drops may need to be used as many as four times a day, but Fromer said that most eye doctors start with once-daily drops given at night.

"We try to keep it simple," he said, "but if one eye drop doesn't work, we'll add another for a synergistic effect."

If eye drops aren't effective, the next step is usually laser treatment. If those treatments don't work, then surgery to implant more effective drainage tubes can be done.

What's important to know is that these treatments can be effective at preventing vision loss -- but if you've already lost vision, they can't get it back.

"We can prevent but not reverse vision loss," Harmon said.

He also said that regular exercise -- 20 minutes of aerobic exercise most days of the week -- can help lower eye pressure. "The healthier your body is, the healthier your eyes are," he noted. Just be sure to clear any exercise program with your doctor first because some types of exercise can raise eye pressure.

The bottom line, to Fromer, is that you can't prevent the development of glaucoma but you can protect your sight.

"If you're gonna get glaucoma, you're gonna get glaucoma," he said. "But you don't have to lose your vision. It can be protected with appropriate medications."

More information

The Glaucoma Foundation has more on glaucoma.

A companion article looks at one man's story of living with glaucoma after being diagnosed as a teenager.

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AIDS experts launch 'CNN of virology' in Canada

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No Proof That Gum Disease Causes Heart Disease, Experts Say

HealthDay – 30 mins ago WEDNESDAY, April 18 (HealthDay News) -- A new scientific statement issued by the American Heart Association says no convincing evidence exists linking untreated gum disease to heart disease or stroke. Nor is there strong evidence that treating gum disease can reduce your risk of heart disease or stroke, the report says.

For more than 100 years, it was said that gum, or periodontal, disease could lead to cardiovascular disease, a major cause of death in the United States, but an extensive analysis found no proof of that connection.

"It's a statement that current science does not support a direct association or a causative association," said Dr. Peter Lockhart, a professor, dentist and co-chair of oral medicine at the Carolinas Medical Center, in Charlotte, N.C.

The report has been in the works for more than three years, Lockhart said. "It was a matter of finding out, what is the state of the science?"

The statement, released April 18, is published in the journal Circulation.

The American Dental Association's Council on Scientific Affairs agrees with the statement. The World Heart Federation, a nongovernmental organization that fights heart disease globally, also endorses it.

Many U.S. adults suffer from some form of gum disease, which can range from mild swelling and redness to periodontitis, when the gums pull away from the teeth and develop pockets that get infected.

The writing group -- co-chaired by cardiologist Dr. Ann Bolger of the University of California, San Francisco -- combed the medical literature on cardiovascular and gum disease from 1950 until mid-July 2011. They found more than 500 studies, and looked in-depth at the most scientific ones.

Gum disease, heart disease and stroke all produce inflammation in the body. The conditions share some risk factors, such as cigarette smoking, age and diabetes, which is why they often develop in the same people.

However, the writing group did not feel the evidence is strong enough to say gum disease causes heart disease or stroke.

"So far, there is no conclusive evidence

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After $1B, experts see progress on autism's causes

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More than half of all cancer is preventable, experts say

ScienceDaily (Mar. 28, 2012) — More than half of all cancer is preventable, and society has the knowledge to act on this information today, according to Washington University public health researchers at the Siteman Cancer Center in St. Louis.

See Also:Health & MedicineLung CancerBreast CancerCancerScience & SocietyPublic HealthEducational PolicyOcean PolicyLiving WellReferenceNanomedicineGynecologic hemorrhageHealth benefits of teaGeneral fitness training

In a review article published in Science Translational Medicine March 28, the investigators outline obstacles they say stand in the way of making a huge dent in the cancer burden in the United States and around the world.

"We actually have an enormous amount of data about the causes and preventability of cancer," says epidemiologist Graham A. Colditz, MD, DrPH, the Niess-Gain Professor at the School of Medicine and associate director of prevention and control at the Siteman Cancer Center. "It's time we made an investment in implementing what we know."

What we know, according to Colditz and his co-authors, is that lifestyle choices people make and that society can influence in a number of ways -- from tobacco use to diet and exercise -- play a significant role in causing cancer. Specifically, the researchers cite data demonstrating that smoking alone is responsible for a third of all cancer cases in the United States. Excess body weight and obesity account for another 20 percent.

But beyond individual habits, they argue that the structure of society itself -- from medical research funding to building design and food subsidies -- influences the extent of the cancer burden and can be changed to reduce it.

The obstacles they see to implementing broad cancer prevention strategies are:

Skepticism that cancer can be prevented. Smoking rates in different states demonstrate that 75 percent of lung cancer in the United States could be prevented with elimination of cigarette smoking.

The short-term focus of cancer research. Benefits of prevention may be underestimated because they take decades to show up, and research funding often spans five years or less.

Intervening too late in life to prevent cancer. Strategies like vaccination against cancer-causing viruses, such as the human papilloma virus that causes cervical cancer, work best when begun early, in this case before young people begin sexual activity.

Research focuses on treatment, not prevention. Treatments focus only on a single organ after diagnosis but behavioral changes reduce cancer and death rates from many chronic diseases.

Debate among scientists. They say health experts have a moral responsibility to highlight cancer risk factors even without knowing the biological mechanism by which they cause cancer.

Societal factors that affect health. Tobacco policy and government subsidies don't do enough to discourage unhealthy behavior, and in some cases they make the unhealthy options more accessible, especially in low-income communities.

Lack of collaboration across disciplines. Scientists and health experts must work together to learn what causes cancer, communicate that to the public and work with community leaders to implement policies that help people lead healthier lives, they say.

The complexity of implementing broad changes. With so many players involved, from health-care providers to government regulators to individuals, it will be difficult to implement broad change over the long term.

According to the American Cancer Society, an estimated 1,638,910 new cancer cases will be diagnosed this year in the United States. Also this year, 577,190 Americans are expected to die of cancer. Only heart disease kills more people in this country. And Colditz's research has shown that these cancer prevention strategies would reduce the burden of heart disease and other chronic conditions as well.

Despite the obstacles, Colditz and his colleagues point to some successes that they say demonstrate that broad change is possible. One example is the relatively quick elimination of unhealthy trans fats from the national diet. And the National Cancer Institute (NCI) has reported that lung cancer rates are declining in both men and women, supporting the benefits of tighter tobacco control policy.

"After working in public health for 25 years, I've learned that if we want to change health, we need to change policy," says co-author Sarah J. Gehlert, PhD, the E. Desmond Lee Professor of Racial and Ethnic Diversity at the Brown School of Social Work and the School of Medicine. "Stricter tobacco policy is a good example. But we can't make policy change on our own. We can tell the story, but it requires a critical mass of people to talk more forcefully about the need for change."

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