More Evidence That Shift Work Might Raise Heart Risks

HealthDay – 1 hr 11 mins ago THURSDAY, July 26 (HealthDay News) -- People working evening shifts, irregular shifts, night shifts and rotating shifts are at an increased risk for heart attack and stroke, a large, new review finds.

The best way to lower the risk of heart attack and stroke associated with shift work is to keep the usual risk factors -- such as blood pressure, cholesterol, weight and diabetes -- under control, experts say.

"Given the commonness of shift work in modern industrialized nations, and industrializing nations, many heart attacks and strokes are likely directly attributable to the effects of shift work," said lead researcher Dr. Daniel Hackam, a clinical pharmacologist at the Stroke Prevention and Atherosclerosis Research Centre in London, Ontario, Canada.

Employers and employees must be aware of this problem, as should doctors and others who see shift workers, he said.

"Shift workers should receive cardiovascular risk factor screening and prevention, and this should be ongoing and regular," Hackam added.

Particular attention should be paid to risk factors that may be worsened by shift work, such as blood pressure, cholesterol and diabetes, he noted.

"Since we are now in a 24/7 society, this problem is not likely to go away any time soon," Hackam pointed out.

The report was published online July 26 in the BMJ.

To look at the connection between heart attack, stroke and shift work, Hackam's group analyzed 34 studies that included more than 2 million people.

This process of pooling results from different studies is called a meta-analysis, and is used by researchers to uncover patterns that are consistent across a large population.

Among the people in these studies, more than 17,000 had some kind of cardiovascular problem. More than 6,500 had heart attacks and almost 1,900 had strokes, the research showed.

Hackam's team found that shift workers had a nearly 25 percent increased risk of having a cardiovascular problem, a 23 percent increased risk of a heart attack and a 5 percent increased risk of a stroke when compared to non-shift workers.

People working night shifts had the highest risk of a coronary event (41 percent), they added.

Although the increased risks are small, because many people are shift workers the number of people at risk is substantial, the researchers explained.

In Canada, for example, almost 33 percent of workers were shift workers in 2008-2009. In all, during that time, 7 percent of heart attacks, 7 percent of all coronary events and almost 2 percent of strokes could be attributed to shift work, the investigators noted.

While this type of study can show an association between two factors, it does not prove a cause-and-effect relationship.

Dr. Gregg Fonarow, a professor of cardiovascular medicine at the University of California, Los Angeles, said that "a number of prior studies have suggested that working outside of regular daytime hours may be associated with an increased risk of cardiovascular events and stroke."

This new study finds shift work is associated with a higher risk of coronary events and stroke, he noted. But an increase in all-cause mortality with shift work was not seen.

"While the increase in cardiovascular risk was modest, with as many as 15 million Americans working full-time on evening shift, night shift or other irregular schedules, these findings may have important public health implications," Fonarow said.

"Individuals with these types of work schedules should recognize the potential increase in risk for cardiovascular events and stroke, and take proactive steps to improve their cardiovascular health," he added.

More information

For more on heart disease, visit the U.S. National Library of Medicine.

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Alcohol Poses Serious Risks for Those With Diabetes

HealthDay – 1 hr 22 mins ago FRIDAY, July 20 (HealthDay News) -- People who have certain chronic medical conditions, such as type 1 diabetes, are even more susceptible than most to the ill effects of alcohol, though they may not be aware of how potentially dangerous alcohol can be.

That was the case for Cynthia Zuber when she first went away to college. Although Zuber had type 1 diabetes, also known as insulin-dependent diabetes, she didn't know at the time that mixing an alcohol binge and insulin use might have deadly consequences.

Zuber was just 18 when she went to a fraternity party.

"It was a party of upperclassmen, and my friend and I, both freshmen, felt very young and out of place," she recalled. "To deal with the discomfort, I started drinking beer."

Throughout the evening, she said, she went back for refills on her own, and people also repeatedly brought her refills. "I had no idea how many beers I had," she said, nor did she know her blood sugar levels because she didn't test them during the party.

Alcohol can cause blood sugar levels to drop dangerously low for people on blood sugar-lowering medications for as long as 12 hours after their last drink, according to the American Diabetes Association.

"Things got out of control quickly, and when we went to leave I had to be carried to the car and into my dorm," she explained.

Zuber said she vomited throughout the night, probably from the beer, but she doesn't know for sure because she didn't test her blood sugar levels before going to bed, either. At some point during the night, she passed out, and when she woke in the morning, she was still vomiting.

When she tested her blood sugar, it was low enough that she knew she'd have to eat something or she would quickly be in serious trouble. The problem was, she couldn't keep food down. She even tried drinking water, but threw that up, too. Someone in her dorm drove her to the emergency department.

"I was so oblivious to the danger I'd put myself in," Zuber recalled. "The doctor, who was wearing Birkenstock sandals and an earring, actually slapped me across the face -- not hard, but to get my attention." The doctor then explained to her a number of ways that alcohol could cause serious problems, or even death, for someone with type 1 diabetes.

Zuber said she didn't give up drinking entirely after that incident, but did cut way back and never again drank enough to have to go to the hospital. Now 36, Zuber recently gave up alcohol entirely because, she said, she just feels better if she doesn't drink.

For anyone with diabetes, the American Diabetes Association recommends having a snack at the same time you're consuming an alcoholic beverage, and to not have more than one drink a day for women and two a day for men. But most important, the association says, is to check your blood sugar before going to sleep after drinking alcohol -- striving for a level between 100 and 140 milligrams per deciliter.

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The Health Benefits, and Risks, of Alcohol

HealthDay – 1 hr 22 mins ago FRIDAY, July 20 (HealthDay News) -- Mirroring so much of life, alcohol consumption comes with plusses and minuses.

A lot of recent research has highlighted the potentially beneficial effects on the heart and other parts of the body of drinking wine and other alcoholic beverages. But risks to health exist, too, as well as the more well-known and potentially life-threatening effects of alcohol, including drunken driving and addiction.

The Good

Alcohol consumption in moderation has been linked to a host of good outcomes. Studies have suggested that drinking alcohol, wine in particular, may reduce your risk for heart disease, stroke, gallstone formation, type 2 diabetes and dementia. It may also give your metabolism a slight boost.

"Alcohol, especially red wine, has resveratrol and antioxidants and bioflavonoids and polyphenols, and all of these wonderful things that dilate the arteries and reduce inflammation," said Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York City, and a spokeswoman for the American Heart Association.

"Alcohol can definitely be part of a heart-healthy diet if you're drinking responsibly," she said.

"Drinking responsibly," though, might very well mean drinking less than you think, another expert noted.

"Moderate alcohol consumption for women is up to one drink a day, and for men it's two drinks a day," explained Elizabeth Kovacs, director of the alcohol research program at Loyola University Medical Center in Chicago. "One drink is 5 ounces of wine, 12 ounces of beer or a 1.5 ounce shot of liquor."

Steinbaum pointed out that people should be especially careful when ordering a glass or two of wine at a restaurant because they're often far larger than one serving size.

Kovacs added that "the benefits of alcohol are pretty restricted, and it's only beneficial if you drink at a low level, you don't take certain medications, you don't have liver or pancreas disease and you're not pregnant."

And, the experts agreed, none of the benefits of alcohol are reason enough to start drinking.

"If you don't already drink, don't start drinking for its health benefits," Steinbaum said. "You can eat a heart-healthy diet, such as the Mediterranean diet with lots of fruits and vegetables, and get a benefit, too. You don't have to have alcohol to protect your heart."

The Bad

Though a small amount of alcohol can help the heart, more is not better, Steinbaum stressed. Alcohol can raise the levels of triglyceride, a harmful fat found in the blood, she said, and it can also lead to higher blood pressure.

Some people also are prone to a condition called holiday heart syndrome, which causes irregular heartbeats when they drink alcohol, though some of them can drink a little without triggering the condition. Steinbaum said she had one patient who knew he couldn't have more than two martinis or he would have an irregular heartbeat.

Excess alcohol consumption can also lead to weight gain, Steinbaum noted, and alcohol can be detrimental to the kidneys and liver as well, particularly for people taking certain medications, such as statins to lower cholesterol or even over-the-counter acetaminophen (Tylenol) to relieve pain.

In addition, recent studies have linked alcohol consumption to an increased risk for certain cancers, asthma and allergies. Alcohol can also be a problem for people who take blood sugar-lowering medications, such as insulin, because it can cause blood sugar levels to drop unpredictably, and to potentially dangerously low levels.

The Ugly

Some of the worst outcomes from alcohol consumption, however, include abuse and addiction, binge drinking, drinking while pregnant, alcohol poisoning, brain damage, increased violent behavior and driving under the influence.

"Alcohol increases the chance of a motor vehicle accident, violence against others, inadvertent violence against oneself, spread of sexually transmitted diseases, unplanned pregnancies, fetal alcohol spectrum disorders and becoming dependent on alcohol," Kovacs said.

She noted that alcohol plays a role in one-third of all car crashes and, according to the U.S. Centers for Disease Control and Prevention, it's a factor in two-thirds of the incidents of intimate-partner violence.

"It's important that people are informed about the effects of alcohol on their body so they can be prepared to not drink, or to drink responsibly," said Kovacs. "The benefits of alcohol consumption are very minimal compared to the risks."

More information

The American Heart Association has more on the cardiovascular effects of alcohol consumption.

To read about the risks that alcohol can pose to people with diabetes click here.

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Study Ties Kids' Allergy Risks to Antibacterials, Preservatives

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Targeted Radiation for Lung Cancer May Carry Risks

HealthDay – 4 mins 23 secs ago WEDNESDAY, June 13 (HealthDay News) -- A woman with early-stage lung cancer died recently after highly targeted radiation therapy zapped not just her tumor, but surrounding tissue, fatally damaging her airway.

Though just a single case report of an apparently deadly complication, the authors warn that targeted radiation therapy -- specifically, stereotactic body-radiation therapy -- has inherent risks, even when done properly and using an even lower dose of radiation than is considered safe.

Stereotactic body-radiation therapy focuses beams of radiation on a tumor in the hopes of killing it. Because it uses highly precise beams that can focus large doses of radiation with millimeter accuracy, the technique is considered an advance over older types of radiation therapy, which are generally more diffuse, explained Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society. The goal is to reduce exposure of healthy tissue to the radiation to avoid side effects, while more effectively shrinking the tumor with the higher doses of radiation delivered over a shorter period of time.

Stereotactic radiation is increasingly used to treat early-stage lung cancer. Though the first choice of treatment for early-stage lung cancer is surgery, radiation is turned to in people who cannot withstand having a portion of their lung removed because of other health issues, such as serious underlying heart or lung disease, said Dr. Ramesh Rengan, an assistant professor of radiation oncology at University of Pennsylvania Perelman School of Medicine.

Rengan wrote the case report published in the June 14 issue of the New England Journal of Medicine.

In the case report, a 61-year-old woman with a history of smoking and stage 1 adenocarcinoma -- meaning the two tumors were small and had not spread to the lymph nodes or other organs -- was treated, seemingly successfully, with stereotactic body radiation. Adenocarcinoma is a common type of non-small cell lung cancer.

But eight months later, not only did the woman have new metastases (spread of the cancer), a bronchoscopy -- a camera threaded into the airway -- showed an "extensive area of necrosis," or dead tissue, near the radiated area.

Her physicians at University of Pennsylvania did not do additional radiation. Instead, she underwent more chemotherapy, but began coughing up blood and died a few months later.

Researchers warned that patients with tumors near "radiation-sensitive" body parts, or body parts easily damaged by radiation relative to the dose needed to treat the cancer, such as the large airways, large blood vessels, the heart, certain nerves and the spinal cord, "may be at increased risk for severe radiation injury."

"The reason why it's so important to get this message out is because these side effects don't manifest themselves immediately. They can take months to show up," Rengan said. "And you will only find them if you are looking. Most patients aren't undergoing bronchoscopy just for the heck of it. On a CT scan, the airway looks fine."

Rengan urged physicians who use stereotactic radiation to follow patients carefully. Furthermore, the levels of radiation that are considered safe may need to be rethought, he added.

"This was a dose level that was previously believed to be safe for this type of tumor in this location," he said.

Lichtenfeld praised the authors for writing the case report. Although one report does not have the weight of a clinical trial involving multiple patients from multiple institutions, anecdotal reports such as this can help raise awareness about the potential complications of a treatment that's increasingly popular.

"Even though the doctors gave the radiation properly, they still got a serious complication," Lichtenfeld said. "What this report is saying is even though we did this the right way, doctors and patients still need to be aware you can have bad effects from this type of radiation used in this way."

More information

The U.S. National Cancer Institute has more on lung cancer.

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Of food supply risks, mad cow's not high on list

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US adds clot risks to some birth control labels

US adds clot risks to some birth …

US health authorities on Tuesday ordered revised labels on some types of birth control including German pharmaceutical giant Bayer's Yaz pills to advise of a possibly higher risk of blood clots.

"Women who use birth control pills with drospirenone (like Yaz) may have a higher risk of getting a blood clot," said a new Yaz label on the US Food and Drug Administration website.

"Some studies reported that the risk of blood clots was higher for women who use birth control pills that contain drospirenone than for women who use birth control pills that do not contain drospirenone."

However, the regulatory agency pointed out that studies have shown mixed results.

"The studies reviewed did not provide consistent estimates of the comparative risk of blood clots between birth control pills that contain drospirenone and those that do not," the FDA said in a statement.

"The studies also did not account for important patient characteristics (known and unknown) that may influence prescribing and that likely affect the risk of blood clots," it added.

"For these reasons, it is unclear whether the increased risk seen for blood clots in some of the epidemiologic studies is actually due to drospirenone-containing birth control pills."

Drospirenone is a synthetic progestin which can suppress ovulation and thereby prevent pregnancy either when used alone or in combination with an estrogen component.

There are 11 approved versions of such pills on the US market, including names such as Gianvi, Loryna, Ocella, Safyral, Syeda, and Zarah.

In December, a panel of experts that advises the FDA urged stronger labeling on drospirenone-containing pills, voting 21-5 that the current labels did not adequately reflect the risks and benefits.

The panel was divided on the question of whether the benefits of such pills outweighed the risks, with 15 saying "yes" and 11 saying "no."

The pills have been marketed on the basis they help alleviate premenstrual symptoms, reduce acne and cause less weight gain than competitors. They have also been the focus of numerous lawsuits.

Two recent studies in the British Medical Journal found that drugs like Yaz and Yasmin increase the risk of serious blood clots three-fold or two-fold compared to earlier-generation oral contraceptives.

The European Medicines Agency concluded last year that such birth control pills carry a higher risk of venous thromboembolism and that warning labels should be updated accordingly.

However, it noted the overall risk of blood clot from any birth control method remains small and stopped short of advising women to stop taking pills containing drospirenone.

Yaz is the second biggest selling product made by Bayer, with $1.56 billion in global sales.

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US adds clot risks to some birth control labels

"US health authorities on Tuesday ordered revised labels on some types of birth control including German pharmaceutical giant Bayer's Yaz pills to advise of a possibly higher risk of blood clots. (AFP Photo/John MacDougall)" title

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US adds clot risks to some birth control labels

"US health authorities on Tuesday ordered revised labels on some types of birth control including German pharmaceutical giant Bayer's Yaz pills to advise of a possibly higher risk of blood clots. (AFP Photo/John MacDougall)" title

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Soy may pose risks to breast cancer patients: study

"A farmer harvests a soy bean field. Eating soy could pose risks to some women who begin consuming it as adults by making breast cancer tumors resistant to treatment, US researchers said on Monday. (AFP Photo/Darren Hauck)" title

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