Causes of weight loss

Thursday, July 12, 2012

Caffeine in Pregnancy Won't Harm Offspring: Study

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Antiobiotic Resistance Spikes During Flu Season

HealthDay – 1 hr 2 mins ago WEDNESDAY, July 11 (HealthDay News) -- Resistance to antibiotics spikes during flu season, likely because that's when the drugs are prescribed more often, researchers report.

Physicians and scientists have worried for years about the possible overuse of antibiotics, since germs can adapt and become immune to them over time.

The researchers looked at statistics regarding antibiotic use and levels of resistance to the drugs. They found that levels of drug-resistant E. coli went up after spikes in prescriptions of two antibiotics, aminopenicillin and fluoroquinolone. The same thing happened to the antibiotic-resistant staph infection called methicillin-resistant Staphylococcus aureus, better known as MRSA. In the months after prescriptions for two other antiobiotics, fluoroquinolones and macrolides, went up, so did cases of MRSA.

"The correlations are concerning, but they also suggest that interventions to reduce antibiotic overuse could help reduce seasonal spikes in resistance," study author Ramanan Laxminarayan said in a Center for Disease Dynamics, Economics & Policy news release. "Patients and doctors should work together to reduce the number of unnecessary antibiotic prescriptions by not taking or prescribing antibiotics to treat viral illnesses, such as colds and flus. Flu shots also have an important role to play, reducing illness in winter months and leading to fewer doctor visits and fewer antibiotic prescriptions as a result."

The study appeared online this month in the journal Clinical Infectious Diseases.

More information:

The U.S. National Library of Medicine has more on antibiotics.

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Brain Scans Using New Dye May Predict Alzheimer's

Disabled Kids 4 Times More Likely to Suffer Violence: Study

HealthDay – 1 hr 2 mins ago WEDNESDAY, July 11 (HealthDay News) -- One in four children with disabilities experiences some form of violence during their lifetime, a new study has found.

In the report, published online July 11 in The Lancet, researchers from the United Kingdom said that the risk of physical, sexual or emotional abuse or neglect for these children is nearly four times greater than for children who are not disabled.

"The impact of a child's disability on their quality of life is very much dependent on the way other individuals treat them," one of the study authors, Mark Bellis of Liverpool John Moores University in England, said in a journal news release.

"This research establishes that the risk of violence to children with disabilities is routinely three to four times higher than that of nondisabled children. It is the duty of government and civil society to ensure that such victimization is exposed and prevented," Bellis added.

For the study, the investigators examined 17 previous studies involving more than 18,000 children from the United States, the United Kingdom, Sweden, Finland, Spain and Israel. Most of the children were between the ages of 2 and 18 years.

The analysis revealed that nearly 27 percent of the children with disabilities had suffered some form of violence, including physical, sexual or emotional abuse or neglect. The study authors noted that lifetime levels of physical violence and sexual violence were high (20 percent and 14 percent, respectively).

The researchers also estimated that children with disabilities are at least three times more likely to be exposed to physical violence and nearly three times more likely to be exposed to sexual violence compared to children without disabilities.

Kids with mental or intellectual deficits are at greater risk for sexual abuse than children with other types of disabilities or no disabilities at all, the authors noted. However, there wasn't enough information to determine the risk for exposure to sexual violence of children with other types of disabilities, they pointed out.

Dr. Etienne Krug, director of the World Health Organization's department of violence and injury prevention and disability, which contributed to the study, commented in the news release: "The results of this review prove that children with disabilities are disproportionately vulnerable to violence, and their needs have been neglected for far too long. We know that specific strategies exist to prevent violence and mitigate its consequences. We now need to determine if these also work for children with disabilities. An agenda needs to be set for action."

The study authors added that children with disabilities living in developing nations could be at particular risk for exposure to violence.

"Estimates are missing for most regions of the world, particularly low-income and middle-income countries. This is a fundamental gap that needs to be addressed because these countries generally have higher population rates of disability, higher levels of violence and fewer support services than do high-income countries," explained Bellis.

Emily Lund and Jessica Vaughn-Jensen from Texas A&M University, authors of an accompanying comment in The Lancet, concluded in the news release that "researchers need to target under-represented disability groups . . .

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Ladies, Drink to Your (Bone) Health

HealthDay – 1 hr 2 mins ago WEDNESDAY, July 11 (HealthDay News) -- Drinking one or two alcoholic beverages several times a week may improve the bone health of older women and reduce their risk for osteoporosis, a small study suggests.

Bones are living tissue with old bone continually removed and replaced in a process called remodeling. In people with the bone-thinning disease osteoporosis, more bone is lost than replaced. Postmenopausal women are at particular risk because of reduced estrogen, a hormone essential for bone strength, the researchers explained.

"This study clearly demonstrates that even small amounts of alcohol have potent actions and can rapidly impact bone metabolism," said lead researcher Urszula Iwaniec, an associate professor in the College of Public Health and Human Sciences at Oregon State University.

As part of a healthy lifestyle, "moderate alcohol may slow bone loss by lowering bone turnover," she said. That means it may lower the risk for osteoporosis, she explained.

"Reducing bone turnover, however, while beneficial to the aging skeleton, may be detrimental to young adults who are still building bone," Iwaniec said.

Although alcohol abuse is a serious medical and public health problem, the effects of moderate drinking on health have not received a lot of attention, Iwaniec noted.

Roughly half of all U.S. women and one-fourth of men will break a bone because of osteoporosis, according to the U.S. National Institutes of Health, which provided partial funding for the study. Because prescription drugs aimed at preventing or treating osteoporosis are expensive and can create unpleasant side effects, it is important to identify lifestyle factors that protect the bones, the study authors said.

For the study, published in the July 11 online edition of Menopause, Iwaniec's team followed 40 postmenopausal women, average age 56, who drank moderately and were not using hormone replacement therapy.

"Moderate" drinking was defined as one-half to two standard drinks a day -- 8 to 10 grams of alcohol -- in the year before the study's start. In the United States, a standard drink is considered a 12-ounce beer, a 5-ounce glass of wine or 1.5 ounces of 80-proof liquor.

When the women stopped drinking for two weeks, the researchers found increased evidence in their blood of bone turnover, which is a risk factor for fractures resulting from osteoporosis.

In less than a day after the women resumed drinking, these markers of bone turnover returned to previous levels, the researchers found.

Previous studies have found moderate drinkers have higher bone density than nondrinkers or heavy drinkers, but the reasons why have been unclear.

It appears that alcohol acts like estrogen in reducing bone turnover, the researchers pointed out.

And the alcohol source doesn't seem to matter, Iwaniec said. "Most of the women in our study were wine drinkers," she said. "However, based on our data in rats, it is the alcohol that's important."

Whether this same effect would occur in men isn't known, Iwaniec said. Also, the study doesn't prove that moderate alcohol consumption wards off osteoporosis; it merely shows an association between the two.

Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York City, noted that the study is especially welcome in light of recent U.S. Preventive Services Task Force recommendations against taking calcium and vitamin D supplements to prevent osteoporosis.

"From that perspective, this finding is very interesting," she said. "I am telling all of my postmenopausal women not to take calcium any more, and there is this panic about how do we help ourselves in preventing fractures and osteoporosis."

This study shows that a couple of drinks might help not only in preventing heart disease, but in preventing osteoporosis, Steinbaum said.

"I do not recommend taking a calcium supplement, but I do recommend a healthy diet that is high in nutrients and calcium and also weight-bearing exercises and one to two glasses of wine a day, which I also recommend to prevent heart disease," she said.

More information

For more information on osteoporosis, visit the U.S. National Library of Medicine.

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Studies Show Value of AIDS Drugs as Prevention

HealthDay – 1 hr 2 mins ago WEDNESDAY, July 11 (HealthDay News) -- Researchers have released the final results of two studies that suggest AIDS drugs can prevent exposed people in Africa from getting infected with HIV by their sexual partners. However, another study indicates that it's a tough job to convince African women who aren't at the highest risk to take preventive medications.

In the big picture, the studies show that "we have a new HIV-prevention strategy, one that's quite powerful but also depends on adherence," said Dr. Jared Baeten, an associate professor of global health at the University of Washington, in Seattle. "The next step is figuring out how to motivate people to take it."

The studies appeared online July 11 in the New England Journal of Medicine.

The general findings of the studies have been previously released, but only now has the research become available in a medical journal after going through a peer-review process.

Two studies offer promising details about the potential for the drugs to prevent -- although not all the time -- the transmission of HIV to heterosexual men and women from their infected partners.

One study in Kenya and Uganda looked at heterosexual couples -- almost all married -- in which one person was infected with HIV, the virus that causes AIDS. The uninfected partners were randomly assigned to take an inactive placebo or a once-daily dose of the drug tenofovir (Viread) or a tenofovir-emtricitabine combination (Truvada) for up to three years. Nearly 5,000 people completed the study.

Those who took Truvada had a 75 percent lower risk of becoming infected with HIV compared to those who received a placebo. The risk was 67 percent lower in those who took Viread compared to a placebo. Even in those who got the placebo, the overall risk of getting infected was low: 52 of 1,468, or a little more than 3 percent, did so.

Truvada treatment in the United States costs several thousand dollars a year, Baeten said, but the discounted price can be as cheap as 25 cents a day in Africa. The drug, which stops the AIDS virus from reproducing in people who are infected, appears to do the same thing in uninfected people who are exposed to the virus, he said. In their cases, the virus doesn't already have a foothold in the body so it dies off.

In this study, 10 percent or less of those who took the drugs reported side effects such as fatigue, diarrhea and nausea, and only in the first month.

The second study of 1,219 HIV-negative adults in Botswana looked at Truvada versus a placebo. Comparing the 33 participants who became infected during the trial -- nine people in the drug group and 24 people on a placebo -- the study found those who took Truvada were 62 percent less likely to become infected with HIV.

In this study, significant loss of bone mineral density was a side effect for participants receiving the drug, compared to those on a placebo.

Another study, in Kenya, South Africa and Tanzania, assigned 2,120 women at higher risk of HIV infection to receive Truvada or a placebo. However, there wasn't much difference in HIV infection rates between the two groups -- about 5 percent in both became infected.

Baeten explained the finding, saying many women stopped taking the drug, which prevented an accurate assessment of its effectiveness.

The next step in research into the use of the drugs to prevent infection is to "figure out how to make them work in the real world, outside of an intensive research setting," Baeten said. In the United States, for example, researchers are studying their use in gay men who are at high risk for infection.

As for condoms, another major player in HIV prevention, Baeten said the prevention drugs will add to their level of security or provide some protection in cases where people can't use condoms.

In an editorial accompanying the studies, two experts stressed that medications should never be viewed as a substitute for the condom.

"Although no evidence of increased risky sexual behavior or decreased condom usage was reported in these studies, we must ensure that pre-exposure prophylaxis does not indirectly encourage such behavior," wrote Dr. Myron Cohen of the University of North Carolina at Chapel Hill and Dr. Lindsey Baden of Brigham and Women's Hospital, Boston.

They added that more research is needed to properly assess who stands to benefit most from these drug regimens, the best timing and dosage, as well as any potential side effects from long-term use.

More information

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

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Diet, Weight Loss Ease Menopause Symptoms: Study

HealthDay – 1 hr 2 mins ago WEDNESDAY, July 11 (HealthDay News) -- Menopausal women who lose weight eating a low-fat diet rich in fruits and vegetables could reduce or eliminate their hot flashes and night sweats, a large new study suggests.

One reason the researchers looked at weight loss as a way of dealing with menopausal symptoms was because of long-standing research linking hormone-replacement therapy to heart disease and breast cancer.

"We wanted to see if this could be an alternative to hormone therapy," said lead researcher Candyce Kroenke, a research scientist at Kaiser Permanente's Northern California Division of Research in Oakland.

"Indeed, women who lost weight in the context of this healthier diet -- decreasing fat, increasing whole grains, fruits and vegetables -- were significantly more likely to reduce or eliminate symptoms," she added.

Reduced hot flashes and night sweats, the key menopausal symptoms, were seen in both overweight and normal-weight women who lost weight, Kroenke noted.

And the reason for that is fairly simple, she said: Fat tends to retain heat and losing weight helps the body dissipate heat more easily.

The report, which was published July 11 in the online edition of Menopause, involved data on more than 17,000 women who took part in the Women's Health Initiative study.

The women with menopausal symptoms who were on a low-fat diet rich in whole grains, fruits and vegetables, who were not taking hormone-replacement therapy and who lost at least 10 pounds in a year were more likely to see night sweats and hot flashes reduced or disappear after a year than did women who maintained their weight (the "control" group), the researchers found.

Dr. Jennifer Wu, an obstetrician/gynecologist at Lenox Hill Hospital in New York City, commented that "this definitely goes along with the idea that good diet and exercise and losing weight contribute to general health."

And, she added, "It's a quick and easy fix for hot flashes and night sweats."

Wu noted that doctors are still reluctant to offer hormone-replacement therapy even though it works. "This is a low-risk fix," she said.

"I think it will work for some patients, and patients may only get a partial relief of their symptoms, but any help is good," Wu pointed out.

"Diet and weight loss is a healthy habit that will hopefully help menopausal symptoms. There is very little downside to doing it," she added.

Another expert agreed.

"Adopting a healthy diet is always a good idea," said Samantha Heller, a nutritionist, exercise physiologist and clinical nutrition coordinator at the Center for Cancer Care at Griffin Hospital in Derby, Conn.

"Healthy foods, including vegetables, soy, whole grains, legumes, nuts and fruits, decrease the risk of many chronic diseases and can improve health and well-being considerably. In this case, along with weight loss of 10 pounds or 10 percent of body weight, women who made healthy dietary changes tended to have decreased symptoms of hot flashes and night sweats," Heller noted.

"This study also highlights the positive effect of ongoing nutrition education by registered dietitians," she added. "Women in the intervention group, who were counseled by registered dietitians, were three times more likely to lose weight than women in the control group. A big factor in unsuccessful weight loss attempts is people not knowing how or where to begin. Nutrition counseling takes the guesswork out of creating a healthy lifestyle and helps motivate and empower people to stay on track."

The research was published just days after a coalition of leading medical groups concluded in a joint statement that hormone-replacement therapy can be useful and safe for many women suffering from the symptoms of menopause.

The coalition includes 15 medical groups, including the North American Menopause Society, the American Society for Reproductive Medicine, the Endocrine Society and the American Academy of Family Physicians.

More information

For more information on menopause, visit the U.S. National Library of Medicine.

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Timeline Detected for Rare, Early Alzheimer's

HIV Drug May Prevent Bone Marrow Transplant Complication

HealthDay – 1 hr 2 mins ago WEDNESDAY, July 11 (HealthDay News) -- An HIV drug significantly reduced the risk of graft-versus-host disease, an all-too-common complication in blood cancer patients following bone marrow transplants, new research finds.

Bone marrow is the spongy tissue inside the bones that contains immature cells, or stem cells. In an "allogeneic" bone marrow transplantation, also called a stem cell transplant, a patient's own stem cells and immune system are wiped out by chemotherapy and radiation. Then, the patient receives the transplant, or bone marrow, from a closely matched donor.

The treatment is used for several types of blood cancers, including lymphoma and leukemia.

But a common complication of a bone marrow transplant is graft-versus-host disease. It occurs when transplanted immune cells attack patients' healthy tissue, a complication that can be minor or life-threatening.

"Graft-versus-host disease affecting the skin, liver, gut and other organs is a dreaded complication of allogeneic stem cell transplantation either from a related or unrelated donor," said one expert, Dr. Jasmine Zain of NYU Langone Medical Center in New York City. "The rates are 35 percent with related donors and up to 57 percent by day 100, even in reduced-intensity transplants," added Zain, who is director of the Bone Marrow Transplant Program and assistant professor in the division of hematologic malignancies and medical oncology at the center.

The study was conducted by a team at the University of Pennsylvania's Perelman School of Medicine and included 38 patients with several types of blood cancers. The cancers included acute myeloid leukemia, myelodysplastic syndrome, lymphoma and myelofibrosis. All of the patients were given the drugs tacrolimus and methotrexate, which suppress the immune system and are a standard treatment to prevent graft-versus-host disease.

The patients were also given a 33-day course of the HIV drug, maraviroc, beginning two days before their transplant.

None of the patients treated with maraviroc developed graft-versus-host disease in the gut or liver within the first 100 days after their transplant. The liver and gut are the most serious locations for the complication, the researchers noted.

After six months, 6 percent of these transplant patients developed severe graft-versus-host disease compared to 22 percent of a group of similar patients who weren't treated with the HIV drug.

In addition, fewer in the group given the HIV drug developed graft-versus-host disease in their liver or gut compared to those given the standard treatment.

One year following transplant, about 15 percent of patients given the HIV drug developed severe graft-versus-host disease compared to 29 percent of patients who received standard therapy.

The study was published in the July 11 edition of the New England Journal of Medicine.

Researchers explained that the HIV drug redirects these immune cells without having to suppress patients' immune systems. Because their immune systems aren't compromised by the drug, patients should be less vulnerable to infections and to a relapse of their cancer.

"It appears that our new approach allows us to prevent some patients from developing

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Scientists Pinpoint Antibody That May Be Specific to MS Patients

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Little change in Dutch euthanasia post-legality

The frequency of doctor-assisted euthanasia in the Netherlands has changed little since the longstanding practice was legalized in 2002, according to a new study.

A summary published Wednesday on The Lancet magazine's website said that "in 2010, of all deaths in the Netherlands, 2.8 percent were the result of euthanasia. This is higher than the 1.7 percent in 2005, but comparable with (levels seen) in 2001 and 1995."

Under Dutch law, a person who asks to die may be administered a lethal mixture of sedatives and muscle relaxants if two doctors agree he or she is suffering "unbearable" pain with no prospect for recovery. Most cases involve cancer victims.

The Lancet study used data from the country's death registry and sent confidential questionnaires to doctors, extrapolating results to represent a cross-section of deaths in different social, medical and geographical areas. Researchers used the same methodology as in previous studies in 1990, 1995, 2001 and 2005.

Dutch doctors are also required to report all euthanasia cases on a non-confidential basis to the country's Euthanasia Commission, but that yields numbers that are widely believed to underreport the total number of euthanasia cases in the country.

All cases sent to the Euthanasia Commission are reviewed by a panel of experts, and some cases each year lead to official sanctions for doctors who fail to follow the rules, or even criminal prosecutions in a handful of cases.

According to commission data, there were 3,136 euthanasia cases in 2010, out of 136,000 deaths countrywide recorded by the Central Bureau for Statistics. That suggests a euthanasia rate of about 2.3 percent, less than the 2.8 percent found in the Lancet study. The total Dutch population is around 16.3 million.

"In the Netherlands, the euthanasia law resulted in a relatively transparent practice," wrote the Lancet study's lead author Bregje Onwuteaka-Philipsen. "Although translating these results to other countries is not straightforward, they can inform the debate on legalization of assisted dying in other countries."

One other noteworthy finding of the Lancet study was that the number of cases of "palliative sedation"

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Wildland firefighters win federal health benefits

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