Cystic Fibrosis Drug Combo May Be Less Effective Than Hoped
One medication seems to partly counteract the other, suggests study on human cells
WEDNESDAY, July 23, 2014 (HealthDay News) -- A powerful drug combo may not be as effective against cystic fibrosis as previously thought. New lab-based research on human cells suggests that one of the medications might stop the other from working properly.
However, this study's findings aren't definitive, and there's still hope for the medications known as ivacaftor (brand name Kalydeco) and lumacaftor, according to the study's senior author.
"The development of drugs like ivacaftor and lumacaftor is undoubtedly a step forward, but our study suggests that more work will need to be done before we can realize the full potential of these drugs," said Martina Gentzsch, an assistant professor with the department of cell biology and physiology at the University of North Carolina, Chapel Hill.
"Fortunately, we now have a better understanding of some of the potential pitfalls to these drug combinations and a means to test alternative strategies to make these drugs more effective," said Gentzsch.
For its part, the Vertex pharmaceutical company, which produces both medications, recently released the results of a phase 3 clinical trial on the drug combo, involving patients with cystic fibrosis. The findings, based on use of the drug combination by more than 1,100 patients, "showed consistent and statistically significant improvements in lung function and other measures of the disease," Vertex said in a statement.
Alan Smyth, a professor of child health and division head at the University of Nottingham in England, agreed that initial research in people, not on cells in the laboratory, was more promising. The drug combo seems to work, he said, and newer drugs of a similar type may help scientists improve on their performance.
However, Smyth cautioned that the phase 3 trial data from Vertex has not yet gone through the peer-review process typically required to give physicians confidence in the results.
An earlier, phase 2 trial -- also with positive results for patients -- was published online in the peer-reviewed journal The Lancet Respiratory Medicine in June.
Cystic fibrosis affects an estimated 30,000 people in the United States, according to the Cystic Fibrosis Foundation. It's an inherited disease that disrupts cells in the lungs and the pancreas, causing mucus to become thick and sticky. The mucus builds up, causing breathing and digestion problems.
"Existing medications target only the symptoms of cystic fibrosis but not the cause of the disease," Gentzsch said. "As a result, they may lead to improvement but do not prevent the overall slow progression of lung disease over time. In addition, many current therapies are time-consuming and can be more difficult to use in young children."
A newer drug known by the brand name Kalydeco targets a protein that doesn't work properly in certain people with cystic fibrosis. Researchers have praised the medication, but it only works in an estimated 5 percent of patients who have a specific genetic variation.
The big question is whether Kalydeco and a drug that's in development known as lumacaftor might provide a one-two punch to treat the wide majority of cystic fibrosis patients. If the combo worked, as some short-term studies have suggested, "the hope would be that disease progression would be slowed and that patients would live longer, healthier lives," Gentzsch said.
But the new study raises doubts. The researchers tested the drugs on epithelial cells, which are found in much of the body, and found evidence that Kalydeco actually reverses some of the effects of lumacaftor. "This is consistent with results reported from recent clinical trials that showed meaningful but modest improvements in lung function in patients treated with this drug combination," Gentzsch said.
Scientists believe Kalydeco helps water escape cells so it can moisten mucus, while lumacaftor paves the way for liquid to get where it's supposed to go. But the study suggests Kalydeco disables some of lumacaftor's effects.
Gentzsch said other medications and other combinations of treatments could indeed benefit patients. Future research into how they affect specific types of patients could lead to more insight into whether they're worthwhile treatments, she said.
The study by Gentzsch and colleagues appears in the July 23 issue of Science Translational Medicine. It was funded by the U.S. National Institutes of Health, the Cystic Fibrosis Foundation, and the Else Kroner-Fresenius Foundation.
For more details about cystic fibrosis, visit the Cystic Fibrosis Foundation (http://www.cff.org/aboutcf/ ).
SOURCES: Martina Gentzsch, Ph.D., assistant professor, department of cell biology and physiology, University of North Carolina, Chapel Hill; Alan Smyth, M.D., professor of child health and division head, University of Nottingham, U.K.; July 23, 2014, statement, Vertex; July 23, 2014, Science Translational Medicine
Dangerous Use of Growth Hormone Surges Among U.S. Teens
Many young people are ordering dubious, hazardous products off of the Internet, researchers warn
WEDNESDAY, July 23, 2014 (HealthDay News) -- A growing number of U.S. teens are using synthetic human growth hormone (hGH) to boost their muscles and athletic ability, a new study finds.
The percentage of teens who admit to using hGH jumped to 11 percent in 2013 -- more than double the 5 percent figure in 2012, the new survey from the Partnership for Drug-Free Kids revealed.
The worrisome trend highlights a need for tighter regulation and oversight of performance-enhancing substances and other "fitness" products, the group said.
"These new data point to a troubling development among today's teens," Steve Pasierb, president of the Partnership said in a group news release. "Young people are seeking out and using performance-enhancing substances like synthetic hGH -- and supplements purporting to contain hGH -- hoping to improve athletic performance or body appearance without really knowing what substances they are putting into their bodies."
Another expert agreed the new data is troubling.
"The marked increase in teens' reported use of performance-enhancing substances such as steroids or synthetic growth hormones over just the last few years cries out for a massive public health campaign to educate them about the catastrophic -- and even fatal -- potential risks of misusing such products," said Dr. Patricia Vuguin, a pediatric endocrinologist at Cohen Children's Medical Center in New Hyde Park, N.Y.
The body produces human growth hormone naturally, and experts have long known that the hormone is essential for growth and cell production in young people. It also helps regulate body composition, muscle and bone growth.
A synthetic form of this hormone, known as hGH, has been available since 1985, the Partnership noted. Congress has approved certain uses of synthetic hGH, such as for muscle-wasting disease associated with HIV/AIDS, adult deficiency due to rare pituitary tumors and the long-term treatment of short stature in children.
Any off-label use of hGH for other medical conditions is strictly prohibited, however.
People hoping to boost their athletic abilities or enhance their appearance have abused synthetic growth hormone in the past. In order to track the use of hGH and other performance-enhancing substances, the researchers surveyed more than 3,700 high school students. They also questioned 750 parents during in-home interviews.
Although gender did not significantly affect use of synthetic hGH, the study found race and ethnicity did play a role. Black and Hispanic young people reported using synthetic hGH at higher rates than white teens. The researchers found that 15 percent of black teens and 13 percent of Hispanics said they used the substance at least once, compared to 9 percent of white teens.
There was also a strong link between use of hGH and steroids, the study showed. Steroid use among teens also rose from 5 percent in 2009 to 7 percent in 2013.
Using synthetic hGH and other performance-enhancing substances and products poses serious health risks, the study authors warned. There is a largely unregulated marketplace, they noted, involving a variety of products promising to boost muscle mass, athletic performance and physical appearance.
"These are not products that assure safety and efficacy," Pasierb said. "Prescription and over-the-counter medicines must go through rigorous testing to be proven safe before being sold to the public, but supplement products appear on store shelves without regulation from the Food and Drug Administration and must actually be proven unsafe before being removed from sale," noted Pasierb.
He said that this "creates a false perception of safety, driving impressionable teens to risk their health with potentially dangerous products that are untested. And while it's doubtful that all of the teens who reported having used synthetic hGH actually obtained prescribed synthetic human growth hormone, the proliferation of commercially available products that are marketed saying they contain synthetic hGH, or promote the natural production of hGH within the body, is staggering."
Teens are also more aware of the online marketing of steroids and synthetic hGH than they were two years ago, and less likely to believe their health is at significant risk by using performance-enhancing drugs, the research revealed.
"Given the current regulatory framework of the supplement industry, and the amount of products being marketed and sold online, it is difficult if not impossible to know what exactly is contained in these products teens are consuming," Pasierb added.
"So the implication for parents, health care professionals, policy makers and regulators is that this is an area of apparently growing interest, involvement and potential danger to teens that calls for serious evaluation of the areas in which current controls on manufacturing and marketing are failing to prevent the use of these products by teens," he explained.
Young people who do not see these substances as risky are more likely to use them, the study authors cautioned.
The new survey highlights "the need to protect young people from those who would prey on them as easy marketing targets," Travis Tygart, CEO of the U.S. Anti-Doping Agency, said in the Partnership news release.
Although 58 percent of parents said they've talked to their kids about steroids or other performance-enhancing substances, the study revealed that only 3 percent believe their teens have ever used the products. Meanwhile, just 12 percent of teens reported having a discussion with their parents about drugs that included synthetic hGH.
"What I encounter when talking to teens is the significant pressure they feel to excel," Tyler Hamilton, former professional cyclist and anti-doping advocate, said in the news release.
"Whether it's in sports, school, social status or appearance, teens feel they need to be better. The study provides a good opportunity for parents and other influential figures in their lives to realize what teens are facing and reinforce a message of unconditional love and acceptance," added Hamilton, who gave back his Olympic Gold medal after admitting to performance-enhancing drug use throughout his career.
Vuguin had her own theories as to the uptick in use of hGH among teens.
"Steroid use among young males, particularly those who lift weights, has been on the radar for years," she said. "But it's surprising and disturbing to see that teenagers of both genders are increasingly using synthetic versions of human growth hormone, ostensibly to maximize muscle mass and minimize body-fat composition," she added.
"While it's difficult to pinpoint why more teens may be using these substances, I strongly suspect that the rising 'selfie culture' among young people -- who increasingly rely on social media to project their body image -- is influencing these disturbing new statistics," Vuguin said.
In addition to tracking the use of performance-enhancing substances, the study found other trends in teen drug abuse, including:
Nearly half, or 44 percent, of teens said they've used marijuana at least once in their lifetime. Of these teens, 41 percent started before they reached 15 years of age.
Roughly one in four teens, or 23 percent, admitted to abusing or misusing a prescription drug at least once.
The percentage of teens who ever tried using over-the-counter cough medicine to get high jumped from 12 percent in 2012 to 15 percent in 2013.
The U.S. Anti-Doping Agency has more on the effects of performance-enhancing drugs (http://www.usada.org/substances/effects-of-performance-enhancing-drugs/ ).
SOURCES: Patricia Vuguin, M.D., pediatric endocrinologist, Cohen Children's Medical Center, New Hyde Park, N.Y.; Partnership for Drug-Free Kids, news release, July 23, 2014
Dogs Can Get Jealous, Too
Primitive form of envy may help them protect their bond with their human, researchers report
WEDNESDAY, July 23, 2014 (HealthDay News) --
Jealousy may not be the sole domain of humans, with new research showing dogs can get downright possessive when it comes to the love of their master.
When their owners showed affection toward what was actually a stuffed dog, the real puppies in the study responded by snapping or pushing the stuffed dog aside, report researchers from the University of California, San Diego (UCSD).
This jealous streak only surfaced when owners were attending to the stuffed dog and not when they were occupied with random objects. However, this was no ordinary stuffed dog: It was engineered to bark, whine and wag its tail convincingly.
Since jealously is generally believed to be an emotion that requires more complex thinking, the researchers suggested there could be a more basic form of jealousy specific to dogs and some other social animals that helps protect their bonds and ward off outsiders.
"Many people have assumed that jealousy is a social construction of human beings -- or that it's an emotion specifically tied to sexual and romantic relationships," study co-author Christine Harris, a psychology professor at UCSD, said in a university news release. "Our results challenge these ideas, showing that animals besides ourselves display strong distress whenever a rival usurps a loved one's affection."
As for whether the puppies in the study viewed the stuffed dog as an actual rival, the researchers pointed to this result as evidence that they did: 86 percent of the puppies sniffed the stuffed dog's rear end.
The study, published July 23 in the journal PLOS ONE, involved 36 puppies. Each dog was just 6 months old. All of the puppies were tested separately and videotaped.
During the test, owners were told to ignore their dog and turn their attention to three different objects. First, the owners attended to the realistic-looking stuffed dog. Then they focused on a pail. The third object in the test was a book.
In observing the dogs' behavior, the researchers looked for signs of aggression, attention-seeking and interest in their owner or the objects. The test was designed to help the researchers determine if the dogs felt an emotion similar to jealousy, or if they were just generally annoyed when they lost their owners' attention.
The dogs demonstrated more jealous behaviors when their owner focused on the stuffed dog than when their owner paid attention to the other objects, the study found. These behaviors included trying to come between their owner and the stuffed dog, pushing their owner and snapping when the owners displayed affection toward the stuffed dog.
The researchers concluded a form of primitive jealousy that exists in babies may also exist in at least one other social animal: dogs. This emotion, the study's authors suggested, may have evolved to help infants compete for resources from their parents, including food, attention, love and care.
The ASPCA provides more information on dog behavior (http://www.aspca.org/pet-care/virtual-pet-behaviorist/dog-behavior ).
SOURCE: Public Library of Science, news release, July 23, 2014; University of California, San Diego, news release, July 23, 2014
Gene Study Gives New Insight Into Puberty in Girls
Findings may also provide clues on biology of diseases, such as type 2 diabetes, researcher says
WEDNESDAY, July 23, 2014 (HealthDay News) -- The timing of a girl's first menstrual period may be determined by hundreds, and possibly thousands, of gene variations, a new study suggests.
Researchers have identified over 100 regions of DNA that are connected to the timing of menarche -- a woman's first menstrual period. The researchers hope these findings will shed light on the biology of a number of diseases ranging from type 2 diabetes to breast cancer.
"These findings will provide additional insights into how puberty timing is linked to the risk of disease in later life," said lead researcher John Perry, a senior scientist at the University of Cambridge MRC epidemiology unit, in the United Kingdom.
"We hope that with the help of future studies, this will in turn lead to better understanding of the underlying biology behind diseases such as type 2 diabetes and breast cancer," Perry said.
Earlier puberty has been linked to increased risks of some of the most common health problems today, including obesity, type 2 diabetes, heart disease and breast cancer. Although estrogen levels are thought to be involved, the full reasons for the connection between menarche and health conditions later in life aren't clear.
The new study found that some of the gene regions linked to menarche overlap with genes tied to hormone production, body weight, weight at birth, adulthood height and bone density -- among other things.
Perry and his colleagues report the findings in the July 23 online issue of Nature.
Combing through data on more than 180,000 women, the researchers found that girls vary widely in the age at which they start menstruating. Some start as early as age 8, while others start in high school. Exercise levels, nutrition and body weight are all influences, but there are probably many other factors involved, too, Perry pointed out.
"We identified over 100 regions of the genome that were associated with puberty timing," he said. "However, our analyses suggest there are likely to be thousands of gene variants -- and possibly genes -- involved."
The implication, Perry said, is that "puberty timing is a much more complex process than we might have originally thought."
Dr. Patricia Vuguin, a pediatric endocrinologist at Cohen Children's Medical Center in New Hyde Park, N.Y., agreed. "Many of these (genes) are completely novel and have never been associated with puberty before," said Vuguin, who was not involved in the study.
Right now, she noted, there is a lot of interest in the factors that influence the timing of puberty -- in part, because children these days are starting puberty at an earlier age, compared with a few decades ago.
The rising tide of childhood obesity is considered a key reason, but studies have found that it's not the whole story.
Often, Vuguin said, parents think if they change something in their child's diet -- like feeding them only organic foods -- that will ensure a "healthy" age at puberty.
"But this (study) is saying, it's not that simple," Vuguin said. "It's not only about body fat, or about what you eat. It's much more complicated than that."
One of the big discoveries, according to Perry, was that a "special set" of genes, known as imprinted genes, may help govern puberty timing. With most genes, we inherit one copy from each parent, and both of those copies are active. Imprinted genes are different; only the copy from one parent is active, while the other is "silent."
Researchers have thought that imprinted genes were important only before birth, for fetal growth and development.
"Our study supports the idea that these genes continue to play a role in later-life health and disease," Perry said.
Both he and Vuguin described this study as a first step toward understanding the biology that links puberty timing and health later in life.
One of the limitations of the work is that all of the women were of European descent. But, Perry said he would expect the genes and underlying biology to be "very similar" in women of all races and ethnicities -- and his team is currently studying that question.
Read more about puberty in girls from girlshealth.gov ( http://girlshealth.gov/body/puberty/index.html ).
SOURCES: John R.B. Perry, Ph.D., senior investigator scientist, MRC epidemiology unit, University of Cambridge, U.K.; Patricia Vuguin, M.D., pediatric endocrinologist, Steven and Alexandra Cohen Children's Medical Center, New Hyde Park, N.Y.; July 24, 2014, Nature, online
Health Highlights: July 23, 2014
Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:
CDC Lab Director Resigns Following Anthrax Scare
The director of the U.S. Centers for Disease Control and Prevention bioterrorism lab that was tied to a recent potential anthrax exposure has resigned.
According to the CDC, the potential exposure occurred between June 6 and 13 at the Bioterrorism Rapid Response and Advanced Technology (BRRAT) Laboratory. Lab staff had been prepping anthrax samples for use in other CDC labs in Atlanta and neglected to deactivate the samples, CNN reported.
BRRAT director Michael Farrell submitted his resignation Tuesday, CDC spokesman Tom Skinner told CNN. He had already been reassigned elsewhere once the anthrax scare became public.
The CDC's investigative report into the incident found that the oversight happened because the lab failed to follow approved sterilization methods, among other reasons.
"The scientists failed to follow a scientifically derived and reviewed protocol that would have assured the anthrax was deactivated," agency director Tom Frieden told CNN.
Leading Doctor in Sierra Leone Ebola Outbreak Is Now Infected
One of the leading physicians in the battle against an outbreak of deadly Ebola virus in Sierra Leone has himself become infected with the illness, news reports say.
According to UPI, Dr. Sheikh Uman Khan is now in a hospital in Kailahun, the epicenter of the epidemic in the West African nation. Ebola spreads easily between people and kills up to 90 percent of those infected. The World Health Organization says that, as of July 19, a total of 632 people have died in the outbreak in Guinea, Liberia and Sierra Leone.
Also according to UPI, health workers are among those falling ill. Sierra Leone newspaper Awareness Times reported that on Tuesday "four popular and dedicated health workers attached to Ebola center located inside Kenema Government Hospital have lost their lives."
There is currently no cure or antivirus against Ebola.
CDC Director Says Antibiotic Resistance a Growing Threat
Tougher measures to control antibiotic resistance need to be taken in the coming years, to avoid the possibility of it becoming the "next pandemic," the head of the U.S. Centers for Disease Control and Prevention said Tuesday.
During an event at the National Press Club, CDC Director Dr. Tom Frieden said the agency plans to isolate, track and prevent bacteria that are resistant to antibiotics in hospitals, USA Today reported.
Antibiotics and similar drugs -- which are also called antimicrobials -- have been used widely to treat infections for decades, according to the CDC, but that has caused some bacteria to mutate and become resistant to these drugs.
"Antimicrobial resistance has the potential to harm or kill anyone in the country, undermine modern medicine, to devastate our economy and to make our health care system less stable," Frieden said Tuesday, the newspaper reported. In fact, antibiotic resistance costs $20 billion in health care spending a year, he added.
Frieden also addressed recent safety lapses at U.S. government labs, which included the discovery of live samples of anthrax and a cross-contaminated strain of bird flu, USA Today reported. The incidents prompted the CDC to shutter two of its research labs and vow to strengthen its lab-safety regulations.
On Tuesday, Frieden reiterated that no one was exposed to any pathogens and that the agency continues to work on improving lab safety, according to the newspaper.
"If you work with dangerous organisms day after day, month after month, year after year, sometimes there is a tendency to get lax," Frieden said, USA Today reported. "What we have to ensure is that though human error may be inevitable, we should do everything in our power to make sure that . . . there will not be human harm."
HIV Meds May Also Help Control Hepatitis C, Study Finds
For people infected with both viruses, early treatment is critical, researchers report
WEDNESDAY, July 23, 2014 (HealthDay News) -- For patients infected with both HIV and hepatitis C, HIV antiretroviral therapy may help control both viruses, a small study suggests.
Researchers said doctors could use their findings to improve treatment strategies for people with the two diseases.
"The findings suggest that HIV suppression with antiretroviral medications plays an important role in the management of individuals with [hepatitis C] and HIV infection," said study leader Dr. Kenneth Sherman, a professor of medicine at the University of Cincinnati College of Medicine. "It supports the concept that in those with HCV/HIV infection, early and uninterrupted HIV therapy is a critical part of preventing liver disease."
The researchers conducted the study to address concerns that treating patients who have HIV -- the AIDS-causing virus -- and hepatitis C with HIV antiretroviral therapy would damage the liver and cause more harm than good.
To put this theory to the test, they closely examined 17 patients infected with both viruses for two years. The patients received approved HIV antiretroviral drugs. They were also examined frequently, and their blood was routinely tested to track any changes in the viruses and their immune response.
The findings were published July 23 in the journal Science Translational Medicine.
Some patients experienced an initial increase in a blood test that shows changes in liver injury, hepatitis C or both in the first 16 weeks of the study.
Over 18 months, however, the study revealed that "viral loads" for hepatitis C dropped back down to levels expected for a patient infected with only hepatitis C and not HIV.
"The drop in [hepatitis C] viral levels was a big surprise, and not what we necessarily expected," said Sherman in a university news release. "There is a complex interaction of biological effects when patients are infected with both HIV and the hepatitis C virus." He explained that initially HIV treatment results in a transient increase in hepatitis C viral replication and evidence of liver injury. However, over time, HIV suppression leads to reduced hepatitis C viral replication.
In the United States, up to 300,000 people are infected with both hepatitis C and HIV. Globally, that number increases to between 4 million and 8 million, the researchers said.
Drug makers Bristol-Myers Squibb and Gilead Sciences supplied the antiretroviral medications used in the study at no charge. One of the scientists involved in the research, Dr. Judith Feinberg, a professor of infectious diseases at the University of Cincinnati, is a Bristol-Myers Squibb investigator and speaker.
The U.S. Department of Health and Human Services provides more information on antiretroviral therapy (http://aids.gov/hiv-aids-basics/just-diagnosed-with-hiv-aids/treatment-options/overview-of-hiv-treatments/ ).
SOURCE: University of Cincinnati Academic Health Center, news release, July 23, 2014
Painful, Itchy Patches Could Be Sign of Skin Cancer
But it's likely to be the non-melanoma type, dermatologist says
WEDNESDAY, July 23, 2014 (HealthDay News) -- Painful or itchy skin lesions could be a warning sign of skin cancer, researchers report.
"Patients sometimes have multiple lesions that are suspicious looking, and those that are itchy or painful should raise high concerns for non-melanoma skin cancers," study author Dr. Gil Yosipovitch, chairman of dermatology at Temple University School of Medicine, said in a Temple University Health System news release.
Researchers looked at the medical records of 268 patients who were confirmed to have skin cancer lesions between 2010 and 2011. The patients were treated at Wake Forest University Baptist Medical Center and had almost 350 lesions in total.
The patients answered questions about the levels of pain and itchiness in their lesions. More than one-third of the skin cancer lesions itched, according to the study. Just under 30 percent were painful. Many people reported that their lesions were both painful and itchy.
Melanoma lesions were the least likely to be painful or itchy. Other skin cancers, especially basal cell carcinoma and squamous cell carcinoma, were more likely to be itchy or painful, the findings showed. Melanoma is much less common than basal cell and squamous cell skin cancers, but it is far more dangerous, according to the American Cancer Society.
"The study highlights the importance of a simple bedside evaluation for the presence and intensity of pain or itch as an easily implementable tool for clinicians in evaluating suspicious skin lesions," the study authors wrote.
Yosipovitch hopes the study will encourage the development of a ranking scale to help doctors use the symptoms of pain or itch -- or both -- to figure out whether patients have skin cancer.
The study appears in the July 23 issue of JAMA Dermatology.
For more about skin cancer, visit the U.S. National Cancer Institute (http://www.cancer.gov/cancertopics/types/skin ).
SOURCE: Temple University Health System, news release, July 23, 2014
Parent's Death May Raise Risk of Early Death for Grown Children, Study Suggests
Odds of dying prematurely 50 percent higher in adults who'd lost a parent in childhood, researchers report
WEDNESDAY, July 23, 2014 (HealthDay News) -- Children and teens who lose a parent might face an increased risk of an early death in adulthood, a new study suggests.
People who were children or teens when a parent died had a 50 percent greater risk of death during the study period than those who had not experienced the death of a parent, according to the report.
Although the study found an association between a parent's death and a child's later risk of premature death, it wasn't designed to prove cause-and-effect.
Also, the increased risk of premature death among these people may be due to both genetic factors and the long-term effects of a parent's death on the health and social well-being of a child, researcher Jiong Li and colleagues at Aarhus University in Denmark theorized.
The study findings were published in the July 22 issue of the journal PLoS Medicine.
The team analyzed data on children born in Denmark, Finland and Sweden between 1968 and 2008. Nearly 190,000 children were between 6 months and 18 years when one of their parents died. During a follow-up period ranging from one to 40 years, almost 40,000 of those people died.
The increased risk of early death persisted into early adulthood, no matter how old a child was when a parent died. The researchers also found that the increased risk of death was higher among children whose parents died from unnatural causes rather than natural causes (84 percent vs. 33 percent). The risk of death was highest among children of parents who committed suicide, according to a journal news release.
The researchers said their findings show the need for health and social support for children and teens who have lost a parent, and added that this support may be necessary for a long time.
The American Academy of Pediatrics explains how to help children cope with death (http://www.healthychildren.org/English/healthy-living/emotional-wellness/Pages/Helping-Children-Cope-with-Death.aspx ).
SOURCE: PLoS Medicine, news release, July 22, 2014
Routine Pulse Check May Prevent Second Stroke, Study Says
Patients, relatives can get reliable results, researchers find
WEDNESDAY, July 23, 2014 (HealthDay News) -- Regularly checking the pulse of a stroke survivor may help prevent another stroke, researchers report.
"Screening pulse is the method of choice for checking for irregular heartbeat for people over age 65 who have never had a stroke. Our study shows it may be a safe, effective, noninvasive and easy way to identify people who might need more thorough monitoring to prevent a second stroke," said study author Dr. Bernd Kallmunzer, of Erlangen University in Germany.
The study included more than 250 people who survived an ischemic stroke (blocked blood flow to the brain). Either the patients or their relatives were taught how to monitor the pulse to detect an irregular heartbeat.
Pulse checks taken by patients and relatives were nearly as accurate as those taken by health care workers, according to the study published online July 23 in the journal Neurology.
The pulse readings taken by the participants and health care professionals were compared to readings of electrical activity in the heart, which showed that 57 of the patients had irregular heartbeats.
Pulse measurements taken by relatives had a sensitivity of 77 percent and a specificity of 93 percent, compared with about 97 percent and 94 percent, respectively, for health care workers.
Sensitivity is the percentage of positive findings that are correctly identified. Specificity is the percentage of negative findings that are correctly identified.
Among patients who did their own pulse checks, 89 percent provided reliable results, with a sensitivity of 54 percent and specificity of 96 percent. False positives occurred in six patients and false negatives in 17 patients.
"The low rate of false positives in this study shows that health care professionals, caregivers and patients can be guided to use this simple tool as a first step in helping to prevent a second stroke," Kallmunzer said in a journal news release.
The U.S. National Library of Medicine has more about stroke (http://www.nlm.nih.gov/medlineplus/stroke.html ).
SOURCE: Neurology, news release, July 23, 2014
Weight Loss Surgery May Help Ease Urinary Incontinence
Nearly two-thirds of women had significant improvement of their symptoms, researchers report
WEDNESDAY, July 23, 2014 (HealthDay News) -- Weight-loss surgery appears to have an additional side benefit -- it may improve urinary incontinence symptoms in women, according to a new study.
The study found that nearly half of women in a weight-loss surgery program reported having incontinence prior to the procedure. After surgery, most of those women said their urinary symptoms either improved or disappeared, said study researcher Dr. Leslee Subak, professor of obstetrics, gynecology and reproductive sciences at the University of California San Francisco School of Medicine.
The women "lost almost 30 percent of their body weight, and about two-thirds who had incontinence at the start were cured at one year with that amount of weight loss. Among those who continued to have incontinence, their incontinence frequency improved a lot," Subak said.
Subak's team is due to present the findings this week at the American Urogynecologic Society and the International Urogynecological Association 2014 scientific meeting in Washington, D.C. Studies presented at medical meetings are typically viewed as preliminary until published in a peer-reviewed journal.
The women included in the study were severely obese, with a median BMI of 46. A women who is 5 feet 4 inches tall who weighs 268 pounds has a BMI of 46.
Health experts refer to obesity and incontinence as the "twin epidemics." That's because 25 to 50 percent of women have urinary incontinence, according to Subak. Of those, 70 percent are obese, she said.
There are several types of weight loss surgery -- also known as bariatric surgery. Most of the women in the study had procedures known as Roux-en-Y gastric bypass or gastric banding.
The improvement in incontinence symptoms continued during the study follow-up, Subak said.
"Both the weight loss and the improvement in incontinence lasted through three years. At year three, [about] 60 percent had remission," she said. Remissions were defined as less than weekly episodes of incontinence. "A quarter were completely dry," she noted.
The amount of weight loss was the strongest predictor of whether incontinence would improve or go away, Subak found. Losing more made urinary symptom improvement more likely.
Subak called the results very encouraging.
In a previous study, Subak found that a six-month focused program of weight loss and diet information helped reduce incontinence in obese women better than four weekly education sessions about weight loss and physical activity.
Dr. Amy Rosenman, a specialist in urogynecology and pelvic surgery in Santa Monica, Calif., and health sciences clinical professor at the University of California Los Angeles David Geffen School of Medicine, said the study findings ring true in practice.
"I have patients who have lost weight and it ended their stress incontinence," she said. Those who lost by nonsurgical means also noticed improvement, she said.
The new findings reflect what has been found previously by other researchers, too, said Rosenman, who is president-elect of the American Urogynecologic Society. "There are many other studies that show weight loss improves leakage, probably due to less pressure, less weight pressing on the bladder from above and beside. So it stands to reason that bariatric surgery would also benefit [the incontinence]," she said.
Like all surgeries, bariatric surgeries are not without risk. The procedures are accompanied by possibility of infection, blood clots and heart attacks, among others, according to the U.S. National Institutes of Health.
Costs for the surgery range greatly, from about $12,000 to $26,000, but are sometimes covered under insurance policies.
Some of Subak's co-authors report advising or consulting for companies such as Crospon, Covidien and Ethicon, which manufacture or are involved in bariatric surgery products.
To learn more about weight loss surgery, visit National Institutes of Health. (http://www.nlm.nih.gov/medlineplus/weightlosssurgery.html )
SOURCES: Amy Rosenman, M.D., health sciences clinical professor, University of California Los Angeles David Geffen School of Medicine, and physician, private practice, Santa Monica, Calif.; Leslee Subak, M.D., professor of obstetrics and gynecology and reproductive science, University of California San Francisco School of Medicine; July 22 to 26, 2014, American Urogynecologic Society and International Urogynecological Association 2014 scientific meeting, Washington, D.C.