Health Tip: Protect Your Joints

(HealthDay News) - Osteoarthritis, a disease of the joints, can be triggered by injury and overuse, by obesity, and by musculoskeletal problems.

Here are ways to help protect your joints, courtesy of the Arthritis Foundation:

• As excess weight can cause stress and excess wear and tear on joints, keep your body at a healthy weight.
• Get regular exercise to strengthen muscles that surround and protect the joints.
• Practice good posture.
• Be careful when lifting or carrying heavy objects.
• Don't ignore pain. When something starts to hurt, stop activity or exercise to prevent strain or injury.
• Don't stay in one position for too long. Try to move the body's joints and muscles regularly
• Always wear protective equipment, including helmets and wrist pads, when appropriate.

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Natural Protein May Hurt Vision

(HealthDay News) -- High levels of an amino acid called homocysteine could harm the eyes, say researchers at the Medical College of Georgia.

They suspect that homocysteine -- already believed to contribute to heart attack, stroke and dementia -- likely helps cause retinal damage and vision loss.

Preliminary evidence suggests that elevated homocysteine levels damage the extensive blood vessel and neuronal network of the retina, said cell biologist Dr. Sylvia Smith.

With a $1.8 million grant from the U.S. National Institutes of Health, Smith hopes to learn more about how elevated homocysteine levels may affect the retina, its structure, functioning, and ability to withstand stress.

The retina, located at the back of the eye, receives light and transforms it into neural impulses that go to the brain.

Homocysteine levels increase when there's a decline in folic acid (folate) levels, Smith noted. This is a problem for many Americans, because they don't eat enough folate-rich fruits, vegetables and grains.

Folate and vitamin B12 convert homocysteine to methionine, an amino acid that plays a vital role in protein synthesis. When this conversion fails to occur, elevated homocysteine levels interfere with the folding and structure of collagen, a component of bone, tissue and blood vessel walls, the team explained.

More information
The American Heart Association has more about homocysteine and cardiovascular disease.

Female Blood Donor Concern May Be Unfounded

(HealthDay News) -- Blood plasma donated by females may not be as dangerous as believed, says a team who question a proposed policy change that would limit the use of plasma from female donors due to the risk of a rare but potentially serious lung condition called transfusion-related acute lung injury (TRALI).

Plasma -- the liquid portion of blood that's separated from red blood cells after a person donated blood -- from females has been implicated as a cause of TRALI, a condition where the lungs fill with fluid. TRALI occurs in an estimated 1 in 1,300 transfusions to 1 in 5,000 transfusions and is the leading cause of transfusion-related death in the United States.

Because of the suspected link between female plasma and TRALI, blood banks in the United States are considering limiting the use of female plasma. Since 2004, the United Kingdom has used only plasma from male donors.

In the study, a team from Duke University Medical Center in Durham, N.C., analyzed 8,300 heart surgery patients. They found no association between transfused female plasma and any harmful outcomes. In fact, the researchers found that patients who received only female plasma had a significant fewer complications.

The findings were presented at the annual meeting of the American Association of Blood Banks.

"Our data showed no deleterious effect associated with female plasma transfusion, and even pointed toward the possibility of a protective effect," Duke anesthesiologist Dr. Ian Welsby said in a prepared statement.

"TRALI is important, and effective preventive steps should be taken to prevent it; however, we believe that more prospective data needs to be evaluated prior to enacting a policy such as the one in the United Kingdom," Welsby said.

"The bottom line is that female donor plasma may not be as harmful as it has been made out to be, and antibodies from female plasma are only one source of TRALI."

More information
The American Cancer Society has more about possible blood product transfusion risks.

Meningitis Vaccine Gets Expanded Approval

(HealthDay News) -- The approved age range for the bacterial meningitis vaccine Menactra has been expanded to include children ages 2 to 10, the U.S. Food and Drug Administration said.

The vaccine had been approved for people ages 11 to 55.

Previously, a product called Menomune was the only meningitis vaccine approved in the United States for use in children ages 2 and older. Both Menactra and Menomune are made by Sanofi Pasteur Inc. and offer protection against four groups of the bacterium that can cause meningitis.

In the United States, about 2,600 people become ill from bacterial meningitis each year. Some 10 percent of those patients die and about 15 percent incur brain damage or limb amputation.

Meningitis vaccine is recommended for children ages 2 to 10 who are at increased risk for developing meningitis including: those who have had their spleen removed or whose spleen is not functioning; those who are traveling to areas outside the United States where the disease is common; and those with a condition called terminal complement component deficiency, which makes it difficult to fight infection. Vaccination is also used to control outbreaks of bacterial meningitis.

More information
The FDA has more about this approval.

Secondhand Smoke Hurts Kids' Grades

(HealthDay News) -- Not only is secondhand smoke a threat to teen health, it can also affect their school test scores, a new study finds.

Researchers at Temple University found that 16- and 18-year-olds exposed to secondhand smoke at home were 30 percent less likely to pass standardized tests than their peers.

They reached this conclusion after analyzing data from thousands of mothers and children in the United Kingdom, and factoring in other known risk factors, such as socioeconomic status, gender and smoking by teens.

The study was published in the Journal of Adolescent Health.

The findings add to a growing body of evidence that secondhand smoke affects children's academic performance, as well as their health, the researchers said.

"It's important that we help smoking parents learn how to reduce their children's exposure to secondhand smoke, a goal that can be achieved without requiring the parent to immediately quit smoking, although that's the ultimate goal for the health of the entire family," study author Bradley Collins, an assistant professor of public health and director of the Health Behavior Research Clinic at Temple, said in a prepared statement.

This study did not answer why secondhand smoke affects teen's test scores. Previous studies have suggested a link between prenatal exposure to cigarette smoke and increased risk of cognitive and academic problems, learning disabilities and impulsivity in children.

More information
The American Lung Association has more about secondhand smoke and children.

America's Top Hospitals Are Real Lifesavers

(HealthDay News) -- Patients in the top-ranked hospitals in the United States are 71 percent less likely to die than those in the lowest-rated hospitals, according to a new study from the health-care ratings company HealthGrades.

The 10th annual HealthGrades Hospital Quality in America Study looked at 41 million Medicare hospitalization records at 5,000 hospitals from 2004 to 2006.

The study authors contend that if all hospitals performed at the level of the top five-star rated hospitals, the lives of 266,604 Medicare patients could have been saved over those three years.
The hospital rankings are based on 18 procedures and medical conditions, ranging from pneumonia and heart attack to valve-replacement surgery.

The study found that overall death rates at American hospitals declined 11.8 percent from 2004 to 2006, with a 12.8 percent decline at the top-rated hospitals and a 11.4 percent decline at the lowest-ranked hospitals.

Of the procedures and conditions included in the study, the largest declines in death rates were noted for pancreatitis (19.2 percent), pulmonary embolism (17.4 percent) and diabetic acidosis and coma (16.6 percent). The smallest declines were seen in resection/replacement of the abdominal aorta (0.4 percent), coronary procedures such as angioplasties and stents (0.8 percent), and heart attack treatments (8.9 percent).

"While we are pleased to see that the hospital industry's focus on improving care quality has continued to reduce mortality rates, a significant variation in quality among the nation's best- and poorest-performing hospitals persists," study co-author Dr. Samantha Collier, who is HealthGrades' chief medical officer, said in a prepared statement.

"Concentrating on emulating practices from exemplary hospitals can result in improvement. If this focus were targeted to four key quality areas -- heart failure, respiratory failure, sepsis and pneumonia -- the nation could achieve up to a 50 percent reduction in potentially preventable deaths," Collier said.

More information
Here's more on the quality of health care from the Agency for HealthCare Research and Quality.

Obesity Boosts Esophageal Cancer Risk

(HealthDay News) -- Obese people are six times more likely to develop esophageal cancer than people with healthy weight, says an Australian study that looked at 800 people with esophageal tumors and 1,600 people without the disease.

People with a body mass index (BMI) of 40 or more were six times as likely to have esophageal cancer as those with a BMI between 18.5 and 25 (a BMI of 30 is considered the threshold for obesity).

According to a team from the Queensland Institute of Medical Research in Brisbane, the finding held true even after accounting for other factors known to be linked to the disease, such as high alcohol consumption and smoking.

This suggests that obesity is an independent risk factor for esophageal cancer, said the study authors, who explained that higher levels of fat tissue in the body increase insulin production. This, in turn, boosts levels of circulating insulin-like growth factor.

Both these hormones stimulate cell growth and inhibit cell death -- conditions that can lead to cancer development, the team said.

The researchers also noted that fat cells produce hormones called adipocytokines that speed up cell growth and play a role in inflammatory processes.

Repeated symptoms of severe heartburn or gastrointestinal reflux disease were also associated with a much higher risk of esophageal cancer, the researchers said.

The more frequent the symptoms, the greater the risk. Gastrointestinal reflux disease quintupled the risk of esophageal cancer, while a combination of acid reflux and obesity increased the risk by a factor of 16.

The study was published Oct. 11 in the online edition of the journal Gut.

More information
The American Cancer Society has more about esophageal cancer.

Health Tip: Getting a Flu Vaccine

(HealthDay News) - An annual flu vaccine can help protect you from the nasty effects of the flu virus.

Here's some background information about the flu vaccine, courtesy of the U.S. Centers for Disease Control and Prevention:

• The injected vaccination contains a killed virus. It is approved for people over the age of 6 months.
• The nasal form of the vaccine is made with a weakened virus, and is approved for people ages 2-49 years. It's not recommended for pregnant women.
• Approximately two weeks after the vaccination, your body develops the antibodies needed to protect itself from specific strains of the flu virus.
• Flu season generally runs from October through May. The best months to be vaccinated are October and November, but you can still be vaccinated later.
• You cannot get the flu from a flu shot, but minor side effects may include swelling, low-grade fever, and aches and pains.
• Similarly, you cannot develop full-blown flu from the nasal spray vaccine, but minor side effects may include runny nose, headache, and sore throat.

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Study Rates Heart Health of Popular Diet Plans

(HealthDay News) -- Not all diet plans are equally heart-healthy, according to a study ranking eight popular weight-loss programs.

Diets that emphasize a variety of fruits and vegetables scored better than those with a heavy protein focus.

The Ornish diet plan came out on top with the most potential to prevent heart disease risk factors. The Atkins diet came in last, lagging behind the Zone and Weight Watchers.

"It was not surprising to me that the Ornish diet came out on top given that the index used is designed to measure dietary components related to risk of heart disease," said dietician Lona Sandon, a national spokeswoman for the American Dietetic Association.

Sandon said the take-home message for consumers is "if heart disease is your concern, you need to focus more on fruits, vegetables and make all your grains whole grains, as well as limit intake of animal foods and fats."

The findings are published in the October issue of the Journal of the American Dietetic Association.

Researchers at the University of Massachusetts Medical School ranked daily meal plans and food recommendations in the Ornish Plan, the Zone Diet, Atkins, two Weight Watchers plans, the South Beach Diet, the New Glucose Revolution and the 2005 MyPyramid plan.

The rankings were based on the Alternate Healthy Eating Index (AHEI), which uses the daily dietary intake of fruits, vegetables, fats, fiber, nuts, soy and white meats instead of red meat to determine how much benefit a diet has for heart health.

The highest possible score is 70. While none of the diets had a perfect score, they varied across a 20-point spread:

Ornish, 64.6.
Weight Watchers high-carbohydrate, 57.4.
New Glucose Revolution, 57.2.
South Beach Phase 2, 50.7.
Zone, 49.8.
MyPyramid, 48.7.
Weight Watchers high protein, 47.3.
Atkins 100-g carbohydrate, 46.
South Beach Phase 3, 45.6.
Atkins 45-g carbohydrate, 42.3.

Study author and clinical psychologist Sherry Pagoto said there's no cut-off point in the AHEI scale below which a diet could be definitively considered heart unhealthy. But other studies have ranked low-quality diets in populations at risk for heart disease around the 30-point mark.

"We were most surprised by the fact that the MyPyramid wasn't even in the top three. We figured that this would be a model diet because it is based on the U.S. Department of Agriculture dietary recommendations," Pagoto said.

However, coming in last doesn't mean a diet is of low quality, she said. All of the diets have the potential to be healthy and have been shown in a variety of studies to result in weight loss, which is itself important to improving heart health. Additionally, coming in first does not mean the diet plan is ideal for everyone, she added.

"While the Ornish plan was on top, it's a hard one for most people to follow," Pagoto said. The Ornish plan is a very low-fat, low-calorie, primarily vegetarian diet developed for people who have survived heart attacks, she explained.

In her work counseling clients at the University of Massachusetts Memorial Weight Center, Pagoto said she has learned that it's important for people to be able to stick to the diet plan they choose.

"There is more than one element of a diet to consider," she said.

People with a personal or family history of heart disease should consider the results of this study as a guide when choosing a diet plan, Pagoto said. But they should also think about their food preferences. For example, people who really like carbohydrates would do better with Weight Watchers than with Atkins, regardless of this ranking system, she said.

Pagoto advises patients to keep a food log over several weeks to get a better idea of their food preferences and calorie intake before starting a diet.

Lack of variety courts diet disaster due to boredom, Pagoto said. People will eventually get tired of the limitations of a tightly controlled or hard-to-implement diet, she said.

Despite not making the top three, the USDA's MyPyramid allows for the most variety, she said.
Sandon said: "What I find in working with clients is that most people tend to eat the same foods on a daily or weekly basis and have little variety. They do not want to have to seek out special foods or learn to prepare new foods they are not familiar with. In general, I find that many people in the initial phase of starting a weight-loss plan are more comfortable sticking to a plan of the same foods most of the time but want permission to have something different here and there."

A second study in the same issue of the journal suggests that using canola-based products instead of other oils all the time could meet national standards for healthy fats. Canola oil can help decrease adults' saturated fatty acid intake by up to 9.4 percent and increase their intake of monounsaturated fatty acids by 27.6 percent. Alpha-linolenic acid intake would increase 73 percent. The switch would not affect total calories, fat and cholesterol, according to the researchers, from the University of Illinois and Pennsylvania State University, who studied the diets of more than 9,000 people.

More information
For more about the USDA's dietary guidelines, visit MyPyramid.

Women Less Likely to Get Heart Defibrillators

(HealthDay News) -- Women are less likely than men to receive implantable defibrillators, and black patients are less likely than white patients to receive the lifesaving heart devices.

Two studies documenting these findings echo previous research, and confirm that little progress has been made in this area of inequity.

"In the mid 1990s, the Institute of Medicine noted that newer technologies and innovative therapies were more likely to be used in men versus women and in whites versus blacks consistently, and recommended that the health-care system needs to figure out how to deliver new therapies more efficiently and equitably," said Dr. Adrian Hernandez, an author of both of the studies, which appear in the Oct. 3 issue of the Journal of the American Medical Association.

"This is a case example where we still haven't done that," added Hernandez, an assistant professor of medicine at the Duke Clinical Research Institute, in Durham, N.C.

"It reconfirms what was found in clinical trials, that the problem still exists," said Dr. Wojciech Zareba, a professor of medicine with the cardiology unit at the University of Rochester (N.Y.) Medical Center. "We do not know the reason for the discrepancy but, in my view, one predominant reason is a lot of education needs to be done among physicians to convince them.

People don't know enough and we should have more advertisements during the evening news on sudden cardiac death in women rather than on asthma drugs or breast cancer."

Some 350,000 people in the United States die each year as a result of sudden cardiac death, making it one of the leading causes of death. Although the risk is initially higher in men than in women, that discrepancy disappears after age 85.

Implantable cardioverter-defibrillators (ICDs), introduced about two decades ago, continually monitor heart rhythms and deliver electrical shocks to help control erratic rhythms. The devices have been shown to reduce mortality in those at highest risk for sudden cardiac death.

Thanks to pivotal trials, Medicare expanded its coverage of ICDs in 2004.

One trial also found that only a small proportion of women who were eligible received an ICD.

But that trial, and others, were conducted before the Medicare expansion.

For the first of the new studies, the researchers looked at the medical records of more than 236,000 Medicare patients from 1999 to 2005. The study had two parts -- one looking at primary prevention (those at risk for sudden cardiac death and cardiac arrest) and one looking at secondary prevention (those who had already had cardiac arrest or sudden cardiac death).

Among patients in the primary prevention component, men were 3.2 times more likely than women to receive an ICD. In the secondary prevention trial, men were 2.4 times more likely to receive an ICD.

White men were more likely than black men to get ICDs and white women were more likely than black women to get them.

The gender discrepancy did not appear to narrow over time.

For the second study, the researchers looked at 13,034 patients with heart failure and left ventricular ejection fraction of 30 percent or less (a measure of how well the heart pumps that indicates the risk for sudden cardiac death) between January 2005 and June 2007. Patients had been admitted to one of 217 hospitals participating in the American Heart Association's "Get With the Guidelines" program. This study only looked at primary prevention.

Overall, just 35.4 percent of patients eligible for ICD therapy had received a device by the time of hospital discharge, but the figure varied by group: 28.2 percent of eligible black women received the therapy, along with 29.8 percent of white women, 33.4 percent of black men and 43.6 percent of white men.

The odds of ICD use were 27 percent lower for black men, 38 percent lower for white women, and 44 percent lower for black women.

The study authors said they weren't sure why these discrepancies exist.

"We're unsure whether there are differences in patient preferences," Hernandez said. "One can imagine that possibly men may ask for defibrillators more often than women or ask to have aggressive therapies more often than women. Alternatively, when offered, women can turn them down more. We don't know."

It's also possible that physicians are more comfortable prescribing the devices for men because clinical trials have been done mostly in men, or they see men who have other risk factors for sudden death more often than women. There could also be system-wide or hospital inequities with women having less than full insurance coverage for ICDs.

In any event, one solution seems clear.

"We need to promote awareness about the use of defibrillators, we need to figure out what are the barriers for use and, specifically, what are barriers for use in women and minorities and how to address these barriers," Hernandez said.

More information
The Heart Rhythm Society has more on ICDs.