Blindness Rates Dropping Worldwide, Study Finds

MONDAY, March 24, 2014 (HealthDay News) -- Global rates of blindness and poor vision have fallen sharply over the past two decades, especially in rich nations, a new study reveals.

And providing eyeglasses for common vision-loss problems could improve the situation even more, according to the researchers.

The investigators analyzed 243 studies conducted in 190 countries and found that rates of blindness and poor vision fell by 37 percent and 27 percent, respectively, from 1990 to 2010.

In wealthy nations, the prevalence rate of blindness dropped by half, from 3.3 million people (0.2 percent of the population) to 2.7 million people (0.1 percent of the population), the findings showed.

In those countries, the rate of poor vision decreased 38 percent, from 25.4 million people (1.6 percent of the population) to 22.2 million people (1 percent of the population).

In high-income countries, women were more likely than men to be blind or to have poor vision throughout the study period.

The study was published online March 24 in the British Journal of Ophthalmology.

During the 20-year study timeframe, macular degeneration replaced cataracts as the most common cause of blindness, except in central and eastern European nations, according to a journal news release. The most common cause of poor vision remained uncorrected refractive errors such as long- and short-sightedness.

The findings show "that even for the highly developed countries one of the most effective, cheapest, and safest ways of improving vision loss by providing adequate spectacles for correcting refractive errors, is being overlooked," study author Rupert Bourne, a professor with the vision and eye research unit at Anglia Ruskin University, in Cambridge, England, and colleagues wrote.

They added that the growing number of people with diabetes will have a major effect on eye health worldwide, with as many as 100 million people expected to develop an eye disease called diabetic retinopathy. Of those, about one-third will be at risk of losing their vision.

"Strategies to screen for diabetic retinopathy and provide timely treatment access are critical to prevent this condition from having a greater impact on blindness prevalence in the future," the researchers concluded.

-- Robert Preidt
Copyright © 2014 HealthDay. All rights reserved. SOURCE: British Journal of Ophthalmology, news release, March 24, 2014

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E-Cigarettes Won't Help You Quit, Study Finds

By Steven Reinberg
HealthDay Reporter

MONDAY, March 24, 2014 (HealthDay News) -- Contrary to some advertising claims, electronic cigarettes don't help people quit or cut down on smoking, a new study says.

Users of e-cigarettes inhale vaporized nicotine but not tobacco smoke. The unregulated devices have been marketed as smoking-cessation tools, but studies to date have been inconclusive on that score, the study noted.

"When used by a broad sample of smokers under 'real world' conditions, e-cigarette use did not significantly increase the chances of successfully quitting cigarette smoking," said lead researcher Dr. Pamela Ling, an associate professor at the Center for Tobacco Control Research and Education at University of California, San Francisco.

These findings -- based on nearly 1,000 smokers -- are consistent with other studies and contradict the claims frequently found in e-cigarette advertising, she said.

"Advertising suggesting that e-cigarettes are effective for smoking cessation should be prohibited until such claims are supported by scientific evidence," Ling said.

For the study, Ling's team analyzed data reported by 949 smokers, 88 of whom used e-cigarettes at the start of the study.

One year later, 14 percent of the smokers had quit overall, with similar rates in both groups.

"We found that there was no difference in the rate of quitting between smokers who used an e-cigarette and those who did not," Ling said.

There was no relationship between e-cigarette use and quitting, even after taking into account the number of cigarettes smoked per day, how early in the day a smoker had a first cigarette and intention to quit smoking, Ling added.

However, the researchers noted that the small number of e-cigarette users may have limited the ability to find an association between e-cigarette use and quitting.

The report, published online March 24 in JAMA Internal Medicine, also found that women, younger adults and people with less education were most likely to use e-cigarettes.

One expert said the study is flawed and shouldn't be taken seriously.

"It's an example of bogus or junk science," said Dr. Michael Siegel, a professor of community health sciences at Boston University School of Public Health.

"That's because the study does not examine the rate of successful smoking cessation among e-cigarette users who want to quit smoking or cut down substantially on the amount that they smoke, and who are using e-cigarettes in an attempt to accomplish this," Siegel said. "Instead, the study examines the percentage of quitting among all smokers who have ever tried e-cigarettes for any reason."

Many of the smokers who tried e-cigarettes may have done so out of curiosity, Siegel said.

"It is plausible, in fact, probable, that many of these 88 smokers were not actually interested in quitting or trying to quit with electronic cigarettes," he said. "These products have become very popular and have gained widespread media attention, and it is entirely possible that many of these smokers simply wanted to see what the big fuss is all about."

Calling that a "fatal flaw" in the research, Siegel said it "destroys the validity of the authors' conclusion."

It would be a tragedy, he said, if policy makers use the study to draw conclusions about the effectiveness of e-cigarettes for smoking cessation purposes.

Erika Ford, assistant vice president for national advocacy at the American Lung Association, said the study confirms what is already clear -- "e-cigarettes are not associated with quitting among smokers."

Ford noted that most e-cigarette companies no longer make claims that their products help smokers quit. "But there is a need for the FDA [U.S. Food and Drug Administration] to begin their oversight of these products. It's time for the FDA to find out which products are making no smoking claims and which ones might be in violation of current law," she said.

The FDA plans to introduce regulations for e-cigarettes, but hasn't yet. In the past, the agency has warned companies about making false claims and for poor manufacturing practices.

Copyright © 2014 HealthDay. All rights reserved. SOURCES: Pamela Ling, M.D., M.P.H., associate professor, Center for Tobacco Control Research and Education, University of California, San Francisco; Michael Siegel, M.D., M.P.H., professor, Department of Community Health Sciences, Boston University School of Public Health; Erika Ford, assistant vice president for national advocacy, American Lung Association; March 24, 2014, JAMA Internal Medicine, online

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Spanking Triggers Vicious Cycle, Study Finds

By Dennis Thompson
HealthDay Reporter

TUESDAY, March 25, 2014 (HealthDay News) -- Parents who spank unruly children may not know it, but they are participating in a vicious cycle that will lead to both more spankings and more misbehavior in coming years, a new study suggests.

Researchers wanted to resolve the age-old "chicken-and-egg" question that surrounds the issue of physical discipline in childhood -- do spankings promote aggression in children, or do naturally aggressive children simply receive more spankings as parents try to control their behavior?

The answer is yes to both, said study author Michael MacKenzie, an associate professor at the Columbia University School of Social Work in New York City.

Across a child's first decade of life, current spankings will lead to future misbehavior -- but current misbehavior also will lead to future spankings, the investigators found.

"You can think of it as an escalating arms race, where the parent gets more coercive and the child gets more aggressive, and they get locked into this cycle," MacKenzie said. "These processes can get started really early, and when they do there's a lot of continuity over time."

The findings are based on almost 1,900 families from the Fragile Families and Child Wellbeing Study. That's a decade-old research project conducted by researchers at Columbia and Princeton universities involving children born in 20 large American cities between 1998 and 2000.

Families in the study took part in assessments shortly after giving birth and when the children were approximately 1, 3, 5 and 9 years old. These assessments included questions about whether the children received spankings and the extent to which the children behaved aggressively, broke rules or acted surly or antagonistic.

About 28 percent of mothers reported spanking their children during their first year of life, increasing to 57 percent at age 3 and then hovering around 53 percent at age 5 and 49 percent at age 9.

But researchers also found that at each age, children who exhibited more behavioral problems went on to experience more spanking at a later age, indicating that the more difficult children might prompt increasing levels of punishment from their parents.

"Some children are eliciting higher levels of physical discipline, and high levels of physical discipline are in turn associated with later higher levels of parental aggression," MacKenzie said.

Even though the study shows that spanking and misbehavior tend to feed each other, the investigators also found strong evidence that spanking a child within the first year of life likely is the catalyst that starts the cycle.

These findings put an end to the "chicken or the egg" debate over which comes first, the spanking or the childhood misbehavior, said Dr. Andrew Adesman, chief of developmental & behavioral pediatrics at Steven & Alexandra Cohen Children's Medical Center of New York in New Hyde Park, N.Y.

"I see it starting with the egg, with the egg being the spanking, and then the spanking then leads to more aggressive behavior, and the aggressive behavior then leads to more spanking," Adesman said.

The findings are published in the March 25 online issue of the Journal of Youth and Adolescence.

If parents can stick to non-physical forms of punishment when a toddler acts out, they are more likely to have a well-behaved child at ages 3, 5 and 9, he said.

"During the early toddler years, parents probably need to get more counseling or advice on strategies for managing children's behavior without resorting to spanking," Adesman said.

Unfortunately, MacKenzie said, it can be tough to avoid the urge to spank, given how stressed and overwhelmed many young parents can become.

"Spanking gives very immediate feedback, because children will stop doing what they were doing, but it's not giving children the ability to regulate themselves over time," he noted.

"But parenting is not an easy thing, and challenging kids make the job even tougher," MacKenzie explained. "We need to give these parents the support they need to do as well as they'd like by their children."

Copyright © 2014 HealthDay. All rights reserved. SOURCES: Michael MacKenzie, associate professor, Columbia University School of Social Work, New York City; Andrew Adesman, M.D., chief, developmental & behavioral pediatrics, Steven & Alexandra Cohen Children's Medical Center of New York, New Hyde Park, N.Y.; March 25, 2014, Journal of Youth and Adolescence, online

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Many Don't Understand Obamacare or Health Insurance, Survey Finds

By Amy Norton
HealthDay Reporter

MONDAY, March 24, 2014 (HealthDay News) -- As the deadline looms for Americans to enroll in "Obamacare" this year, a new study finds that many people -- especially the uninsured and those with lower incomes -- know little about the new health care law, known as the Affordable Care Act.

Most significantly, researchers found, Americans show little understanding of the cornerstone of the reform -- the online marketplaces, or "exchanges," that have been set up to help people shop for an insurance plan, and find out if they're eligible for Medicaid or subsidies to help pay for their health insurance.

Overall, half of the 6,000 U.S. adults surveyed did not even know what an exchange was, and among the uninsured, a full 64 percent didn't know. In addition, over 40 percent of survey respondents did not know what an insurance deductible was, including nearly 60 percent of the uninsured.

Experts were concerned by the findings, reported in the March 24 online edition of the Proceedings of the National Academy of Sciences. But they were not shocked.

"No, this doesn't surprise me at all," said Dr. Kavita Patel, a fellow at the Washington, D.C.-based Brookings Institution.

Low "health literacy" -- people's understanding of health information and ability to use it -- is a well-known problem, and not limited to health care reform, noted Patel, who was not involved in the study.

To be fair, the new report is based on a survey done in August and September of last year -- before the state and federal exchanges were up and running, and before the troubled federal website was grabbing headlines everywhere.

By now, Americans may know more, according to Silvia Barcellos, an economist at the University of Southern California who led the study.

She said she and her colleagues are planning a follow-up survey in April to see if there has been a change.

Regardless, Barcellos said, the current findings are worrisome, especially the lack of awareness among the uninsured.

"These are the people everyone is counting on to enroll," she noted.

And the problems go beyond awareness of the exchanges. "Many people lack a basic understanding of how health insurance works," Barcellos said.

March 31 is the deadline for enrolling for insurance coverage for 2014 under the Affordable Care Act.

Of all survey respondents, 42 percent did not know what an insurance deductible was -- including 58 percent of the uninsured.

The same was true for 30 percent to 45 percent of those living between 100 percent and 400 percent of the federal poverty level. Many of those Americans are eligible for tax credits to help pay for insurance bought through the exchanges. They are another group that stands to benefit the most from the Affordable Care Act.

But if uninsured and lower-income people don't understand how health insurance works, Barcellos said, "how can you expect them to make informed decisions when they choose a plan?"

Sharon Long, of the Urban Institute's Health Policy Center in Washington, D.C., agreed.

"Health insurance is complicated, and we're talking about people who may never have had it in the past," said Long, who was not involved in the study. "It's ironic that we're asking people without that experience to make good choices."

Brookings' Patel pointed out that this problem was anticipated. Federal and state governments have so-called navigator programs to help applicants get through the enrollment process. Those navigators include individuals and groups -- from nonprofits to hospitals to church groups -- who are trained and certified (and paid) by the government.

"The role of the navigators is important," study author Barcellos said. But, she added, people also need to know the programs exist.

There are other potential ways to make the exchanges more user-friendly, according to Barcellos. One step, she said, could be to redesign the exchange websites to "nudge" people to the best plans -- by highlighting certain economical and better-quality plans on the first page of the site.

Barcellos said research has shown that when people have too many choices -- especially complex ones -- their tendency is to opt for whatever seems easiest.

"Or," she said, "they may make no choice at all."

Copyright © 2014 HealthDay. All rights reserved. SOURCES: Silvia Helena Barcellos, Ph.D., research scientist, University of Southern California Center for Economic and Social Research, Playa Vista, Calif.; Kavita Patel, M.D., managing director, clinical transformation and delivery, Brookings Institution, Washington, D.C.; Sharon Long, Ph.D., senior fellow, Health Policy Center, Urban Institute, Washington, D.C.; March 24, 2014, Proceedings of the National Academy of Sciences, online

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Fibromyalgia Might Be Harder on Younger Patients, Study Finds

SATURDAY, Oct. 26 (HealthDay News) -- Young and middle-aged fibromyalgia patients report worse symptoms and poorer quality of life than older patients, a new study reveals.

Fibromyalgia is characterized by symptoms such as musculoskeletal pain and tenderness, fatigue, and sleep and memory problems. The disorder, which most often affects women, has no known causes and few effective treatments.

The study included 978 fibromyalgia patients who were divided into three age groups: 39 and younger, 50 to 59, and 60 and older. The younger and middle-aged patients were more likely to be employed, unmarried, smokers, have a higher education level and lower body-mass index (BMI), a measure of body fat that takes height and weight into account.

They were also more likely to have a history of abuse and to have had fibromyalgia symptoms for a shorter length of time than older patients, the study authors said.

"Among the three age groups of young, middle-aged and older, symptom severity and quality of life differs," study senior author Dr. Terry Oh, a physical medicine and rehabilitation physician at the Mayo Clinic in Rochester, Minn., said in a clinic news release.

The findings were surprising, because older people generally have poorer quality of life and physical health than younger people, Oh said.

The researcher noted that female fibromyalgia patients in all three age groups reported a lower quality of life than average U.S. women, and that the difference between their physical health and that of the average woman was more significant than mental health differences, particularly in young patients.

The study was to be presented this week at the American College of Rheumatology annual meeting, in San Diego.

In other Mayo studies presented at the meeting, researchers found that about 7 percent of fibromyalgia patients have inflammatory rheumatic conditions and that these patients don't respond as well to treatment as those without rheumatic diseases, and that fibromyalgia patients may also have skin-related symptoms such as excessive sweating, burning and other sensations.

Because the studies were presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: Mayo Clinic, news release, Oct. 26, 2013

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Flu Can Kill Even Healthy Children, Study Finds

By Steven Reinberg
HealthDay Reporter

MONDAY, Oct. 28 (HealthDay News) -- Children, even those without severe medical conditions, can die from the flu in as little as three days after symptoms appear, U.S. health officials warn.

Between 2004 and 2012, flu complications killed 830 children in the United States, many of whom were otherwise healthy, according to the U.S. Centers for Disease Control and Prevention.

Most striking is that 35 percent of these children died before being hospitalized or within the first three days of developing symptoms, according to the report published online Oct. 28 in Pediatrics.

"We found these influenza-related deaths can occur in children with and without medical conditions and in children of all ages, and that very few of these children have been vaccinated," said lead author Dr. Karen Wong, a CDC medical epidemiologist.

Researchers who reviewed those deaths found that only 22 percent with a high-risk medical condition and just 9 percent without a significant medical condition had been vaccinated.

Wong doesn't know why so many children die so fast. "About a third of these children die within the first three days of their first reported symptoms," she said.

One expert wasn't surprised that many otherwise healthy children who died did so before being admitted to the hospital.

"First, parents don't realize that flu can be fatal," said Dr. Marcelo Laufer, a pediatric infectious diseases specialist at Miami Children's Hospital.

Second, parents of children with chronic diseases "know the system better, so they come earlier than healthy patients," he said.

Because flu can progress so quickly, prevention is really the best strategy, Wong said. "And that's why we recommend every child 6 months or older get vaccinated every year," she said.

Because an infant under 6 months of age can't be given flu vaccine, Wong said it is vital that pregnant women get a flu shot to help protect their newborn, and that everyone likely to be near the baby also be vaccinated so they can't pass flu to the infant.

Wong said children who get the flu need to be watched carefully. She recommends getting in touch with the child's doctor when symptoms start.

"That's especially true for kids with high-risk medical conditions and for very young children," she explained. "These children are at especially high risk for flu complications."

Laufer, however, said a phone call to the doctor isn't enough. "It's very difficult for a pediatrician on the other side of the phone to understand how sick the child really is," he said.

Parents should take their child to the doctor or emergency department if they're sicker than what one would expect with a common cold, he said.

"Parents should realize that influenza is much more than sniffles," Laufer added. "A kid with influenza is a kid who is very sick, is a kid who is lethargic, has decreased appetite, is not drinking as much and not urinating as much in addition to other flu symptoms," he said.

Wong added that early antiviral treatment is recommended for high-risk children who develop symptoms of influenza. "That's another thing they can talk to their health care provider about," Wong added.

Antiviral drugs include Tamiflu, Relenza, Symmetrel and Flumadine.

In the study, Wong's group found that of the 794 children whose medical history was known, 43 percent had no medical condition that put them at high risk of dying from flu.

As for children with high-risk medical conditions who died, 33 percent had neurological conditions such as cerebral palsy or seizure disorder, and 12 percent had a genetic condition that put them at risk for flu complications.

Asthma, lung disease, heart disease and cancer can also increase a child's odds of dying from flu, the researchers noted.

Each year in the United States, flu causes an estimated 54,000 to 430,000 hospitalizations and 3,000 to 49,000 deaths, with infection rates highest among children, according to the CDC.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Karen Wong, M.D., M.P.H., medical epidemiologist, U.S. Centers for Disease Control and Prevention; Marcelo Laufer, M.D., pediatric infectious diseases specialist, Miami Children's Hospital; November 2013, Pediatrics

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Many Lupus Patients Forgo Needed Medication, Study Finds

By Amy Norton
HealthDay Reporter

SATURDAY Oct. 26 (HealthDay News) -- Many poorer patients with the autoimmune disease lupus don't take their medications as prescribed, a new U.S. study suggests.

Researchers found that lupus patients on Medicaid -- the public health insurance program for the poor -- were often not sticking with their prescriptions. Over six months, patients picked up enough medication to cover only 31 percent to 57 percent of those days.

The findings are concerning, experts say, not only because lupus drugs can help send symptoms into remission, but because they may also stave off some of the long-term consequences of the disease.

"It's alarming," said lead researcher Dr. Jinoos Yazdany, of the University of California, San Francisco. "These medications have a proven track record of improving patients' outcomes."

The study used pharmacy claims data, so it's not possible to say why people were not taking their medication as prescribed, Yazdany said.

But money could be one factor. Medicaid covers the drugs, Yazdany noted, but even a small co-pay could be a barrier for low-income patients.

Drug side effects could be another issue, Yazdany said, as could a lack of education about the medications. "Some people may not be fully aware of the benefits of these drugs," she said.

Yazdany is scheduled to present the findings Saturday, at the American College of Rheumatology's annual meeting in San Diego.

The most common form of lupus is systemic lupus erythematosus (SLE). In SLE, the immune system attacks the body's own tissue, damaging the skin, joints, heart, lungs, kidneys and brain.

The disease mostly strikes women, usually starting in their 20s or 30s.

Lupus drugs include immune-system suppressors, such as cyclophosphamide (Cytoxan) and tacrolimus (Prograf), and anti-malaria drugs, such as hydroxychloroquine (Plaquenil), which can ease the fatigue, joint pain and skin rash seen in lupus.

Part of the goal is to control symptom flare-ups, including fatigue, fever, joint pain and skin rash. But the drugs can also reduce organ damage that can lead to kidney failure and heart disease.

The study included 23,187 Medicaid patients, mostly women, who were prescribed at least one drug for lupus. Yazdany's team used pharmacy claims to gauge whether patients were sticking with their prescribed regimen.

In general, patients lacked medication for a substantial proportion of the six months. But black, Hispanic and Native American patients were less compliant than white and Asian patients -- with only enough medication to cover a little more than half of the time period. And people living in the Midwest were less compliant than residents of other regions.

Overall, fewer than one-third of all patients had enough medication to cover at least 80 percent of the study period.

Dr. Cristina Drenkard, an assistant professor at Emory School of Medicine in Atlanta, said this finding is "very concerning."

Low-income minorities with lupus are known to fare worse than their white counterparts, and the reasons are probably many, noted Drenkard, whose research focuses on lupus. But it's likely that lesser adherence to drug regimens is one reason, she said.

Drenkard and her colleagues recently published a small study looking at whether a "self-management" program could help low-income black women with lupus. And they found that women who attended workshops at a public clinic were feeling better and doing a better job of taking their medication and generally managing their disease.

"We think self-management support like this is important for people with SLE," Drenkard said.

Still, a program like that would be only one part of the solution, these experts added.

"We need more research to understand what the barriers are to drug adherence, from the patient point of view," Yazdany said.

Another study to be reported at the same meeting underscores the importance of sticking with prescriptions. Researchers found that among more than 1,700 lupus patients in 11 countries, those taking anti-malaria drugs were less likely to show damage to their kidneys, heart or other organs over six years.

Do lupus patients with private insurance do a better job of sticking with their medications? It's not clear, said Yazdany. With Medicaid, there are state databases to comb through, but there is no similar way to study lupus patients with private insurance on a national level.

For now, Yazdany said it's important for all lupus patients to bring any medication concerns to their doctor. If side effects are an issue, she said, your doctor may be able to adjust the dose or switch the medication.

"We have more [drug] options available now than we used to," Yazdany said. "So there's a good chance that something else will work for you."

Data and conclusions presented at meetings are typically considered preliminary until published in a peer-reviewed medical journal.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Jinoos Yazdany, M.D., MPH, assistant professor, University of California, San Francisco; Cristina Drenkard, M.D., Ph.D., assistant professor, medicine, Emory School of Medicine, Atlanta; Oct. 26, 2013, presentation, American College of Rheumatology annual meeting, San Diego

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Too Few Kids Follow Bike Helmet Laws, Study Finds

SATURDAY, Oct. 26 (HealthDay News) -- Helmets are worn by only about one in 10 Los Angeles County children involved in bicycle accidents, despite a state law that requires helmets for riders under age 18, a new study finds.

The findings show the need for new education programs to increase the use of bike helmets, according to the study authors.

The researchers analyzed the medical records of more than 1,200 children, median age 13, who were treated for bicycle accident-related injuries in Los Angeles County between 2006 and 2011.

Overall, just over 11 percent of the children were wearing a helmet at the time of the accident, but there were significant racial/ethnic differences in helmet use. About 35 percent of white children wore helmets, compared to 7 percent of Asian children, 6 percent of black children and 4 percent of Hispanic children, the findings revealed.

The investigators also found that children over age 12 were less likely to wear a helmet and that helmet use was lower among children with public insurance than among those with private insurance (7.6 percent versus 15.2 percent), according to the study presented Oct. 26 at the national conference of the American Academy of Pediatrics (AAP) in Orlando, Fla.

Nearly 6 percent of the children in the study required emergency surgery and the death rate was 0.7 percent. Of the nine children who died, eight were not wearing a helmet.

"Our study highlights the need to target minority groups, older children and those with lower socioeconomic status when implementing bicycle safety programs in Los Angeles County," study author Dr. Veronica Sullins said in an AAP news release.

Research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed journal.

Each year in the United States, bicycle crashes and bicycle-related head injuries cause 150,000 emergency department visits and nearly 400 deaths, according to the U.S. Centers for Disease Control and Prevention.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: American Academy of Pediatrics, news release, Oct. 26, 2013

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'Super-Magnets' Pose Rising Threat to Kids, Study Finds

By Kathleen Doheny
HealthDay Reporter

SUNDAY, Oct. 27 (HealthDay News) -- Powerful "super-magnets" found in adult desk toys and other novelty items still trigger many emergency-room visits after children swallow them, according to a new report, even though some products with these magnets have been recalled.

"These ingestions have increased over the past three to five years," said study researcher Dr. Daniel Rosenfield, a pediatric resident at the University of Toronto and the Hospital for Sick Children, in Canada.

At the hospital, Rosenfield's team looked back at the records involving about 2,700 ingestion incidents from 2001 through 2012. They found that 94 involved magnets, with ingestion of multiple magnets increasing the most in the last three years of the study.

These neodymium-iron-boron magnets became popular about that time, sold in toys, jewelry and other novelty items, including desk toys used for fun and stress relief by adults. These desk toys include magnetic marbles and magnetic sculpting balls.

Rosenfield is scheduled to report the findings Sunday at an American Academy of Pediatrics meeting in Orlando, Fla.

Although recalls are in place for some of these products in both the United States and Canada, many of the items are still in circulation or available online, Rosenfield said. Many parents, as well as teachers and others, remain unaware of the dangers of these magnets, he said.

"The problems with these multiple magnets is, if you ingest more than one at a different point in time, they can attract [each other] across loops of the gut, causing pressure to build up," Rosenfield said.

In the study, the children ranged in age from 7 months to 13 years, but the average age was about 4 years.

In the case of the 13-year-old, Rosenfield said, the teen was trying to mimic a tongue piercing with a stud, and swallowed three magnets.

Six children had to be taken to the operating room to remove the magnets and others had to have them removed by way of an endoscope or tube, according to the study. Others were given laxatives or were observed to see if the magnet passed. No deaths occurred.

Children often ingest the magnets without a parent knowing, Rosenfield said, so parents and doctors should be alert to the possibility of magnet ingestion if a child complains of stomachache without apparent causes. With an abdominal X-ray, he said, ingestion can be detected fairly quickly.

The problem of magnet ingestion is ongoing, said Dr. Cathy Burnweit, chief of pediatric surgery at Miami Children's Hospital. Burnweit reviewed the study but did not participate in it. She said she has often treated children who have swallowed magnets, although coins are what she fishes out most often.

"Sometimes magnets get stuck in the lower throat," Burnweit said. "If they get through there, a solitary item will usually pass into the stool." But the scenario described by Rosenfield also occurs, she said. "If there are two magnets and they are in different places, the loops of bowel will be drawn together and can rupture the intestines," she said. "This can happen within hours to days."

Parents are busy, she said, but more awareness is key. "Be very cognizant of toys, coins and little objects, particularly in the toddler age group," she said. If an object can fit down the diameter of a toilet paper roll, she said, "children have been known to swallow it."

The U.S. Consumer Product Safety Commission held a hearing earlier this month, asking experts to comment on its proposed new rule to prohibit sales of the super-magnet products.

Because the new study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Daniel Rosenfield, M.D., pediatric resident, University of Toronto and the Hospital for Sick Children, Toronto; Cathy Burnweit, chief of pediatric surgery, Miami Children's Hospital, Florida; Oct. 27, 2013, presentation, American Academy of Pediatrics meeting, Orlando, Fla.

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Childhood Gun Injuries, Deaths on Rise in U.S., Study Finds

MONDAY, Oct. 28 (HealthDay News) -- Gunshot wounds put about 7,500 children in the hospital and cause 500 in-hospital child deaths each year in the United States, according to a new study.

And these pediatric shooting injuries and fatalities are increasing, the researchers said.

The analysis of national data also found a significant association between the percentage of gunshot wounds that occur in homes and the percentage of homes with guns, according to the study, which was presented Sunday at the national conference of the American Academy of Pediatrics in Orlando, Fla.

"Handguns account for the majority of childhood gunshot wounds, and this number appears to be increasing over the last decade," study lead author Dr. Arin Madenci said in an academy news release. "Furthermore, states with higher percentages of household firearm ownership also tended to have higher proportions of childhood gunshot wounds, especially those occurring in the home."

Child hospitalizations for gunshot wounds increased from about 4,300 in 1997 to more than 7,700 in 2009, the study found. In-hospital child deaths from gunshot wounds rose from 317 to 503 during that time.

Many current gun-control efforts focus on limiting the availability of military-style semi-automatic assault rifles. "[However], policies designed to reduce the number of household firearms, especially handguns, may more effectively reduce the number of gunshot injuries in children," Madenci said.

Another study presented at the meeting examined the types of injuries among more than 450 gunshot victims younger than age 18 who were treated at an urban trauma center between 2005 and 2010. Of those patients, 78 were younger than 14 years old, 86 percent were male and 80 percent were black. The death rate was 7 percent.

Patients aged 5 to 9 years old were six times more likely than those aged 10 to 14 to have multiple injury sites.

Study author Dr. Phyllis Hendry said further analysis of firearm injury data found that children younger than 14 differ from older teens in several key areas.

"They are four times more likely to be shot at home and are much more likely to arrive by ambulance than by private car or walk-in," Hendry said in the news release, noting that older teens often walk in or get dropped off at emergency-room entrances. "Over 60 percent of the time, the shooter and the type of firearm were unknown."

The researchers said emergency records often lack important details that are needed to help develop effective crime and injury-prevention strategies. They recommend improving the links between emergency medical services, hospital and law-enforcement records.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: American Academy of Pediatrics, news release, Oct. 28, 2013

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Headaches Accompanying Lupus Often Not Disease-Related, Study Finds

MONDAY, Oct. 28 (HealthDay News) -- Headaches are common in people with lupus, but are not linked to disease activity, according to a new study.

Researchers reviewed records for more than 1,700 people with lupus, an autoimmune disease that can damage skin, joints and organs, and looked at the headaches they experienced over a number of years. The investigators found that 18 percent of the patients had headaches at the time of diagnosis, but that proportion increased to 58 percent after 10 years.

Headaches were linked to a lower health-related quality of life, but were independent of treatment specific to lupus and were not associated with disease activity or lupus medications such as steroids, antimalaria drugs, and immune system-suppressing drugs, according to the study published Oct. 28 in the journal Arthritis & Rheumatism.

"While lupus patients with headaches reported lower quality of life, the majority of cases resolved on their own without lupus-specific therapies," wrote lead author Dr. John Hanly, of Dalhousie University and the Queen Elizabeth II Health Sciences Center in Halifax, Nova Scotia, and colleagues.

Prior studies have reported that between 24 percent and 72 percent of lupus patients suffered headaches. This large range may be due to the lack of a uniform definition of headache, Hanly said.

Dr. Michael Lockshin, of Weill Cornell Medical College and Hospital for Special Surgery in New York, said the findings "strongly suggest that lupus headache is not a sign of disease activity, but may be linked to other neurological manifestations." As a result, the current headache criterion in guidelines used to evaluate lupus flares is no longer useful and should be discarded, he writes in an accompanying journal editorial.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: Arthritis & Rheumatism, news release, Oct. 28, 2013

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HIV Patients Get a Mental Lift From Exercise, Study Finds

FRIDAY, Aug. 16 (HealthDay News) -- Regular exercise can give a brain boost to people with HIV, according to a new study.

Trouble with memory and thinking, something doctors call "neurocognitive impairment," affects nearly half of people infected with HIV, the virus that causes AIDS. It can interfere with the ability to do daily tasks such as handling finances, driving and taking medication as scheduled, experts say.

However, the new study suggests that exercise "may reduce or potentially prevent neurocognitive impairment in HIV-infected persons," according to a team led by Dr. David Moore of the University of California, San Diego.

Their study included 335 people with HIV who were asked how much they exercised. They also underwent testing to assess seven brain functions commonly affected by HIV: verbal fluency, working memory, speed of information processing, learning, recall, executive function and motor function.

Those who got regular exercise were half as likely to show signs of impaired mental function as those who did not exercise, according to the study published in the August issue of the Journal of NeuroVirology.

The major benefit of exercise in people with HIV seems to be the reduction of risk factors that can affect the brain such as high blood pressure and abnormally high levels of fats in the blood, Moore said.

The findings add to previous research showing a link between exercise and brain health in people with HIV.

"Physical exercise, together with other modifiable lifestyle factors such as education, social engagement, cognitive [mental] stimulation and diet could be fruitful interventions to support people living with HIV," Moore said in a journal news release.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: Journal of NeuroVirology, news release, Aug. 13, 2013

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One In Six Hospitals Offers Private Services To Boost Income, Finds BMJ Investigation, UK

Main Category: Public Health
Article Date: 17 Jul 2013 - 16:00 PDT Current ratings for:
One In Six Hospitals Offers Private Services To Boost Income, Finds BMJ Investigation, UK

One in six hospitals in England have introduced new private treatment options this year, as cost pressures tighten restrictions on some NHS services, reveals a BMJ investigation today.

This includes a growing number of hospitals offering patients the choice of "self funding" for treatments and services that are subject to restrictions or to long waiting times on the NHS, such as IVF, cataract surgery and hernia repair.

In these cases, treatments are offered at cheaper rates than in the private sector.

The BMJ obtained data from 134 acute hospital trusts in England through freedom of information requests and found that:

119 trusts (89%) now offer traditional private care or "self funded" services21 (16%) added new self funding or private treatment options for 2013-14, and17 (13%) now allow patients to pay for one or more services at notional NHS rates, under the self funding scheme

Providers told the BMJ that the schemes make care more accessible. But critics say that the growth of self funding has muddied the waters between private care and the NHS by creating a two tier system - particularly in combination with government rule changes that allow hospitals to raise up to 49% of funds through non-NHS work.

Hospitals to have introduced new options for patients in the past year include Warrington and Halton Hospitals NHS Foundation Trust for varicose vein surgery, Epsom and St Helier University Hospitals NHS Trust for liver scans, and age related macular degeneration, and Princess Alexandra Hospital NHS Trust in Essex for imaging services and chemotherapy.

Mid Cheshire Hospitals NHS Foundation Trust has also recently begun offering "self funded" cycles of IVF treatment for patients who have used up their NHS funded cycles.

Many trusts that the BMJ contacted said they did not differentiate between "self funded" and "private" care. But John Appleby, chief economist at the healthcare think tank the King's Fund, said that, regardless of price, care was still being funded from patients' own pockets and was driven by cost restrictions.

Critics argue that self funding not only blurs the lines between NHS and private care but could also disadvantage NHS patients because, unlike more traditional private patients, self funding patients are often treated in the same premises as NHS patients.

The lines are arguably being blurred even further by a new scheme from the private provider Care UK, which recently introduced a new self pay option at four of its 11 NHS funded treatment centres across England.

A spokesman for Care UK said self-pay patients "will not be prioritised over NHS patients." But Nicholas Hopkinson, a consultant chest physician in London, said he opposed self funding as it could lead to an "inferior service" for those not paying.

John Appleby believes that, as self pay schemes expand, they should be strictly governed and separated from NHS care to ensure that NHS patients are not being adversely affected.

The Foundation Trust Network, which represents NHS foundation hospital trusts in England, said that most trusts had systems in place to stop paying patients "queue jumping" ahead of NHS patients when being treated in the same facility, and that it expected more treatments to be available to self funding in the future.

But David Hunter, Professor of health policy and management at Durham University, warns that not only could self funding schemes pave the way for "a two-tier or multi-tier system which is both complicated and inequitable," they could also lead to commissioners and providers focusing their energies on more lucrative procedures to raise additional funds.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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