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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Violent Video Games Tied to Combative Thinking in Study

By Alan Mozes
HealthDay Reporter

MONDAY, March 24, 2014 (HealthDay News) -- Frequent exposure to violent video games increases the likelihood that children and teens will engage in aggressive behavior themselves, new research indicates.

The study of more than 3,000 children found that habitually playing games such as "Call of Duty" and "God of War" might alter their view of their real-world environment and peers, the researchers said.

"[Violent gaming] basically changes a child's or adolescent's personality in some sense, so that they start to see their world in a more aggressive way," said study co-author Craig Anderson, director of the Center for the Study of Violence at Iowa State University.

"They start to expect people to behave more aggressively toward them, and they tend to see aggressive solutions as being more appropriate for solving problems," Anderson said.

More than 90 percent of American kids play video games, many of which portray violence in a fun framework free of negative consequences, the researchers said. Because of these large numbers, research such as this has significant implications, they said.

Still, parents shouldn't panic, Anderson said.

"Playing a violent video game isn't going to take a healthy kid who has few other risk factors and turn him into a school shooter," he said. "But it is a risk factor that does drive the odds for aggression up significantly."

Anderson said there are many other known risk factors for aggression, such as growing up with parents who are visibly aggressive or living in a violent neighborhood.

The children enrolled in the study, which was published online March 24 in the journal JAMA Pediatrics, came from six primary and six secondary schools in Singapore. All were between 8 and 17 years old, and nearly three-quarters were boys.

For three years, the students were surveyed annually about the time they spent playing video games and about the nature of their favorite games.

In addition, the children discussed their feelings of empathy and aggression, and were asked about any past aggressive behaviors. For example, children were asked if they felt it was OK to respond to certain provocative situations by hitting someone, whether they ever thought about hurting a peer and whether seeing someone else who was upset bothered them.

By stacking violent video game habits up against aggressive thought patterns and behavior, the investigators determined that during the three-year study period kids with a lot of exposure to violent video games were more likely to engage in aggressive behavior.

This link seemed to result from a lasting increase in aggressive thinking, the researchers said. That included a rise in aggressive fantasies, and a growing tendency to attribute hostile motives to others.

The shifts in thinking associated with heavy use of violent games occurred for both girls and boys, even when parents monitored their child's gaming habits. The changes were also found to be independent of a child's initial aggressiveness, the study found.

The researchers also said having feelings of empathy didn't seem to dampen the link between violent gaming and aggression, and the link was seen more or less across all age groups.

The authors said more research is needed to better understand the effects of playing video games that glorify brutality. "[But] at least one major reason aggressive behavior went up in children is because violent video games seemed to increase a child's violent thought patterns," Anderson said.

Richard Gallagher, director of the Parenting Institute at the New York University Child Study Center, said he wasn't surprised by the findings.

"Research data with persons of all ages has consistently indicated that playing violent video games does change attitudes and does possibly alter behavioral tendencies," he said. "And it's looking like it shifts kids to what's considered to be a kind of disturbed and biased thinking."

This is important for people to know in terms of public policy and parenting, Gallagher said.

"These kinds of games are not benign," he said. "They might not cause all kids to get involved with negative and aggressive behavior, but they do push them more in that direction."

Copyright © 2014 HealthDay. All rights reserved. SOURCES: Craig Anderson, Ph.D., distinguished professor, psychology, and director, Center for the Study of Violence, Iowa State University, Ames, Iowa, and past president, International Society for Research on Aggression; Richard Gallagher, Ph.D., director, Parenting Institute, and associate professor, New York University Child Study Center, New York City; March 24, 2014, JAMA Pediatrics, online

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New Therapy May Shrink Enlarged Prostate With Fewer Side Effects: Study

MONDAY, March 24, 2014 (HealthDay News) -- A new noninvasive procedure may bring long-term relief from symptoms caused by an enlarged prostate, a new study suggests.

As men age, the prostate gland grows larger and may begin to press on the urethra. Enlarged prostate affects more than half of men by age 60 and causes symptoms such as frequent urination, weak urine stream and a persistent feeling of having to urinate.

Surgery is the standard treatment for the condition, but can cause complications such as sexual dysfunction and impotence, experts note.

The new treatment is called prostate artery embolization. "Prostate artery embolization is a promising therapy that has been performed outside the United States to improve men's symptoms," explained Dr. Man Hon, chief of interventional radiology at Winthrop University Hospital in Mineola, N.Y.

"This procedure works by closing the blood supply to the prostate," said Hon, who was not involved in the new study. "As a result, the prostate shrinks in size, causes less blockage, and the symptoms improve."

The study was conducted in Portugal and included nearly 500 men, aged 45 to 89, with enlarged prostate -- formally called benign prostatic hyperplasia -- who underwent prostate artery embolization.

Improvements in symptoms were reported by 87 percent of men three months after the procedure, 80 percent after 18 months, and 72 percent after three years. The procedure did not cause sexual dysfunction or impotence, according to the findings, which were slated for presentation on Monday at the annual meeting of the Society of Interventional Radiology (SIR), in San Diego.

"The results of prostate artery embolization (PAE) are similar to surgery but with fewer complications," study author Dr. Martins Pisco, director of radiology at Saint Louis Hospital in Lisbon, said in a meeting news release. "Patients are discharged three to six hours after the treatment with most of the individuals we've treated noting almost immediate symptom relief."

"I believe PAE could eventually become standard treatment for enlarged prostate," he added.

However, Dr. James Spies, president elect of SIR, stressed that further studies are needed before the procedure could become widely available. Also, studies presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

Another expert agreed that more study is needed. Dr. Manish Vira is director of the Fellowship Program in Urologic Oncology at The Arthur Smith Insitute for Urology in New Hyde Park, NY. He pointed out that the Portuguese study was not designed to compare the success rate of embolization to that of other treatments.

However, Vira added that "the results are especially significant given the very low complication rate and no incontinence. If these results are replicated in the ongoing U.S. trials, then prostate artery embolization will become an attractive treatment option" for men with enlarged prostate who have not responded well to other treatments.

-- Robert Preidt
Copyright © 2014 HealthDay. All rights reserved. SOURCES: Manish A. Vira, M.D, director, Fellowship Program in Urologic Oncology, The Arthur Smith Institute for Urology, New Hyde Park, NY; Man Hon, M.D, chief, interventional radiology, Winthrop University Hospital, Mineola, NY; Society of Interventional Radiology, annual meeting news release, March 24, 2014

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Targeted Radiation Might Help Fight Advanced Breast Cancer: Study

MONDAY, March 24, 2014 (HealthDay News) -- A minimally invasive treatment that delivers radiation directly to tumors may slow progression of breast cancer that has spread to the liver, a new study suggests.

The treatment is called yttrium 90 (Y-90) radioembolization. Doctors insert a catheter through a tiny cut in the groin and guide it into the artery that supplies the liver. Radiation-emitting micro beads are then sent through the catheter and float out to kill small blood vessels that feed the tumor.

Researchers led by Dr. Robert Lewandowski, an associate professor of radiology at Northwestern University Feinberg School of Medicine in Chicago, looked at the outcomes of 75 patients. The women ranged in age from 26 to 82, and had chemotherapy-resistant breast cancer that had spread to the liver ("metastatic" disease). Their liver tumors were too large or too numerous to be treated with other methods, the authors noted.

Y-90 radioembolization therapy stabilized 98.5 percent of the treated liver tumors, according to the study, which was to be presented Monday in San Diego at the annual meeting of the Society of Interventional Radiology.

In addition, 24 of the women experienced a more than 30 percent shrinkage in tumor size after treatment, which caused few side effects.

"Although this is not a cure, Y-90 radioembolization can shrink liver tumors, relieve painful symptoms, improve the quality of life and potentially extend survival," Lewandowski said in a society news release.

"While patient selection is important, the therapy is not limited by tumor size, shape, location or number, and it can ease the severity of disease in patients who cannot be treated effectively with other approaches," he added.

Two breast cancer experts were cautiously optimistic about the findings.

According to Dr. Neelima Denduluri, "while these results appear promising, this is a very small retrospective study," meaning that it fell short of the "gold standard" type of prospective trial that tracks patients going forward over time. "Randomized controlled prospective studies addressing this issue are necessary before radioembolization can be incorporated routinely," she believes.

For now, "in women that cannot receive systemic therapy due to toxicities [side effects], are not eligible for clinical trials that utilize new agents, or have exhausted conventional chemotherapy options, radioembolization may be a choice," said Denduluri, a medical oncologist with Virginia Cancer Specialists in Arlington, Va., a US Oncology Network affiliate.

Dr. Stephanie Bernik is chief of surgical oncology at Lenox Hill Hospital in New York City. She said that while this type of therapy has been used to fight liver tumors, "the ability to use this therapy in treatment of metastatic breast cancer to the liver offers some hope to patients with the disease."

Bernik stressed that, right now, the treatment can only extend survival for women with advanced breast cancer, it is not a cure. However, "as the technique is modified and perfected, it is hoped the [treatment] can help achieve remission in women with advanced disease."

Each year in the United States, about 117,000 patients are diagnosed with breast cancer that has spread to the liver. Chemotherapy is the standard treatment in such cases, but is not effective in, or suitable for, all patients.

Experts note that studies presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

-- Robert Preidt
Copyright © 2014 HealthDay. All rights reserved. SOURCES: Neelima Denduluri, M.D., medical oncologist, Virginia Cancer Specialists, Arlington, Va., a US Oncology Network affiliate; Stephanie Bernik, M.D., chief of surgical oncology, Lenox Hill Hospital, New York City; Society of Interventional Radiology, news release, March 24, 2014

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There Is No Safer Football Helmet for Kids: Study

By Dennis Thompson
HealthDay Reporter

MONDAY, Oct. 28 (HealthDay News) -- High-tech helmets and custom mouth guards do not reduce concussion risk for high school football players any more effectively than low-cost helmets or off-the-shelf mouth guards, a new study says.

Neither specific brands nor higher-cost protective gear resulted in fewer concussions among more than 1,300 football players at 36 high schools during the 2012 season, according to a study scheduled for presentation Monday at an American Academy of Pediatrics (AAP) meeting in Orlando, Fla.

"We're certainly not saying that helmets and mouth guards aren't important. They do what they are supposed to do. Mouth guards prevent dental injuries, and helmets prevent skull fractures and scalp and face lacerations," said Dr. Margaret Alison Brooks, the study's lead co-investigator. "But I don't think the manufacturing companies have the data to support [the claim that] if a parent buys a specific model, their child will have a reduced risk of concussion."

About 40,000 sports-related concussions occur in United States high schools every year, the researchers said.

Many manufacturers of football helmets and mouth guards cite laboratory research that their pricey equipment will better cushion impact and reduce players' risk of concussion, said Brooks, an assistant professor of orthopedics and rehabilitation at the University of Wisconsin.

"We were interested in whether we can support the manufacturer claims that more expensive, newer, fancier football helmets really reduce the risk of concussion," she said.

Players involved in the study completed a preseason questionnaire listing their personal statistics and previous injuries. Athletic trainers took notes on all concussions that occurred throughout the year.

The players wore helmets manufactured by three companies: Riddell (52 percent), Schutt (35 percent) and Xenith (13 percent). About 75 percent of helmets were relatively new, having been purchased since 2009.

The study also noted which mouth guards players wore. About 60 percent of players wore generic models provided by schools, while the rest wore models custom-fitted by dental professionals or specifically marketed to reduce the risk of concussions.

During the 2012 season, 115 players sustained a concussion -- about 8.5 percent of all players in the study, the researchers said.

The concussion rate did not vary among players based on the type of helmet worn or the age of the helmet. The helmet brand also made no difference in the severity of concussions, which was measured by the number of days lost from play due to concussion.

"As long as the helmet their child is wearing is in good condition, is properly fit and is worn correctly, then the parent shouldn't feel bad if their child is not in a $400 or $500 helmet," Brooks said.

Players with custom-fitted mouth guards actually suffered a higher concussion rate than those who used generic models.

The realities of both physics and human anatomy make it unlikely that any helmet could better reduce the chances of concussion, Brooks said.

"There's a lot of debate regarding whether you can create a helmet that could reduce concussion risk, given the structure of the skull," she said. "The brain isn't attached to the skull. It's floating freely in spinal fluid. You can dissipate the force of something striking the skull, but you can't reduce the forces that make the brain bounce back and forth inside the skull following impact."

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

Dr. Margot Putukian, director of athletic medicine at Princeton University, said the new study adds further evidence to the questionable ability of helmets to prevent concussions.

"I think the companies are well-meaning and they are trying to develop technology that might reduce impact, but we're not seeing their efforts translate into a reduction in concussion," said Putukian, who was not involved with the study. "There is risk in sports that can't be completely negated by equipment."

Coaches and officials would have a better chance of reducing concussions if they limited contact during practice and taught athletes the proper technique for tackling, study author Brooks said.

"I personally don't have a problem with more emphasis on enforcing rules that limit contact with the head," she said. "You shouldn't be leading with your head. You shouldn't be tackling with your head. We should be teaching kids that the head should not be the leading point of contact."

On Sunday, the AAP released a new report with guidance for pediatricians caring for children and teens who suffer concussions.

The medical group outlined how long kids should stay home after concussions, depending on symptom severity, and recommended using a symptoms checklist. The AAP recommended a collaborative team approach, including the player's pediatrician, family members and certain school staff members.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Dr. Margaret Alison Brooks, assistant professor of orthopedics and rehabilitation, University of Wisconsin, Madison; Dr. Margot Putukian, director of athletic medicine, Princeton University, Princeton, N.J.; Oct. 27 and 28, 2013, presentations, American Academy of Pediatrics meeting, Orlando, Fla.

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Study of Male Birth Defect Lets Pesticides Off the Hook -- for Now

MONDAY, Oct. 28 (HealthDay News) -- Only a weak link exists between pesticide exposure and a common birth defect in baby boys, according to a new study.

Researchers examined the association between hundreds of chemicals used in commercial pesticides and a birth defect called hypospadias, in which the urethral opening on the penis is on the underside rather than on the tip.

This birth defect occurs in about five of every 1,000 male infants, and the cause is usually unknown. Some studies have suggested a slightly increased risk for infants whose parents work around pesticides, but many have found no such link.

"We didn't see many chemicals that suggested an increased risk, and of those that did, most of them were infrequently used," study lead author Suzan Carmichael, an associate professor of pediatrics at Stanford University, said in a university news release.

"It is good news that such exposures are rare, but at the same time, when exposures are rare, it makes studies harder to do," she said.

In the study, researchers compared data from 690 male infants born with hypospadias and nearly 2,200 male infants who did not have the birth defect. The infants were born in California's Central Valley, which has one of the highest rates of pesticide use in the nation, according to the study. The mothers of the children lived fairly close to where pesticides were used.

The researchers found that 15 chemicals used in pesticides had possible associations with hypospadias, but they said further research is needed, according to the study, which was published online Oct. 28 in the journal Pediatrics.

Study co-author Gary Shaw, a professor of pediatrics at Stanford, said the jury is still out on the possible association between pesticides and hypospadias.

"These results extend what we know, but at the end of the day they need to be replicated before we can really be sure whether there is or is not a real risk associated with these chemicals," Shaw said in the news release.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: Stanford University, news release, Oct. 27, 2013

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Study Links Americans' Low Fiber Intake to Higher Heart Risk

FRIDAY, Oct. 25 (HealthDay News) -- People who don't eat enough fiber seem at increased risk for heart problems, and too few Americans are consuming enough fiber, a new study says.

Researchers analyzed data collected from more than 23,000 U.S. adults between 1999 and 2010 and found that low fiber intake was strongly associated with heart disease risk factors such as obesity, inflammation and metabolic syndrome. The syndrome is a group of symptoms that puts people at increased risk for diabetes and heart disease.

Previous studies have found that dietary fiber may help lower blood pressure, cholesterol levels and inflammation. Despite those findings, this new study found that Americans don't have enough fiber in their diets.

Fiber-rich foods include fruits, vegetables, legumes and grains.

The Institute of Medicine -- an independent nonprofit organization that advises the U.S. government on health issues -- recommends 38 grams of fiber a day for men aged 19 to 50 and 30 grams a day for men over 50. The IOM recommends 25 grams a day for women aged 19 to 50 and 21 grams a day for women over 50.

But the average dietary fiber intake among the study participants was only about 16 grams per day, according to the study, which was published in the December issue of the American Journal of Medicine.

The new findings show the need to develop new strategies and polices to increase Americans' dietary fiber intake, study senior investigator Dr. Cheryl Clark, of the Center for Community Health and Health Equity at Brigham and Women's Hospital and Harvard Medical School, said in a journal news release.

The researchers also found racial and ethnic differences. Compared to whites, Mexican-Americans had higher levels of fiber in their diet, while blacks had lower levels.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: The American Journal of Medicine, Oct. 18, 2013

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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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Antibiotic-Resistant Infections Up Among Hospitalized Kids: Study

SATURDAY, Oct. 26 (HealthDay News) -- Hospitalized children are developing antibiotic-resistant staph infections of their musculoskeletal systems in rising numbers, resulting in longer hospital stays, more surgeries and other related complications, a new study finds.

The researchers looked at the number of cases of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA) musculoskeletal infections at a large U.S. children's hospital between 2001 and 2010.

"Methicillin-sensitive" means an infection does respond to treatment by the antibiotic.

During the study decade, there were 111 MSSA and 37 MRSA cases. The proportion of MRSA cases rose from 9 percent in 2001 to 29 percent in 2010, a threefold increase. Compared to those with MSSA, kids with MRSA had longer hospital stays (13 days versus 8 days) and were more likely to have multiple surgeries (38 percent versus 15 percent).

Children with the antibiotic-resistant infections were also more likely to have complications such as blood clots, septic shock, recurrent infection and cell death (22 percent versus 6 percent), according to the study presented Saturday at the American Academy of Pediatrics national conference, in Orlando, Fla.

"As MRSA infections rise, prompt recognition and aggressive treatment of MRSA musculoskeletal infections are critical to avoiding life-threatening complications, and improving patient outcomes," study lead author Eric Sarkissian said in an academy news release.

"Our findings support prior concern about the increased virulence of MRSA compared to MSSA infections," Sarkissian said. "Optimizing patient outcomes will require increased health-care provider vigilance, early broad-spectrum antibiotic administration and aggressive surgical management."

Because this study was 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: American Academy of Pediatrics, news release, Oct. 26, 2013

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Study Ties Y Chromosome Variations to Prostate Cancer Risk

FRIDAY, Oct. 25 (HealthDay News) -- Men with certain inherited variations in their Y chromosome may have a higher risk of prostate cancer, according to a large new study.

Researchers from the University of Utah School of Medicine said the identification of these genetic mutations could help scientists develop tests to determine men's risk for developing the disease and also improve prostate cancer treatments.

In conducting the study, the researchers used the Utah Population Database, which dates back to the 1800s and identifies more than 6.5 million people, spanning 15 generations. The study was narrowed down to 1.25 million men who had at least two parents, four grandparents and six or eight great-grandparents also in the database.

All of the men who did not have a father in the database were labeled as "founders" and assigned a specific Y chromosome identification (YID). Founders' sons, grandsons and great-grandsons also were assigned the same YID. Of these groups, nearly 260,000 had at least two men sharing the same Y chromosome.

The men's genealogical and medical records also were linked to the Utah Cancer Registry, enabling the researchers to determine which of the men developed prostate cancer.

The researchers said that since most of the Y chromosome does not recombine during cell division, it is passed almost entirely unchanged from father to son.

"As a result, each male resident of Utah shares the Y chromosome of his father and his father's father and so on," study leader Lisa Cannon-Albright said in a news release from the American Society of Human Genetics.

"This provided the ability to estimate the risk for prostate cancer in independent Y chromosomes represented in Utah," said Cannon-Albright, chief of the genetic epidemiology division at the University of Utah School of Medicine.

Once the researchers estimated the number of prostate cancer cases expected to occur in each YID group, they compared this estimate to the actual number of prostate cancers.

Focusing on 1,000 YID groups that included between about 200 and 2,300 men, the study revealed the prostate cancer incidence was significantly higher than expected in 73 specific Y chromosome groups.

The researchers said that in one YID group of nearly 9,800 men, they predicted that about 45 prostate cancer cases would have occurred. When they compared their estimate to the state's cancer registry, they found that 65 men in the group had actually been diagnosed with prostate cancer.

A separate group of about 500 men revealed that 26 had prostate cancer. The researchers had estimated, however, that about 10 cases would develop among this group.

Among the men who did not share the Y chromosome of the founder, 39 developed prostate cancer. This rate was not statistically different from the 36 cases of the disease predicted by the researchers, who concluded that there is a Y chromosome-linked risk for prostate cancer that is not seen among men who do not share a common Y chromosome.

The study findings were scheduled for presentation Friday at the American Society of Human Genetics meeting, in Boston. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

-- Mary Elizabeth Dallas
Copyright © 2013 HealthDay. All rights reserved. SOURCE: American Society of Human Genetics, news release, Oct. 25, 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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Moms With Lupus More Likely to Have Children With Autism, Study Suggests

By Serena Gordon
HealthDay Reporter

SATURDAY, Oct. 26 (HealthDay News) -- Women with lupus are twice as likely to have a child with autism compared to mothers without the autoimmune disease, new, preliminary research finds.

However, the overall risk is still low and the findings won't change the management of women with lupus, said one expert.

"I wouldn't tell my lupus patients not to get pregnant," Dr. Yousaf Ali, acting chief of rheumatology at Mount Sinai Hospital in New York City.

The study was undertaken to follow up on earlier, small reports that found that women with systemic lupus erythematosus (SLE) -- the most common form of the disease -- may have an excess risk of having children with an autism spectrum disorder, said lead investigator Dr. Evelyne Vinet, an assistant professor in the rheumatology department at McGill University Health Center in Montreal.

"We identified all women with systemic lupus erythematosus in a Quebec database and matched them to women who didn't have SLE, and we were able to see how many of their children were diagnosed with an autism spectrum disorder," Vinet said.

About 1.4 percent of children born to women with lupus were diagnosed with an autism spectrum disorder, compared to 0.6 percent of children born to women without lupus, the study found. It's important to note that while this study found an association between lupus in women and autism in their children, it wasn't designed to prove that the mother's lupus caused the autism.

Vinet is scheduled to present the findings Saturday at the American College of Rheumatology annual meeting in San Diego.

In lupus, as with other autoimmune disorders, the body's own immune system mistakenly attacks and destroys healthy cells, damaging the skin, joints and other organs. In some cases, the brain and nervous system are affected.

Autism spectrum disorders include a group of neurodevelopmental disabilities that can range from mild, as in Asperger's syndrome, to full-blown autism. Children with autism display social problems, communication difficulties and restricted, repetitive patterns of behavior.

Vinet said research done in mice has suggested that the rogue immune system cells that account for a mother's lupus may react with cells in the brains of her offspring.

The new study included 509 women with lupus who had 719 children and, for comparison, a group of nearly 5,900 women without lupus who had about 8,500 children.

In addition to finding that the incidence of autism disorders was doubled for children of women with lupus, the researchers also found that the autism diagnosis occurred earlier in children whose mothers had lupus. The average age was 3.8 years for children of women with lupus compared to 5.7 years for children of women without lupus.

Vinet said it's not clear why children of women with lupus would be diagnosed sooner. But the researchers hypothesize that the autism in these children may be more severe, or it may simply be that women with lupus are more vigilant about any changes in their children's health.

The researchers also controlled the data to see if pregnancy complications, such as preterm birth, gestational diabetes or being born small for gestational age, would affect the rate of autism in the children. After controlling for these factors, they found the risk of autism was slightly more than twofold for the children of women with lupus.

Ali said it would be important for these findings to be replicated in another study.

The findings shouldn't alarm women with lupus who want to become mothers, he noted.

"Lupus is a disease of young women of childbearing age, and the absolute risk of having children with an autism spectrum disorder is very small," Ali said.

Women who want to start a family should see their doctors ahead of time so they can switch medications before pregnancy if necessary (some aren't considered safe for pregnancy), Ali and Vinet said. They should also wait until their disease has been quiet for at least six months before conceiving, the doctors said.

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: Evelyne Vinet, M.D., assistant professor, McGill University Health Centre, Montreal; Yousaf Ali, M.D., acting chief, rheumatology, Mount Sinai Hospital, New York City; Oct. 26, 2013, presentation, American College of Rheumatology annual meeting, San Diego

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Ultrasound Device May Improve Emergency Stroke Care: Study

FRIDAY, Oct. 25 (HealthDay News) -- The use of a hands-free ultrasound device in combination with a clot-busting drug appears safe for patients with a common kind of stroke, a small, new study finds.

An ischemic stroke occurs when blood flow to the brain is blocked. When this happens, the hands-free ultrasound device is placed on the patient's head and delivers ultrasound to boost the effectiveness of the clot-busting medicine tPA (tissue plasminogen activator).

The new trial was funded by the U.S. National Institutes of Health and was published Oct. 24 in the journal Stroke.

"Our goal is to open up more arteries in the brain and help stroke patients recover," study author Dr. Andrew Barreto, an assistant professor of neurology in the Stroke Program at the University of Texas Health Science Center at Houston, said in a journal news release.

Unlike the traditional hand-held ultrasound device that's aimed at a blood clot, the hands-free version uses 18 separate probes and showers the deep areas of the brain where large blood clots cause severe strokes, the researchers said.

The new study included 12 men and eight women with an average age of 63. The patients had moderately severe ischemic strokes and received tPA within four and a half hours after the start of their stroke symptoms. They also received two hours of exposure to the hands-free ultrasound device.

Ninety days after the combined treatment, 65 percent of the patients had either returned home or were in post-stroke rehabilitation. A quarter of the patients had no stroke-related disability, and one patient had slight disability.

"This technology would have a significant impact on patients, families and society if we could improve outcomes by another 5 percent to 10 percent by adding ultrasound to patients who've already received tPA," Barreto said.

Barreto's team has launched an international study of the ultrasound approach combined with the clot buster, to be conducted in 830 ischemic stroke patients.

Two stroke experts not connected to the study said the device shows promise.

"The potential benefit of this technology is its simplicity and potential for widespread use within primary stroke centers that are the first to see the majority of ischemic stroke patients," said Dr. Jeffrey Katz, chief of vascular neurology at North Shore University Hospital in Manhasset, N.Y.

Katz said that if the data from trials continues to be positive, "we may finally have the first proven adjunct to intravenous tPA that has the potential for mass use because it does not rely on the availability of trained operators or expensive specialized facilities."

Dr. Sampson Davis, an emergency medicine physician at St. Michael's Medical Center in Newark, N.J., added: "Because I am the first doctor to encounter stroke patients, I'm excited about medical technology and thrilled to see such a timely study unfolding."

"Although more research steps are needed, including the aforementioned larger patient size, this project holds promise and is a step in the right direction in treating stroke," Davis said.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCES: Jeffrey Katz, M.D., chief of vascular neurology, North Shore University Hospital, Manhasset, N.Y.; Sampson Davis, M.D., emergency medicine physician, St. Michaels Medical Center, Newark, N.J.; Stroke, news release, Oct. 24, 2013

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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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