Corticosteroids May Speed Pneumonia Recovery in Some

TUESDAY, May 31 (HealthDay News) -- Patients with an inflammatory lung condition known as community-acquired pneumonia appear to recover faster when treated with corticosteroids in addition to the standard regimen of antibiotics, Dutch researchers say.

Those treated with a combination of corticosteroids and antibiotics also required a shorter hospital stay than patients treated with antibiotics alone, the study authors found.

The observations stem from what is believed to be the largest study to date focused on the potential of corticosteroids for the treatment of community-acquired pneumonia, or CAP.

Dr. Sabine Meijvis, from the St. Antonius Hospital in Nieuwegein, the Netherlands, and colleagues reported their findings in the May 31 online edition of The Lancet.

Meijvis and her team noted that, currently, CAP is typically treated with antibiotics following an early diagnosis.

To explore whether corticosteroids might reduce the risk for complications and fatalities, the team focused on just over 300 Dutch CAP patients. Half of the patients were placed on a standard antibiotic protocol coupled with 5 milligrams a day of the corticosteroid dexamethasone. The other half were given antibiotics plus a placebo (an inactive treatment).

After four days, the research team found that those given the corticosteroid experienced less lung inflammation, and recovered more quickly than those who were just given antibiotics.

The corticosteroid group also required one less day of hospitalization than the antibiotic group (6.5 days versus 7.5 days). In addition, by the end of one month, the corticosteroid group had experienced better "social functioning" relative to the antibiotic group, the investigators found.

"Serious adverse events were rare" among the corticosteroid group, the study team noted in a journal news release, while at the same time cautioning that "the benefits of corticosteroids should be weighed against the potential disadvantages of these drugs, such as superinfections and gastric disturbances."

Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City, said the findings were in line with what he might expect.

"It doesn't surprise me because corticosteroids are used as nuclear anti-inflammatories," he said, noting they might suppress an otherwise lingering fever within 24 hours. "And they would mask a lot of symptoms and make a patient feel generally better whether they're asthmatics or have some inflammatory disease."

"But the downside," he cautioned, "is that we know that corticosteroids are immune-suppressive. And so the possibility exists that when you use them, you could be prolonging the actual recovery time even as you are masking the symptoms, although this study doesn't say that."

This is a potential danger for otherwise healthy people and especially so for those who have high blood pressure or diabetes, he said. "So any medication is a double-edged sword," he added. "And the use of corticosteroids in this case has to be weighed against possible complications."

More information

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

SOURCE: Len Horovitz, M.D., pulmonary specialist, Lenox Hill Hospital, New York City, and Northshore-LIJ Health System; The Lancet, news release, May 31, 2011Copyright

Childhood Cancer Therapies Tied to Gastrointestinal Issues

WEDNESDAY, May 25 (HealthDay News) -- Children who are successfully treated for cancer are at greater risk of developing mild to severe gastrointestinal problems down the road, a new study finds.

Researchers from the University of California, San Francisco analyzed the self-reported gastrointestinal (GI) problems of 14,358 patients who survived at least five years following treatment for cancers such as lymphoma, leukemia, brain tumors or bone tumors.

More than 40 percent experienced some type of GI problem -- including ulcers, esophageal disease, indigestion, polyps, chronic diarrhea, colitis, gallstones and jaundice -- within two decades of their treatment, the investigators found.

Moreover, people diagnosed with cancer at an older age and who had to undergo more rigorous therapy (chemotherapy, radiation, surgery) were more likely to experience long-term GI issues, according to the study in the May issue of Gastroenterology.

About one in 500 young adults in the United States is a survivor of childhood cancer, the study authors noted in a UCSF news release.

"While physicians continue to learn about the long-term consequences of pediatric cancer and its therapy, it is essential that we provide comprehensive follow-up care that appropriately addresses the complications cancer survivors may experience," lead study author Dr. Robert Goldsby, pediatric cancer specialist at UCSF Benioff Children's Hospital and director of the UCSF Survivors of Childhood Cancer Program, said in the news release.

"These are serious issues that can have a real impact on a person's quality of life," Goldsby added.

More information

The U.S. National Cancer Institute has more on childhood cancers.

SOURCE: University of California, San Francisco, news release, May 19, 2011Copyright

Scientists Find Molecular Similarities in Brains of Those With Autism

WEDNESDAY, May 25 (HealthDay News) -- The symptoms and severity of autism vary widely, but new research shows remarkable similarities at the molecular level in the brains of people with the disorder.

Researchers from Los Angeles, Toronto and London analyzed post-mortem brain tissue samples from 19 people with autism and 17 without.

In the healthy brains, researchers saw distinct differences in the gene expression in the frontal lobe vs. the temporal lobe of the cerebral cortex -- differences that help determine the structure and function of the two brain regions.

Specifically, between the frontal and temporal lobes in the healthy brains, more than 500 genes were expressed at different levels. Gene expression is the process by which a gene's DNA sequence is copied into RNA to produce proteins, which perform specific tasks within the cell.

But researchers didn't find those same patterns in autistic brains. Instead, researchers found only eight differences in the gene expression in the frontal and temporal lobes.

"In a healthy brain, the frontal and temporal lobes can be differentiated," said principal investigator Dr. Daniel Geschwind, a distinguished professor of neurology, psychiatry and human genetics at the David Geffen School of Medicine at UCLA. "But in autism we didn't see that. Instead, the frontal lobe closely resembles the temporal lobe."

Many of those regional differences in the cerebral cortex are established during fetal development, researchers added.

The study is published in the May 25 online issue of Nature.

Over the past decade, researchers have discovered lots of gene variants that seem to play a role in some cases of autism, but none of the mutations were present in a large percentage of people with the disorder.

Prior research has also implicated regions of the cerebral cortex, which is highly developed in humans, in autism. The frontal lobe is involved with judgment, language, planning, social cognition and personality, while the temporal lobe is important for language and emotions, Geschwind said.

But this is the first study to show differences in the patterns of gene expression between brain regions. It's those patterns of gene expression that enable the brain to function normally and to communicate properly with other regions of the brain, explained Robert Ring, vice president for translational research for Autism Speaks.

"This study allows us to look at the complexity of what's going on at a molecular level in the brain, a step up from the gene," Ring said. "Here we have the opportunity to really see that the development of normal brain physiology requires differences in the regional activity of gene networks. This report provides evidence that the expected pattern of these differences is absent in autism."

Researchers say the findings may help in the development of medications that target the pathways. "The fact that it's shared says there is some hope of beginning to unwind this and develop some treatments that would target those pathways," Geschwind said.

Compared to the healthy brains, autistic brains had less activity in the genes responsible for neuron function and communication, and a heightened level of gene expression in genes involved in immune function and inflammatory response.

Some of those genes have also previously been implicated in autism, researchers noted.

An estimated one in 110 U.S. children -- including one in 70 boys -- has an autism spectrum disorder, according to background information in the study. Autism affects behavior and impairs the ability to communicate and establish social relationships. Diagnoses have increased tenfold in the past decade.

More information

The U.S. National Institutes of Health has more on autism.

SOURCES: Daniel Geschwind, M.D., Ph.D., distinguished professor, neurology, psychology and human genetics, University of California, Los Angeles; Robert Ring, Ph.D., vice president, translational research, Autism Speaks, New York City; May 25, 2011, online, NatureCopyright

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Study Finds Almost 1 in 5 Young Adults Has High Blood Pressure

WEDNESDAY, May 25 (HealthDay News) -- About 19 percent of U.S. adults aged 24 to 32 have high blood pressure, but many of them are unaware that they have the potentially life-threatening condition, new research reveals.

High blood pressure, or hypertension, is associated with a slew of health problems, including coronary heart disease, heart failure, stroke and kidney failure. The study, funded by the U.S. National Institutes of Health (NIH), found the risk for this condition among young adults is actually greater than previously thought.

Researchers analyzed the blood pressure readings of more than 14,000 young adults who took part in the National Longitudinal Study of Adolescent Health (Add Health).

The findings, published in the current online edition of the journal Epidemiology, are a departure from previous study findings. In the recent U.S. National Health and Nutrition Examination Survey (NHANES), only 4 percent of young adults were found to be hypertensive.

"This fivefold increase in the incidence of high blood pressure in a younger, healthier population is the start of a trend of 'un-health' that we are about to see in our youth," said Dr. Suzanne Steinbaum, a preventive cardiologist at Lenox Hill Hospital in New York City. She was not involved in the study.

"As 30 percent of people are overweight or obese, there is a rise in other issues associated with that, such as diabetes and, now high blood pressure," Steinbaum added. "With high blood pressure happening at this younger age, the chances that we will see heart developing earlier is likely."

The reasons for the difference between the new study findings and those from NHANES is unclear.

"We explored several possible explanations for the difference between this study and NHANES, including participant characteristics, where they were examined and the types of devices for measuring their blood pressure," Kathleen Mullan Harris, principal investigator of the new study, said in an NIH news release. "None of these factors could account for the differences in estimates between the two surveys."

The investigators also pointed out that the proportion of young people who had been previously diagnosed with high blood pressure was similar in both studies: 9 percent for NHANES respondents and 11 percent for Add Health respondents.

Whatever the reason for the disparity, the new data "are a call to action," Steinbaum said. "We need to remind our younger population the critical nature of the role of diet and exercise in staying healthy, and that it must begin as early in their lives as possible or it will have negative effects on their health."

More information

The American Heart Association has more on the prevention and treatment of high blood pressure.

SOURCE: Suzanne Steinbaum, M.D., preventive cardiologist, Lenox Hill Hospital, New York City; U.S. National Institutes of Health, news release, May 25, 2011Copyright

Stroke Patients May Regain Function Just as Easily at Home

WEDNESDAY, May 25 (HealthDay News) -- Home-based exercise managed by a physical therapist is just as effective at restoring stroke patients' walking ability as a formal rehabilitation program using a specialized treadmill, a new study indicates.

The results also defy conventional wisdom that stroke recovery peaks at six months, demonstrating that patients who began rehabilitation even six months after their stroke continued to improve their walking for up to a year.

"It's a fantastic study, rigorously done," said Dr. Richard B. Libman, chief of vascular neurology at Long Island Jewish Medical Center in New Hyde Park, N.Y. "It's incredibly important . . . not to write patients off after a certain period of time has elapsed. Patients have the potential to improve way after the point where we thought they couldn't."

Researchers, calling it the largest stroke rehabilitation study ever done in the United States, randomly assigned more than 400 stroke patients with moderate or severe walking impairments to one of three study groups, two involving "locomotor" training and one involving home exercise. The patients were recruited from inpatient rehab facilities in California and Florida and had an average age of 62. Slightly more than half were men.

All received 36 supervised, 90-minute sessions over a period of 12 to 16 weeks, in addition to usual care.

Those in "locomotor" training attended a formal rehabilitation program where they used a treadmill while wearing a harness that offered partial body-weight support. Following treadmill training, they practiced walking. The early locomotor group started training two months post-stroke; the other locomotor participants began six months after their stroke. For the home-exercise group, a physical therapist focused on enhancing patients' flexibility, range of motion, strength and balance to improve walking ability, starting two months post-stroke.

Study author Pamela Woods Duncan, a professor of community and family medicine at Duke University School of Medicine, said she and her team were surprised to find that patients in the home exercise group did as well as those in locomotor training, which they thought would produce superior results.

Indeed, at the end of one year, more than half (52 percent) of all study participants had improved their walking ability, with similar gains among all three groups. No differences were found among those who had started treadmill training two months or six months after their stroke.

"I think it's an extremely important study," Duncan said. "Those at home had equal outcomes . . . and fewer minor adverse events," such as dizziness and falls.

She and the other researchers also noted that the progressive home exercise program involved less expensive equipment, less training for physical therapists, fewer clinical staff members and better patient compliance.

"Collectively, our results suggest that home exercise is a more pragmatic form of therapy with fewer risks," they wrote.

Libman called the study, published May 26 in the New England Journal of Medicine, "practically revolutionary" for its potential to change standard stroke rehabilitation care.

"I think it's going to change the management of stroke, and third-party payers are going to be extremely interested in the results of the study," he said. "I think it will save a huge amount of money for the healthcare system and be psychologically and emotionally beneficial for patients."

Participants' improvement measurements were based on how well they could walk independently by the end of the study. Severely impaired patients were considered improved if they were able to walk around the inside of a house, while patients already mobile at home were considered improved if they progressed to walking independently in the community.

Not only did the physical therapy patients recover walking ability as well as the locomotor group, they were also less likely to drop out of treatment -- 3 percent vs. 13 percent of the locomotor group.

Minor adverse events, mostly falls, were reported by about 56 percent of participants, with no significant differences among groups. Patients who started locomotor therapy at two months and were severely impaired, however, were more likely to report multiple falls.

Dr. Walter Koroshetz, deputy director of the U.S. National Institute of Neurological Disorders and Stroke (NINDS), said few studies have compared stroke therapies and provided evidence "in such very rigorous fashion."

"So this is probably the tip of the iceberg," he said. "It's precedent-setting . . . with very practical results."

Funding for the study was provided by NINDS and the National Center for Medical Rehabilitation Research.

More information

To learn more about strokes, visit the U.S. National Institute of Neurological Disorders and Stroke.

SOURCES: Pamela Woods Duncan, Ph.D., professor, community and family medicine, Duke University School of Medicine, Durham, N.C.; Richard B. Libman, M.D., chief, division of vascular neurology, Long Island Jewish Medical Center, New Hyde Park, N.Y.; Walter Koroshetz, M.D., deputy director, National Institute of Neurological Disorders and Stroke, Bethesda, Md.; May 26, 2011 New England Journal of MedicineCopyright

CDC Report Shows Bacterial Meningitis Cases on the Decline

WEDNESDAY, May 25 (HealthDay News) -- The incidence of bacterial meningitis dropped by 31 percent between 1998 and 2007, new government research shows.

The drop was led by reductions in infections by two powerful germs -- Neisseria meningitidis and Streptococcus pneumoniae -- that are covered by available immunizations. With fewer infections among young children, the burden of the disease is now mainly borne by older adults, the study authors found.

"The good news is that fewer people are getting bacterial meningitis. The bad news is that if you get it, it's still a very serious infection," said study co-author Dr. Cynthia Whitney, chief of the bacterial respiratory diseases branch at the U.S. Centers for Disease Control and Prevention in Atlanta.

"There are still at least 4,000 cases a year, including about 500 that are fatal," she noted.

Results of the study are published in the May 26 issue of the New England Journal of Medicine.

Bacterial meningitis is a dangerous bacterial infection that causes inflammation of the membranes that cover the brain and spinal cord, according to the CDC.

Signs of meningitis in people over the age of 2 include fever, headache and stiff neck, according to the CDC, while symptoms in newborns and infants can include fever, seizures, constant crying, a bulge in the soft spot on the head and stiffness in the body and neck. Bacterial meningitis can be contagious.

The five types of bacteria that were most responsible for bacterial meningitis in the 1970s and 1980s were Haemophilus influenzae, N. meningitidis, S. pneumoniae, group B streptococcus and Listeria monocytogenes, according to the study.

In the late 80s and early 90s, the incidence of bacterial meningitis dropped by 55 percent, likely because an infant vaccine was introduced in 1990 for H. influenzae type B (Hib).

Since that time, other vaccines have been introduced for strains of N. meningitidis and S. pneumoniae that appear responsible for the shrinking infection rate caused by those germs. The rate of one type of S. pneumoniae decreased by 92 percent during the study period, and the incidence of N. meningitidis dropped by 58 percent.

The findings were based on information from the CDC's Emerging Infections Programs Network, which included eight surveillance sites across the United States. These sites include data on about 17.4 million people.

During the surveillance period between 1998 and 2007, the incidence of bacterial meningitis dropped from two cases per 100,000 people to 1.38 cases per 100,000 people. The average age of those affected increased from 30.3 years to 41.9 years.

The incidence of meningitis was highest among blacks and children under 2 months old throughout the study period, the CDC reported.

In addition, rates of death caused by bacterial meningitis didn't change significantly over the study period. Among adults, those aged 65 or older were most likely to die from the illness.

The youngest and oldest people are typically more susceptible to infections from a variety of causes, but Whitney said that the CDC researchers aren't sure why blacks have significantly higher rates of bacterial meningitis.

Kenneth Bromberg, director of the Vaccine Study Center at the Brooklyn Hospital Center, said it can be difficult to tease out the reasons why certain groups have higher rates of some infections: Is it an inherent susceptibility? Is it an access-to-care issue? In this case, he said he thinks that black people may have a genetic susceptibility to certain bacteria that cause meningitis.

There are three different types of vaccines available for bacterial meningitis. These vaccines don't cover every strain that can cause meningitis, but they do offer protection against many of the common strains. The Hib vaccine, which covers H. influenzae, is part of routine childhood immunizations.

The meningoccocal vaccine (MCV4), which protects against N. meningitidis, covers against a form of bacterial meningitis that is often passed from person-to-person when many people are living in close quarters, such as a college dormitory or military barracks. The CDC recommends the first dose of this vaccine be given at 11 to 12 years old, and then a booster at 16 years old; it's also recommended for certain high-risk children aged 2 through 10. If you're over 16 when you first receive this vaccine, the CDC says only one dose is needed.

The pneumococcal vaccine (called PCV-13 for children and PPSV in adults) is part of routine childhood immunizations. People who are at higher risk of developing bacterial meningitis may receive a booster dose. In addition, people who are over 65, or younger people who have chronic health conditions or a compromised immune system, should also receive this vaccination, as should anyone who smokes or has asthma, despite their age, according to the CDC.

"Public health surveillance like this is exceedingly important in evaluating our public health strategies. It's good to see that the rates of bacterial meningitis are going down, but the death rate has not gone down for those who do have it," noted Bromberg.

"The good news is that we're doing something to prevent bacterial meningitis, and we've made a lot of strides in the past decade. But, physicians and patients need to know that bacterial meningitis still occurs and it is still a deadly serious infection," Whitney said.

Besides getting immunized, Whitney noted that staying healthy and not smoking can help keep your immune system primed to fight off these infections. She said it's also important to note that Listeria is a significant cause of meningitis, and that pregnant women need to be especially careful about the foods that they eat to avoid this infection.

More information

To learn more about bacterial meningitis, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Cynthia Whitney, M.D., M.P.H., chief, bacterial respiratory diseases branch, U.S. Centers for Disease Control and Prevention, Atlanta; Kenneth Bromberg, M.D., chairman, pediatrics, and director, the Vaccine Research Center, The Brooklyn Hospital Center, New York City; May 26, 2011, New England Journal of MedicineCopyright

Daily Four-Drug Combo Pill Halves Heart Disease Risk: Study

WEDNESDAY, May 25 (HealthDay News) -- A cheap, once-daily, four-drugs-in-one medication, dubbed a "polypill," appears to cut users' odds for heart disease and stroke by 50 percent, a new international study finds.

The pill combines two blood pressure-lowering medications with aspirin and a cholesterol-lowering statin and is designed to make all these heart-protecting drugs easy to take, researchers say. That, along with its expected cheap cost, might improve compliance with medication regimens, experts suggest.

"We think the role for the polypill is among those at risk of heart disease, in preventing heart attacks and strokes," said lead researcher Dr. Anthony Rodgers, a professor of global health at The George Institute in Sydney, Australia.

The study was funded by public health agencies in Australia, Brazil, New Zealand and the United Kingdom. India-based drug maker Dr. Reddy's Laboratories supplied the pill but did not play a role in funding.

Rodgers stressed that there are still unanswered questions about the pros and cons of using this type of combination pill versus prescribing several pills, where doses and medications are tailored to individual patients. A trial is ongoing to look at that question, he said.

However, tailoring medications in this area is not as important as it once seemed, Rodgers believes. "We realize now the importance of treating the overall risk. And this

Study Suggests Supplement May Protect Against Preeclampsia

FRIDAY, May 20 (HealthDay News) -- Though a new study suggests that a dietary supplement could lower the likelihood that high-risk pregnant women will develop preeclampsia, the jury is still out over whether it actually works and a specialist recommends that women not try it yet.

Preeclampsia is a pregnancy complication that can boost blood pressure to abnormally high levels, causing hypertension. It affects about 5 percent of first pregnancies.

"Women die of uncontrolled hypertension through stroke or multi-organ failure," said Dr. David Williams, an obstetrician and consultant in maternal medicine at University College London Hospitals, who co-wrote a commentary accompanying the study, which was published online May 19 in BMJ.

"Comprehensive prenatal care and modern medical practice in developed countries makes maternal mortality from preeclampsia a rare event, but it accounts for 20 percent of maternal mortality in many developing countries," Williams explained.

Scientists suspect that low levels of an amino acid called L-arginine could play a role in the development of the disease, and some have wondered whether antioxidant vitamins could lower the risk of the condition.

For the study, researchers in Mexico assigned high-risk pregnant women to one of three groups: 228 ate food bars containing L-arginine and antioxidant vitamins; 222 ate bars with vitamins only; and 222 ate bars that didn't contain the amino acid or the vitamins, considered the placebo group.

After eating the food bars daily from 20 weeks into their pregnancy through delivery, only 13 percent of the women who ate bars with L-arginine plus antioxidants developed preeclampsia; they also were less likely to give birth prematurely. In the vitamins-only group, 23 percent developed preeclampsia, as did 30 percent of women in the placebo group.

"This relatively simple and low-cost intervention may have value in reducing the risk of preeclampsia and associated preterm birth," the study concluded.

But the authors of the accompanying commentary raise questions about possible harmful effects and suggest there needs to be more research to understand "the numerous inconsistent strands of evidence relating to L-arginine and its possible effects on preeclampsia."

Williams said: "We still do not understand the complex, interacting ways in which preeclampsia develops, and it is likely to be different in different women. More work needs to be done to understand the potential of L-arginine with antioxidant vitamins, and at this stage, we do not recommend that this supplementation should be given to women at risk of preeclampsia."

More information

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

SOURCES: David Williams, M.D., consultant in maternal medicine, University College London Hospitals, London; BMJ, news release, May 19, 2011Copyright

Experts Say Cholesterol Screenings Should Start in Childhood

FRIDAY, May 20 (HealthDay News) -- All children should be screened for high cholesterol when they're 9 to 11 years old, according to new guidelines from the National Lipid Association.

The group also urges that children with a family history of premature cardiovascular disease or elevated cholesterol be screened for cholesterol with a simple blood test as early as age 2.

"It's important that people know if a history of high cholesterol runs in their family," Dr. Patrick M. Moriarty, professor of medicine at the University of Kansas Medical Center and an author of the guidelines, said in a news release from the association. "Family discussions can lead to early diagnosis, which is critical because changes in diet and eating habits at a young age can help reduce the impact . . . later in life. Plus, treatment is more effective when started early, before cholesterol deposits in blood vessels become too advanced."

The recommendations are part of new guidelines for the screening, diagnosis and treatment of inherited high cholesterol, or familial hypercholesterolemia, a condition marked by high LDL cholesterol, the "bad" type of cholesterol that blocks arteries. The hereditary condition affects more than 600,000 Americans, according to the association.

"Some estimates suggest that only about 20 percent of patients with

Straight or Gay? Vowels in Speech May Give it Away

FRIDAY, May 20 (HealthDay News) -- For the average listener, the vowel sounds in an unfamiliar voice quickly give away the speaker's sexual orientation, a new study finds.

"I'm not sure what exactly the listeners are responding to in the vowel," study lead author Erik C. Tracy, a cognitive psychologist at Ohio State University, said in a news release from the American Institute of Physics. "Other researchers have done various acoustic analyses to understand why gay and heterosexual men produce vowels differently. Whatever this difference is, it seems that listeners are using it to make this sexual orientation decision."

When hearing an unfamiliar voice at the other end of the phone line, most people instantly judge the stranger's characteristics based on how they speak, and the new study suggests listeners are usually pretty accurate in their determination.

"This is a phenomenon that occurs every day," Tracy said. "We are constantly speaking with people we don't know on our phones, and just from this conversation, we might be able to identify personal characteristics about that person, such as their gender, age, race or sexual orientation."

In order to understand how this process works, Tracy and a colleague focused on one characteristic -- sexual orientation. They asked seven gay and seven heterosexual males to record single-syllable words (including "mass," "food" and "sell") and then played the recordings for listeners. The study participants were then asked to identify the sexual orientation of the speakers when hearing only the first letter sound of those words, the first two letter sounds, or the entire words.

The listeners were unable to determine the sexual orientation after hearing the sound of the first letter in the spoken word, for example, just the "m" sound in the word "mass." But, "when presented with the first two letter sounds

Sleep Disorder Linked to Heart Rhythm Problems

FRIDAY, May 20 (HealthDay News) -- People with an implantable cardiac defibrillator and a breathing disorder that occurs during sleep are at greater risk for potentially deadly heart problems during the night, new research suggests.

An implantable cardiac defibrillator (ICD) is a device that monitors heart rhythm and corrects an abnormal heartbeat with an electrical shock. The new study revealed a significant increase in cases of ventricular tachycardia (a dangerous rapid heartbeat) and ventricular fibrillation (a severely abnormal heart rhythm) among patients with ICDs who also were diagnosed with sleep-disordered breathing.

In the study, published in the May issue of the journal HeartRhythm, researchers in Israel analyzed 45 patients with ICDs in an overnight sleep study and followed them over the course of one year.

Twenty-six of the study participants (57.8 percent) had sleep-disordered breathing, and these patients were more likely to receive what the researchers call "appropriate ICD therapy" -- a shock to correct the heart rhythm.

The risk for ventricular arrhythmias was higher between midnight and 6 a.m. among patients with sleep-disordered breathing, the results showed. The researchers concluded that patients with an ICD who experience nighttime arrhythmias should undergo screening for sleep-disordered breathing.

"Currently, there is limited data available with regard to the predictors of fatal arrhythmias in patients with an ICD," study author Dr. Tawfig Zeidan-Shwiri, of Ramban Medical Center in Haifa, Israel, said in a news release from the Heart Rhythm Society.

"Our study sought to find specific clinical data to help improve the safety and quality of life of patients living with an ICD, and the results indicate that the presence of sleep-disordered breathing should be considered in all patients with appropriate ICD therapy," Zeidan-Shwiri added. "However, more studies are needed to assess whether treatment of sleep-disordered breathing reduces the risk of appropriate ICD therapy."

More information

The U.S. National Institutes of Health has more information on sleep-disordered breathing.

SOURCE: Heart Rhythm Society, news release, May 18, 2011Copyright

Treating Back Pain May Reverse Its Impact on Brain

FRIDAY, May 20 (HealthDay News) -- Treating chronic lower back pain can reverse pain-related changes in brain activity and function, according to a new study.

Prior research has shown that people with chronic pain may experience cognitive problems and reduced gray matter in brain areas that play a role in pain processing and the emotional aspects of pain, such as anxiety and depression. But it wasn't clear if treating chronic pain could reverse those brain changes.

This study included patients who had lower back pain for more than six months and underwent either spinal injections or spinal surgery to treat the pain. MRI scans of the patients' brains were conducted before and six months after their procedures.

"When they came back in, we wanted to know whether their pain had lessened and whether their daily lives had improved. We wanted to see if any of the pain-related abnormalities found initially in the brain had at least slowed down or been partially reversed," study senior author Laura S. Stone, of the Alan Edwards Center for Research on Pain at McGill University in Montreal, said in a university news release.

Brain activity and function did show signs of recovery in the patients after treatment, the researchers found.

The study was published May 17 in the Journal of Neuroscience.

"If you can make the pain go away with effective treatment, you can reverse these abnormal changes in the brain," she said.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about chronic pain.

SOURCE: McGill University, news release, May 17, 2011Copyright

Football Players Urged to Beat the Heat

SATURDAY, May 21 (HealthDay News) -- Football players need to acclimate to hot weather workouts long before they hit the training field in August, an expert advises.

Doing so will help prevent cramps, dehydration and other potentially serious heat-related injuries, according to Dr. David Lintner, chief of the Methodist Center for Sports Medicine in Houston.

Heat-related illnesses have claimed the lives of nearly 40 U.S. football players since 1995. The majority of serious heat illness cases occur during the first four days of summer football practice, according to the American College of Sports Medicine. This is because most players aren't used to the heat, are unprepared for the intensity of practice, and are not used to exerting themselves while wearing equipment.

"If your first introduction to the heat is when you put on your pads and start hitting, you're not going to have the endurance, the strength or the concentration you need to succeed," Lintner said in a Methodist Hospital news release. "Not properly preparing for the heat could set you back three weeks."

He stressed, "Spending all summer indoors is not a good idea," even if players are taking steps to get stronger, such as lifting weights.

"A big part of the summer conditioning process has to take place outside. Whether it's basketball, running or working outside, the body needs time to get accustomed to the heat. If players don't get used to the heat, they open themselves up to serious heat illness and, in more serious cases, death," added Lintner, team physician for the Houston Texans and Houston Astros.

"You can get acclimated to the heat by starting off with 20 minutes a day and gradually work up to an hour. Taking a little time every day will make preparing for the upcoming season much more enjoyable and successful," he said.

More information

The National Athletic Trainers' Association has more about heat illness.

SOURCE: The Methodist Hospital, news release, May 4, 2011Copyright

Keeping Cool in the Heat

SATURDAY, May 21 (HealthDay News) -- As summer approaches and temperatures rise, so does the risk of heat-related illnesses, experts say.

"We are not invincible when it comes to exercise in the heat," said Brendon McDermott, an athletic trainer with the University of Tennessee at Chattanooga and member of the Korey Stringer Institute (KSI) Medical and Science Advisory Board, in a news release from the National Athletic Trainers Association. "In extreme cases, if medical care is not provided in a timely manner, long-term damage and sometimes death can occur."

Among the most common heat-related illnesses:

Exertional heat stroke, a serious and potentially fatal illness that can occur when core body temperature tops 104-105F. Symptoms include seizures and confusion, nausea, vomiting, headache and dizziness. Get immediate medical attention if heat stroke is suspected.Heat exhaustion, which is less serious than heat stroke but still something to take seriously. This results from the loss of fluid or sodium. Symptoms include loss of coordination, dizziness or fainting, headache, nausea and persistent muscle cramps. A person with heat exhaustion should be quickly moved to a cool, shady place. They should also rest with their feet elevated and drink plenty of water. Heat cramps, characterized by intense pain and persistent muscle contractions that continue during and after exercise. Heat cramps are treated by drinking water, resting, stretching and eating foods high in sodium.

To prevent and treat these illnesses before they become serious or fatal, KSI and the National Athletic Trainers' Association recommends that people who are going to exert themselves in the heat:

Allow time for heat acclimatization. Increases in the duration or intensity of physical activity should be gradual. This process can take up to 14 days to complete. Take breaks. Be sure to include adequate rest between exercise regimens.Hydrate. Drink plenty of water or sports drinks before, during and after outdoor activities. Urine that is darker in color is a key warning sign of dehydration.Time it right. Whenever possible, exercise during the early morning or late evening when the temperatures are cooler. Know when to quit. Fever or other pre-existing illnesses can make a person more susceptible to heat related conditions.

More information

The U.S. Centers for Disease Control and Prevention offers additional tips for preventing heat-related illnesses.

SOURCE: National Athletic Trainers Association, news release, May 9, 2011Copyright

Genes Tied to Severity of Cystic Fibrosis Identified

SUNDAY, May 22 (HealthDay News) -- The severity of cystic fibrosis, a life-threatening hereditary condition that affects the lungs and digestive system, seems to be influenced by genetic variations, researchers have found.

"Most cystic fibrosis patients born today live to their mid-30s, but that's an average. Some succumb to the disease before their 10th birthday, while others live into their 50s and we wanted to know why," Dr. Garry Cutting, a professor of pediatrics and member of the McKusick-Nathans Institute for Genetic Medicine at Johns Hopkins, said in a Hopkins news release.

The study, published online in Nature Genetics, used DNA from 3,467 patients -- including unrelated patients from the Genetic Modifier Study out of the University of North Carolina at Chapel Hill, the Canadian Consortium for Genetic Studies out of the University of Toronto, and related patients and their parents from the CF Twin and Sibling Study at Johns Hopkins.

The researchers hope their findings will help extend the life expectancy of people with the disease. "To achieve this goal, we had to work together as one group," Cutting said.

The investigators from all three studies collaborated and analyzed 600,000 sites of variation within the genome in search of common variations that are more frequently associated with severe cases of cystic fibrosis.

The result: The researchers were able to identify a region encompassed by two genes on chromosome 11 linked to severe cases of the disease. A second region on chromosome 20 was also identified. Continued study of this region revealed five genes that are turned on in respiratory cells, some of which are known to cause inflammation.

"We already know which gene causes cystic fibrosis, but to a large extent that gene does not by itself explain how severe the condition will be," explained Cutting. "Now we've discovered new genes that influence the course of disease and may enable prediction of disease severity and, most importantly, the customization of treatments for patients with unfavorable genetic modifiers -- this is the realization of individualized medicine," he added.

The investigators pointed out that further studies are needed to determine exactly how these genes alter the severity of cystic fibrosis.

"Of course we want to continue to push the median life expectancy up so that hopefully patients with more severe cases of cystic fibrosis will, with multimodal therapy, survive longer. And this is the first step toward developing such therapies for these patients," Cutting concluded.

More information

The Cystic Fibrosis Foundation provides detailed information on the symptoms and treatment for cystic fibrosis.

SOURCE: Johns Hopkins Medicine, news release, May 22, 2011Copyright

Blood Pressure Drug Helps Those With Mild Heart Failure

SUNDAY, May 22 (HealthDay News) -- New Swedish research suggests that the drug Inspra reduces the threat of major cardiovascular complications among patients who have a mild form of heart failure.

This latest finding builds on earlier work that was published by the New England Journal of Medicine last fall. That study suggested that Inspra (eplerenone), an aldosterone antagonist, helps control cardiovascular complications among patients with a history of serious chronic heart failure.

Since far more people suffer from mild heart failure, this new finding could mean the drug might benefit a far broader group of patients, the researchers added.

The Swedish analysis makes an even stronger case for the use of Inspra in patients with mild heart failure because, in addition to reducing mortality, it also reduces the incidence of the irregular heart beat condition known as atrial fibrillation, study co-author Karl Swedberg, from the University of Gothenburg in Sweden, said in a news release from the European Society of Cardiology.

Atrial fibrillation "is a condition which both increases morbidity and complicates the care of patients with heart failure," he explained.

Swedberg and his colleagues were slated to present the findings Sunday in Gothenburg at the Heart Failure Congress 2011, organized by the Heart Failure Association of the European Society of Cardiology.

The study team noted that Inspra is currently approved for the control of high blood pressure as well as for the treatment of heart attack patients who experience congestive heart failure. It is not yet approved for the treatment of patients who experience mild heart failure. It is available generically in the United States, according to the news release.

Experts estimate that almost 6 million people in the United States suffer from heart failure.

The current finding stems from a re-analysis of a larger study that involved more than 2,700 heart failure patients being cared for at 278 different health centers.

Focusing specifically on those participants who had experienced mild (class 2) heart failure, the authors found that just 2.7 percent of those patients who were placed on a regimen of between 25 milligrams to 50 milligrams daily of Inspra for a little less than two years experienced atrial fibrillation.

This compared with 4.5 percent of those patients who were randomized to receive a sugar pill instead.

Dr. Byron K. Lee, director of the Electrophysiology Laboratories and Clinics within the division of cardiology at the University of California, San Francisco, noted that exactly how Inspra seems to help heart patients is not well understood.

"It is unclear how eplerenone works to lower the risk of abnormal heart rhythms like atrial fibrillation and atrial flutter," he said. "However, there are many potential mechanisms. One possibility is that eplerenone may help maintain potassium levels. Patients with heart failure are often on high-dose diuretics that remove fluid at the expense of removing potassium. Thats why heart failure patients need to watch their potassium level vigilantly."

More information

For more on atrial fibrillation, go to National Library of Medicine.

SOURCE: Byron K. Lee, M.D., director, Electrophysiology Laboratories and Clinics, division of cardiology, University of California, San Francisco; European Society of Cardiology, news release, May 22, 2011Copyright