Weight-Loss Surgery May Not Lower Death Risk: Study

SUNDAY, June 12 (HealthDay News) -- Weight-loss surgery doesn't decrease the risk of death among severely obese middle-aged adults, a new study says.

U.S. researchers looked at 850 male patients at Veterans Affairs medical centers who had weight-loss (bariatric) surgery between January 2000 and December 2006. Their average age was 49.5 and their average body mass index was 47.4 (a body mass index, or BMI, over 40 is considered severely obese).

The death rate in this group of patients was compared to that of a control group of about 41,000 VA patients (average age 54.7, average BMI 42) who didn't have surgery.

Eleven of the 850 bariatric surgery patients (1.29 percent) died within one month after surgery. Unadjusted analysis of the death rates over a six-year period showed that the bariatric surgery patients had lower death rates than those in the control group, but further analysis showed that bariatric surgery was not significantly associated with reduced risk of death, said Matthew L. Maciejewski, of the Durham VA Medical Center in Durham, N.C., and colleagues.

The study, published online and in the June 15 print issue of the Journal of the American Medical Association, was to be presented Sunday at an AcademyHealth research meeting in Seattle.

Even though bariatric surgery doesn't reduce the risk of death among middle-aged male patients, many of them still decide to undergo the procedure because there's strong evidence that it reduces body weight and obesity-related health problems, and improves quality of life, the researchers said.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about bariatric surgery.

SOURCE: Journal of the American Medical Association, news release, June 12, 2011Copyright

Heart Attack Victims Face Greater Risk of Dying When Ambulances Are Diverted

SUNDAY, June 12 (HealthDay News) -- Heart attack patients whose ambulances are diverted from the nearest ER to another one further away are at greater risk of dying -- not just soon after the heart attack, but for up to a year after the intervention, a new study finds.

Researchers examined data from 13,860 Medicare patients who were admitted to emergency departments for heart attack at hospitals in four California counties (Los Angeles, San Francisco, San Mateo and Santa Clara) between 2000 and 2005. Ambulance traffic was diverted from the nearest emergency department to another hospital on an average of 7.9 hours out of 24 hours.

Compared to patients who received care at the nearest hospital, those whose nearest emergency department were diverting ambulances for 12 hours or more had higher death rates after 30 days (19 percent vs. 15 percent), 90 days (26 percent vs. 22 percent), 9 months (33 percent vs. 28 percent), and one year (35 percent vs. 29 percent).

The researchers also found differences in treatment patterns once patients were admitted to the emergency department. Catheterization rates were 49 percent for patients who weren't diverted and 42 percent for those whose nearest emergency department was sending ambulances to a hospital further away for 12 hours or more.

Rates of percutaneous coronary interventions such as balloon angioplasty or stent placement was 31 percent for patients who weren't diverted and 24 percent for patients who were diverted during a 12-hour period or more.

The study appears online and in the June 15 print issue of the Journal of the American Medical Association, and will be presented at an AcademyHealth meeting.

"These findings point to the need for more targeted interventions to appropriately distribute system-level resources in such a way to decrease crowding and diversion, so that patients with time-sensitive conditions such as

Scientists Identify Genes Linked to Migraines

SUNDAY, June 12 (HealthDay News) -- Researchers have identified three genes linked to migraine headache and found that people who inherit any one of these genes have a 10 to 15 percent greater risk for the condition.

Migraine headache -- an abnormality in the response of nerve cells to stimuli -- is characterized by recurring severe headaches, which often result in nausea as well as sensitivity to light and sound.

In examining genetic data from more than 23,000 women, including over 5,000 migraine sufferers, the researchers found an association between the headaches and variations in three genes: TRPM8 (which plays a role in sensitivity to cold and pain), LRP1 (a gene involved in the transmission of signals between neurons) and PRDM16.

"While migraine remains incompletely understood and its underlying causes difficult to pin down, identifying these three genetic variants helps shed light on the biological roots for this common and debilitating condition," the study's lead author, Dr. Daniel Chasman, assistant professor in the preventive medicine division at Brigham and Women's Hospital and Harvard Medical School, said in a hospital news release.

One migraine expert called the findings "very exciting."

"The thinking for a long time was that migraine is most commonly a multi-genetic condition with potentially many genetic variations that contribute," noted Dr. Audrey Halpern, clinical assistant professor in the department of neurology at NYU Langone Medical Center in New York City. "We clearly understand now that migraine is a condition characterized by disordered sensory processing."

Although the study authors said the findings are encouraging, they noted that more research is needed to better understand exactly how each of these three genes is associated with migraine.

Halpern agreed that much more study lies ahead to unravel the genetics of migraine.

"This current research will help us more fully understand what happens during migraine, but there is also much more to learn," she said. "We've always known it's a genetic condition -- but the last 10 years we've learned it's a neurological condition. This study brings those two ideas together."

The report is published in the June 12 online edition of the journal Nature Genetics.

More information

The U.S. National Library of Medicine has more about migraines.

SOURCES: Audrey Halpern, M.D., clinical assistant professor, department of neurology, NYU Langone Medical Center, New York City; Brigham and Women's Hospital, news release, June 12, 2011Copyright

Meditation May Help Women Cope With Hot Flashes

FRIDAY, June 3 (HealthDay News) -- An easy-to-learn meditation technique can help ease the hot flashes, night sweats and insomnia of menopause, a new study says.

The University of Massachusetts research showed that mindfulness training, based on a Buddhist meditation concept, reduced the distress associated with hot flashes and improved physical, psychosocial and sexual functioning.

"The findings are important because hormone replacement therapy, used to treat menopause symptoms in the past, has been associated with health risks," said study author James Carmody, an associate professor of medicine in the division of preventive and behavioral medicine.

About 40 percent of menopausal women suffer from hot flashes and night sweats, which undermine their quality of life, the researchers noted. But since hormone replacement therapy has been linked with an increased risk of heart disease, breast cancer and stroke, Carmody observed that "not only are women looking for alternative treatments, it is an NIH (National Institutes of Health) priority to find behavioral treatments."

No other treatment has been found to substitute for hormone therapy, according to the study, but mindfulness training appears to allow women to be "less reactive" to menopausal symptoms.

Mindfulness therapy helps focus on the present. Practitioners avoid making judgments and simply accept whatever is passing through their mind while focusing on each breath. The technique is not difficult to learn, but requires some discipline in the beginning, experts noted.

The researchers aimed to influence women's reaction to their symptoms, "including psychological distress, social embarrassment and anxiety."

"We wanted to see if we could affect women's resilience in response to these symptoms," Carmody explained. "We were not trying to affect the symptoms themselves, although there was some effect on those as well."

The study divided 110 women between the ages of 47 and 69 into two groups, one receiving the training, the other "waitlisted" to learn the technique.

Participants filled out questionnaires to determine factors known to influence hot flashes, such as alcohol use, yoga and exercise.

Researchers also measured four dimensions of quality of life: physical, psychosocial, vasomotor (hot flashes), and sexual function. The women rated how much they were bothered by symptoms on a four-point scale ranging from "not at all" to "extremely" bothered. They kept diaries noting the number and intensity of hot flashes and night sweats. On average, the women had five or more moderate to severe hot flashes, or night sweats, a day when the study began.

After taking classes once a week for eight weeks, and a full day of training, the training group women had an average decrease of 15 percent in how much their symptoms bothered them vs. 7 percent for the control group. While hot flash intensity did not differ significantly, the training group reported better sleep, and less anxiety and perceived stress.

At the beginning of the study, which ran from November 2005 to September 2007, participants had "clinically significant" sleep problems. Improved sleep was an important outcome, the study found.

"The thing that surprised us the most was the effect on sleep," said Carmody, noting that mindfulness training was found to be as effective as hormone replacement therapy in reducing insomnia.

Another expert praised the study for using the "mind-body connection" to help women with serious menopause symptoms with "no side effects."

"We've known about the mind-body connection," said Dr. Jill M. Rabin. "We're just beginning to unlock the power of the mind to have an impact on our physiological selves."

The study authors were "self-critical regarding the limitations of the study," said Rabin, chief of the division of ambulatory care and head of urogynecology at the Long Island Jewish Medical Center. Among other things, the study lacked an active control group program, they wrote.

Noting that the women were mostly white and had a high level of education, Rabin said more study was needed to see if the results apply to the general population.

"It's not that the results don't apply, or will be different for a different population," she said. "We just don't know."

The research is published in the June issue of Menopause.

More information

To learn more about mindfulness training, visit University of Massachusetts Medical School.

SOURCES: James Carmody, Ph.D., associate professor, medicine, division of preventive and behavioral medicine, University of Massachusetts Medical School, Worcester; Jill M. Rabin, M.D. chief, Division of Ambulatory Care, head, Urogynecology, Long Island Jewish Medical Center, North Shore-LIJ Health System; June 2011 issue, Menopause: The Journal of the North American Menopause SocietyCopyright

Drifting Pesticides May Endanger People in Nearby Workplaces

FRIDAY, June 3 (HealthDay News) -- People who work near fields sprayed with pesticides face an increased risk for Parkinson's disease, a new study has found.

Not just agricultural workers but teachers, firefighters, clerks and others whose workplaces are near fields in California's Central Valley are at greater risk for the degenerative disorder of the central nervous system, according to researchers from the University of California, Los Angeles.

"This stuff drifts," the study's senior author, Dr. Beate Ritz, an epidemiology professor at the UCLA School of Public Health, said in a university news release. "It's borne by the wind and can wind up on plants and animals, float into open doorways or kitchen windows -- up to several hundred meters from the fields."

The study focused on three pesticides used on the fields: the fungicides maneb and ziram and the herbicide paraquat. The researchers estimated the exposure of 703 people who lived or worked in the area over a 25-year span, taking into account how far they were from the fields sprayed with the chemicals. About half of the people in the study had Parkinson's.

The risk for Parkinson's rose threefold for those who worked near fields sprayed with the three pesticides, the study found. Exposure to just ziram and paraquat raised risk by 80 percent. Earlier analysis by the researchers had found a 75 percent jump in risk for people who lived near fields where maneb and paraquat were sprayed.

The findings suggest that the chemicals act together in increasing the risk for Parkinson's, according to the study, published online in the European Journal of Epidemiology.

"Our estimates of risk for ambient exposure in the workplaces were actually greater than for exposure at residences," said Ritz. "And, of course, people who both live and work near these fields experience the greatest ... risk. These workplace results give us independent confirmation of our earlier work that focused only on residences, and of the damage these chemicals are doing."

More information

The U.S. Environmental Protection Agency offers tips on reducing pesticide risk.

SOURCE: University of California, Los Angeles, news release, May 26, 2011Copyright

Mental Illness Linked to Greater Risk of Death After Heart Attack

FRIDAY, JUNE 3 (HealthDay News) -- People with mental illness are more likely to die following a heart attack or serious cardiac event, a new study finds.

One explanation for this increased risk is that people with mental illness are 14 percent less likely to receive lifesaving treatments for their heart condition, researchers found.

Those treatments included coronary artery bypass graft (bypass surgery) and angioplasty (a procedure to open blocked arteries using a stent), both of which have been shown to improve outcomes for heart patients, researchers said.

The study, published June 1 in the British Journal of Psychiatry, examined 22 published studies that compared the level of care given to those with and without serious mental disorders.

"In 10 studies that specifically addressed care for people with schizophrenia, those with the disease received only half the interventions offered to those without schizophrenia," lead researcher Alex J. Mitchell, of the University of Leicester and University Hospitals of Leicester NHS Trust, said in a news release from the university.

Six studies involving more than 800,000 people found that the risk of death was 11 percent higher in the year after a cardiac event in people with a history of serious mental illness than those without.

"People with known mental health conditions have higher background rates of cardiovascular risk factors such as smoking, inactivity and obesity. We already know that this is reflected in a higher rate of heart disease, but what we demonstrate here is that mortality is greater even after patients come under health care," Mitchell said. "We don't yet know the reason for these poorer outcomes but it is worrying that we also find such patients may receive less frequent lifesaving interventions."

The study authors concluded more research is needed to determine whether patients with severe mental illness are declining treatment or whether physicians are not offering the same level of care to the mentally ill that they offer to their patients without mental disorders.

More information

The U.S. National Institute of Mental Health offers statistics on the prevalence, treatment and costs of mental illness.

SOURCE: University of Leicester, news release, June 1, 2011Copyright

Fit Doctors More Likely to Prescribe Exercise: Study

FRIDAY, June 3 (HealthDay News) -- Medical students who are physically fit are more likely to encourage their future patients to exercise, according to a new study.

Researchers found that medical students who had normal cholesterol levels and who met the current U.S. physical activity guidelines often felt strongly that being active themselves would set a better example for the people they were treating.

In analyzing certain markers of physical health -- such as cardiorespiratory fitness -- and attitudes on physical-activity counseling in 577 medical students over the course of five years, the investigators found that 80 percent of students believed physical-activity counseling would be highly relevant in their future clinical practice.

The study authors, led by Dr. Felipe Lobelo, health scientist with the U.S. Centers for Disease Control and Prevention, pointed out that the students who said exercise counseling was important were in good shape themselves. In fact, they were 1.7 times more likely to exhibit healthy levels of cardiorespiratory fitness and 3.2 times more likely to have normal triglyceride (blood fat) levels than students who didn't believe exercise was as important.

"I'm a strong believer in doctors practicing what they preach, and I think this study illustrates the concept perfectly because it's based on doctors' objective markers of health," Lobelo said in a news release from the American College of Sports Medicine.

"Previous evidence indicates that nearly two-thirds of patients would be more willing to become physically active if their doctors advise it, and these patients find an active, healthy doctor's advice more credible and motivating. It is critical for current and future doctors to understand the public health importance of providing physical activity counseling to every patient," Lobelo concluded.

The findings were scheduled for presentation this week at the annual meeting of the American College of Sports Medicine, held in conjunction with the World Congress on Exercise Is Medicine, in Denver. 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.

More information

The U.S. National Library of Medicine has more on the link between exercise and health.

SOURCE: American College of Sports Medicine, news release, June 2, 2011Copyright