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Heat cramps, heat exhaustion and potentially fatal heat stroke are risks when exercising or playing sports during the summer, but they can be prevented by taking a few simple precautions, advises a Medical College of Georgia expert.

Heat illness occurs when the body loses its ability to cool itself, Tim McLane, a certified athletic trainer at the MCGHealth Sports Medicine Center, said in a news release from MCGHealth. In normal conditions, the body uses sweat evaporation to cool itself during exercise. But hot, humid weather hinders sweat evaporation, which increases the risk of heat illness, he explained.

McLane offered the following safety tips:
During practices or games, alert your coach or trainer if you don’t feel well.
In order to acclimate to hot, humid conditions, gradually boost your workout intensity and duration over 10 to 14 days.
Wearing loose-fitting, light-colored clothing helps disperse body heat.
Limit strenuous exercise to early morning or late evening when temperatures are cooler. If you have to exercise in the middle of the day, limit your intensity and increase the length of your breaks.
Stay in the shade as much as possible.
Don’t take salt tablets — they may help with cramps but do not prevent heat illness.
Monitor your hydration by checking body weight. The ideal way to determine sweat loss is to weigh yourself before and after exercise.

Dehydration — a major risk factor for heat illness — can occur in as little as 30 minutes if you’re exercising in hot, humid conditions, McLane said. Athletes should drink fluids regularly because waiting until you feel thirsty may be too late. By then, you may have already lost about 2 percent of body weight as sweat.

Drink at least 16 ounces of fluid about two hours before exercise and drink at least 7 to 10 ounces of fluid every 10 to 20 minutes during exercise, McLane recommends. After exercise, drink 24 ounces per pound of body weight lost through sweat.

SOURCE: MCGHealth, news release.

Picking the time of day to give birth may not be a choice very many women can make, but it could influence her chances of a smooth delivery, new research shows.

In a study of more than 700,000 births at all Dutch hospitals between 2000 and 2006, researchers found that the risks of newborn death and admission to the neonatal intensive care unit were higher with nighttime than daytime deliveries.

The findings, say the researchers, are in line with trends in other studies not only in obstetrics, but in hospital intensive care units as well.

Overall, the new study found, infants at smaller community hospitals who were born in the evening (between 6 p.m. and midnight) or overnight into early morning (between midnight and 8 a.m.) were 32 percent to 47 percent more likely to die than those born during the day.

Larger medical centers that would see more high-risk pregnancies — so-called tertiary centers – did not have as much of a difference between night and day. At these hospitals, only overnight births – as opposed to evening births — were linked to an increased risk of newborn death.

The findings were similar when the researchers looked at the risk of all adverse birth outcomes together.

But they stress that, in developed countries, serious complications are rare no matter what time of day or night a woman delivers.

“It is very important indeed to realize that risks are generally low and that the level of care in these kinds of Western countries is high,” senior researcher Dr. Eric A.P. Steegers, of Erasmus University Medical Center in Rotterdam, told Reuters Health in an e-mail.

Of the nearly 656,000 singleton births at community hospitals, between 0.05 and 0.09 percent of infants died during or soon after birth. Rates were higher among infants born at tertiary hospitals, but were still less than 1 percent.

It’s possible, Steegers said, that the increased risks reflect the fact that fewer senior staff members — including obstetricians, neonatologists and anesthesiologists — are available during night shifts.

Supporting that idea, the researchers found fewer infant deaths and complications at community hospitals when senior staff were present. At night, when such staff are at home on call, less experienced doctors may be making the initial decisions on how to manage high-risk situations.

Steegers said that more research is needed, however, to understand the extent to which hospital organization plays into the higher risk of childbirth complications at night.

It’s also possible that staff fatigue is a factor, since night-shift work is at odds with the body’s natural rhythms. But unfortunately, naps don’t seem to do the trick: It may take up to half an hour for sleepy minds to get back up to speed after a slumber, the researchers note.

Even if organizational factors at hospitals do explain the higher nighttime risks, Steegers said, it is not clear whether revamping the system would eliminate those risks.

For example, he noted, it might be possible to have senior staff available 24 hours a day if there were fewer hospitals providing obstetrics care. But fewer centers could well mean that some women would be delayed in getting to the hospital, which could increase the odds of complications.

SOURCE: http://www3.interscience.wiley.com/journal/123467987/abstract

Older men and women with lower levels of vitamin D in their blood are more prone to become depressed over time, new research shows.

Many studies have been published recently on the potential health benefits of vitamin D, and the potential risks of deficiency. Low vitamin D levels have been linked to heart disease, stroke, high blood pressure, and more severe asthma.

In older people, insufficient vitamin D is quite common, and has been linked to fractures, worse physical function, greater frailty, and a wide variety of chronic illness.

In the current study, Dr. Luigi Ferrucci of the National Institute on Aging in Baltimore and colleagues looked at whether low vitamin D levels and depression in older people might be related.

They followed 531 women and 423 men 65 and older who were participating in the InCHIANTI Study, a long-term investigation of factors associated with loss of mobility in aging people, over six years.

At the study’s outset, 42 percent of the women and 18 percent of the men were depressed, while three-quarters of the women and half of the men had levels of vitamin D below 50 nanomoles per liter, which is generally considered insufficient.

Seventy-two percent of the depressed people and 60 percent of the non-depressed people had vitamin D insufficiency – the level above deficiency — the researchers found. Women with vitamin D insufficiency showed a worse decline in mood at three and six years into the study; their scores on a standardized test measuring depressive symptoms increased more at three and six years compared to the scores for women who had adequate vitamin D. This increase could have tipped the scale into a diagnosis of depression for some people.

Women with low vitamin D who weren’t depressed at the beginning of the study were also twice as likely to become depressed over the following six years as the women who had sufficient levels of the nutrient. While similar patterns were seen for men, the association wasn’t as strong, and in some cases could have been due to chance, according to the researchers.

The study does not prove that low vitamin D levels cause depression, the authors note; people with low levels of the nutrient might have other characteristics that predispose them to the blues.

Still, they suggest that preventing “vitamin D deficiency in the elderly may become in the future a strategy to prevent the development of depressive mood in the elderly and avoid its deleterious consequences on health. In addition, normalization of vitamin D levels may be part of any depression treatment plans in older patients.”

Vitamin D, produced by the body when skin is exposed to sunlight, is also found in certain foods such as oily fish. It helps cells absorb calcium and is important for bone health.

However, the authors conclude, before any strategies to boost vitamin D can be adopted they must be tested in larger and more rigorously designed trials.

SOURCE: http://jcem.endojournals.org/cgi/content/abstract/jc.2010-034 7v1 Journal of Clinical Endocrinology and Metabolism.

Men who are six feet tall or taller may have a higher risk of blood clots in their veins than do their shorter counterparts, while height does not seem to have an impact on women’s risk, a new study suggests.

The blood clots, known as venous thromboembolisms, include clots in the deep veins — usually in the legs — and pulmonary embolism, a potentially fatal condition that occurs when a deep-vein blood clot travels to the lungs.

Certain situations can lead to clots in some people, such as being immobilized after surgery or taking a long-haul flight. There are also lifestyle-related factors, such as obesity and smoking, which can leave a person more vulnerable to the blood clots.

Some studies have found a correlation between height and clot risk, with greater height equaling greater risk. But those studies have only included men.

In the new study, of nearly 27,000 Norwegian adults followed for 12 years, researchers confirmed an association between height and clots among men, but found no similar pattern among women.

Overall, the tallest men — those who were taller than 181 centimeters, or roughly 6 feet — had double the clot risk of men who were shorter than 173 centimeters, or 5 feet, 8 inches. That was with factors such as weight, smoking habits and diabetes taken into account.

The findings, reported in the American Journal of Epidemiology, do not prove that greater height itself is a risk factor for clots.

The researchers accounted for a number of factors that could have explained the link, but there may be other variables at work that were unmeasured in the study, according to lead researcher Dr. Sigrid K. Brakken, of the University of Tromso in Norway.

However, Brakken told Reuters Health by email, it is plausible that taller height could affect the odds of blood clots in the veins — due to what’s known as “venous stasis,” or slowed blood flow in the veins, particularly those of the legs. That slower flow increases the potential for blood clotting.

The reason the association is seen only in men, according to Brakken, is likely because fewer women are tall enough for their height to affect clot risk.

The findings are based on data from 26,727 Norwegians between the ages of 25 and 96 who were followed for 12 years. During that time, 462 developed a first-time clot; they were often related to specific causes, like surgery, trauma or medical conditions such as cancer — but in 42 percent of cases, there were no such “provoking” factors.

Among men who stood at six feet or taller, there were 1.68 clots per 1,000 men per year. That compared with a rate of 0.84 per 1,000 men per year among those who were shorter than 5 foot 8.

When the researchers accounted for weight and several other factors that affect clot risk, the tallest men still had double the risk of the shortest men.

If further research confirms that greater height is a risk factor for clots, Brakken said, it could help identify those people who need to take steps to prevent the blood clots.

Not smoking, losing excess weight and getting regular exercise are among the ways to lower clot risk.

Moderate drinking cuts heart disease risk in younger adults, new research shows.

However, young adults are at low risk for heart disease, the researchers point out in the journal Circulation, “and the beneficial effects obtained by a moderate alcohol intake may be negligible compared with the increased risk of, for instance, traffic accidents and cancer.”

Moderate drinking — typically defined as a drink or two a day — can be heart healthy in older men and women, although heavy drinking does not protect the heart, and carries many other health risks.

Because heart disease is so rare in men under 40 and women under 50, it has been difficult to study the effects of alcohol consumption on heart disease risk in these younger individuals.

To address this problem, Dr. Alberto Ascherio of the Harvard School of Public Health in Boston and colleagues pooled data from eight studies from North America and Europe that included over 192,000 women and nearly 75,000 men. The men’s average age was around 50, while the average age for women was 54. At the study’s outset, all of the participants were free from cardiovascular disease, and all had reported their alcohol drinking habits.

Overall, Ascherio and his colleagues found, consuming 30 grams of alcohol a day (about two or three standard drinks) reduced women’s risk of developing heart disease by 42 percent, and cut men’s risk by 31 percent. When the researchers broke the study participants into three age categories — those 50 and under, those 50 to 59, and people 60 and older — they saw the same pattern of reduced risk with moderate drinking in each age group.

Given that the risk of heart disease is so low in younger people, Ascherio and his colleagues say, the protective effects of alcohol are likely to be stronger in older people at higher risk of heart problems. However, all possible health risks of alcohol need to be taken into account when developing guidelines on alcohol consumption for people of different ages, they conclude.

SOURCE: Circulation

Screening women for breast cancer does not appear to increase overall survival from the disease, a new study finds.

The increased survival rates may instead be due to controlling risk factors and improved treatments, the researchers suggest.

“Mammography screening is not as good as we hoped years ago,” said study author Dr. Karsten Jorgensen, a researcher at the Nordic Cochrane Centre in Copenhagen, Denmark.

“It is questionable if it saves women from dying from breast cancer, but we are certain that it has serious harms such as overdiagnosis and overtreatment of lesions that would otherwise never have caused problems, unnecessary recalls with long-term psychological consequences, and unnecessary biopsies and worries,” Jorgensen added.

The report is published in the March 24 online edition of the BMJ.

For the study, Jorgensen’s team compared the changes in death rates from breast cancer in two Danish screening programs with areas in Denmark that do not screen women for breast cancer. They looked at the 10-year period after screening would be expected to have an effect on breast cancer deaths and compared that with the 10-year period before screening was started.

In addition, they looked at three age groups: women aged 55 to 74, who would benefit from screening; women aged 35 to 55, who were too young to have benefited from screening; and women aged 75 to 84, who were too old to have seen an effect from screening.

“In the age group that could benefit from screening mammography, breast cancer mortality in Danish regions that did not offer mammography screening decreased similar or more than in those regions that did [offer mammography],” Jorgensen said.

Jorgensen’s group found among women aged 55 to 74, breast cancer deaths dropped by 1 percent per year in the screened areas, compared with 2 percent per year in the non-screened areas. Among women aged 35 to 54, deaths from breast cancer dropped by 5 percent per year in the screened areas and 6 percent per year in the non-screened areas. For women aged 75 to 84, there was no significant change in breast cancer mortality either with screened or non-screened areas, the researchers noted.

“The decline in breast cancer mortality began years before the mammography screening program did, and the declines in breast cancer mortality were much larger in age groups too young to benefit than in the age groups that could,” Jorgensen said. “The absence of an effect of screening mammography in population statistics is clearly contrary to expectations, and our findings speak against screening mammography being effective.”

So, it is not clear-cut that mammography screening saves lives, Jorgensen said. The same researchers reported previously in the same journal that one of three breast cancers detected by mammograms never cause a problem, possibly regressing on their own without treatment.

“Similar to our study, breast cancer mortality in the U.S. has declined much more in women below 50 years than in women over 50 years, where the expected effect and screening coverage is larger. It is time to dare to ask the critical questions about screening mammography that has been avoided for many years. We may not like what we find, but it is the only right thing to do,” Jorgensen said.

However, Robert Smith, director of cancer screening at the American Cancer Society, couldn’t disagree more with that conclusion.

“The main problem with their analysis is that it is over a short period of time, and they are not able to isolate deaths attributable to cases diagnosed in the pre-screening period,” he said.

Mammography does save lives, Smith said. The ability to diagnose breast cancer early is a major reason the deaths from breast cancer have declined, he said.

Smith agrees that prevention strategies and better treatment have also saved the lives of women with breast cancer. “But they pale to the contribution of screening,” he said.

SOURCES: Karsten Jorgensen, M.D., Nordic Cochrane Centre, Rigshospitalet Department, Copenhagen, Denmark; Robert Smith, Ph.D., director, cancer screening, American Cancer Society, Atlanta; BMJ, online