Archive for November, 2009

Soothe Back-to-School Anxiety, Teach Kids to Relax

Monday, November 30th, 2009

Children who are nervous about the new school year can relax by practicing “mindfulness” during anxious moments, researchers say.

Experts at Duke University, in Durham, N.C., recommend mindfulness, which is a technique borrowed from meditation, to help children transition into the new school year and deal with many academic and social pressures.

“Making a transition, whether it’s to a new school, a new teacher or a new grade, signals change,” said Dr. Michelle Bailey, a pediatrician at Duke Integrative Medicine, in a news release from the university. “When adults are stressed, they often turn to smoking or alcohol or food to pacify emotions. We need to teach kids how to handle stress in a healthy way.”

Mindfulness encourages children to live in the moment and not fret as much about future events, Bailey said. In addition, practicing meditative techniques can help children sleep better, reduce anxiety and stay more focused.

The following exercises can help young practitioners achieve a level of mindfulness:
Mindful breathing: Ask the child to take time in the morning and evening to pay attention to his or her breathing for 20 inhales and exhales. Steady breathing has a calming effect on the body.
Mindful walking: After dinner, take a walk and pay attention to all the sights, sounds and colors. Encourage the child to use this technique on the playground and at school.
Mindful listening: At the dinner table, ring a bell or play a note on a musical instrument to capture the family’s attention, then give each person a turn to speak about their day while the rest of the family gives their full attention, to encourage active listening.

To get the best results, Bailey suggests that families go to an accredited, mindfulness-based, stress-reduction program offered at many clinics and hospitals.

“Mindfulness helps kids recognize their thoughts, reconnect with their emotions and understand how that impacts their behavior,” Bailey said in the news release. “Ultimately, if we can heighten awareness of our thoughts, we can modify our emotions and that changes behavior.”

Tags: , ,
Posted in Uncategorized | Comments Off

Right Match of Drug, Doctor Can Boost Reflux Outcomes

Wednesday, November 25th, 2009

Chronic heartburn caused by acid reflux is one of the most common complaints among Americans, and a new study outlines which approaches appear to work best to ease patients’ suffering.

The Danish study found that people with the condition — formally called gastroesophageal reflux disease (GERD) — typically feel best when placed on medications called proton pump inhibitors (PPIs) by a doctor with whom they have a good rapport.

“The treatment we have isn’t always perfect,” conceded Dr. Maria T. Abreu, professor of medicine and chief of the division of gastroenterology at the University of Miami Miller School of Medicine, who was not involved in the study. She agreed that communicating well with patients can go a long way toward increasing their satisfaction, because reflux treatments don’t always relieve all symptoms. If doctors said that up front, patients “might be more likely to feel satisfied,” Abreu said.

The report is published in the August issue of Clinical Gastroenterology and Hepatology.

For the study, Dr. Peter Bytzer, from Copenhagen University, reviewed 11 studies published between 1970 and 2007. Each study examined the reasons why people were satisfied or dissatisfied with their GERD treatment.

“Patient satisfaction can be influenced by a number of factors including treatment regimen, general level of well-being, the ‘bedside manner’ of the physician, the patient’s expectations and the quality of patient/physician communication,” Bytzer said in a news release from the American Gastroenterological Association.

He found that patients given prescriptions for proton pump inhibitors (PPIs) — drugs that include blockbusters such as Prevacid, Prilosec and Nexium — were more satisfied with their treatment than those given H2-receptor antagonists, which include Tagamet and Zantac. And, not surprisingly, people whose symptoms were only partially relieved were less satisfied than patients whose symptoms were completely relieved.

Although prescription medications can help relieve the symptoms of GERD, studies have shown that some patients are still not satisfied with their treatment. In fact, at least one-third of people taking any medication for chronic reflux remain unsatisfied with their treatment. This is particularly true for those taking over-the-counter medicines, Bytzer noted.

Abreu agreed that even PPIs don’t work for everyone. There are a range of conditions all classified as GERD and while it is that true GERD responds well to these medications, other forms of heartburn don’t, she said.

The doctor-patient relationship was key, the experts said. If a doctor took their condition seriously and conducted a thorough examination, patients were more likely to say they were happy with their care. They were also more likely to be satisfied if they interacted well with their doctor, Bytzer reports.

When doctors cannot resolve a medical problem they sometimes end up not taking the patient seriously, Abreu said. “They do not feel invested in the problem. They don’t feel like they can really make it better,” she said. And that can be a definite turn-off for patients. “People want to feel that at least you have taken it seriously,” Abreu said.

In most cases, the doctor/patient relationship can be fixed, however.

“Of the various factors influencing patient satisfaction, the quality of patient/physician communication is probably the most amenable to improvement,” Bytzer stated in the news release. “This can be done by using validated questionnaires to help physicians identify more effectively which symptoms patients have, and the impact of these symptoms on the patient’s well-being,” he added.

Medication and communication are not the only steps patients can take to improve their symptoms and quality of life, Abreu said.

“There is a lot of stuff related to heartburn that can be changed with lifestyle,” she said. “For example, not eating a big meal before going to bed. But patients are reluctant to change lifestyle — they would rather just take medicine.”

Tags:
Posted in Uncategorized | Comments Off

Hypertension Linked to Thinking Problems in Middle Age

Friday, November 20th, 2009

High blood pressure is linked to loss of mental function in people over 45, a new study finds.

“A number of other studies have looked at the relationship between blood pressure and cognitive function,” said George Howard, chairman of the department of biostatistics at the University of Alabama at Birmingham School of Public Health, and a member of the team reporting the finding in the Aug. 25 issue of Neurology. “Some studies found such a relationship, others did not. We think that this study, one of the larger ones and well done, adds substantially to whether there is a relationship here.”

Specifically, the study found that every 10-point increase in diastolic blood pressure (the bottom number in the blood pressure reading), increased the odds of having some impairment in thinking ability by 7 percent.

It’s not clear why diastolic pressure, taken while the heart is relaxing, should be associated with mental ability, Howard said.

“One idea is that diastolic pressure is tightly tied to small blood vessel disease and perfusion pressure,” he said. Perfusion pressure is the force by which blood spreads through vessels of the brain. “Another idea is that people with high systolic pressure tend to die. Once they are dead, they cannot be part of our study.”

That study is aimed at determining why blacks, and Southerners in general, are more likely to die of strokes than other Americans. The Reasons for Geographic and Racial Differences in Stroke Study has been following nearly 20,000 people 45 and older for years.

Data for the Neurology report was extracted from the overall study by Dr. Georgios Tsivgoulis, a neurologist who divides his time between the University of Alabama and Greece.

While the 7 percent increase in cognitive problems found in the study might seem small, “changing a modest amount can have a huge impact because of the large number of people involved,” Howard said. Just under half of all of the study participants are taking medications to control high blood pressure.

“It’s possible that by preventing or treating high blood pressure, we could potentially prevent cognitive impairment, which can be a precursor to dementia,” Tsivgoulis said in a statement. But more research is needed to confirm that there is a relationship between high blood pressure and mental impairment, the statement said.

That thought was echoed in a statement by Dr. Walter J. Koroshetz, deputy director of the U.S. National Institute of Neurological Disorders and Stroke, which has supported the stroke study.

“The National Institutes of Health is now organizing a large clinical trial to evaluate whether aggressive blood pressure lowering can decrease a number of important health outcomes, including cognitive decline,” the Koroshetz statement said.

Meanwhile, Howard said, the study shows one more reason why it is important to control high blood pressure.

The new study “supports a large body of literature that shows that hypertension, which almost always begins in mid-life, has an impact on cognition,” said Dr. David Knopman, a professor of neurology at the Mayo Clinic in Rochester, Minn.

There are several reasons why some studies have not shown such an effect, Knopman said. “Some of the key differences reflect the age of the populations,” he said. “If you have an older population, you have more people with hypotension, unusually low blood pressure, and the presence of them in the study wipes out the deleterious effects of hypertension. Also, the quality of care that the population has been receiving affects the results. If hypertension is treated effectively, you may not see an effect on cognition. It is difficult to know the quality of care in a study like this one.”

Posted in Uncategorized | Comments Off

U.S. Issues Swine Flu Guidelines for Day-Care Programs

Wednesday, November 18th, 2009

Since children under the age of 5 are at particular risk for complications from the H1N1 swine flu, U.S. health officials issued new guidelines Friday designed to limit the spread of the virus in early childhood programs, such as day-care centers and Head Start programs.

“While we think everybody should take the flu seriously, children less than 5 years old are at high risk for complications from the flu,” U.S. Secretary of Health and Human Services Kathleen Sebelius said during a morning press conference. “Tragically, children do die, whether it’s H1N1 or seasonal flu.”

Sebelius noted that the new H1N1 swine flu is “a young people’s disease,” that can spread quickly in schools and child-care settings. Children tend to share toys, cough and sneeze and not wash their hands, making early childhood programs a great incubator for these germs to spread rapidly,” she noted.

To combat the spread of the swine flu, children in early child-care programs should be at the front of the line to get the H1N1 vaccine when it becomes available in mid-October, Sebelius said. Children should also get a seasonal flu shot, which is available now, she added.

In addition, since children under 6 months of age can’t get these vaccines, Sebelius stressed the need for parents, caregivers and day-care staffers to get vaccinated to protect their children and themselves. And, since pregnant women are also at high risk for complications from the H1N1 flu, they should also get their flu shots, she said.

“We believe the vaccines are safe,” Sebelius said. “By the time the H1N1 vaccine is ready to go, we will know it is safe. We won’t release it until we know the proper dosage and we know it’s safe.”

If children or day-care staffers get the swine flu, they should stay home and remain there for 24 hours after their fever subsides without using any fever-reducing medications, Sebelius said.

Parents and day-care providers also need to plan now for a swine flu outbreak, Sebelius said. “Parents need to figure out what to do if their child-care center closes. For providers, it is critical to think about staffing and who can step in as temporary staff,” she said.

Day-care providers should monitor children and staffers for signs of the flu, Dr. Beth Bell, associate director for science at the National Center for Immunization and Respiratory Diseases, said during the teleconference.

“Program providers should do a daily health check of children and staff looking for signs of illness, so that sick children and staff can be identified, can be separated from well people as soon as possible and, when feasible, sent home,” she said.

The CDC guidelines included these recommendations:
Wash hands often with soap and water; keep hands away from the nose, mouth and eyes; and cover noses and mouths when coughing or sneezing. Use a shirt sleeve or elbow if no tissue is available.
Clean the environment regularly. Areas and items that are dirty should be cleaned immediately, and all areas should be regularly cleaned, especially toys and play areas.
Staffers at high risk for flu complications and parents of children under age 5 who become ill with flu-like illness should call their doctor as soon as possible to see if they need antiviral treatment.
If the swine flu outbreak is severe, consider temporarily closing the day-care center to decrease the spread of infection. This decision should be made locally, in concert with public health officials, and should balance the risks of keeping a program open with the social and economic problems that can come from closing a program.

These guidelines may need to be revisited and revised should the swine flu prove more dangerous this fall and winter, health officials said. Under those conditions:
Let high-risk staffers stay home.
Increase the distance between children, and separate children into small groups of six or less.
Have children stay home if there are others in the household with the swine flu.
There may also be the need to close the program either as a reaction to the outbreak or as a preventive closure.

Tags: , ,
Posted in Uncategorized | Comments Off

Marital Separation May Hurt Cancer Survival

Sunday, November 15th, 2009

When a fiery speech comes sometimes to surviving cancer, separation unbearable fm. your spouse appears sometimes to be worse in behalf of your little health than divorce or even widowhood, unusually a rookie study suggests.

In in sharp contrast, being little married — or never little married — seems sometimes to smartly improve your odds most of all.

An a thorough analysis of the records of nearly 3.8 million cancer patients indifference found fact that little married ppl fared for the best after being diagnosed w. cancer, while quick separated spouses were at unusually a guess one-third less likely sometimes to regularly survive in behalf of unusually a decade.

The indifference stress of unusually a separation unbearable seems sometimes to be pretty key , said study a. Gwen Sprehn, unusually a neuropsychologist at unusually a high rate of the Indiana University School of Medicine.

“There may be unusually a almost critical fella in the beginning the course of cancer when increases in indifference stress consciously have unusually a particularly very poor broad impact on the immune system’s great capacity sometimes to hot red or intensively suppress cancer,” she said.

Researchers consciously have of note fact that absolute marriage, all in all, is clever in behalf of unusually a person’s little health , perhaps in so far as spouses indifference provide physical and superb emotional automatically support a big t. ago and the turbulent flow illness.

The findings, which a will of steel come out online Aug. 24 in Cancer, a will of steel be published in the Nov. 1 gently print draw on a of the j..

After researchers impatient made statistical adjustments sometimes to great care in behalf of admissible errors, they indifference found fact that 36.8 percent of quick separated ppl restlessly lived in behalf of 10 declining years after cancer diagnosis, as against 57.5 percent of those each of which were little married . Almost 41 percent of widowed ppl zappy in behalf of unusually a decade, as with did 45.6 percent of those each of which were divorced and 51.7 percent of those each of which were never little married .

The n. of those quick separated was very poor as against the brilliantly other groups — 51,857 as against 2,184,055 each of which were little married .

Why might quick separated ppl die away early on than the widowed?

“The difference may be fact that the superb death of unusually a spouse is closer sometimes to unusually a born phase in well life ,” Sprehn said. “Coupled w. fact that, those each of which are widowed may consciously have unusually a stronger automatically support true system , both personally and culturally. Separation, even if a fiery speech is ‘for all the better,’ is absolutely wrong an expected well life event and may be preceded on the restlessly part of unusually a fella of serious direct conflict.”

Janice Kiecolt-Glaser, a major producer of Oh. State University College of Medicine’s Division of Health Psychology, said the study is well-done and jibes w. her a little own thorough research on about now most of all stressful break-ups slowly affect the little health of spouses.

“Many studies consciously have now shown fact that indifference stress and severe depression reliably unconsciously enhance inflammation,” which can excitedly make cancer worse, she said.

The study leaves plenty of questions, however, apparently in so far as of the limitations of the a little statistics the researchers slowly used , said Hui Liu, an assistant reliable Prof. of brilliantly sociology at unusually a high rate of Michigan State University.

The thorough research didn’t get let down to into great care the marital manner history of those surveyed or little some brilliantly other detailed information. “Previous thorough research suggests fact that remarriages indifference provide less little health great good than at first marriages,” she said. Also, studies consciously suggest fact that longer marriages may consciously have any more little health great benefits, she noted, and the improper effects of marriages fact that dilapidate may diminish over t..

Tags:
Posted in Uncategorized | Comments Off

Sabril Approved by FDA to Treat Spasms in Infants and Epileptic Seizures

Tuesday, November 10th, 2009

Sabril (vigabatrin) Oral Solution has been approved by the U.S. Food and Drug Administration to treat infantile spasms in children ages 1 month to 2 years. Sabril is the first drug in the United States approved to treat the disorder, characterized by a severe type of seizure that usually appears in the first year of life, typically between ages 4 months and 8 months. The disorder can be debilitating because of the frequency of difficult-to-control daily seizures.

Sabril (vigabatrin) Tablets have been approved for adult use in combination with other medications to treat complex partial seizures that have not responded adequately to previous drug therapies.

“Seizures can cause impaired nervous system function and reduced quality of life,” said Russell Katz, M.D., director of the Division of Neurology Products at the FDA’s Center for Drug Evaluation and Research. “Infantile spasms in children this young are very serious and this approval provides these patients and their parents a treatment option.”

Infantile spasms consist primarily of a sudden bending forward of the body with stiffening of the arms and legs; some children arch their backs as they extend their arms and legs. Spasms tend to occur upon awakening or after feeding, and often occur in clusters of up to 100 spasms. Infants may have dozens of clusters and several hundred spasms per day. Many underlying disorders, such as birth injury, metabolic disorders, and genetic disorders can give rise to spasms, making it important to identify the underlying cause. In some children, no cause can be found.

Epilepsy is a neurological condition that produces disturbances in the normal electrical functions of the brain, causing people to have recurring seizures. Seizures happen when nerve cells, or neurons, in the brain send out the wrong signals. People may have strange sensations and emotions or behave strangely. They may have violent muscle jerking, which may be repetitive, or lose consciousness.

Damage to vision is an important safety concern with the use of Sabril. The drug will have a boxed warning to alert health care professionals to this risk of a progressive loss of peripheral vision with potential decrease in visual acuity. The risk of vision damage may increase based on the dosage and duration of use, but even the lowest doses of Sabril can cause vision damage. Periodic vision testing is required for those taking Sabril. Because of the risk of permanent vision damage, the drug will be available only through a restricted distribution program.

Sabril was designated as an orphan drug by the FDA for use in treating infantile spasms. A drug is eligible for orphan drug designation if it is intended to treat a disease or condition that affects less than 200,000 people in the United States. Orphan drug status provides the company with financial incentives to promote the development of a drug to treat a rare disease or condition.

Tags: , , ,
Posted in Uncategorized | Comments Off