Asians Seem to Suffer Less During Childbirth

(HealthDay News) -- Asian women experience less labor pain than other women, say U.S. researchers.

"Labor progress and pain are influenced by many different factors but are difficult to study because conditions during labor are continually changing," Dr. Pamela Flood, of the anesthesia department at Columbia University, said in a news release from the American Society of Anesthesiologists.

"We created mathematical models to assess labor progression and pain in 500 women having their first babies," Flood explained. "This technique has the benefit of allowing researchers to assess the labor experience for individual women, in addition to the responses of a group as is seen in this study. Ideally, in the future we can use this model to predict when and if a woman will be able to deliver vaginally."

The researchers studied 100 sequential deliveries from each of five ethnic groups -- Asian, Hispanic, black, white and other -- and found significant associations between ethnicity, labor progress and labor pain.

Asian women had slower active labor and reported less pain than women of other ethnicities. The researchers also found that women who weighed more generally had slower active labor.

The study is in the November issue of Anesthesiology.

"The ability to predict labor pain would be helpful to assist in the development of specific coping mechanisms during labor, helping each woman better know what to expect," Flood said. "More accurate expectations about labor pain and progress will help new mothers and their doctors to plan their treatment."

SOURCE: American Society of Anesthesiologists, news release, Oct. 26, 2009

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At Least 114 U.S. Kids Dead From Swine Flu

(HealthDay News) -- At least 114 U.S. children have now died from laboratory-confirmed H1N1 swine flu, including 19 during the past week -- the largest one-week increase since the outbreak began in April, U.S. health officials said Friday.

But these deaths are almost certainly an underestimation of the actual number, Dr. Thomas R. Frieden, director of the U.S. Centers for Disease Control and Prevention, said during an afternoon press conference Friday.

"We can provide information on the number of laboratory-confirmed hospitalizations and deaths -- we know that that's an underestimation of the total," he said.

Of the children who have died, two-thirds had chronic health problems such as asthma, cerebral palsy and muscular dystrophy, Frieden said.

"In a usual flu season, 90 percent of the deaths are among people over the age of 65. In H1N1, 90 percent of the deaths are in people under the age of 65," he said.

The swine flu continues to spread throughout the country; for most people the infections are mild to moderate. It is now widespread in 48 states, although there are signs it has begun to recede in some Southeastern states, he said.

Frieden said the latest statistics continue to show that H1N1 swine flu is a disease that afflicts younger people, and can be especially serious for those underlying medical conditions. "In the past two months, we have seen more hospitalizations in people under the age of 65 than in most entire flu seasons," he said.

"One of the things we have been surprised to see," Frieden added, "is that even among people who have an underlying condition, such as asthma or heart disease or lung disease, only half sought care for influenza-like illness. People with underlying conditions with fever and cough should see their [health-care] provider promptly."

While vaccine shortages persist, there are 26.6 million doses now in circulation, up from 16.1 million doses last week. The supply is "increasing steadily," said Frieden. "The gap between supply and demand is closing."

Production delays have resulted in far fewer doses of the vaccine being available than federal officials had hoped for by this time. The first estimates called for 40 million doses by the end of October and 190 million doses by year's end.

Since the genetics of the virus have not changed, the vaccine is a good match, Frieden said.

Frieden also said there is a stronger than usual demand for the seasonal flu vaccine, prompting some shortages. "Of the 89 million doses that have already been distributed, the overwhelming majority have already been given," he said. But more doses will be available in November and December.

Supplies of the antiviral drug Tamiflu should be plentiful, but there have been shortages of the liquid form given to children, Frieden said. To help overcome that shortage, the federal government is releasing the 234,000 remaining doses of liquid Tamiflu that have been stockpiled, he said.

SOURCES: Oct. 30, 2009, teleconference with Thomas R. Frieden, M.D., M.P.H., director, U.S. Centers for Disease Control and Prevention, Atlanta

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Coffee may lower endometrial cancer risk

NEW YORK (Reuters Health) - Women dread a diagnosis of endometrial cancer, but those who drink at least two cups of caffeinated coffee a day may have a lower risk for this cancer of cells lining the uterus.

Coffee drinking seemed to particularly protect overweight and obese women, study co-author Dr. Emilie Friberg, at the Karolinska Intstituet in Stockholm, Sweden, told Reuters Health by email.

Friberg's team twice surveyed 60,634 Swedish women about their coffee intake - when they enrolled in the Swedish Mammography Cohort study between 1987 and 1990, and again in 1997.

During the 17 years, on average, that the researchers followed patients, 677 women - about 1 percent -- developed endometrial cancer. The average age at diagnosis was 67.

In the overall study group, those who daily drank 2 or more cups were significantly less likely to develop endometrial cancer, compared with those who drank fewer cups of coffee.

Each additional daily cup seemed tied to a 10 percent lower risk for endometrial cancer, after allowing for age and other factors potentially tied to endometrial cancer risk among all the women.

However, they observed the strongest effect among overweight and obese women, who, Friberg's team notes, have "the highest risk for endometrial cancer."

Each additional cup of coffee seemed to decrease endometrial cancer risk by 12 percent among overweight women and by 20 percent among obese women, Friberg and colleagues report in the International Journal of Cancer.

The investigators suggest that coffee may affect blood sugar, fat cells, and estrogen, all of which play a role in endometrial cancer. However, they write that the current findings should be confirmed in other populations.

In particular, "a study also including de-caffeinated coffee would make it possible to separate the effect of coffee and caffeine," Friberg said.

SOURCE: International Journal of Cancer

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Anemia Drug May Raise Stroke Risk in Kidney Patients

(HealthDay News) -- A drug designed to fight anemia appears to double the risk of stroke in patients with diabetes and kidney disease without substantially improving their quality of life, a new study finds.

Darbepoetin alfa, marketed as Aranesp and known as an erythropoiesis-stimulating agent (ESA), is often prescribed for diabetic patients with chronic kidney disease and mild anemia.

"The benefits we assumed we would have by treating anemia were less striking and the risks were more striking," said lead researcher Dr. Marc A. Pfeffer, a professor of medicine in the cardiovascular division of Brigham and Women's Hospital in Boston.

"This provides new data for doctors and patients to make their own risk-benefit assessment," he said. "There was a perception that treating anemia would make people feel so much better that we'll take risks, but the benefit in quality of life was not as great as we thought, and there was a clear doubling of your risk for a stroke."

The report was published in the Oct. 30 online edition of the New England Journal of Medicine to coincide with its scheduled presentation at the annual meeting of the American Society of Nephrology in San Diego.

For the study, Pfeffer's team randomly assigned more than 4,000 patients with diabetes, chronic kidney disease and anemia to receive Aranesp or placebo. During the study, 632 patients receiving Aranesp died or suffered a cardiovascular event, compared to 602 of the patients receiving placebo.

As well, 101 patients taking Aranesp had a fatal or non-fatal stroke compared with 53 of the placebo patients, the researchers found. In addition, patients taking Aranesp reported only a modest improvement in their fatigue, the researchers noted.

In earlier studies, Aranesp and a similar drug, epoetin alfa, marketed as Procrit or Epogen, were linked to increased risk of death in cancer and stroke patients.

Pfeffer believes that people with more severe kidney disease, such as those on dialysis, might still find Aranesp beneficial and the risk acceptable.

"People on dialysis generally feel even worse and generally have even more severe anemia, and this class of therapy has been very helpful to them," he said.

Because the drug was beneficial to these patients, doctors assumed it would help less severely anemic patients, Pfeffer said.

"But this use of ESAs exceeded the data," he said. "Now we have the data, and we will revisit how the drug is used now."

Dr. Phillip Marsden, a professor of medicine at the University of Toronto and author of an accompanying journal editorial, said these findings mean that doctors and patients will have to discuss whether or not to start the medication.

"For most of these patients, the modest improvement in quality of life will not be enough to subject themselves to the increased risk of stroke and death," he said.

ESAs have been used for two decades, Marsden noted. "It is a bit shocking that it took us 20 years to address whether or not these drugs were safe -- and now we know more."

Dr. Ajay Singh, clinical chief of the renal division and director of dialysis at Brigham and Women's Hospital, said this "landmark study" raises the fundamental question of whether epoetin or darbepoetin should routinely be used in treating anemia of chronic kidney disease.

"Earlier studies raised the specter of increased risk with ESA treatment. This study definitively confirms that there is meaningful risk with routine use of ESAs," said Singh, also an associate professor of medicine at Harvard Medical School.

"In my own practice, I will be cautious in using ESAs for most patients with chronic kidney disease, balancing risk with benefits and reserving treatment largely for patients who need frequent blood transfusions or who are candidates for a kidney transplant," he said.

SOURCES: Marc A. Pfeffer, M.D., Ph.D., professor of medicine, cardiovascular division, Brigham and Women's Hospital, Boston; Phillip Marsden, M.D., professor of medicine, University of Toronto, Canada; Ajay Singh, M.D., clinical chief, renal division, director, dialysis, Brigham and Women's Hospital, and associate professor, medicine, Harvard Medical School, Boston; Oct. 30, 2009, New England Journal of Medicine, online

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Virulent Strain of MRSA Resists Treatment

(HealthDay News) -- New research holds bad news for health officials worried about a potentially lethal infection called MRSA that haunts hospitals: A strain that infects the bloodstream is five times more deadly than other strains.

To make matters worse, the USA600 strain appears to be at least partially immune to an antibiotic that's used to treat the condition, the researchers have found.

A full half of patients infected with the strain died within a month, according to a study scheduled to be presented at the annual meeting of the Infectious Diseases Society of America, held Oct. 29 to Nov. 1 in Philadelphia. That's nearly five times the death rate of other people infected with MRSA, and 10 to 30 percent of those who acquire MRSA infections in the bloodstream die within a month, the study found.

MRSA, or methicillin-resistant Staphylococcus aureus, causes infections in the skin and bloodstream. It can also infect surgical wounds and cause pneumonia. In most cases, it sickens people in the hospital, but cases are becoming more common outside the health-care community, according to information in a news release from the Henry Ford Health System.

Researchers think it's possible that the USA600 strain is unique. But they don't know if other factors -- such as the age of patients -- could be at play.

Those who developed the USA600 strain tended to be older than those who acquired other MRSA strains, averaging 64 compared with 52 years old, the study noted.

"While many MRSA strains are associated with poor outcomes, the USA600 strain has shown to be more lethal and cause high mortality rates," Dr. Carol Moore, the study's lead author and a research investigator at the Henry Ford Hospital's division of infectious diseases, said in the news release.

"In light of the potential for the spread of this virulent and resistant strain and its associated mortality," she said, "it is essential that more effort be directed to better understanding this strain to develop measures for managing it."

MRSA is challenging to treat because strains can be immune to many medications. The USA600 strain appears to be more immune than other strains to the drug vancomycin, which often still has the power to vanquish MRSA.

SOURCE: Henry Ford Health System, news release, Oct. 31, 2009

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Cholesterol Drugs May Help Prevent Flu Deaths

(HealthDay News) -- Statins, frequently used to cut cholesterol levels, may also help prevent death from severe flu, a new study suggests.

According to the researchers, a growing body of evidence suggests that statins -- which include medicines such as Lipitor, Crestor and Zocor -- can reduce death from severe infections. Whether they help with flu, however, has been more uncertain.

"Statins may have a role in reducing mortality from influenza, but our findings do not justify broader use of statins without confirming these findings in the setting of randomized controlled trials," said study author Dr. Ann R. Thomas, from the Emerging Infections Program at the Oregon Department of Human Services Public Health Division in Portland.

"Statins may have a benefit, in conjunction with vaccine and antivirals, in reducing morbidity and mortality associated with influenza, likely due to their effect of reducing the body's inflammatory response to influenza infection," she added.

The results of the study are to be presented Friday at the Infectious Diseases Society of America annual meeting in Philadelphia.

For the study, Thomas' team looked at the outcomes of hospitalized influenza patients over two flu seasons.

The researchers found that patients who were taking statins were more likely to be older, male, white or Asian with underlying health conditions such as cardiovascular disease. In addition, they were more likely to have had a flu shot.

While those with cardiovascular disease were more likely to die, those who received statins while in the hospital were less likely to die.

Whether statins are also effective in preventing deaths from the H1N1 swine flu is not known, Thomas said. "Our data are from the 2007-2008 influenza season, well before novel H1N1 emerged, so no one knows for sure if statins would reduce mortality from H1N1," she said.

"However, since the likely mechanism of statins in reducing mortality is their general effect of down-regulating the immune system, it is plausible that statins might be useful in treating influenza infections due to novel H1N1," she noted.

Infectious diseases expert Dr. Marc Siegel, an associate professor of medicine at New York University School of Medicine in New York City, said that the study "is of limited value."

Siegel believes it's statins' ability to prevent death from heart disease and not any benefit against flu that results in fewer deaths among those taking these drugs.

"Influenza increases your risk of dying from heart disease. At the same time, statins reduce your risk of dying from heart disease. So, it's not surprising to find that there are fewer deaths among those taking statins," Siegel said.

"You can't conclude from this study that people with influenza should take statins," he said. "Statins are protective in a situation where the heart is at risk, even influenza -- that, I'll buy."

SOURCES: Ann R. Thomas, M.D., M.P.H., Emerging Infections Program, Oregon Department of Human Services Public Health Division, Portland; Marc Siegel, M.D., associate professor, medicine, New York University School of Medicine, New York City, and author, Swine Flu: The New Pandemic; Oct. 29, 2009, presentation, Infectious Diseases Society of America annual meeting, Philadelphia

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Better Drug Emerges for Steroid-Induced Bone Loss

(HealthDay News) -- The drug teriparatide is better at increasing bone density and reducing vertebral fractures in patients with glucocorticoid-induced osteoporosis than the drug alendronate, a new study finds.

Glucocorticoids are steroid hormones produced in the body or contained in drugs that are used to control inflammation in patients with autoimmune diseases, such as rheumatoid arthritis, lupus and Crohn's disease, as well as inflammatory conditions such as asthma. Glucocorticoid-induced osteoporosis can occur in people taking steroid medications such as prednisone, prednisolone, dexamethasone and cortisone, according to background information provided in a news release about the study.

The study participants included 428 patients, aged 22 to 89, with confirmed osteoporosis who had received more than 5 milligrams a day of prednisone or the equivalent for more than three months. For the study, 150 patients were randomly assigned to receive 20 micrograms a day of injectable teriparatide plus oral placebo, and 144 patients received 10 milligrams a day of oral alendronate plus injectable placebo. All the participants received supplements of calcium (1,000 milligrams a day) and vitamin D (800 International Units a day).

After 36 months, lumbar spine bone mineral density was 11 percent higher than at the start of the study in the teriparatide group compared with 5.3 percent higher in the alendronate group, the researchers found. Bone mineral density improvement for total hip was 5.2 percent in the teriparatide group versus 2.7 percent in the alendronate group, and 6.3 percent versus 3.4 percent, respectively, in the femoral neck.

Patients in the teriparatide group had fewer vertebral fractures (1.7 percent) than those in the alendronate group (7.7 percent) and also had higher levels of calcium concentrations (21 percent versus 7 percent), according to the study findings published in the November issue of the journal Arthritis & Rheumatism.

A significant number of individuals are regularly treated with steroids to control inflammation, "which puts them at risk for developing osteoporosis. A need for therapies that mitigate this side effect of steroid use and substantially improve bone mass is vital," study leader Dr. Kenneth Saag, of the University of Alabama, said in a news release from the journal's publisher.

"Our research shows that teriparatide is a safe and effective treatment for patients with steroid-induced [osteoporosis] and should be considered as a therapeutic option for those at high risk of bone fracture," he concluded.

SOURCE: Arthritis & Rheumatism, news release

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After Age 55, Workplace Stress Seems to Decline

(HealthDay News) -- Feeling stressed at work? If you're younger than 50, it might get worse -- at least for a while.

Researchers from the University of Nottingham in England report that stress levels peak when people reach their early 50s but start to dip as they move toward old age.

That's not necessarily good news, either: Work-related stress apparently stays with people into retirement.

The findings come from a new report that analyzed hundreds of research publications from the last two decades.

"Work-related stress is thought to be responsible for more lost working days than any other cause, and it is becoming clear that it is also one factor affecting older workers' willingness and ability to remain in the labor force," the report's lead author, Amanda Griffiths, a professor of occupational health psychology, said in a university news release. "Therefore, protecting tomorrow's older workers, as well as today's, will pay dividends as older workers will form a major part of tomorrow's workforce."

The researchers said their study attempted to fill a gap in research that had focused on workers as a whole and not tended to look at age groups in particular.

They found that people who are older than 50 to 55 could have less stress for several reasons: They might have retired already, gained seniority that offers more control over their work or opted for a less-stressful position.

"As we get older, people's priorities may also change," Griffiths said. "They often have caring responsibilities or wish to spend time with grandchildren and develop other interests. Their work and career may not be their primary drivers."

"Making work attractive and flexible, to allow older people to balance work and their other interests more easily, may be one very important step forward," she said.

SOURCE: University of Nottingham, news release

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Almost 6 Million U.S. Cases of Swine Flu in First Few Months

(HealthDay News) -- Up to 5.7 million cases of H1N1 swine flu hit the United States between April and July, according to a new estimate from the U.S. Centers for Disease Control and Prevention.

That number came from a model that estimated that for every confirmed case of H1N1 flu there were 79 unreported cases, according to a report published Thursday in the CDC journal Emerging Infectious Diseases.

Speaking at an afternoon teleconference on Thursday, Dr. Anne Schuchat, director of CDC's National Center for Immunization and Respiratory Diseases, explained why the CDC uses such models to get an idea of the actual number of H1N1 flu cases.

"Not every case will result in a person seeking medical care," she noted. "Not every person who seeks medical care will be tested for flu. Not every person tested for flu will have a result that is positive. Not every positive result will get reported. So you can imagine that what we count -- whether it's cases or hospitalizations or deaths -- will be underestimates of the full burden."

The report estimates that there were between 1.8 million and 5.7 million cases of flu, as well as 9,000 to 21,000 hospitalizations and about 800 deaths related to the pandemic flu.

There has been no current update of these numbers since July, Schuchat said. "But we do believe many millions of people have already contracted this virus here in the U.S. And by now we have had well over 20,000 hospitalizations," she noted.

Schuchat also cautioned that the 79-to-1 multiplier used in the report is only a best guess and should be taken with "a grain of salt."

She also had some news on the H1N1 vaccine front, noting that the supply of vaccine is changing day by day. As of Thursday there were 24.8 million doses available, Schuchat said, 1.6 million doses more than yesterday.

Production delays have resulted in far fewer doses of the vaccine being available than federal officials had hoped for by this time. The first estimates called for 40 million doses by the end of October and 190 million doses by year's end.

Every day more vaccine is becoming available, however, and officials hope to see an end to the shortage over the next several weeks.

"I appreciate the frustration people are seeing as they are unable to find vaccine," Schuchat said. "Over the next several weeks it should become more easily available and each day we are seeing forward progress."

She also said that supplies of the antiviral drug Tamiflu should be plentiful. While there may be some shortage of the liquid form usually given to children, pharmacists can convert pills into a liquid. Parents too can mix the drug with chocolate syrup to make it more palatable for children who have trouble taking pills, she said.

In related news, Swiss pharmaceuticals giant Novartis AG said on Thursday that it is on schedule to meet its U.S. government contract for H1N1 vaccine, the Associated Press reported.

Fears had circulated in recent weeks that the company might have to delay shipments of the sought-after vaccine, and U.S. officials had announced earlier in October that they had only received 23 million of a predicted 45 million doses by mid-month. However, Novartis remains on target to deliver 25 to 30 million doses of the vaccine to the United States by the end of November, the AP said.

SOURCES: teleconference with: Anne Schuchat, M.D., director, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention; Oct. 29, 2009, CDC, Emerging Infectious Diseases; Associated Press

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Low vitamin D tied to heart, stroke deaths

(Reuters Health) - Low vitamin D levels in the body may be deadly, according to a new study hinting that adults with lower, versus higher, blood levels of vitamin D may be more likely to die from heart disease or stroke.

Vitamin D is an essential vitamin mostly obtained from direct sunlight exposure, but also found in foods and multivitamins.

Dr. Annamari Kilkkinen, at the National Institute for Health and Welfare in Helsinki, Finland, and colleagues compared blood levels of vitamin D and deaths from heart disease or stroke over time in 2,817 men and 3,402 women in Finland.

At enrollment, participants were just over 49 years old on average, and had no indicators of cardiovascular disease, the researchers note in the American Journal of Epidemiology.

During follow-up of about 27 years on average, 640 of the participants (358 men) died from heart disease and another 293 (122 men) died from stroke.

Compared with participants' with the highest vitamin D, those with the lowest had 25 percent higher risk of dying from heart disease or stroke, Kilkkinen noted in an email to Reuters Health.

There was a "particularly striking association" between vitamin D levels and stroke deaths, the researcher noted, in that having the lowest vitamin D seemed to confer "twice the risk," compared with having the highest vitamin D.

Allowing for age, gender, and other demographic factors, plus alcohol intake, smoking, physical activity, and season in which vitamin D levels were obtained did not significantly alter these associations.

In this study, vitamin D levels were "substantially lower" than levels thought to be sufficient, and "somewhat lower" than those reported in previous studies in other European and American populations.

However, there is no "absolute consensus" as to what the optimal range of vitamin D should be, the investigators note. Also, it's not known whether low vitamin D actually causes increased risk for heart disease or stroke. Clearly, further study is needed, they conclude.

SOURCE: American Journal of Epidemiology

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Migraine Headache

A migraine is a common type of headache that may occur with symptoms such as nausea, vomiting, or sensitivity to light. In many people, a throbbing pain is felt only on one side of the head.

Some people who get migraines have warning symptoms, called an aura, before the actual headache begins. An aura is a group of symptoms, usually vision disturbances, that serve as a warning sign that a bad headache is coming. Most people, however, do not have such warning signs.

See also:

* Headache
* Mixed tension migraine (features of both a migraine and tension headache)

Alternative Names

Headache - migraine
Causes, incidence, and risk factors

A lot of people get migraines -- about 11 out of 100. The headaches tend to first appear between the ages of 10 and 46. Occasionally, migraines may occur later in life in a person with no history of such headaches. Migraines occur more often in women than men, and may run in families. Women may have fewer migraines when they are pregnant. Most women with such headaches have fewer attacks during the last two trimesters of pregnancy.

A migraine is caused by abnormal brain activity, which is triggered by stress, certain foods, environmental factors, or something else. However, the exact chain of events remains unclear.

Scientists used to believe that migraines were due to changes in blood vessels within the brain. Today, most medical experts believe the attack actually begins in the brain itself, where it involves various nerve pathways and chemicals. The changes affect blood flow in the brain and surrounding tissues.

Migraine attacks may be triggered by:

* Alcohol
* Allergic reactions
* Bright lights
* Certain odors or perfumes
* Changes in hormone levels (which can occur during a woman's menstrual cycle or with the use of birth control pills)
* Changes in sleep patterns
* Exercise
* Loud noises
* Missed meals
* Physical or emotional stress
* Smoking or exposure to smoke

Certain foods and preservatives in foods may trigger migraines in some people. Food-related triggers may include:

* Any processed, fermented, pickled, or marinated foods
* Baked goods
* Chocolate
* Dairy products
* Foods containing monosodium glutamate (MSG)
* Foods containing tyramine, which includes red wine, aged cheese, smoked fish, chicken livers, figs, and certain beans
* Fruits (avocado, banana, citrus fruit)
* Meats containing nitrates (bacon, hot dogs, salami, cured meats)
* Nuts
* Onions
* Peanut butter

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Pregnancy

You feel sick but happy. You're tired but excited about the future. Your body is changing and your moods are volatile. You are pregnant. Are you ready? Learn about what's happening to you and your baby at the Pregnancy Learning Center. From preparing to get pregnant and preventing pregnancy, to knowing what to expect during pregnancy through delivery, the Learning Center offers a wealth of multimedia information to help guide you through this special time.

What doctor is best for you at this time? What about prenatal care? Are there special vitamin supplements you're supposed to be taking while pregnant? Feeling stressed? Want to relax and connect with the little being growing inside of you? Check out our information on alternative therapies for pregnant women.

What kinds of tests are recommended during pregnancy? The Learning Center organizes information you need throughout the course of your special time. We hope your pregnancy is a healthy one, but what if you are diagnosed with a complication? Our multimedia center provides information about many different problems that can arise during the course of the next nine months. Some of our learning tools are geared toward women who have a medical condition (such as diabetes or asthma) prior to getting pregnant.

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Breast Cancer

Cancer is a scary word. But breast cancer is not a death sentence and every day there are more breast cancer survivors due to advances in treatments and drug therapy. Cancers are abnormal cells in the body which grow uncontrollably. Breast cancer is one of the most common cancers in women, although men get breast cancer too.

There are many known risk factors for breast cancer. Healthline's Breast Cancer Learning Center offers tools and expert articles to help you understand whether or not you are in a high risk group. It is now recommended that women in high risk groups have an MRI scan along with their annual mammogram. No matter what your risk of getting cancer, today we are armed with tremendous knowledge about how to prevent breast cancer.

Know the symptoms of breast cancer. Most breast lumps are non-cancerous - so when should you be concerned? Learn about how breast cancer is diagnosed. Most women find lumps themselves during breast self-exams. Finding and treating breast cancer early greatly increases your chances of survival and of being completely cured.

If you are diagnosed with breast cancer, there are many resources to help you through it. Getting to the right medical team is crucial to good breast cancer care and increased survival rates. Breast cancer is complex. There are different stages of breast cancer and different types - invasive or non-invasive, hormone receptor positive or negative. The tumor size, shape and the rate of cell division all determine the prognosis. Once treated, breast cancer patients must be evaluated for recurrence.

The Breast Cancer Learning Center's multimedia offerings will help you anticipate your journey to healing. The Alternative Therapies section provides information you can discuss with your doctor if there are complementary practices you want to try.

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High Blood Pressure

Every encounter you have with a health care professional likely involves getting your blood pressure checked. Why is blood pressure measurement such an important indicator of health? What does it mean if your blood pressure is high? High blood pressure, also known as hypertension, is the force applied against the wall of the arteries as the heart pumps. High blood pressure is a silent disease, one that may not have any symptoms for months or even years.

Blood pressure measurements are checked with a syphgmomanometer and a stethoscope. An inflatable cuff is placed around the arm and a stethoscope placed over the arteries in the crook of the elbow. As the cuff is deflated, a sound is heard as the blood courses through the artery. The first sound heard is measured and that is the systolic blood pressure. Normal systolic blood pressure is less than 120 (mm Hg). When the sound stops, the measurement is the diastolic blood pressure. Normal diastolic blood pressure is less than 80 (mm Hg).

Complications of high blood pressure are no joke. What happens is that the walls of the arteries lose their elasticity over time and the heart has to work harder to push the blood through them. Every organ and body system is therefore affected by high blood pressure. That is why treatment is so important. People sometimes want to stop taking their medications when they feel better. That is a dangerous practice with high blood pressure and can lead to life threatening problems such as heart attack or stroke.

Prevention of high blood pressure is a key to wellness. The High Blood Pressure Learning Center offers multimedia guides to preventing high blood pressure and its complications with very simple lifestyle adjustments. You may want to explore complementary and alternative therapies. The Learning Center provides talking points for discussions with your health care provider.

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Preventive Antibiotics Help Some Kids Fend Off Urinary Infections

(HealthDay News) -- Children who are predisposed to recurrent urinary tract infections are commonly treated with preventive antibiotics, and a new Australian study suggests that such prophylactic therapy may have at least a modest effect.

Only 13 percent of youngsters who were given the antibiotic combination of trimethoprim plus sulfamethoxazole (brand names Bactrim and Septra) developed a urinary tract infection while on the medication compared to 19 percent of the children on a placebo, according to the study.

"There was a small benefit across many groups of children, which will be worthwhile in some -- e.g., very young children, those with severe infections and those with recurrent infections," said the study's lead author, Dr. Jonathan C. Craig, a professor of clinical epidemiology at the School of Public Health at the University of Sydney in Australia.

Results of the study are published in the Oct. 29 issue of the New England Journal of Medicine.

Urinary tract infections (UTIs) are very common in children. According to the study, 2 percent of boys and 8 percent of girls will have at least one UTI by the time they're 7 years old. Although often a mild infection, UTIs can be serious, with as many as 5 percent of children with one of these infections developing some type of kidney damage.

And that kidney damage can be long-lasting, according to Dr. Alejandro Hoberman, of the Children's Hospital of Pittsburgh, who authored an accompanying editorial in the journal.

"Some children have a condition known as vesicoureteral reflux, which with a urinary tract infection can lead to renal scarring, which can eventually lead to high blood pressure, the pregnancy complication preeclampsia and even kidney problems," Hoberman explained.

Craig's study included children with varying degrees of vesicoureteral reflux, which means urine backs up from the bladder into the kidney, as well as children without this condition. However, all of the children included in the study had had at least one symptomatic UTI.

The median age of the children at the start of the study was 14 months, and they were recruited from four centers in Australia. Just under two-thirds of the children were girls.

Half of the children (288) were randomly selected to receive the antibiotic combination preventively for 12 months, while the other youngsters received a placebo for 12 months.

The finding that 13 percent of the children receiving antibiotics developed a UTI during the study period versus 19 percent of those on placebo means that 14 children have to be treated with antibiotics to prevent one UTI from occurring, according to the study.

There were no statistically significant differences in the rates of adverse events in either group.

"This study is a welcome addition to the literature. It was a larger sample of children and had a control group with placebo, but there were only modest treatment effects. I think it's probably not a one-size-fits-all approach. There may still be subgroups of children [like those with reflux] who may benefit more," said Hoberman.

But, he added, "I'm not ready to completely discount antimicrobial prophylaxis yet. Let's not throw the baby out with the bathwater."

Craig said he believes the modest reduction in urinary tract infections with preventive antibiotic use outweighs the potential risks, such as the possible development of antibiotic-resistant bacteria.

More Information

To learn more about urinary tract infections in children, visit the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

(SOURCES: Jonathan C. Craig, M.B.Ch.B., Ph.D., professor of clinical epidemiology, School of Public Health, University of Sydney, Australia; Alejandro Hoberman, M.D., chief, division of general academic pediatrics, professor of pediatrics, and Jack L. Paradise M.D. Endowed Professor of Pediatric Research, University of Pittsburgh School of Medicine and Children's Hospital of Pittsburgh, Pa.; Oct. 29, 2009 New England Journal of Medicine)

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Cell Phone May Reduce Bone Density in Hips

Wearing a cell phone on your hip may reduce bone density in an area of the pelvis commonly used for bone grafts, a new study suggests.

Turkish researchers used dual X-ray absorptiometry to measure bone density at the upper rims of the pelvis (iliac wings) in 150 men who carried their cell phones on their belts. The men carried their phones for an average of 15 hours a day, and had used cell phones for an average of six years.

Bone density was slightly reduced on the side of the pelvis where the men carried their cell phones, the study found. The difference wasn't statistically significant and didn't approach bone level density reductions seen in people with osteoporosis. However, the men were relatively young (average age 32), and further bone weakening may occur, said Dr. Tolga Atay and colleagues at Suleyman Demirel University in Isparta.

The study, published in the September issue of the Journal of Craniofacial Surgery, suggests that electromagnetic fields emitted by cell phones may have a harmful effect on bone density.

However, the researchers emphasized that their findings are preliminary and noted that future generations of cell phones may reduce users' exposure to electromagnetic fields. In the meantime, it "would be better to keep mobile phones as far as possible from our body during our daily lives," Atay and colleagues concluded.

The iliac wings of the pelvis are widely used for bone grafting, which means any reduction in bone density there may affect reconstructive surgery. In procedures where bone density is important for good outcomes, surgeons may want to consider the possible effects of exposure to electromagnetic fields from cell phones, the researchers suggested.

SOURCE: Journal of Craniofacial Surgery, news release, Oct. 23, 2009

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WHO : Sex, alcohol, fat among world's big killers

LONDON (Reuters) - Tackling just five health factors could prevent millions of premature deaths and increase global life expectancy by almost 5 years, the United Nations World Health Organization (WHO) said Tuesday.

Poor childhood nutrition, unsafe sex, alcohol, bad sanitation and hygiene, and high blood pressure are to blame for around a quarter of the 60 million premature deaths around the world each year, the WHO said in a report.

But while not having enough nutritious food is a big health risk for those in poorer countries, obesity and being overweight pose yet bigger risks in richer nations -- leading to a situation in which obesity and being overweight causes more deaths worldwide than being underweight.

"The world faces some large, widespread and certain risks to health," the WHO said in its Global Health Risks report. It examined 24 major health risks, and said recognizing and assessing them would help policy makers draw up strategies to improve health in the broadest and most cost-effective ways.

"As health improves, gains can multiply," it said. "Reducing the burden of disease in the poor may raise income levels, which in turn will further help to reduce health inequalities."

The report warned that although some major health risk factors, such as smoking, obesity and being overweight, were usually associated with high-income countries, more than three-quarters of the total global burden of diseases they cause now occurs in poor and developing countries.

"Health risks are in transition: populations are aging owing to successes against infectious diseases; at the same time, patterns of physical activity and food, alcohol and tobacco consumption are changing," it said.

"Understanding the role of these risk factors is important for developing clear and effective strategies for improving global health."

The Geneva-based U.N. health agency listed the world's top mortality risks as high blood pressure (responsible for 13 percent of deaths globally), tobacco use (9 percent), high blood glucose (6 percent), physical inactivity (6 percent), and obesity or being overweight (5 percent).

These factors raised the risk of chronic diseases and some of the biggest killers such as heart disease, diabetes and cancers, and affected "countries across all income groups -- high, middle and low," it said.

The WHO said its study, which used data from 2004 -- the latest available -- showed how health was becoming "globalised" and warned that developing countries now increasingly face a double burden of risks to health.

"The poorest countries still face a high and concentrated burden from poverty, undernutrition, unsafe sex, unsafe water and sanitation," it said. "At the same time, dietary risk factors for high blood pressure, cholesterol and obesity, coupled with insufficient physical activity, are responsible for an increasing proportion of the total disease burden."

The WHO added that if the risks in its report had not existed, life expectancy would have been on average almost a decade longer in 2004 for the entire global population.

Reuters Health

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Depression Often Goes Untreated in Working Moms

(HealthDay News) -- More than 65 percent of U.S. mothers with depression don't receive adequate treatment, a new study has found.

Black, Hispanic and other minority mothers are least likely to receive adequate treatment. Mothers with health insurance are three times more likely to receive adequate treatment than those without insurance, wrote the researchers at the University of Wisconsin-Madison School of Medicine and Public Health.

"Health insurance facilitates access to adequate treatment for maternal depression. Expanding health insurance coverage to mothers with depression is a critical step in helping them get the care that they need," study author Dr. Whitney P. Witt, an assistant professor of population health sciences, said in a news release from the university.

The analysis of national data on 2,130 mothers with depression also found that working mothers were less likely to receive adequate treatment, possibly because long work hours make it difficult for them to find time to seek treatment. This means that workplaces could prove a useful location for depression intervention.

"Services like employee-assistance programs can help these mothers get screened and treated, even if they are unable to visit a provider or a mental health professional in the health-care setting," co-author Kristin Litzelman, a population health sciences doctoral student, said in the release. "Since healthy employees are productive employees, it's often a win-win for employers to offer benefits that support employee mental health."

Depression in mothers can have a major impact on the entire family, especially on the health and well-being of their children, the researchers noted. Treating depression in mothers can improve the long-term health of their families.

Health-care providers need to understand the racial, ethnic and educational disparities that affect treatment of mothers with depression in order to intervene and help these patients get the care they need, the study authors noted.

The study was released online in advance of publication in an upcoming print issue of the Journal of Behavioral Health Services and Research.

SOURCE: University of Wisconsin, news release, Oct. 19, 2009

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Foot Care for People With Diabetes

(HealthDay News) -- People with diabetes are especially prone to foot problems, so it's important to take good care of your feet and inspect them frequently.

The American Academy of Orthopaedic Surgeons offers these suggestions:

* Wash your feet daily with soap and water, and carefully dry them afterward.
* Use a rich moisturizer on your feet, but don't apply it between the toes.
* Keep toenails trimmed, but cut them straight across. Clipping the corners can lead to ingrown nails.
* Avoid using antiseptics, sharp tools or heating pads on the feet.
* Keep feet warm and dry with cozy socks.
* Prevent circulatory problems by avoiding smoking. And don't sit with your legs crossed.

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Alcohol may help women stay mobile

NEW YORK (Reuters Health) - For people in their 70's, light to moderate alcohol intake may offer women, but not men, some protection against loss of mobility, a study hints.

But the investigators caution that most of this benefit is tied to the drinkers' lifestyle.

The study looked at associations between alcohol intake and the mobility levels reported by 3,061 healthy men and women who were 70 to 79 years old and living in the Pittsburgh, Pennsylvania and Memphis, Tennessee areas.

At enrollment, none had difficulty walking a quarter mile, climbing 10 steps, or performing basic activities of daily living. Every 6 months over the next 6.5 years, the participants had either a clinical examination or completed a mobility survey.

From these evaluations, Dr. Cinzia Maraldi of the University of Ferrara in Italy and colleagues determined that 24 percent of the study subjects had become unable to walk a quarter mile, climb 10 steps without resting, or perform daily activities. Another 49 percent developed difficulty performing these tasks.

When Maraldi's team looked at mobility according to weekly alcohol intake, as determined at study enrollment, moderate drinking in men and light to moderate drinking in women appeared to be associated with lower loss of mobility.

For men, moderate intake was defined as 8 to 14 drinks per week. For women, light drinking was 1 to 3 drinks per week and moderate drinking, 4 to 7 drinks a week.

However, most of the apparent protective effect on mobility of light and moderate alcohol intake was found to be due to lifestyle factors of the drinkers - particularly lower body weight, higher physical activity levels, higher income, and more education.

In the Journal of the American Geriatrics Society, Maraldi and colleagues suggest caution in "attributing a direct benefit of moderate alcohol intake on functional ability," since these findings show that lifestyle plays a more important role in elder's ability to maintain mobility.

SOURCE: Journal of the American Geriatrics Society, October 2009

Reuters Health

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Healthy home may help keep the weight off

NEW YORK (Reuters Health) - If you've lost a lot of weight and want to keep it off, banishing high-fat foods and getting rid of your TV sets might help, along with eating less and staying active, new research hints.

Researchers found that people who had lost weight and had maintained a normal weight for 5 years were much more physically active than obese people who hadn't lost weight and were also being better able to control their food intake.

But people's home environment also mattered, Dr. Suzanne Phelan of California Polytechnic State University in San Luis Obispo and her colleagues found. The weight loss maintainers had fewer TVs in their homes, and were less likely to be stocking their shelves with fatty foods.

Phelan and her team looked at 167 weight-loss maintainers and two groups of 153 treatment-seeking obese individuals to investigate behaviors and environmental factors that might promote sustained weight loss. People in the control groups had been participating in two different studies of weight loss interventions, but remained obese.

People who had kept the weight off expended 2,877 calories in physical activity per week, on average, compared to 762 per week for one of the control groups and 1,003 for the other, the team found.

In addition, weight loss maintainers had fewer TVs in their homes and more exercise equipment than the control groups.

There were also marked differences in the kinds of foods people had in the pantry, with the weight loss maintainers having significantly fewer high-fat items and more low-fat foods like fruits and vegetables and low fat dairy foods.

The weight-loss maintainers clearly had stronger self-control than the persistently obese people, Phelan and her team note, but it's not clear why.

"The home environment of the weight-loss maintainers contained fewer high-fat foods and televisions and, thus, may have demanded fewer self-control resources than the more 'toxic' home environments of the treatment-seeking obese," they note in the Annals of Behavioral Medicine.

"You have to pay attention to your home environment if you want to succeed," Phelan advised in a statement from the Health Behavior News Service. "Do you have TVs in every room? When you walk into your kitchen, do you see high-fat food or healthy food?"

"If you want to choose better foods, keep better foods within reach. Don't just rely on willpower," Dr. David Katz, director of Yale University School of Medicine's Prevention Research Center in New Haven, Connecticut, commented in the statement.

"If you want to be more active, create opportunities for exercise that are always within reach. Don't just rely on motivation," added Katz, who wasn't involved in Phelan's study. "We should be propagating the awareness that lasting weight control is about skill power, not just willpower."

SOURCE: Annals of Behavioral Medicine, October 2009.

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Antipsychotic Drugs Spur Dramatic Weight Gain in Kids

Children and teens who take medicines for conditions such as schizophrenia, bipolar disorder and autism tend to put on a substantial amount of weight, a new study finds.

The worry is that excessive weight gain and other metabolic changes in childhood can place kids at risk for chronic health problems as adults. Some of these medicines, collectively known as "atypical antipsychotics," have been linked to increased blood-fat levels.

"We are very much afraid that this will lead to diabetes and metabolic syndrome," said study author Dr. Christoph Correll, medical director of the Recognition and Prevention program at the Zucker Hillside Hospital in Glen Oaks, N.Y.

The study, reported in the Oct. 28 issue of the Journal of the American Medical Association, is the largest analysis of its kind, Correll said.

Jeanette M. Jerrell, a professor of neuropsychiatry at the University of South Carolina School of Medicine in Columbia, is the co-author of a similar study published last year in the Archives of Pediatrics and Adolescent Medicine.

"We found that obesity/weight gain, type 2 diabetes mellitus and cardiovascular conditions were more prevalent in the treated cohort," she noted.

Her study also found that kids taking multiple antipsychotics were at significantly higher risk for obesity/weight gain, type 2 diabetes, abnormal blood-fat levels and cardiovascular problems.

"This new study is important because it draws further attention to the safety profile of antipsychotics in young populations, and the critical need for expanding the evidence base to guide clinical decisions," she said.

Concerns about the safety of atypical antipsychotics are not new. In 2003, the U.S. Food and Drug Administration ordered manufacturers of these drugs to add a warning about the risk for hyperglycemia and diabetes.

What's more, a 2008 report in The Lancet suggested that some of these drugs -- sometimes called "second-generation" antipsychotics -- may be no better than older, "first-generation" medicines. The authors concluded that each drug must be weighed individually based on its efficacy and side effects.

Correll's study was designed to assess the safety and effectiveness of the newer class of drugs in youth. His team followed 272 patients, aged 4 to 19, who were taking an antipsychotic for the first time. Patients were being treated for mood spectrum, schizophrenia spectrum or aggressive behavior spectrum disorders.

Fifteen pediatric patients who refused to participate or discontinued their antipsychotic medication within four weeks of starting served as a control group.

The study focused on four antipsychotics commonly prescribed to children: aripiprazole (Abilify), olanzapine (Zyprexa), quetiapine (Seroquel) and risperidone (Risperdal).

After nearly 11 weeks, the treated kids gained an average of 18.7 pounds on Zyprexa, 13.4 pounds on Seroquel, 11.7 pounds on Risperdal and 9.7 pounds on Abilify, while the control group gained less than half a pound. Between 10 percent and 36 percent became overweight or obese during the treatment period, according to the study.

"In these kids that we studied, there was rapid and dramatic weight gain, more than has been described before," said Correll, who is also a scientist in the Center for Psychiatric Neuroscience at the Feinstein Institute for Medical Research in Manhasset, N.Y.

Use of each drug was linked to wider bellies and increased "fat mass" -- the proportion of the body comprised of fat.

The drugs had varying effects on metabolic levels. Zyprexa and Seroquel users experienced significant adverse changes in total cholesterol and trigylcerides. Risperdal use resulted in a significant increase in triglycerides. Abilify, however, appeared "metabolically neutral," Correll said.

"Some of these kids are maintained on these medications for many years if not indefinitely, so it's definitely a concern," said Ronald T. Brown, dean and professor of public health at Temple University Health Sciences Center in Philadelphia. "For children who really don't absolutely need these drugs, they need to be doing more behavioral approaches in psychotherapy."

In an accompanying editorial, Drs. Christopher K. Varley and Jon McClellan of Seattle Children's Hospital concluded that large, independently funded studies are needed to establish the long-term safety and benefit of these drugs in children.

"Until those data are available, consideration of less risky treatment interventions and scrupulous attention to metabolic parameters in children and adolescents who receive atypical antipsychotic medications are essential," they wrote.

Correll, in fact, is currently involved in a longer-term follow-up study to assess the health effects of these drugs in children over an extended period of time.

For now, he advises clinicians and families to carefully weigh the risks and benefits of the medications against the risk of the illness, and to consider other pharmaceutical and non-pharmaceutical options. It's also important to teach children about healthy lifestyles and to closely monitor kids' weight, lipid levels and blood glucose, he said.

SOURCES: Christoph Correll, M.D., medical director, Recognition and Prevention Program, Zucker Hillside Hospital, and scientist, Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, N.Y.; Jeanette M. Jerrell, Ph.D., professor, neuropsychiatry and behavioral science, University of South Carolina School of Medicine, Columbia, S.C.; Ronald T. Brown, Ph.D., dean and professor, public health, Temple University Health Sciences Center, Philadelphia; Oct. 28, 2009, Journal of the American Medical Association

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Radiation From Medical Scans Soaring

Americans' exposure to radiation from medical procedures has exploded over the past few decades, to six times the level of 1980, a new report shows.

In 2006, almost 380 million diagnostic and interventional radiological procedures were performed in the United States, on top of 18 million nuclear medicine examinations.

"Back in about 1980, 15 percent of radiation that the U.S. population got was from medicine and the rest was predominantly from natural background radiation," noted Dr. Fred Mettler Jr., U.S. Representative to the United Nations Scientific Committee on the Effects of Atomic Radiation and a professor of radiology at the University of New Mexico in Albuquerque. "In the last 20 years, medical exposure has gone up between 600 and 700 percent from what it was, and it is now the biggest source of radiation to the U.S. population."

"The issue," Mettler continued, "is that this is a controllable source. We regulate the effluent from nuclear power plants so the public doesn't get exposure but medical exposure is essentially unregulated. The largest source in the U.S. is essentially unregulated, and it's up to your family doctor or any other doctor to hand it out."

Mettler is lead author of a paper appearing in the November issue of Radiology that summarizes the conclusions of two previous reports on radiation sources in the U.S. Those reports were issued by the U.S. National Council on Radiation Protection and Measurements and the United Nations Scientific Committee on Effects of Atomic Radiation.

The findings are in line with previous studies, one of which attributed up to two percent of all cancers to CT scans alone and another which concluded that cumulative exposure to radiation from CT scans increases the risk for malignancy by as much as 12 percent.

The last comprehensive assessment of radiation exposure was conducted in 1980-1982, a veritable eternity by medical and scientific standards.

"We needed to get a grip on how much radiation the U.S. was getting and where it was coming from," Mettler said.

In the intervening years, the number of procedures performed has risen "by leaps and bounds," he said. "The biggest chunk of that is CT scanning, which has been growing at better than 10 percent a year while the U.S. population is growing at less than 1 percent."

Widely used as a diagnostic tool, CT scans provide detailed images of organs, allowing more accurate diagnoses of conditions such as cancer. But CT involves a higher radiation dose than most other imaging tests. According to this paper, CT provides half of the country's total radiation dose, even though it represents only 17 percent of total procedures.

Emergency room physicians may be at the epicenter of the surge in scan use, Mettler said. "Twenty-five to 40 percent of CT scans are ordered out of the ER," he noted. "The emergency physicians are in a tough box because they're worried about getting sued. And they tend to get patients who they haven't seen before. This is a one-time walk-in and their mantra is, 'We can't afford to miss anything.'"

Of course, the trend is not limited to the U.S., although it may be more extreme here. Globally, the per-capita annual dose from medicine has doubled in the past decade or so.

Still the U.S. leads the pack, with 12 percent of all radiologic procedures and half of nuclear medicine procedures performed here.

"We have a little under 5 percent of the world's population and 25 percent of X-ray studies in the world and double and triple that of other developed countries," Mettler said. "Nobody thought about how much radiation goes with this."

But not all of uptick in scans has been unnecessary, said Dr. Robert Zimmerman, executive vice chair of radiology at Weill Cornell Medical Center in New York City.

"We don't really know how much of it is overuse. We do know some of it is overutilization, but CT is a valuable imaging modality. CT is a great test. There's no question that in the appropriate cases it's going to save lives."

There are things radiologists can do to curb its use, including reducing the doses, while manufacturers are working on new and improved machines, Zimmerman said.

Physicians can also tailor their use, thinking twice about using this type of technology in children, who are more sensitive to radiation and have longer to develop side effects.

"When I get a call for a CT scan, my first question is, 'How old is the patient?' If it's 40 or under my antennas go up and if they're 70 my antennas don't get so excited. Mostly my idea is a CT might be a good thing but you would like to think about radiation beforehand," Mettler said. "There's a lot of stuff going on now that isn't justified. Nobody's ever shown that many of these things we do make a difference in outcome."

SOURCES: Fred A. Mettler Jr., M.D., U.S. representative to the United Nations Scientific Committee on the Effects of Atomic Radiation, and professor, radiology, University of New Mexico, Albuquerque; Robert Zimmerman, M.D., executive vice chair, radiology, Weill Cornell Medical Center, New York City; November 2009 Radiology
HealthDay

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Swine Flu Declared a National Emergency

Saturday President Obama declared the H1N1 flu, also known as the swine flu, a national emergency. The move allows Kathleen Sebelius, the U.S. Health and Human Services Secretary to quicken the regulatory process for health providers if they are besieged with cases of the swine flu, by waiving certain regulations.

The declaring of a federal emergency, according to White House officials, was not because there has been a major increase in the number of H1N1 cases, even though the numbers have been increasing gradually. The move was to help health care facilities when they become inundated with cases of H1N1. This will allow them the ability to make quick moves to contain H1N1 flu cases, including moving patients diagnosed with the virus to a designated area of their facility or moving them to another treatment facility, such as a nearby armory. Declaring a national emergency can also allow some of the restrictions placed on Medicare and Medicaid patients to be removed.

According to the president’s declaration of a national emergency, cases of the swine flu do continue to grow across the country, and “the potential exists for the pandemic to overburden health care resources in some localities.” The waiver could remove the chances of a hospital being overwhelmed by cases of the swine flu and allow hospitals to set up off-site locations where anyone with symptoms of the swine flu would go for treatment. Public health experts said the move by the president is a relief, even though health services are not strained yet, the cases have continued to increase significantly during the month of October.

According to the Center for Disease Control and Prevention between August 30th and October 17th there have been 2,416 deaths attributed to the swine flu, and the virus has already led to at least 21,823 Americans being hospitalized. Prior to that time, from April through August, there were 593 deaths and 9,079 hospitalizations. The virus is now considered active and spreading in 46 states,

While the more seasonal flu virus mostly affects the elderly, the swine flu tends to affect children. The number of children the U.S. has already lost to the swine flu is more than usually die during the entire flu season. Pregnant women, young adults and children seem to be more at risk.

Officials initially had hoped to have at least 120 million doses of swine flu vaccines available by mid-October, but there have been some production problems and only 16 million doses have been made available.

The government is taking some rather large measures to help when treating H1N1, including the now-established emergency. Do not panic, because the declaration was not because of a huge surge in cases of the flu. The move was a proactive step to help hospitals if they are inundated with a large number of flu cases due the virus continuing to grow across the U.S. While the number of H1N1 flu vaccines available is less than what had been expected, there are some available and more are due for arrival. Call your doctor or health department to schedule a vaccine today.
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WHO: 1 of 5 Baby Not immunized

Through immunization, infant mortality and children from dangerous diseases can be suppressed. According to the World Health Organization (WHO), 106 million children in the world have been immunized in 2008. However, it was 1 in 5 children are still away from the immunization program.
The majority of children are not vaccinated in countries of low socioeconomic groups, such as Asia and Africa. In general, they are in remote areas inaccessible health professionals. Therefore, the WHO together with UNICEF and the World Bank will raise funds up to U.S. $ 1 billion for next year's immunization program.


WHO considers the amount spent is a valuable investment. Vaccination has been proven to protect the baby from the 2.5 million deaths annually. However, according to a WHO report, 90 percent of children aged less than five years are routinely immunized from developed countries.

By providing a full immunization, case numbers fell some dangerous disease drastically, one could even dieradikasi. Some polio vaccination immunization is to protect from paralysis due to polio, BCG immunization prevent tuberculosis of the brain and bone, and DPT immunization to protect children from diphtheria, pertussis, and tetanus.

"We must overcome the differences between rich and poor countries," said Dr Margaret Chen, General Director of the WHO. WHO seems to overcome the challenges it is still a big gap. In 2000, the world cost about 8 U.S. dollars (USD 73,000) per birth infants immunized in developing countries. In the future costs expected to increase to 18 U.S. dollars given the increasingly high prices of vaccines.

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WHO: 5,000 People Killed by A-H1N1 virus

Nearly 5,000 people are reported dead because of infected A-H1N1 virus, or swine flu infections since it emerged this year and spread into a global pandemic. Reported the world's health agency (WHO), Friday (23/10) in Geneva, Switzerland.
WHO says, the number would the death toll may be higher than these reports, because many countries stopped counting cases of swine flu infection. Countries that report that the victim died from the virus for the first time is Iceland, Sudan, Trinidad and Tobago.


In London, England, vaccine manufacturers GlaxoSmithKline PLC said, one dose of vaccine is sufficient to protect children from H1N1 virus infection. In a statement, Glaxo said, one dose of vaccine is sufficient to increase the child's immune system to fight the virus. This is based on research conducted in Spain on 200 children aged six months to three years.

The statement was issued to refute the opinion of experts who say that children need two doses of the vaccine because their immune systems are weaker than adults.

Pandemrix GlaxoSmithKline vaccine containing adjuvant production, the chemical that strengthens the active ingredients of vaccines and increase the body's immune system response. Although most of the flu vaccine in Europe in general contain adjuvant, but not a lot of data that prove the safety of a group of children and pregnant women.

Adjuvant alone was used by Glaxo flu vaccine products and already used by 41,000 people in the face of transmission of bird flu, swine flu, and common influenza.

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Soybean Milk Cholesterol Free

Although small shape, soybean can be processed into various food products, one of which is soy milk. Composition of soy milk is similar to cow's milk, therefore it can be used soy milk instead of cow's milk, especially for those who are allergic to cow's milk lactose.
Another advantage of soy milk than cow's milk is not at all contain cholesterol. However, according to Prof. Dr. Made Astawan, author of Nutrition and Ingredients Food Aneka, cholesterol content of cow's milk is still relatively very low when compared with other animal food. Because it does not have to worry about drinking cow's milk.


Quality protein, soy milk is also almost equal to the quality of cow's milk protein. Protein eficiency ratio (PER) of soy milk is 2.3 whereas cow's milk PER is 2.5. PER means that every 2.3 grams of protein you eat will result in weight gain of 2.3 grams. Thus, the higher the PER value reflects the better quality protein.

In general, soy milk contains vitamins B1, B2 and niacin in an amount equivalent to cow's milk or breast milk, and contains vitamin E and K in considerable amounts.

However, soy milk does not contain vitamin B12 and mineral content, especially calcium, less than cow's milk. Therefore, soy milk is usually produced by the factory are always supplemented with minerals and vitamins.

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Do You Have Ever tattoo or piercing?

Hepatitis C virus is a dangerous virus. The virus is a major cause of liver infection that is very contagious and can cause cirrhosis and liver cancer. Until there is currently no vaccine to prevent this disease because the virus mutates very quickly.

Medical world to know the seven types of viral hepatitis (liver inflammation), namely A, B, C, D, E, G, and TT. However, the type of viral hepatitis A, B, and C is more frequently encountered in our country. The difference between the hepatitis virus is located on the difference in infection kronisitas and long-term damage they caused.


Compared with hepatitis B, hepatitis C virus far more virulent and more frequently causes chronic liver disease. Hepatitis C virus (VHC) has a number of mutations (genetic changes) are high that often arise mutant could escape from the ambush "army" of antibodies the body. As a result, there has been no successful vaccine created to prevent this viral infection.

According to dr Superior Budihusodo, SpPD-KGEH, Chairman of the Indonesian Heart Association researcher, virus transmission occurs through blood or infected body fluids such as blood transfusions, the use of tattoos with non-sterile equipment, exchange of injecting drug antarpengguna injection, and repeated use of needles or other medical devices that are not sterile.

VHC infection is often referred to as covert infections because VHC infection is often asymptomatic, or if any, symptoms typically mild and not so many people do not seek treatment to the doctor. In fact, the number of people who are not diagnosed, he could act as a carrier (carrying the virus) and spread it to others unknowingly.

Some symptoms of VHC infection, among others, a sense of fatigue, fever and chills, no appetite, nausea and vomiting, skin looks yellow, pain in upper right abdomen, and weight loss of unknown cause.

If you experience one or more of these symptoms, you are not necessarily infected, given that most people infected with it VHC rarely have symptoms.

"Because the disease is asymptomatic (no symptoms), it is better to do laboratory checks, especially for those in high risk. The young in mind, the higher the possibility of recovery," said dr Excellence.

To know if you are in high risk groups, try to remember the events that might have been able to make you get hepatitis C. Some questions that can guide you is:
- Have you ever received a blood transfusion or organ transfusions?
- Did you ever perform dialysis (hemodialysis)?
- Do you have family members who have hepatitis C?
- Do you have a tattoo or pierced with a needle once a non-sterile?
- Have you ever had high-risk sexual activity without protection (condom)?
- Are you including medical workers who had contact with blood in the workplace?
- Do you use nail clippers, toothbrushes, razors, and needle acupuncture (which may be contaminated with blood in it) turns with other people?

If you answered "YES" to one or more of these questions, consult your doctor immediately.

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What Hormones and Migraine Connection?

In terms of health, many of the advantages of being female. But not when talking about headaches, especially migraine.

It is estimated that 18 of 100 women aged 12 years and over had at least feel a migraine or a headache that affects one side of the head. In men, this headache attack only 6 percent of the population. Why is this disease attacks women more often? The experts expect it because of hormones.


Many factors cause headaches, both men and women, including genetic factors and age. In women, the main cause is mainly due to hormonal changes.

The influence of hormones seen in the fact that most patients experienced migraine attacks at the time before, during, or after the coming months. Migraines are also many suffered by women of childbearing age, and gradually disappears at menopause.

The use of contraceptive pills and hormone therapy can also trigger headaches. During pregnancy, usually in order headache attacks decreased.

Mayoclinic sites mentioned in the hormones estrogen and progesterone, which play an important role in the menstrual cycle and pregnancy, affects chemicals in the brain that cause headaches. High levels of estrogen which will cause headaches, while the low estrogen actually exacerbate the pain in his head.

Stress factors can also increase the expected frequency of migraine attacks. As for foods that contain tiramin, such as cheese, and feniletamin (in brown) can also stimulate migraine attacks.

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Watch out, earphones Could Make Deaf

When listening to your favorite song comes on the radio, in the gym or on an MP3 player or iPod, we will direct spontaneous increase the volume and sing along. However, beware of the loud volume through the earphones. Because, too often exposed to loud music can cause hearing loss.
In the United States reported more and more adults and adolescents diagnosed with deafness due to old age (presbiakusis) that this condition is normally only appears in the age of 50 years. Apparently, teenagers and young adults are the people who every day listening to earphones for hours.

According to an audio expert from Cape Town Medi-Clinic, Lisa Nathan, the accumulation of loud noises or will grow slowly and almost without symptoms. "It took several years before the disorder appears or the person has a hearing problem," he said.

For example, a 15-year teenager who often listen to MP3 or iPod in a loud volume every day, maybe just have a hearing loss before the age of 30.

"Sooner than hearing damage is determined by lifestyle and exposure to other noise sources, for example, if the person is often to clubs or play a band, then the damage will be worse," he said.

Own ears created by the various parts of the functions work together so that one is able to hear, process, and understand the world around him. However, when the sounds around us are too loud or noisy, the hair cells of cochlea fine at home in the ear (cochlea) is damaged. These hair cells function to catch the sound frequency and forwarded to the central auditory perception in the brain.

"In the beginning of hair cell damage is only temporary. Symptoms such as when one ear is closed. Sometimes these symptoms are also accompanied by tinnitus, ie the conditions under which we like to hear the buzzing in the ears," said Nathan.

Tinnitus is actually a normal thing because it is a sign of damage has occurred in the hair cells. However, the more damage it does, the damage will become permanent because the cells had been damaged could not repair themselves or trigger death. As a result of this damage is deaf.

The sound is measured by decibel (dB), with a value of 0 is the softest sound audible to humans and the 180 is the noise generated by the rocket that will be flown into space.

The average sound level of the conversation about 60 dB, while the sound of rock concerts to reach 115 dB. Experts believe, exposure to noise exceeding 85 dB in the long run is very dangerous. Keep in mind, the highest volume of an MP3 player or iPod is about 100 dB. "The recommended maximum level is less than 85 dB," said Nathan.

To prevent the negative impact of the earphones before, Nathan recommends the use of earphones that eliminate background noise so that we can hear good music without being interrupted by the entry of outside sounds. That way, we do not need to set the volume of loud music.

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Tips sperm grow stronger

A study published recently in the journal Fertility and Sterility found that men who consume antioxidants (which many of the active substance derived from fruit and vegetables) have better sperm quality in some movements, ejaculate volume, sperm concentration as well as those who frequently consumed meat and full-fat dairy products.

Antioxidants have long been described as useful agents in slowing the aging process, boost the immune system, protects the body from exposure to free radicals that can damage body cells that are protected from diseases such as cancer, arthritis, Parkinson's and Alzheimer's. And it is said also useful in enhancing sperm

Research done by several universities in Spain was examined 61 men, 30 had a poor sperm kualtiasnya, 31 normal cement. They were given the opportunity to eat 93 different foods and not allowed to take vitamin / supplements during the study.

The man who was known to the normal cement are those who eat foods rich in fiber, carbohydrates, antioxidants, rich in folic acid, vitamin C, and the cement licopen than bad.

If so, in order to increase the quality of sperm, the men need to consume lots of foods that contain antioxidants, then? Yes, said Jaime Mendiola, head of research and teaching at the University of Murcia.

Then, what source the best antioxidants? Carrie Bloxson, nutritional consultant from New York states that you should take nutritional supplements and not a replacement origin. "I also recommend that you megnonsumsi food supplements sintentik original than that bodies do not need to process the chemicals it carries."

Bloxson recommends a set of sperm quality-enhancing substances in foods such as:
* Folic acid: spinach, asparagus, beans and lentils.
* Vitamin C: broccoli, oranges, strawberries.
* Lycopene: tomatoes, watermelon, grapes.

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