Search Results for: stroke
EBOLA UPDATE: Death Toll Passes 1,200; Improvement Seen in Three African Doctors Who Received Experimental Treatment
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The death toll in the ongoing Ebola outbreak in West Africa has passed 1,200, according to the World Health Organization, with infection rates continuing to outpace containment efforts. Concerns over the disease also continue to spread, with a 30-year-old woman in Germany isolated and then taken to a specialist medical unit after being found with a high fever. However, the Liberian information minister was also recently quoted as saying that three African doctors treated with the experimental ZMapp treatment are showing “remarkable signs of improvement.” The drug was used to treat two Americans who are now also showing signs of improvement. Read more on Ebola.
Study: Older Americans Receiving Cancer Screenings Against Recommendations
As many as half of older Americans continue to receive cancer screenings despite the recommendation by several professional societies that certain cancers not be screening for in people who aren’t expected to live for another 10 years, according to a new study in JAMA Internal Medicine. “There is general agreement that routine cancer screening has little likelihood to result in a net benefit for individuals with limited life expectancy,” wrote Trevor Royce, MD, in the study. Keith Bellizzi of the University of Connecticut‘s Center for Public Health and Health Policy in Storrs added that "Each screening test carries different risks and benefits ... Individuals should be counseled about these risks in order to make an informed decision (sometimes involving caregivers or family members)." Read more on cancer.
Study: Dramatic Drop in Deaths, Hospitalization for Heart Disease and Stroke
Lifestyle changes, better treatment and effective preventive measures have caused a dramatic drop in deaths and hospitalizations for heart disease over the past decade, according to a new study in the journal Circulation. In a review of data on nearly 34 million Americans covered by Medicare, researchers found that from 1999 to 2011 hospitalizations rates for heart attacks dropped by 38 percent; rates of unstable angina dropped by almost 85 percent; and hospitalizations for both heart failure and stroke dropped by approximately one-third. "The findings are jaw-dropping," said lead researcher Harlan Krumholz, MD, a professor of cardiology at the Yale School of Medicine in New Haven, Conn, according to HealthDay. "They really show that we have begun to reverse this epidemic of heart disease and stroke." Read more on heart and vascular health.
EBOLA UPDATE: Death Toll at 1,013 as Two More Doctors are Set to Receive an Experimental Treatment
(NewPublicHealth is monitoring the public health crisis in West Africa.)
Two more Ebola-infected doctors are set to receive the experimental ZMapp drug that was given to two American health workers and a Spanish priest. The Americans continue to receive treatment in an Atlanta hospital, while the 75-year-old missionary died early this morning. The death toll of the West African outbreak—the largest Ebola outbreak in history—now stands at 1,013, according to the World Health Organization. Read more on Ebola.
FDA Approves New Colorectal Screening Test
The U.S. Food and Drug Administration (FDA) has approved the first stool-based colorectal screening test to identify cancers such as colon cancer or precursors to cancer. The test can detect red blood cells and DNA mutations that can indicate certain types of abnormal growths. Colorectal cancer is the third most common cancer among those that affect both men and women, and regular screening tests for all people ages 50 and older could reduce related deaths by at least 60 percent, according to the U.S. Centers for Disease Control and Prevention. “This approval offers patients and physicians another option to screen for colorectal cancer,” said Alberto Gutierrez, PhD, director of the Office of In Vitro Diagnostics and Radiological Health at the FDA’s Center for Devices and Radiological Health, in a release. “Fecal blood testing is a well-established screening tool and the clinical data showed that the test detected more cancers than a commonly used fecal occult test.” Read more on cancer.
Study: Women, Blacks Affected Most by Heart Disease and Stroke
Women and African-Americans are affected the most by chronic diseases linked to increased risk of heart attack or stroke, according to a new population-based study in the journal Circulation. Researchers analyzed the five major risk factors for heart disease—high cholesterol, smoking, high blood pressure, obesity and diabetes—in more than 13,500 Americans from 1987 to 1998, finding that while the combined risk for women dropped from 68 percent to 58 percent, it was still higher than the risk for men, which dropped from 51 percent to 48 percent. The study also found that diabetes more than doubled the risk of heart disease for African-Americans when compared to whites—28 percent versus 13 percent. Researchers said the difference could be because heart disease has been traditionally viewed as a disease of white men, affecting how it is treated. Read more on health disparities.
For the last several years, the U.S. Centers for Disease Control and Prevention (CDC) has been promoting a concept called “Total Worker Health,” which combines safety programs to prevent accidents on the job with health promotion programs such as smoking cessation. The idea is that emerging evidence recognizes that both work-related factors and health factors that are often beyond the workplace together contribute to many health and safety problems for employees and their families.
A new report in the CDC’s latest Morbidity and Mortality Weekly Report (MMWR) shows why the combination can be critical, finding that the risk for coronary heart disease (CHD) and stroke is higher for blue-collar and service workers than it is for white-collar workers. Studies have suggested that before, but the new MMWR recommends strategies that companies can implement to reduce that risk.
In the new report, CDC researcher Sarah Luckhaupt, MD, analyzed National Health Interview Survey data for 2008-2012. She found that the prevalence of a history of CHD or stroke among people ages 18 to 55 was 1.9 percent for employed adults, but among the employed the risk was 40 percent higher in blue-collar workers (e.g. construction workers and truck drivers) and 53 percent higher in service workers (e.g. hairdressers and restaurant servers). Luckhaupt says that job stress, shift work, exposure to particulate matter, noise and secondhand smoke are all likely contributing factors to the higher rates of CHD and stroke.
In a conversation with NewPublicHealth, Luckhaupt said that employers can help improve the health profiles of employees by using the Total Worker Health program, launched by CDC and the National Institute for Occupational Safety and Health three years ago as a guideline for workplace wellness programs. CDC now publishes quarterly reports on effective Total Worker Health programs established by employers across the United States. Recent examples include:
- Live Well/Work Well at the Dartmouth-Hitchcock Medical Center in N.H., which aims to improve worker safety and health at the medical center.
- Hearing loss prevention at the Domtar Paper Company in Kingsport, Tenn., and the 3M manufacturing plant in Hutchinson, Minn., which address both noise reduction exposure on the job and in the community.
- A “Culture of Health” at Lincoln Industries, a manufacturing factory in Lincoln, Neb., which includes companywide stretching for 15 minutes every day to help prepare the muscles that will be used on the job; massage therapists who assess and treat people who may be at risk for injury; an on-site clinic for health maintenance, wellness coaching and acute care; counseling and support programs; and social and fitness events.
Study: Low-income Teens in Better High Schools Engage in Fewer Risky Behaviors
Low-income teenagers attending “high-performing” high schools are less likely than their peers in lower-performing schools to engage in risky behaviors such as carrying a weapon, binge drinking, using drugs other than marijuana and having multiple sex partners, according to a new study in the journal Pediatrics. Researchers analyzed 521 students who were accepted into a high-performing charter school; when compared to 409 students who also applied to top charter schools but were not selected in a random lottery, the kids in the high-performing schools were less likely to engage in at least one of the identified “very risky” behaviors—36 percent, compared to 42 percent. There was no statistical difference for more common risky behaviors, such as lighter drinking and smoking cigarettes. Read more on education.
Too Few People At Risk for Heart Disease are Receiving Recommendations for Aspirin Therapy
Despite the important role it can play in preventing heart disease, only 40 percent of the people who are at high risk of cardiovascular disease reported receiving a doctor’s recommendation for aspirin therapy, according to a new study in the Journal of the American Heart Association. Approximately one-quarter of people at low risk received the recommendation. “Cardiovascular disease is a significant problem in the United States and the appropriate use of prevention strategies is particularly important,” said Arch G. Mainous III, PhD, the study’s lead investigator and chairman of the department of health services research, management and policy at the University of Florida’s College of Public Health and Health Professions, in a release. “Aspirin has been advocated as a prevention strategy but only for certain patients. There are health risks associated with the treatment. It is important that doctors are directing the right patients to get aspirin for cardiovascular disease prevention.” The U.S. Preventive Services Task Force recommends aspirin use to prevent heart attack and stroke in men ages 45-79 and women ages 55-79. Read more on heart health.
Study: Coping Skills Programs for Mothers of Children With Autism Helps All Involved
Mothers of children with autism who participated in coping skills programs saw reduced stress, illness and psychiatric problems—all of which they are at higher risk for—while also improving their connections with their children, according to a new study in the journal Pediatrics. Such programs also benefit their children, as these risk factors are associated with poorer health outcomes for the children. Researchers entered 243 mothers of children with disabilities (two-thirds of which were autism) into six weeks of either Mindfulness-Based Stress Reduction (mindfulness practice) or Positive Adult Development (positive psychology practice), finding that both reduced stress and other negative impacts. Read more on mental health.
Earlier this month, following the heatstroke death of a Georgia toddler who was left in a sweltering car for hours, Tennessee became the first state in the nation to pass a law that specifically protects people from liability for forcibly breaking into cars and rescuing kids they think are at risk of heatstroke. The law requires those individuals to call 911 first and follow instructions.
Many states have Good Samaritan laws that may protect people in such instances, but the specifics vary from state to state, according to Cristina M. Meneses, JD, MS, a staff attorney with the Network for Public Health Law’s Eastern Region. A recent Today show poll found that 88 percent of the 44,000 people asked would break into a car to rescue a child they thought was in danger, but specific laws can increase the response—and potentially remove penalties—while raising awareness of the issue. More such laws could soon follow. Janette Fennell, founder and head of KidsAndCars, a nonprofit based in Kansas City, Mo., which advocates for laws that will protect kids from heat in vehicles, said she’s received inquiries from two states about those laws since Tennessee’s law was passed. Another set of laws that KidsAndCars tracks are those that penalize adults for leaving kids in cars. Nineteen states currently have such laws on the books.
“It’s a good deterrent for anyone who might think, ‘Oh, I’ll just leave them in the car for a minute,’” said Fennell, “because it’s often that minute that turns into much longer and results in injury or death.”
According to the National Highway Traffic Safety Administration (NHTSA), more than 40 kids—often under age 2—die each year of “vehicular heatstroke.” Seventeen U.S. kids have died after being left or trapped in car since the beginning of 2014. Fennell and other experts say many people just don’t realize how quickly temperatures can climb in a car, even if the window is cracked open a bit—when outside temperatures are in the low 80's, the temperature inside a vehicle can reach deadly levels in only 10 minutes, even with a window rolled down two inches. Children's bodies, in particular, overheat easily; and infants and children under four years old are at the greatest risk for heat-related illness.
NHTSA research shows that heatstroke deaths and injuries often occur after a child gets into an unlocked vehicle to play without a parent or caregiver's knowledge. Other incidents can occur when a parent or caregiver who is not used to transporting a child as part of their daily routine inadvertently forgets a child sleeping in the back.
Last week, KidsAndCars launched a petition drive to encourage NHTSA to require technology in all cars that would remind a driver that there is a child in the back. There are devices parents can install, but a 2012 study by NHTSA found that none that the agency studied were consistently effective.
“You get a warning if you don't buckle your seatbelt, leave a car door open, your gas is low or you leave your headlights on,” said Fennell. “If a child is left behind then you absolutely need a warning.”
Guidelines from NHTSA and other safety experts aimed at never leaving a child unattended in a car include:
- Make a habit of looking in the vehicle—front and back—before locking the door and walking away
- Ask childcare providers to call if a child doesn't show up for care as expected
- Put items in the back seat you’ll have to retrieve such as a purse or briefcase, or put a stuffed animal in sight of the driver to indicate there’s a child in the car.
Strokes Fall Among Older Americans
Fewer older Americans are having strokes and those who do have a lower risk of dying from them, according to researchers at the Johns Hopkins Bloomberg School of Public Health. The study, published in JAMA, followed close to 15,000 stroke-free patients ages 45 to 64, beginning in the 1980s and ending in 2011. It found a 24 percent overall decline in first-time strokes in each of the last two decades and a 20 percent overall drop per decade in deaths after stroke. However, the decline was found mainly in people over age 65, with little progress in reducing the risk of strokes among younger people. The researchers say the decrease in stroke incidence and mortality is partly due to more successful control of risk factors such as blood pressure, smoking cessation and use of statin medications for controlling cholesterol, but that more efforts are needed to reduce strokes in younger people, including reducing obesity and diabetes and increasing physical activity. Read more on mortality.
Study: Insufficient Sleep Can Harm Memory
Lack of sleep, currently considered a public health epidemic in the United States, can also lead to errors in memory, according to a new study in Psychological Science. The study found that participants who didn’t get a full night’s sleep were more likely to make mistakes on the details of a simulated burglary they were shown in a series of images. “We found memory distortion is greater after sleep deprivation,” said Kimberly Fenn, an associate professor of psychology at Michigan State University and a co-investigator of the study. “And people are getting less sleep each night than they ever have.” The U.S. Centers for Disease Control and Prevention has linked the insufficient sleep epidemic to car crashes, industrial disasters and chronic diseases such as hypertension and diabetes. Read more on mental health.
The U.S. Environmental Protection Agency (EPA) has recently released a new graphic design available for use by insect repellent makers to more easily show how long the product is effective. “We are working to create a system that does for bug repellents what SPF labeling did for sunscreens,” said Jim Jones, Assistant Administrator of the Office of Chemical Safety and Pollution Prevention. “By providing vital information to consumers, this new graphic will help parents, hikers and the general public better protect themselves and their families from serious health threats caused by mosquitoes and ticks.” The release of the graphic design was accompanied by a joint statement from the EPA and the U.S. Centers for Disease Control and Prevention (CDC) urging the public to use insect repellents and take other precautions to avoid biting insects that carry serious diseases, including Lyme and West Nile virus. Incidence of insect-borne diseases is on the rise, according to the CDC. In order to place the new graphic on their labels, manufacturers must submit a label amendment, including test results on effectiveness. The public could see the graphic on repellent products early next year. Read more on infectious disease.
CDC: 60 Percent of Diners Will Use Menu Calorie Counts When Available
Approximately 6 in 10 U.S. adults will choose their restaurant meals in part because of menu label information when it’s available, according to the U.S. Centers for Disease Control and Prevention’s (CDC) latest Morbidity and Mortality Report. Researchers analyzed the self-reported usage of 118,013 adults in 17 states in 2012 to determine that about 57 percent will look to the provided calorie information. New York had the highest rate, with 61.3 percent, while Montana had the lowest, at 48.7 percent. Federal law requires calorie information be provided by any restaurant with 20 or more locations; while the regulations are not yet final, many establishments already voluntarily provide menu labeling, according to the CDC. Read more on nutrition.
Depression, Stress, Hostility Tied to Higher Stroke Risk
Depression, stress and hostility may be linked to a higher risk for stroke, according to a new study in the journal Stroke. Using information provided by approximately 7,000 adults who did not have heart disease or a history of stroke at the beginning of the study, researchers followed up nearly nine years later and determined that depression was associated with an 86 percent increased chance of a stroke or a transient ischemic attack, stress was associated with a 59 percent increase and hostility doubled the risk. “[C]hronic stress and negative emotions are important psychological factors that affect one's health, and findings from this study link these factors to brain health in particular," said the study's lead author, Susan Everson-Rose, an associate professor of medicine at the University of Minnesota, according to HealthDay. "Patients and their health care providers should be aware that experiences of chronic stress and negative emotional states can increase risk for stroke.” Read more on heart health.
Washington State Sees Most Measles Cases Since 1996
A slight decline in Washington State’s mumps and rubella vaccination rate has coincided with the state’s highest number of measles case in 18 years, according to officials. Washington has reported 27 cases so far this year and is currently in the midst of its third outbreak. While homegrown measles was declared officially eliminated from the United States in 2000, infections from people who have travelled overseas remain a threat. There were 554 total cases of measles and 17 outbreaks reported in the United States between Jan. 1 and July 3 of this year. Read more on infectious diseases.
AHA to Fund Research Network for the Prevention of Heart Disease, Stroke
With a $15 million grant from the American Heart Association (AHA), four major medical institutions are coming together to form a research network with the goal of preventing heart disease and stroke. The Strategically Focused Prevention Research Network Centers will include investigators at Northwestern University in Chicago, Vanderbilt University in Nashville, the Icahn School of Medicine at Mount Sinai in New York City and the University of Texas-Southwestern Medical Center in Dallas. “Heart attack and stroke can strike suddenly, and frequently without warning. The best way to reduce premature mortality from cardiovascular diseases and stroke is to prevent the development of the risk factors that lead to these conditions,” said AHA President Elliott Antman, MD, professor of medicine at Harvard Medical School and a senior physician in the cardiovascular division of the Brigham and Women’s Hospital in Boston, in a release. “Scientists working in these research centers are helping to discover the mechanisms that will allow all Americans to live healthier lives, helping lead us to a culture of health.” Read more on heart health.
Study: One-Third of U.S. Total Knee Replacements ‘Inappropriate’
Approximately one-third of all total knee replacements in the United States are unnecessary and “inappropriate” under a patient classification system used in Spain, according to a new study in the journal Arthritis & Rheumatology. Researchers said the findings demonstrate a need for the United States to develop similar patient selection criteria so as to limit the unneeded surgeries. There are more than 600,000 total U.S. knee replacements annually—meaning that approximately 200,000 are unnecessary, according to the study—and from 1991 to 2010 the number of Medicare-covered replacements climbed by approximately 162 percent annually. Read more on aging.
Kids’ ADHD Medications Not Linked to Increase Risk of Substance Abuse
While children with attention-deficit/hyperactivity disorder (ADHD) are twice as likely to abuse drugs, the medications prescribed to treat ADHD do not play a role in the increased risk, according to a new study in the journal Pediatrics. In fact, researchers determined that the combination of behavioral techniques and ADHD medications actually lowers the risk of substance abuse. "Obviously, the medications that are used to treat ADHD have the potential for abuse, but the vast majority of children with ADHD do not develop a substance abuse problem," said Michael Duchowny, MD, a pediatric neurologist at Miami Children's Hospital. "More research has to be done to find out why some children are more susceptible than others." Common ADHD medications include amphetamines such as Adderall or Dexedrine, and methylphenidates such as Concerta, Metadate CD or Ritalin. Read more on substance abuse.
A new database on pain research established by the National Institutes of Health (NIH) and several other federal agencies might help practitioners choose more effective and safer options for their patients dealing with pain. It could also potentially reduce reliance on opioid drugs, which often turns patients into addicts and creates an easy source of the drugs for potential abusers.
The database, launched last week, is called the Interagency Pain Research Portfolio (IPRP) and offers information on federal pain research projects. According to the NIH, pain is a symptom of many disorders and can be a disease itself; the economic cost of pain is estimated to be hundreds of billions of dollars annually in lost wages and productivity.
“This database [allows] the public and the research community...to learn more about the breadth and details of pain research supported across the federal government. They can search for individual research projects or sets of projects grouped by themes uniquely relevant to pain,” said Linda Porter, PhD, Policy Advisor for Pain at the National Institute of Neurological Disorders and Stroke (NINDS), part of the NIH.
Both in public speeches and private briefings with reporters, U.S. Centers for Disease Control and Prevention Director Tom Frieden, MD, MPH, has called on physicians to find alternatives to narcotics for pain patients when medically advisable, such as guided imagery and other forms of relaxation. He’s also called for starting with less potent medications than narcotics, in order to reduce the chance of addiction and to introduce far fewer amounts of prescription drugs into the community where they are often taken from medicine cabinets by people—especially young adults—for whom they’re not prescribed. According to the Substance Abuse and Mental Health Administration, approximately 22 million people nationwide have taken narcotic pain relievers for non-medical reasons.
U.S. Food and Drug Administration head Margaret Hamburg, MD, also spoke on the subject during a town hall meeting last week on prescription drug abuse, hosted by the Johns Hopkins School of Public Health and the Clinton Foundation. Hamburg said that “we need to recognize that opiates are... probably most often not the treatment strategy of first choice...but it may be the option a provider knows best. We need to actively engage with the scientific research community and industry to try to develop new non-opiate, non-addictive pain strategies...”
“Hypertension affects nearly one in three adults and kills more people around the world than anything else. It is both too common and too often poorly controlled.”
So said Tom Frieden, MD, MPH, director of the U.S. Centers for Disease Control and Prevention (CDC), during a panel discussion at the annual meeting of the American Society of Hypertension (ASH) this past weekend. The panel was convened by ASH, the American Heart Association and the CDC to launch a project supporting improved control of hypertension worldwide. According to the panel an estimated 970 million people have hypertension worldwide, and the disease is responsible for more than nine million deaths, as hypertension can lead to heart disease and stroke.
Data from the groups finds that rates of hypertension have increased in both developed and developing nations, due in part to an aging population and lifestyles that include high salt diets and low physical activity.
For the developing world, the CDC; the Pan American Health Organization; and other regional and global stakeholders are identifying both cost effective medicines and inexpensive delivery strategies for the drugs to help patients afford and receive them.
In the United States, the Affordable Care Act is expected to increase the number of people on hypertension medications, but despite the availability of coverage for hypertension diagnosis and treatment there remains concern over disparities. A study of more than 16,000 members of the Hispanic community published in the American Journal of Hypertension earlier this year found that while the prevalence of hypertension among Hispanics is nearly equal to that of non-Hispanic whites, diagnosis of the disease is much lower, as is general awareness of its symptoms and treatment options.
"Given the relative ease of identifying hypertension and the availability of low-cost medications, enabling better access to diagnostic and treatment services should be prioritized to reduce the burden of cardiovascular disease on Hispanic populations,” said Paul Sorlie, MD, the lead author of the study and an epidemiologist with the National Heart, Lung and Blood Institute. “This study gives us the information needed to support the development of policies that can improve this access and, subsequently, the overall health of countless US citizens.”
- A new infographic from the Measure Up/Pressure Down initiative of the American Medical Group Association provides some key patient information about hypertension, including normal and dangerous ranges of blood pressure—numbers patients should be familiar with.
- A map from the Institute for Health Metrics and Evaluation at the University of Washington shows hypertension levels for 2001 to 2009 by race and gender.