Tips for Safe Snow Fun

By Robert Preidt, HealthDay Reporter



SATURDAY, Feb. 28, 2015 (HealthDay News) -- Winter sports are a great way to get exercise and fresh air, but they're not without risks.


In 2013, more than 343,000 people in the United States received medical treatment for winter sports injuries, according to the Consumer Product Safety Commission.


Skiing topped the treatment list, with 138,559 injuries. Snowboarding accounted for 95,348 accidents; sledding, more than 63,000; and ice skating, about 47,000.


"When it comes to winter sports, safety starts with knowing and practicing the rules," Dr. Michael Cheek, a sports medicine specialist and American Academy of Orthopaedic Surgeons spokesperson, said in an academy news release.


Many skiing and snowboarding injuries can be prevented by using proper equipment and getting appropriate training, he pointed out.


"Before hitting the slopes, inexperienced participants should consider taking a lesson [or several] from a qualified instructor to help prepare for the unexpected, like learning how to fall safely," Cheek said.


Common causes of sledding injuries include collisions at the end of sledding runs and sledding in improper positions.


General winter-sports safety advice includes going out with a partner and staying in sight of each other. Before heading outdoors, tell someone who isn't joining you about your plans and likely location.


The academy also recommends the following:



  • Check the weather before you leave, and pay attention to warnings about storms and severe temperature drops. Make adjustments for icy conditions, deep powder, wet snow and dangerous weather conditions.

  • Always carry a cell phone in case of an emergency.

  • Wear several layers of light, loose and water- and wind-resistant clothing, and appropriate protective gear such as goggles, helmet, gloves and padding.

  • Check that all your equipment, such as ski and snowboard bindings, are in good working order.

  • Be sure to warm up before your activity. Cold muscles, tendons and ligaments are at increased risk for injury.


More information


The U.S. Centers for Disease Control and Prevention offers winter health and safety tips.


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Belief in Acupuncture Key to Effect on Back Pain, Study Suggests

By Robert Preidt, HealthDay Reporter



FRIDAY, Feb. 27, 2015 (HealthDay News) -- Acupuncture for back pain is more likely to help people who believe the treatment will work, new research suggests.


The study included 485 people who received acupuncture for back pain and completed questionnaires before they began treatment, at two and three months into treatment, and then again at six months after treatment.


Patients who had low expectations of acupuncture before they began the therapy gained less benefit than those who believed it would work, according to the researchers at the University of Southampton in England.


The investigators also found that patients who had a positive view of their back pain and felt in control of their condition had less back-related disability while undergoing acupuncture.


The findings, published in the March issue of the Clinical Journal of Pain, showed that "psychological factors were consistently associated with back-related disability," study author Dr. Felicity Bishop said in a university news release.


"When individual patients came to see their back pain more positively, they went on to experience less back-related disability," Bishop said.


"In particular," she explained, "they experienced less disability over the course of treatment when they came to see their back pain as more controllable, when they felt they had better understanding of their back pain, when they felt better able to cope with it, were less emotional about it, and when they felt their back pain was going to have less of an impact on their lives."


One arthritis doctor said the study findings illustrate an important point.


"This study emphasizes the influence of the placebo effect on pain. The process whereby the brain's processing of different emotions in relation to their treatment can influence outcome is a really important area for research," Dr. Stephen Simpson, director of research at Arthritis Research UK, said in the news release.


Arthritis Research UK funded the study.


More information


The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more about back pain.


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Global Blood Pressure Program Could Save Millions of Lives, Experts Say

By Robert Preidt, HealthDay Reporter



FRIDAY, Feb. 27, 2015 (HealthDay News) -- Treating half of people with uncontrolled high blood pressure could prevent 10 million heart attacks and strokes worldwide over 10 years, according to experts.


Most people with uncontrolled high blood pressure (or "hypertension") are in low- and middle-income countries and have poor access to diagnosis, care and treatment, said the authors of a commentary published Feb. 26 in The Lancet.


In an effort to get those people into treatment and reduce their risk of premature death, a new program called the Global Standardized Hypertension Treatment Project has been launched by the U.S. Centers for Disease Control and Prevention and the Pan American Health Organization (PAHO).


"Heart disease and stroke are silent killers -- on a mass scale. Cardiovascular disease kills more people around the world than all infectious diseases combined," CDC director and commentary co-author Dr. Tom Frieden, said in a CDC news release.


"Hypertension is a major contributor to cardiovascular disease and the question is not whether treatment of hypertension should be undertaken on a global scale, but how quickly effective programs can be established," he added.


Each year, high blood pressure kills 9.4 million people worldwide, about the same number as deaths from all infectious diseases. High blood pressure is the leading cause of heart attack and stroke, which are the leading causes of death in the world, according to the experts.


"Hypertension affects some 250 million people in the Americas, and in most countries rates of blood pressure control are unacceptably low," Dr. Carissa Etienne, PAHO director, said in the news release.


This project holds tremendous potential for reducing early deaths, as well as the damaging economic effects heart disease has around the world, Etienne said.


Even though high blood pressure is probably the easiest chronic non-infectious disease to treat, only 13 percent of the 1 billion people worldwide with high blood pressure have it under control, the experts pointed out.


High blood pressure treatments can be made relatively inexpensive, even for people in low- and middle-income countries, according to the commentary authors.


The new program is based on four principles:



  • Developing standardized treatment approaches.

  • Recognition that all members of a health care team play a crucial role in controlling blood pressure.

  • Elimination of cost barriers for patients and make refilling prescriptions easier.

  • Close tracking of patients' blood pressure and improvements.


More information


The American Academy of Family Physicians has more about high blood pressure.


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Hospital Design May Not Boost Patient Satisfaction, Research Suggests

By Robert Preidt, HealthDay Reporter



FRIDAY, Feb. 27, 2015 (HealthDay News) -- Hospital design has little effect on patient satisfaction, according to a new study.


Researchers analyzed surveys of more than 5,600 hospital patients in both newly renovated facilities and older facilities.


"Our team wanted to know how important aesthetics are to a patient's experience with care. So we looked at surveys from patients before and after a move. We then compared those results to satisfaction surveys from patients being cared for on similar units that had not undergone a move to a new facility," said study author Dr. Zishan Siddiqui. He is an assistant professor of medicine at Johns Hopkins University School of Medicine.


"We originally thought new and pleasing surroundings would improve patient satisfaction scores with physicians, nurses and overall care, but our study showed this is not the case," Siddiqui said in a Hopkins news release.


The study appears in the March issue of the Journal of Hospital Medicine.


Some hospital officials believe that improving their facilities to be more patient-focused will automatically improve patient satisfaction.


"Not so. Hospital leaders will have to stop blaming poor patient satisfaction scores on aging buildings and units," Siddiqui said.


"Although we did see significant improvement in facility-related satisfaction scores [in newer facilities], we did not see significant change in satisfaction related to care, or overall satisfaction, for that matter," he added.


More effective ways to improve patient satisfaction include training health care providers on personalized care, educating patients, and involving families in care decisions, the researchers said.


More information


The American College of Surgeons has more about doctor personalities and burnout.


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Immune System Changes Tied to Chronic Fatigue Syndrome

By Dennis Thompson

HealthDay Reporter



FRIDAY, Feb. 27, 2015 (HealthDay News) -- Chronic fatigue syndrome appears to be linked to specific changes in a person's immune system, particularly increased amounts of chemical messengers that regulate immune responses, researchers report.


The study adds to growing evidence that chronic fatigue syndrome is caused by a malfunctioning immune system, said lead author Dr. Mady Hornig. She is director of Translational Research at the Jerome L. and Dawn Greene Infectious Disease Laboratory at Columbia University's Mailman School of Public Health, in New York City.


The immune system of a new chronic fatigue syndrome patient appears unable to shut down or reduce its response to an infection that has passed, Hornig said.


Instead, the system continues to pump out large amounts of cytokines -- chemical messengers that coordinate the response of the immune system's many cell types.


"Their immune system is no longer resilient and able to bounce back after this cytokine surge" in response to an infection, Hornig said. "We need the system to be regulated, so it shuts off after the disease is gone, and that isn't happening here."


Doctors now can look for increased levels of these chemicals in the blood of patients who might have chronic fatigue syndrome, potentially aiding in their diagnosis, she said.


"We may be able to reduce the time it takes to get a diagnosis, and reduce the time it takes to get them some treatment," Hornig said. Treating chronic fatigue syndrome early could reduce its future impact on patients' lives, she added.


The new study, published Feb. 27 in the journal Science Advances, comes on the heels of a new Institute of Medicine report that declared chronic fatigue syndrome a "legitimate" illness that should be treated by doctors as a disease rather than an emotional problem.


Between 836,000 and 2.5 million Americans suffer from chronic fatigue syndrome, and an estimated 84 percent to 91 percent of people with the disorder are not diagnosed, according to the IOM. Chronic fatigue syndrome tends to strike people in their 40s and 50s, and occurs four times more often in women than men.


"It is so valuable to be able to find something that can help further validate the disease status of this condition," Hornig said of her team's results. "It's a biological disorder, not a psychological one."


The new study relied on data gathered during two large U.S. studies of chronic fatigue syndrome, involving 298 people diagnosed with CFS and 348 healthy "control" subjects. As part of these studies, participants provided blood samples.


Researchers analyzed the blood sample data, looking at the presence of cells and chemicals related to the immune system.


They noted that distinct increases occurred in the cytokine levels of people who'd been diagnosed with chronic fatigue syndrome for fewer than three years, compared with both the "healthy" controls and people with long-term CFS. The changes are only present early on in the course of disease, and don't appear in long-term patients.


The results indicate that there are stages of chronic fatigue syndrome, and that new patients likely need treatments different from those who have had CFS for a long time, Hornig said.


"It may be possible to prevent the long-term consequences of this illness by intervening early and dampening down these cytokines," she said. "It also has implications for the very large population of people who have had this disease for a long time and for whom a different strategy may be important."


The findings mesh with other recent research that has linked chronic fatigue syndrome to a faulty immune system, said Dr. Jacob Teitelbaum, director of the Fatigue & Fibromyalgia Practitioners Network.


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Hepatitis C Infections in Hospitals Show Need for Tight Infection Control Practices

By Steven Reinberg

HealthDay Reporter



FRIDAY, Feb. 27, 2015 (HealthDay News) -- Two cases of hepatitis C infection that occurred during routine surgeries highlight the need for hospitals to tighten infection control to prevent more transmissions, officials said Friday.


In one case, two New Jersey patients (one of them had hepatitis C) received an injection of the anesthetic propofol from the same medication cart. In the other instance, two Wisconsin patients (one of them had hepatitis C) received kidneys that had been prepared for transplantation on the same machine, according to an article in the Feb. 27 issue of Morbidity and Mortality Weekly Report, a publication of the U.S. Centers for Disease Control and Prevention.


The source of the infection in the Wisconsin case was not pinpointed, said Gwen Borlaug, coordinator of the HAI Prevention Program at the Wisconsin Division of Public Health, but "we identified breaches in infection control practices in the operating room that likely resulted in the transmission."


In the New Jersey case, the infection was traced to contaminated equipment that was taken from one operating room to another. Dr. Barbara Montana, medical director of the communicable disease service at the New Jersey Department of Health, said, "Fortunately, these infections can be prevented when health care providers follow basic infection prevention practices."


According to the CDC, 22 outbreaks of health-care-associated hepatitis infections occurred from 2008 through 2014. Most of the outbreaks occurred in outpatient care centers and long-term care facilities.


These outbreaks typically involved unsafe injection practices, such as using medication vials on multiple patients or reusing needles or syringes, Borlaug said. Other outbreaks have occurred as a result of contaminated items, such as blood sugar testing devices, she said.


"It is imperative to always practice sound infection control measures, such as cleaning and disinfecting used medical equipment and patient care items, and observing safe injection practices," Borlaug said.


Patients can also play a part in preventing these infections, Montana said.


"Patients should ask questions about infection prevention practices, such as whether health care providers are following good infection prevention practices, including hand washing and using a new needle/syringe for each patient and cleaning equipment between patients," she said.


Hepatitis C is a virus that attacks the liver. In its chronic form, it affects some 3.2 million Americans, according to the CDC. However, about 75 percent to 85 percent of those with chronic hepatitis C eventually develop acute disease, which can result in serious liver damage and liver cancer.


Hepatitis C is a leading cause of liver cancer and the need for liver transplantation, according to the agency.


Unlike its cousins hepatitis A and B, which can be prevented with a vaccine, there is no vaccine for hepatitis C. However, it can be treated.


Until widespread screening of the blood supply began in 1992 in the United States, there was no screening test for the virus. For that reason, the CDC recommends that anyone born between 1945 and 1965 get tested for hepatitis C.


Dr. Marc Siegel, a professor of medicine at NYU Langone Medical Center in New York City, said these cases are likely only the tip of the iceberg and many more such infections occur in hospitals.


"These two cases are reminders of the small amount of hepatitis C virus that is necessary to cause infection and the importance of proper sterilization and handling of all dental and medical equipment at all times, especially amid a national epidemic of viral hepatitis with no vaccine for hepatitis C," he said.


More information


Visit the U.S. Centers for Disease Control and Prevention for more on hepatitis C.


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When Babies Spit Up, Don't Panic

By Robert Preidt, HealthDay Reporter



FRIDAY, Feb. 27, 2015 (HealthDay News) -- Some babies spit up more than others, but it doesn't necessarily mean they have a problem, an expert says.


A baby's stomach is small and can tolerate only small amounts of food. As a baby grows, so does his or her stomach and spitting up becomes less common, explained Dr. Josephine Dlugopolski-Gach, an assistant professor in the department of pediatrics at Loyola University Chicago Stritch School of Medicine.


Also, the esophageal sphincter -- the flap that keeps stomach contents from coming back up -- is not fully functional in babies, she explained.


"Babies typically outgrow spitting up by 6 months. This is when the stomach muscles and the flap that keeps food in the stomach matures. Also, when babies start eating more solid foods and sitting up, spit-up becomes less frequent," Dlugopolski-Gach said in a university news release.


"There are medications to help reduce the discomfort of frequent spitting up, but they usually do not help with how often the child is spitting up. Your pediatrician can help decide if the medication is right for your child," she said.


You can reduce spitting up by: burping your baby after every 1 to 2 ounces or 5 to 10 minutes of feeding; holding your baby upright for several minutes after feeding; and by putting the baby in a car seat or swing for 30 minutes after feeding, Dlugopolski-Gach suggested.


While normal, spitting up can be a warning sign of a bigger problem if a baby also has poor weight gain, vomits bile or blood, cries constantly and is inconsolable, is lethargic and has decreased urine production or projectile vomiting, Dlugopolski-Gach said.


More information


The American Academy of Family Physicians has more about spitting up in babies.


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ER Physician Raises Concerns About Powdered Caffeine

By Mary Elizabeth Dallas, HealthDay Reporter



FRIDAY, Feb. 27, 2015 (HealthDay News) -- The availability of both alcohol and caffeine in powdered form that can be added to food or drinks has sparked public concern, but one expert says the substances don't pose equal risks.


Several states, including Pennsylvania, have taken steps to preemptively ban the sale of powdered alcohol, but an emergency specialist warns that powdered caffeine is probably the greater health threat.


"Of the two, caffeine is the more concerning one for me," Dr. Glenn Geeting, an emergency physician at Penn State Hershey, said in a hospital news release.


One reason for his concern is that powdered caffeine can be easily purchased online. Another is that powdered caffeine is concentrated. A teaspoon of the substance contains roughly the same amount of caffeine as 25 cups of coffee. That's more than four times the amount that appears safe to consume in a day, according to the Penn State Hershey experts.


The main difference between powdered and liquid alcohol is its packaging. The powder may be more convenient to pack and carry, but it's not a concentrated form of alcohol. Critics warn however, young people may be tempted to snort it or use powdered alcohol to spike drinks.


The potential for abuse however doesn't seem any greater than the risks associated with liquid alcohol, according to Geeting.


"For those who are worried about powdered alcohol being smuggled into schools or theaters, it is likely to be harder to hide, more expensive than liquid alcohol and takes at least 30 seconds to dissolve," he said. "It would be really painful to snort and takes about half a cup of it to get an ounce of alcohol. It seems like it would be easier to just drink a shot."


Over the past year however, powdered caffeine has caused numerous overdoses nationwide that have resulted in hospitalizations, according to the news release. At least two people died after using the substance, said the Penn State Hershey experts.


"Like any drug, it creates a toxic syndrome, and it can create real problems," said Geeting. Signs of a caffeine overdose include:



  • Rapid or erratic heartbeats

  • Agitation

  • Vomiting

  • Seizures


"While mortality is not very common with powdered caffeine, it is a possibility," Geeting noted. "I think it is worth using caution."


Complicating matters, powdered caffeine is considered a dietary supplement, which means it is not regulated by the U.S. Food and Drug Administration. The agency cautioned consumers against using the substance, to avoid a potential overdose. The FDA also advised parents to be aware of the danger this substance could pose to teens or young adults.


More information


The U.S. Food and Drug Administration provides more information on the dangers associated with powdered caffeine.


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Airport Screenings Miss Roughly Half of Sick Travelers: Study

By Mary Elizabeth Dallas, HealthDay Reporter



FRIDAY, Feb. 27, 2015 (HealthDay News) -- Airport screenings for infectious diseases often miss 50 percent or more of sick travelers, mostly because people do not tell the truth about their exposure to illnesses, a new study suggests.


"Honest reporting can not only improve on-site detection, but is essential to enable authorities to follow up with travelers who may have been exposed but have not yet developed symptoms," wrote researcher and graduate student Katelyn Gostic, from the Lloyd-Smith Lab at University of California, Los Angeles.


Using a mathematical model, researchers from UCLA and the London School of Hygiene and Tropical Medicine analyzed airport screenings for six viruses: SARS coronavirus, Ebola virus, Middle East respiratory syndrome coronavirus (MERS-CoV), Marburg virus, influenza H1N1, and influenza H7N9.


They found one of the biggest barriers to successful health screenings at airports is a lack of honesty among passengers. This is a particular issue among travelers trying to avoid delays, they noted.


Gaining a better understanding of how infectious diseases progress could help ensure that passengers are asked the appropriate questions in screening surveys, the researchers said. For example, being exposed to a symptomatic Ebola patient is a risk factor for contracting the disease.


At best, 25 percent of people were honest about their exposure to the flu during the 2009 pandemic, the study published recently in the journal eLife showed. The researchers pointed out that some passengers might have even concealed their symptoms with medication.


The study's authors suggested that policymakers consider devoting more resources to arrival screening, which could reduce the number of missed cases.


"We found that for diseases with a long incubation period such as Marburg and Ebola, taking passengers' temperature to test for fever is particularly ineffective at the start of an epidemic but does pick up more cases as it stabilizes," Gostic said. In the early phase of disease epidemics, questionnaires are the most effective way to detect potential illnesses, she added.


Although screening for fevers upon arrival at a destination has been criticized for being ineffective, the study found this method could catch cases that were missed at departure.


When it comes to diseases such as swine flu, which take a shorter time to incubate, Gostic noted that fever screening is the most effective method throughout an epidemic.


Infrared noncontact thermometers do not pick up all fevers, usually only catching them 70 percent of the time, the researchers pointed out.


More information


The U.S. Centers for Disease Control and Prevention provides more information on health screenings at airports.


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Study Links Recession to Spike in Suicides Among Middle-Aged

By Dennis Thompson

HealthDay Reporter



FRIDAY, Feb. 27, 2015 (HealthDay News) -- The financial stress of the last recession likely contributed to a recent increase in suicides among middle-aged Americans, researchers report.


Job, financial or legal problems played a role in 37.5 percent of all completed middle-age suicides in 2010, up from just under 33 percent of suicides in 2005, according to findings published in the Feb. 27 issue of the American Journal of Preventive Medicine.


Mental health problems remained the leading factor in middle-aged suicides, and were involved in four out of five suicide deaths, the study noted.


But financial pressures probably played a key role in triggering suicidal action in someone who might have only been contemplating suicide, the study authors added. However, the study could only find an association between tough economic times and suicide rates, it couldn't prove cause and effect.


"The middle-aged bear the brunt of economic stress associated with a downturn," said study author Katherine Hempstead, director of the Robert Wood Johnson Foundation and the Center for State Health Policy at Rutgers University in Princeton, N.J. "They're the bread-winner groups who are raising kids, paying for college, planning for their retirement and supporting their elderly parents."


Overall, suicide rates for U.S. adults between the ages of 40 and 64 have risen about 40 percent since 1999, the study found.


However, what had been a slow, steady increase in suicides among that age group jumped dramatically between 2007 and 2010.


Researchers decided to explore whether the last recession -- which began in December 2007, according to the U.S. National Bureau of Economic Research -- played a role in the increased suicide rate among middle-aged adults.


Economic evidence suggests that middle-aged people may have experienced more hardship during the recession, the study authors said. For example, more than one out of four workers aged 50 to 64 experienced salary reductions during the recession, compared with one out of five younger workers, according to background notes with the study.


To perform their study, the researchers turned to the National Violent Death Reporting System (NVDRS). The system links detailed information on violent deaths from multiple sources, including medical examiner and coroner reports, toxicology reports, law enforcement records, supplemental homicide reports and death certificates.


The researchers evaluated suicide data from 16 states that report to the NVDRS, excluding three states that either only recently began contributing data or only contribute information from parts of the state.


Based on the data, the researchers identified 17 distinct suicide circumstances in three major categories:


The researchers found an increase between 2005 and 2010 in middle-aged suicides involving external circumstances such as job loss or financial pressure. During the same period, suicides involving personal or interpersonal circumstances either remained stable or declined.


Younger people -- those under 40 -- did not show the same increased influence of financial factors on their decision to die by suicide, the researchers found. The percentage of suicides among younger adults linked to job loss or financial hardship remained level, even as these problems played an increasing role in middle-aged suicides.


"That middle-aged population, there is a lot more riding on their ability to have an income," said Dr. Christine Moutier, chief medical officer of the American Foundation for Suicide Prevention. "They're that sandwiched generation, having fiscal responsibilities for both sides, the younger and the older, their children and their parents."


Middle-aged people also have a dwindling number of years in the job market, meaning they have less time to make up for any lost earnings or declines in their investments, Moutier added.


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How to Weigh Yourself the Right Way

Health Tip: Offer Kids the 5 Food Groups

Health Tip: What's Triggering Your Irritable Bowel Syndrome?

By Diana Kohnle, HealthDay Reporter


(HealthDay News) -- Irritable bowel syndrome (IBS) may be characterized by symptoms including abdominal discomfort, diarrhea, gas, constipation and bloating.


The Mayo Clinic says these factors may trigger IBS symptoms:



  • Certain foods, particularly dairy, chocolate, cabbage, cauliflower, beans, fruit, broccoli, high-fat foods, alcohol and carbonated beverages.

  • Emotional stress can worsen IBS symptoms, but may not cause them.

  • Changes in hormone levels, such as during menstruation.

  • Conditions such as gastroenteritis, or excess bacteria in the gut.


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Seasonal Flu Vaccine Even Less Effective Than Thought: CDC

By Steven Reinberg

HealthDay Reporter



THURSDAY, Feb. 26, 2015 (HealthDay News) -- This year's flu vaccine is even more disappointing than previously reported, showing just 18 percent effectiveness against the dominant H3N2 strain of flu, health officials reported Thursday.


That's a drop from the 23 percent protection level estimated for the flu shot earlier in the season, said experts at the U.S. Centers for Disease Control and Prevention.


The situation for children was even worse. The CDC panel pegged the effectiveness of the injected vaccine for kids aged 2 to 8 to be just 15 percent.


And the nasal-spray version of the vaccine may not protect young children at all, health officials said.


"Studies can't confirm that the [nasal] vaccine has a benefit," said Dr. Joseph Bresee, chief of the Epidemiology and Prevention Branch at CDC's National Center for Immunization and Respiratory Diseases.


Why the poor performance?


"These low numbers, which are lower than we normally see, are because the flu viruses that are circulating have mutated to look very different than the vaccine strains," Bresee explained.


He added that the H3N2 flu strain that is currently circulating was not factored into this season's vaccine because decisions about which strains to target were made last February. As happens each year, choices about which strains to include are made months in advance so that manufacturers have time to make enough vaccine, Bresee explained.


In fact, this new strain of H3N2 was seen for the first time in March 2014 and didn't become dominant until September, Bresee noted. "That was much too late to make a new vaccine," he said.


"This is a very unusual circumstance where a new strain develops and becomes a dominant strain so quickly and after the vaccine had already been produced," he said.


On Thursday, the Word Health Organization made its recommendation for the makeup of next season's vaccine, Bresee said. Next week, the U.S. Food and Drug Administration will decide which strains will be included in next season's flu vaccine for the United States. Bresee said the FDA usually follows the WHO recommendations.


WHO recommended that this year's mutated H3N2 strain as well as updated versions of other strains be included in next season's vaccine, Bresee added.


Although this year's vaccine is only somewhat effective and the flu season has peaked, Bresee still recommends getting a flu shot.


"Year in and year out, flu vaccines are still the best way to protect yourself against flu," he said. "Most years, the vaccine is 50 to 70 percent effective. The vaccine doesn't protect everybody every time, but it's odds on the best way to protect yourself against flu."


Dr. Marc Siegel, a professor of medicine at NYU Langone Medical Center in New York City, agreed that the vaccine is still the best protection against flu.


"Yes, it's still worth getting it though the season has already peaked," he said.


The CDC said that the flu season isn't over yet, and there is an increasing number of B viruses circulating, which are a better match to the vaccine and could bring final vaccine effectiveness numbers up.


This year's flu season has also hit children hard, the agency said, with 86 children dying from complications of flu by Feb. 7. For context, the CDC noted that in an average year, child deaths from flu vary from as few as 30 to as many as 170 or more.


The CDC currently recommends that everyone aged 6 months and older get vaccinated. Even if the flu shot isn't a perfect match to circulating strains, vaccination can still prevent some infections and reduce severe disease that can lead to hospitalization and death, the agency said.


Other ways to treat and prevent flu from spreading include early treatment with antiviral drugs such as Tamiflu and Relenza, and washing hands frequently and covering your mouth when coughing or sneezing.


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Epilepsy Surgery Gets High Marks From Patients in Survey

By Alan Mozes

HealthDay Reporter



THURSDAY, Feb. 26, 2015 (HealthDay News) -- More than nine in 10 epilepsy patients who had brain surgery to try to control their seizures are happy they did so, a new survey reveals.


The review appears to be driven by the fact that patients saw the number of debilitating seizures they experienced after surgery either drop significantly or disappear altogether, the researchers noted.


"One percent of the U.S. population has epilepsy, and among that group there are about 750,000 patients with recurring seizures that are not well-controlled," said study co-author Dr. Marianna Spanaki-Varelas, director of the Henry Ford Comprehensive Epilepsy Program at Henry Ford Hospital in Detroit. "Of those, 30 to 35 percent are [surgical] candidates because they do not respond to the roughly 15 appropriate epilepsy drugs that we have."


A great majority of those who have surgery say it was worthwhile because many remain seizure-free long after surgery and many see a big improvement in their quality of life, Spanaki-Varelas noted.


The survey findings are published in the February issue of Epilepsy & Behavior.


The surgery, during which a portion of the brain is removed to treat debilitating seizures, is typically reserved for patients whose seizures originate in a single spot in the brain.


"We would not operate on people who have more than one spot of the brain that generates seizures," Spanaki-Varelas said. "And we also would not operate on focal patients whose problem brain region is too close to areas that control motor or sensory function or speech."


That said, Spanaki-Varelas added that epilepsy surgery is still "highly underutilized in this country." She said only 1,500 Americans have the surgery each year, even though recent research has shown that the procedure is actually no more risky than hip replacement surgery.


"There is a misconception, even among physicians, that surgery should be considered the very last resort," Spanaki-Varelas explained. "But we should not delay surgery until all drugs are tried. If a patient fails on one, two or, at maximum, three medications, alone or in combination, then they need to be considered as [surgical] candidates."


That position, Spanaki-Varelas noted, is supported by the American Academy of Neurology.


To assess how well epilepsy patients fare following surgery, the study authors focused on a pool of 470 men and women with epilepsy. All had been operated on at Henry Ford between 1993 and 2011.


Of the group, 50 patients had died since surgery. After reviewing electronic medical records and recent clinic notes, the research team was ultimately able to conduct follow-up phone surveys with more than 250 patients.


On average, quality-of-life surveys were conducted nearly 11 years post-surgery, though more than one-quarter of the patients (27 percent) were reached more than 15 years following their initial operation.


The result: 92 percent of patients said they considered their surgery to be "worthwhile."


Slightly less than one-third said they were currently seizure-free, while three-quarters described the results of their surgery as "favorable," meaning total seizure relief or only rare occurrences of "disabling" seizures.


Those "favorable" outcomes held steady over time, seen among 77 percent of patients during the five years after surgery and among 78 percent of patients who reached the 15-year-plus mark.


Seizure-free status was somewhat less steady, seen among roughly 40 percent prior to the five-year mark, but only among 29 percent after five to 10 years. Between 10 and 15 years after surgery, the numbers rose back to 38 percent, only to drop to 26 percent among the 15-year-plus group.


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U.S. Ebola Survivor Dr. Craig Spencer Gives His Side of the Story

By Dennis Thompson

HealthDay Reporter



THURSDAY, Feb. 26, 2015 (HealthDay News) -- Many U.S. politicians and media outlets hyped the threat of U.S. cases of Ebola last year, according to a newly written personal account by Dr. Craig Spencer, the last American Ebola patient treated in the United States.


He also believes that officials and the media unnecessarily maligned those who were risking their lives to combat the West African epidemic.


Spencer contracted the virus while performing aid work at an Ebola treatment center in Guinea, and fell ill days after his return to New York City. He entered Bellevue Hospital on Oct. 23 as New York's first Ebola patient, and spent 19 days there recovering from his infection.


"Though I didn't know it then -- I had no television and was too weak to read the news -- during the first few days of my hospitalization, I was being vilified in the media even as my liver was failing and my fiancee was quarantined in our apartment," Spencer wrote in a letter in the Feb. 26 New England Journal of Medicine.


While he was in the hospital, media outlets hyped the potential threat of Ebola and criticized Spencer for going out into the city after his return, he wrote. At the same time, politicians used the virus seemingly to score election-season points with voters by enacting poorly considered quarantines.


"After my diagnosis, the media and politicians could have educated the public about Ebola," Spencer wrote. "Instead, they spent hours retracing my steps through New York and debating whether Ebola can be transmitted through a bowling ball."


Fear motivated these decisions, and Spencer said as an American aid worker he well understands that fear, "because I felt it on a personal level."


He often woke up in the middle of the night during his work in Guinea, sweating and heart racing, convinced that he'd contracted Ebola even though his temperature was normal.


"Ebola is frightening not just because of its high fatality rate, but also because of how little we know about it," he wrote. "We cannot explain exactly what it does to our bodies, nor tell patients who survive it how it may affect them in the future."


While he found the high-pressure work rewarding, Spencer felt profound relief when he left Guinea following his tour of duty. He remembers "the calm that settled over me the last time I left the [Ebola treatment] center, knowing that I'd no longer be exposed to Ebola."


Back in New York, Spencer continued to worry that he might fall ill with Ebola and infect his fiancee or others.


"Touching others and shaking hands -- forbidden actions throughout West Africa -- still made me uncomfortable," he wrote. "Twice a day, I held my breath in fear when I put a thermometer in my mouth."


The day of his hospitalization, Spencer woke up knowing something was wrong. He felt warmer and more tired than usual, and seemed to be breathing more quickly. When he took his temperature and found it elevated, he immediately called in and was rushed to the hospital.


But while he struggled in the hospital, the outside world picked over his daily activities since his return from West Africa and criticized him for moving freely about, Spencer said.


The media gave scant attention to the fact that all available evidence on Ebola "suggested that it was nearly impossible for me to have transmitted the virus before I had a fever," he wrote.


At the same time, the governors of New York and New Jersey implemented strict home quarantine rules that demonized workers fighting the raging epidemic and acted counter to the best public health practices, Spencer wrote.


"Instead of being welcomed as respected humanitarians, my U.S. colleagues who have returned home from battling Ebola have been treated as pariahs," he wrote. "I believe we send the wrong message by imposing a 21-day waiting period before they can transition from public health hazard to hero."


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Are You a Helicopter Child?

Anne Borrowdale was visiting her parents in Suffolk, England, when a salesman rang the doorbell and her father – a minister in his mid-80s at the time – answered it. After several minutes of chatter, Borrowdale stepped in. "I went to the door and said firmly, 'He’s told you he’s not interested. Goodbye,' and shut the door," says Borrowdale, 59, an author and speaker in Oxford, England.


Borrowdale soon regretted it.


"I’d treated him like a child who wasn’t capable of making sensible decisions anymore in front of a stranger," she says. "I’d let my worry about elderly people getting conned override his dignity."


Similar to helicopter parents, who hover too closely over their adolescent children, adult children may find their involvement in their aging parents’ lives is unnecessary, unwelcome or both – even if just for a moment, as in Borrowdale's case.


“There’s an inherent tension between an older adult’s desire for independence, desire to make their own choices [and] take their own risks, and the adult child’s broader vision of saying, ‘You can’t do that because it’s too risky; you will hurt yourself; this person is not good to be around,’” says Carol Levine​, director of the United Hospital Fund’s Families and Health Care Project, which develops partnerships between health care professionals and family caregivers. “It is a protective response – and that’s not bad because there are certain things that all of us need to be protected from by somebody who cares for us."


But sometimes, adult children can overstep their bounds – or at least be perceived as overstepping their bounds. That can alienate parents, who might resist their children’s involvement by turning away. It can infantilize them, too. “What you don’t want to do with older people is confuse [them] with children,” says Robert Kane​, director of the University of Minnesota’s Center on Aging. “They have opinions and beliefs and, in some cases, they have the right to take informed risk. You can’t take away that right – you don’t want to take it away. What you want to do is make sure they truly understand the risk.”


Adult children who are extremely involved in their parents’ care might also make the situation worse for the health care staff at hospitals or long-term care facilities​, says Sherry Saturno​, a social worker and executive director of the Hudson Valley Care Coalition, a nonprofit in New York.


“Children may become hyper-vigilant and easily angered because they can’t control what is physically happening with their parents, so they’ll try to micromanage issues they can control,” such as their meals or clothes, she says. “In turn, that affects the health care staff because children in such a situation may misdirect their anger and frustration to the facility staff.” Most of the time, however, adult children are more than welcome in such facilities. "Their presence, their interest and their support are really important," Levine says. "They are often the glue that keeps things together."


Here’s how to toe the line between caring and overbearing:


1. Start discussions early.


The time to start talking with your aging parents about tough issues related to aging is now, says Patricia Parmelee​, director of the Center for Mental Health and Aging at the University of Alabama. ​"It makes families uncomfortable, and so we delay," she says. "And the typical situation that happens is decisions get made under pressure and on a very short timeline, and at least a good portion of the time, nobody’s happy with the outcome."


So get a head start on the conversation. Talk about what type of medical care your parents want if they start to decline, the features of a facility they could see themselves living in and whom they’d like as a health care proxy.


Be prepared for denial and pushback, Kane says. He suggests taking a practical approach to discussions by pointing out to older adults at risk for heart failure, for example, that their multistory home won’t always be the right fit for their abilities. “When you’re dealing with your parents, you bring a huge amount of emotional baggage and history,” he says. “You need to recognize that you’re going to be the adult in the room, and so you have to basically find a way to sort of push that down.”


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Fewer Americans Burdened by Medical Bills: Study

By Karen Pallarito

HealthDay Reporter



THURSDAY, Feb. 26, 2015 (HealthDay News) -- The number of Americans struggling to pay medical bills has declined every year since 2011 and particularly since 2013, a new government report shows.


Health policy and medical bill experts believe the new patient protections and coverage offered under the Affordable Care Act, as well as the steadily improving national economy, may have contributed to families' financial relief.


A less positive possibility is that some families in "high-deductible" health plans may be holding off on using medical services, experts added.


In 2011, 56.5 million people under the age of 65 were in families that had problems paying medical bills in the previous 12 months. But that dropped to just under 48 million people in the first half of 2014, according to the U.S. National Center for Health Statistics (NCHS), part of the U.S. Centers for Disease Control and Prevention.


"So we're seeing almost 9 million fewer people in that age group who are in families having problems payment medical bills," said Robin Cohen, an NCHS statistician and the report's author.


NCHS examined people with bill-paying problems by age, gender, race and ethnicity, insurance status and economic status. In every year since 2011, each demographic group experienced year-over-year relief from all types of medical bills, including doctor and hospital charges.


"To me, it's just kind of like a 'Wow,' " said Lynn Blewett, a professor of health policy and management at the University of Minnesota School of Public Health.


Since 2011, the proportion of children and adults under age 65 in families strained by medical expenses has declined by 3.5 percentage points. A good chunk of that improvement -- nearly 2 percentage points -- occurred between 2013 and the first half of 2014, when the number of people reporting medical bill-paying problems dropped by more than 4 million.


"It's a precipitous drop," Cohen observed.


Even though the latest numbers are based on just six months of data, the 2014 numbers are valid and provide an apples-to-apples comparison with 2013 data, she said.


NCHS began asking Americans about their medical bill-paying difficulties in 2011. The report provides early estimates of the problem based on household surveys involving more than 370,000 people.


Blewett said the improvement in bill-paying concerns may reflect, among other factors, a reduction in uninsured Americans and an increase in people with coverage through programs like Medicaid and the state Children's Health Insurance Program.


The number of uninsured Americans under age 65 fell to almost 41 million in the first quarter of 2014, from slightly more than 44 million in 2013. And the numbers have tumbled steadily since 2010, the year President Barack Obama signed the Affordable Care Act (ACA) into law, according to CDC data.


Health policy experts say early gains in health insurance are due in part to the extension of coverage to young adults under their parents' health insurance plans, and the expansion of Medicaid eligibility rules in some states. Each of these policy changes were part of the ACA, sometimes referred to as Obamacare.


The landmark law's expansion of private health plans through federal and state marketplaces began in October 2013, for 2014 insurance coverage.


But many people waited until February or later to sign up, said David Warner, a health and social policy professor at the University of Texas at Austin.


Warner doesn't believe sign-ups through the new ACA health insurance marketplaces are reflected in the NCHS report, since coverage would not have kicked in for the vast majority of medical bills people incurred over the previous year.


However, some of the earlier implemented ACA initiatives, such as guaranteed coverage for children regardless of pre-existing conditions, may have contributed to the trend the report found, he said.


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Rise in Use of Animals for Research

By Robert Preidt, HealthDay Reporter



THURSDAY, Feb. 26, 2015 (HealthDay News) -- There has been a surge in the use of animals in experimental research in the United States since the late 1990s, with mice accounting for most of the increase, a new study indicates.


The findings challenge research industry claims of decreased use of animals, the study authors said.


The study authors analyzed unpublished data from the U.S. National Institutes of Health on the use of all vertebrate species at the 25 research institutions that are the largest recipients of grants from the federal government.


The results showed that the use of animals in research at these facilities rose nearly 73 percent from 1997 to 2012, mainly due to increases in the use of mice. There were declines in the use of cats, dogs, primates, rabbits, hamsters and other larger mammals.


Unregulated species -- mice, rats, birds bred for experimentation, and cold-blooded creatures -- accounted for nearly 99 percent of the animals used in the labs, according to the study published online Feb. 25 in the Journal of Medical Ethics.


The findings match reports from other countries about increased use of mice for genetic modification, wrote study author Alka Chandna, from the laboratory investigations department of People for the Ethical Treatment of Animals, and colleagues.


They said there is growing public opposition to animal experimentation, along with evidence that animal studies often don't translate to humans, and added that there are new technologies that can be used in research instead of animals.


The findings show that more needs to be done to reduce the use of animals in scientific research and for more transparency in reporting on whether this is being achieved, the study authors said.


While there is still tension between researchers and animal rights advocates, both sides seek to better understand one another, according to an accompanying commentary by Dr. Lisa Hara Levin, medical director of Animal Care & Control of New York City.


She said research institute policies need to be updated to better inform the public about their use of animals, and called for increased dialogue between a wide range of interested parties.


More information


The Humane Society of the United States has more about animal testing.


Copyright © 2015 HealthDay. All rights reserved.


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U.S. Pedestrian Death Rate Leveling Off, But Still Too High

By Robert Preidt, HealthDay Reporter



THURSDAY, Feb. 26, 2015 (HealthDay News) -- The number of pedestrians killed on U.S. roads is expected to remain unchanged from 2013 to 2014, according to a report from the Governors Highway Safety Association (GHSA).


But that number is still about 15 percent higher than it was in 2009, the report says.


The analysis of preliminary data from the first six months of 2014 found that 2,125 pedestrians died nationwide, compared with 2,141 in the first six months of 2013.


"This is a clearly a good news, bad news scenario," Jonathan Adkins, GHSA executive director, said in an association news release.


"While we're encouraged that pedestrian fatalities haven't increased over the past two years, progress has been slow. Protecting pedestrians is a priority for GHSA and our members; we're determined to drive the number down to zero," he added.


Even as a growing number of Americans choose walking as their preferred way to get around, efforts to improve pedestrian safety have stalled, according to report author Allan Williams, former chief scientist at the Insurance Institute for Highway Safety.


"Pedestrian deaths declined steeply from 7,516 in 1975 to 4,735 in 2013. But when you consider the percentage of pedestrians killed in all motor vehicle crashes, the gains are less pronounced. The rate was 17 percent in the late 1970s and early 1980s. It fell to a low of 11 percent in the past decade, but climbed back to 14 percent in 2013," Williams said in the news release.


He noted that that nation's four most populous states -- California, Florida, Texas and New York -- accounted for 43 percent of all pedestrian deaths in the United States in 2013. Delaware and Florida had the highest rates of pedestrian deaths at nearly 3 per 100,000 residents.


In 2013, pedestrians accounted for the highest percentage of road deaths (45 percent) in Washington, D.C. In New York, pedestrians accounted for 28 percent of road deaths, followed Nevada and Delaware, where pedestrians account for 25 percent of the road deaths in each state.


The report did offer some good news. In 24 states and the District of Columbia, pedestrian deaths were down in the first half of 2014 compared with the same period in 2013, while deaths remained the same in five states. There were nine or fewer pedestrian deaths in 16 states, with Nebraska and Wyoming each reporting just one.


There have been large drops in pedestrian deaths involving seniors and children since 1975. For example, children aged 12 and younger accounted for 21 percent of pedestrian deaths in 1975, but that rate fell to 4 percent in 2013. However, the report found there was a 28 percent increase in the deaths of pedestrians ages 20 to 69 between 1975 and 2013.


About 70 percent of pedestrian deaths involve males, and many of them are hit by vehicles at night and in the fall and winter months, the report said.


Alcohol appears to be a major risk factor for pedestrian deaths. In 2013, 36 percent of pedestrians 16 and older who died had blood alcohol concentrations of .08 or higher, according to the report.


More information


The U.S. Centers for Disease Control and Prevention has more about pedestrian safety.


Copyright © 2015 HealthDay. All rights reserved.


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Health Tip: Eat Right to Get Through Winter

By Diana Kohnle, HealthDay Reporter


(HealthDay News) -- Short days, low temperatures and being stuck inside can take a toll on anyone's mood, including a child's. But the right diet can help boost energy, mood and focus during the winter doldrums.


The Academy of Nutrition and Dietetics recommends these foods:



  • Serve grilled or broiled salmon.

  • Offer clementines, a citrus fruit that's seedless, easy to peel, sweet and nutrient-rich.

  • Roast winter squash, which is nutrient-rich and naturally sweet. Prepare spaghetti squash tossed with sauce, or roasted butternut squash with cinnamon and maple syrup.

  • Sweet potatoes -- fiber-rich and a good source of vitamin A and potassium -- can be sliced into chips or fries and roasted or pureed. Then add to macaroni and cheese or oatmeal.

  • Cauliflower offers a wealth of vitamins and anti-cancer properties. Roast or chop in the food processor and serve instead of rice.


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Get Over Your Fear of Fruit With These 10 Exotic Choices

We simply don’t eat enough fruit. Even though cold-pressed juices are all the rage, and we’ve become a nation obsessed with smoothies, it’s become rare for people to pick up a piece of whole fruit and bite into it.


The recently released 2015 Dietary Guidelines Advisory Committee report revealed that fruit intake remains low in this country. Only about 15 percent of the overall population in the U.S. is meeting fruit recommendations – which is about 2 cups daily.


Looks like only young children (ages 1 to 8 years) come close to eating enough fruit, although about half of that is juice.


One intriguing way to get kids interested in eating more fruit was identified in a new study that suggests hands-on activities with unfamiliar or unusual fruits during playtime will enhance their willingness to try these fruits at mealtime. Maybe we all need some new inspiration to eat more fruit.


Sometimes unfounded fears keep diet-conscious adults from eating more fruit. I still hear worries about the sugar in fruit, even though this is the naturally-occurring kind. No, it’s not the same as high fructose corn syrup or a candy bar. Other fruit disparagement involves concerns about acid-alkaline balance. Forget that.


We shouldn’t fear fruit. We should look for ways to add more fruit to our plate – and not just in our glass. Whole fruits are valuable contributors of fiber and potassium, two “problem nutrients” that still remain vastly under-consumed in this country, according to the recent Dietary Guidelines Advisory Committee.


Maybe checking out some new exotic fruits will inspire you to eat fruit more often. That’s why I love this campaign from Frieda’s: “Eat one fruit a day that scares you.” The specialty produce company is asking people to share their #FearNoFruit adventures on Facebook, Twitter and Instagram.


According to Frieda's website: “We want to encourage you to be brave, be bold, be adventurous and put those scary-looking fruits in your shopping basket and order them at your favorite restaurant. We want to expose your palate to new flavors, expand your epicurean horizons and excite your senses with exotic deliciousness.”


That’s a good mission to have. Here are some of the scary fruits Frieda’s wants you to get to know. How many of these have you eaten before?


Buddha’s Hand


This strange hand-like fruit, also known as the Fingered Citron, is one of the oldest citrus fruits. Sometimes described as a “lemon with fingers,” Buddha’s Hand is treasured for its sweet floral fragrance and mild zest. Inside the fruit there is little to no flesh or juice – it’s all rind and pith. For this reason, Buddha’s Hand isn’t really for eating whole, although the rind can be candied, used in baking or added into liqueurs and other spirits.


Cactus Pear


Also known as prickly pears or tunas, cactus pears are the fruit of the nopal cactus. The fruit’s smooth skin has very fine spines, and the inside flesh has a juicy, watermelon-like texture and contains many small, crunchy edible seeds. The fruit’s color can range from green to yellow to pink and red. Using gloves, slice in half and scoop out the flesh with a spoon, or peel and slice and add to salads, smoothies and cocktails.


Cherimoya


Cherimoyas are native to the mountains of Ecuador and Peru. Now they're grown in most tropical areas around the world and in Southern California. Cherimoyas have a wonderfully sweet, custard-like, banana-pineapple flavor when ripe. The inner flesh is soft, moist and creamy-white with large, inedible seeds. They're also known as custard apples and are a close relative to Atemoyas.


Dragon Fruit


Dragon fruit, also known as pitaya, is a beautiful cactus family fruit with bright magenta or white flesh speckled with small, edible seeds. The flavor is mild with a slight earthy flavor. The texture of dragon fruit is often compared to kiwifruit. Although it's the fruit of a cactus, it does not have any spines or needles on the outer skin, unlike its cousin, the cactus pear.


Durian


Durian is native to Southeast Asia, where it's regarded as the “king of fruits.” Known for its thorn-covered husk and strong odor, the fruit can reach the size of a basketball. The interior sections contain thick, yellow, soft and sweet flesh, but it has a really foul smell. It's only available in frozen or canned form in the U.S.


Mangosteen


Primarily grown in Thailand and Southeast Asia, the mangosteen is a special little fruit about the size of a plum with a firm purple shell and a beautiful creamy-white inner flesh that is separated into citrus-like segments. The flesh has a mouthwatering, silky smooth juicy texture – similar to a lychee. The flavor is a tropical combination of ripe peach, strawberry and citrus.


Kiwano


Also known as horned melon or horned cucumber, Kiwano® have a unique appearance that makes them a favorite among children and a conversation piece for dinner guests. The pulp is lime-green, jelly-like and filled with tender, white, edible seeds, similar to those found in cucumbers. Slice into wedges, or cut in half lengthwise and eat directly from the shell with a spoon.


Passion Fruit


Native to Brazil, passion fruit is considered the largest berry of all plants. The passion fruit’s thick purple skin wrinkles when ripe. Inside, it has small, black edible seeds surrounded by an aromatic, jelly-like pulp that has a lemony, sweet-tart flavor.


Rambutan


Native to Malaysia, this punky relative of the lychee has a spiky red shell covering a sweet and juicy grape-like flesh that surrounds an inedible woodsy seed. The name is derived from the word for hair, a reference to the hair-like spines that cover the fruit’s skin. The aromatic sweet-tart flavor is perfect for desserts or just enjoyed out of hand.


Starfruit


Also known as carambola, starfruit is an oblong golden-colored fruit with five deep ridges or “wings” running down its length. When cut crosswise, starfruit has a beautiful star shape. The thin waxy skin covers a golden flesh with a refreshingly crisp, chewy texture and lightly sweet and tangy flavor. Without peeling, slice crosswise for a perfect star-shaped presentation.


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ADHD May Raise Odds for Premature Death

By Steven Reinberg

HealthDay Reporter



WEDNESDAY, Feb. 25, 2015 (HealthDay News) -- People with attention-deficit hyperactivity disorder (ADHD) are more than twice as likely to die prematurely as those without the common disorder, a new study finds.


The risk is small, but it's a clear indication that the disorder is a serious problem, the researchers said.


In a study of more than 2 million people, Danish researchers found that accidents were the most common cause of premature death among people with ADHD. And the risk was significantly higher for women and those diagnosed in adulthood, the researchers added.


"Our results add to the overwhelming existing evidence that ADHD is a true disorder and should not be taken lightly," said lead researcher Dr. Soren Dalsgaard, a senior researcher at Aarhus University.


Still, Dalsgaard stressed that the actual number of premature deaths among those with ADHD was small. "Although ADHD doubles the risk, it is important to note that the absolute risk is very low," he said. Out of more than 32,000 people with ADHD, 107 died early, he noted.


ADHD is a neurodevelopmental disorder that affects at least 11 percent of American children aged 4 to 17, according to the U.S. Centers for Disease Control and Prevention. They tend to be inattentive, impulsive and hyperactive, which can cause them to struggle academically and socially. The disorder often lingers in adulthood.


The new study was published online Feb. 26 in The Lancet.


"It's common for people with ADHD to be impulsive and act without thinking, which can lead to accidents," said Stephen Faraone, author of an accompanying journal editorial.


Faraone agreed with Dalsgaard that the risk of premature death related to ADHD is small. "But the increase is another sign that this is a serious disorder that needs to be taken seriously," he said.


Treating ADHD is the best way to reduce the risk of dying early, added Faraone, director of child and adolescent psychiatry research at SUNY Upstate Medical University in Syracuse, N.Y.


Treatments can include medication, psychotherapy, training or a combination of treatments, according to the U.S. National Institute of Mental Health.


For the study, Dalsgaard and colleagues collected data on nearly 2 million people included in a large Danish registry who were followed from their first birthday to 2013. Maximum follow-up was 32 years.


More than 32,000 of the people had ADHD. Over the years, 107 people with ADHD died. They were about twice as likely to die prematurely as people without the disorder, even after the researchers took into account factors such as sex, family history of mental problems and parents' age and education.


Accidents were responsible for more than half of the 72 deaths for which there was a known cause.


The risk of dying prematurely rose along with age at ADHD diagnosis. People diagnosed at age 18 or older were more than four times as likely to die early, compared with those without the condition. In contrast, children diagnosed before age 6 had about double the risk of dying prematurely, compared with those without ADHD, researchers say.


In addition, girls and women with ADHD had a higher risk of an early death, compared with boys and men with the condition, the study team found.


Research has shown that ADHD often occurs with other behavioral problems, Dalsgaard said. These can include a substance use disorder, oppositional defiant disorder (a pattern of angry/irritable mood and defiant behavior) or conduct disorder (disruptive and violent behavior and problems following rules), he said.


When ADHD was combined with all three disorders, the odds for premature death were more than eight times higher than for people without ADHD or a co-existing behavioral disorder, the researchers noted.


"ADHD has huge impacts on everyday life, and people with ADHD and their families deserve that this is acknowledged," Dalsgaard said.


More information


Visit the U.S. National Institute of Mental Health.


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Dangerous C. Difficile Germ Infects 500,000 Americans a Year: CDC

By Steven Reinberg

HealthDay Reporter



WEDNESDAY, Feb. 25, 2015 (HealthDay News) -- Almost half a million Americans were infected with the bacteria Clostridium difficile in 2011, and 29,000 died within a month of diagnosis, U.S. health officials report.


"Infections with C. difficile have become increasingly common over the last few decades, and are seen in patients in health-care facilities as well as people in their communities," Dr. Michael Bell said at a U.S. Centers for Disease Control and Prevention press conference Wednesday.


C. difficile, which causes inflammation of the colon and deadly diarrhea, is often linked to antibiotic use, said Bell, deputy director of healthcare quality promotion at the CDC's National Center for Emerging and Zoonotic Infectious Diseases.


Antibiotics can destroy the natural bacterial balance in the colon, allowing C. difficile to take over, he explained.


These infections can be prevented by controlling use of antibiotics, and making sure health-care facilities use infection-control procedures when treating patients infected with C. difficile, Bell said. Such measures have resulted in a 10 percent drop in C. difficile infections since 2011, he added.


"If we can improve antibiotic prescribing, we expect to see rates of C. difficile infection improve dramatically," Bell said. This means taking antibiotics only when necessary and for as long as necessary, he explained.


Treatment of C. difficile involves antibiotics. However, even when the infection is cured, it is difficult to restore the colon's normal bacteria, which enables C. difficile to recur, Bell explained.


"One in five patients has at least one relapse that requires treatment," he said.


Although anyone can get C. difficile, the elderly are especially vulnerable.


"About 55 percent of health care-associated C. difficile infections and 80 percent of the deaths that occur because of it happen in people 65 years of age and older," Bell said.


Moreover, he added, "one out of nine patients over 65 years old with C. difficile infection dies within 30 days of diagnosis."


The report was published Feb. 26 in the New England Journal of Medicine.


Severe C. difficile infection can damage the colon, requiring surgery, Bell added.


In addition, C. difficile spreads easily. "It forms hard spores that can contaminate the environment," he said. These spores are not killed by antibacterial cleansers or hand sanitizers.


Bell said the best way to prevent transmission is to wash away the spores with soap and water, and for health-care workers treating infected patients to wear gloves.


For the report, researchers collected data on C. difficile infections in 10 areas of the United States in 2011. They wanted to know how many infections were related to health-care facilities, such as hospitals and nursing homes, and how many were contracted in the community at large.


Two-thirds of C. difficile infections occurred in hospitals and nursing homes, the investigators found. However, 150,000 infections were community-associated, meaning they happened among those who had not been inpatients in a health-care facility.


"About 80 percent of patients with community-associated C. difficile infection did have contact with health-care settings, like a doctor's office or a dental clinic, and most of those patients were also given antibiotics," Bell said.


The researchers estimated that there were 453,000 C. difficile infections in the United States that year. They calculated that women, whites and those aged 65 and older were most likely to be infected.


Moreover, the study authors estimated that 83,000 people experienced a first recurrence of C. difficile infection, and that 29,300 people died from the bacteria in 2011.


Dr. Marc Siegel, a professor of medicine at NYU Langone Medical Center in New York City, is concerned that C. difficile infections are increasing in the general community.


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Long Sleep Time, Higher Stroke Risk?

By Kathleen Doheny

HealthDay Reporter



WEDNESDAY, Feb. 25, 2015 (HealthDay News) -- Adults who sleep more than eight hours a night may face a higher risk of stroke, a new analysis suggests.


These so-called "long sleepers" were 46 percent more likely to have a stroke than those who got only six to eight hours of sleep a night, the researchers found.


However, the researchers don't know if the long sleep is a cause, consequence or early warning sign of declining brain health. After reviewing previous research on the possible link between sleep and stroke risk, they said they only found an association that they can't explain.


The study is published online Feb. 25 in Neurology.


"Previous studies have already suggested a possible association between sleep and risk of stroke," said lead researcher Yue Leng, of the University of Cambridge in England. But the new analysis also looked at the relationship between a change in sleeping duration over time and how that affected stroke risk.


While the possible link needs more research, Leng said the message is definitely not to cut sleep to reduce stroke risk. Adequate sleep is crucial for good health.


In the study, the researchers followed nearly 9,700 people participating in a European study, tracking their sleep patterns and any incidence of stroke for nearly 10 years. The men and women, average age 62 when the study started, reported their sleep duration once between 1998 and 2000, and again four years later. They told how many hours they slept a night and how well they slept.


About 70 percent said they slept six to eight hours a night. One in 10 said they slept more than eight hours. Those who slept less than six hours or more than eight were likely to be older, female and not physically active.


Over the follow-up period, 346 people had strokes. Those who slept longer than eight hours had a 46 percent increased stroke risk, and those who slept less than six hours had an 18 percent higher risk. But the number in the group reporting less than six hours of sleep a night was too small to call that link statistically solid, Leng said.


Those who reported being long sleepers in both of the two surveys faced double the risk of stroke when compared to those who reported average sleep times, according to the study.


And people whose sleep pattern changed -- from sleeping less than six hours a night to more than eight hours a night -- had about four times the risk of stroke as those who consistently got an average amount of sleep, Leng found.


Lack of sleep can lead to higher stress hormone levels, in turn raising blood pressure and stroke risk. But after Leng took factors such as high blood pressure into account, the relationship between long sleep and stroke risk persisted.


Dr. Alberto Ramos, an assistant professor of neurology at the University of Miami Miller School of Medicine, wrote an editorial to accompany the study. He suspects that the long sleeping time is a warning signal. But "the change in sleeping patterns is more the concern," he said.


Long sleepers would be wise to monitor their lifestyle, eating a healthy diet and exercising regularly, Ramos said. Adults over the age of 60 or 65 who notice they are sleeping more should make sure their cardiovascular risk factors such as blood pressure and cholesterol are under control, he added.


More information


To learn more about stroke risk factors, visit U.S. Centers for Disease Control and Prevention.


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Heart Failure Patients Who Struggle With Daily Tasks at Greatest Risk

By Robert Preidt, HealthDay Reporter



WEDNESDAY, Feb. 25, 2015 (HealthDay News) -- Heart failure patients who struggle to perform daily tasks are at increased risk for hospitalization and death, a new study shows.


The study included more than 1,100 people with heart failure, average age 75, who were classified as having either minimal, moderate or severe difficulty with activities such as getting dressed, cleaning the house, climbing stairs, taking medications and using the bathroom.


"Difficulty with daily living is easy to assess in a routine doctor's visit, and can provide important information to help guide conversations about goals of care," wrote study author Dr. Shannon Dunlay, an advanced heart failure cardiologist at the Mayo Clinic in Rochester, Minn.


"Patients who report difficulties may be candidates for a more thorough assessment and physical therapy evaluation to improve or halt the decline in mobility," she added. "Our findings support the assessment of mobility as a part of the routine clinical care of patients with heart failure."


In the study, nearly one-fifth of the heart failure patients were obese and most had other medical conditions such as high blood pressure (87 percent), anemia (57 percent) and diabetes (36 percent).


Almost 60 percent of the patients had difficulty with one or more daily tasks at the start of the study, including 24 percent who had moderate difficulty and nearly 13 percent who had severe difficulty.


Older women, unmarried people and those with obesity, diabetes or anemia had more difficulty with daily activities and mobility. Heart failure patients with dementia had difficulty with twice as many daily tasks as others.


During about three years of follow-up, 910 of the heart patients were hospitalized and 614 died. Heart failure was the most common cause of hospitalization (18 percent), followed by heart rhythm disorders (nearly 5 percent), and pneumonia (4 percent).


Average length of survival was close to six years for those with minimal difficulty with daily activities, three years for those with moderate difficulty, and 1.5 years for those with severe difficulty, according to the study published Feb. 25 in the journal Circulation: Heart Failure.


"We suspect that the difficulty with daily activities that we observed is not entirely attributable to the patients' heart failure," Dunlay said in a journal news release.


"Most patients with heart failure are elderly and have many other chronic conditions, and we need to consider providing comprehensive care," she noted.


More than 5 million Americans have heart failure, the researchers noted.


More information


The U.S. National Heart, Lung, and Blood Institute has more about heart failure.


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Flavored Booze Beverages Tied to Higher Injury Risk in Teens

By Robert Preidt, HealthDay Reporter



WEDNESDAY, Feb. 25, 2015 (HealthDay News) -- Consuming super-sized, flavored alcoholic beverages greatly increases underage drinkers' risk of injury, a new study finds.


"These findings raise important concerns about the popularity and use of [flavored alcohol beverages] among youth," wrote Alison Albers of Boston University School of Public Health and colleagues.


"This is particularly true for the super-sized 'alcopops,' which remain largely unregulated and continue to present an emerging public health problem of harmful alcohol consumption among youths," they added.


The researchers analyzed data from more than 1,000 teens and young adults, aged 13 to 20, who took part in an online survey asking about their drinking habits.


Those who said they drink super-sized versions of flavored alcohol beverages were more than six times as likely to say they'd suffered alcohol-related injuries as those who did not consume such beverages, the researchers noted.


The study was published Feb. 25 in the American Journal of Public Health.


"Our findings were similar to those of other research indicating that mixing energy drinks with alcohol is associated with greater risk for both adverse outcomes of drinking and increased risk-taking behaviors," the researchers said in a journal news release.


More information


The U.S. National Library of Medicine has more about underage drinking.


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Additives in Processed Foods May Alter Gut Bacteria

By Robert Preidt, HealthDay Reporter



WEDNESDAY, Feb. 25, 2015 (HealthDay News) -- A common ingredient in many processed foods might increase the risk of inflammatory bowel disease (IBD) and metabolic syndrome, a new study in mice suggests.


Emulsifiers are used to improve food texture and to extend shelf life. In experiments with mice, researchers found that emulsifiers can alter the make-up of bacteria populations in the digestive tract.


This can lead to inflammation that may contribute to the development of IBD and metabolic syndrome, the researchers said.


IBD -- which includes Crohn's disease and ulcerative colitis -- affects millions of people and is often severe and debilitating, according to the researchers. Metabolic syndrome is a group of obesity-related conditions that can lead to diabetes, as well as heart and/or liver diseases.


But, it's important to note that this study was conducted in mice, and research done in mice doesn't always translate to humans. This study wasn't designed to show whether or not emulsifiers might cause health problems in humans.


The study was published Feb. 25 in the journal Nature.


There have been sharp rises in the rates of IBD and metabolic syndrome since the mid-20th century, the study authors noted.


"A key feature of these modern plagues is alteration of the gut microbiota in a manner that promotes inflammation," study co-leader Andrew Gewirtz, from the Institute for Biomedical Sciences at Georgia State University, said in a university news release.


Study co-leader Benoit Chassaing, also of the Institute for Biomedical Sciences, added, "The dramatic increase in these diseases has occurred despite consistent human genetics, suggesting a pivotal role for an environmental factor."


Chassaing explained that "food interacts intimately with the microbiota [of the digestive tract] so we considered what modern additions to the food supply might possibly make gut bacteria more pro-inflammatory."


The researchers are now designing experiments to determine how emulsifiers affect people.


"We do not disagree with the commonly held assumption that overeating is a central cause of obesity and metabolic syndrome," Gewirtz said. "Rather, our findings reinforce the concept suggested by earlier work that low-grade inflammation resulting from an altered microbiota can be an underlying cause of excess eating."


More information


The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about Crohn's disease.


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