Public Health

Severe stress in pregnancy may affect fetal growth

August 30, 2008 on 1:41 pm | In Uncategorized | Comments Off NEW YORK (Reuters Health) - Women who go through a traumatic event during or soon before pregnancy may be at increased risk of having an underweight baby, a large study suggests.

Researchers found that of more than 1 million Danish women who gave birth over 24 years, those who dealt with the death or serious illness of a loved one shortly before or during pregnancy were more likely to have a low-birthweight baby.

The findings, reported in the journal Psychosomatic Medicine, do not prove that severe stress during pregnancy harms fetal growth. However, it is possible that this is the case, according to lead researcher Ali S. Khashan, of the University of Manchester in the UK.

Research indicates that high levels of stress hormones in the mother can hinder fetal growth, and severe stress may make it difficult for some pregnant women to follow a healthy lifestyle.

Still, Khashan told Reuters Health, the current findings are "subtle," linking severe stress to a relatively small effect on birthweight. "So the overall risk to an individual experiencing 'normal' stress is tiny," the researcher explained.

On the other hand, Khashan said, the study does give "valuable insights" into the importance of the uterine environment in fetal development and, ultimately, babies' well-being.

The researchers based their findings on records for 1.38 million women who gave birth in Denmark between 1979 and 2002. Denmark's system of national registers allowed the researchers to link each woman with data on her first-degree relatives -- parents, siblings, spouses and other children -- and identify those who'd faced a family member's death or serious illness during pregnancy or within the six months before pregnancy.

Overall, the study found, women who'd lost a family member were 22 percent more likely than other women to have a baby who weighed below the 5th percentile at birth. Serious illness in a family member was also linked to poorer fetal growth.

While the findings do not prove a cause-and-effect relationship, they do underscore the importance of trying to stay healthy during pregnancy, according to Khashan.

"Expectant mothers should follow standard medical advice and maintain a normal, healthy lifestyle pre-conception and in pregnancy," the researcher advised.

SOURCE: Psychosomatic Medicine, July/August 2008.

Copyright © 2008 Reuters Limited.

Many return to sports after getting a new shoulder

August 30, 2008 on 1:41 pm | In Uncategorized | Comments Off NEW YORK (Reuters Health) - Many physically-active people will return to recreational sports after having shoulder replacement surgery, research shows.

In fact, most of the people who had the surgery in order to continue to participate in sports reported that their ability had actually improved, Dr. Eric C. McCarty of the University of Colorado School of Medicine in Denver and colleagues found.

Most studies to date on activity after joint replacement has focused on hip and knee replacement, the researchers note in a report in the American Journal of Sports Medicine. The one small study that looked at shoulder replacement focused on golf.

To examine the ability of people to return to other types of activity after the surgery, McCarty's team looked at 75 adults who underwent a total of 86 shoulder replacements. They were followed for up to 9.4 years, with average an average follow-up of 3.7 years.

Forty-eight of the study subjects (64 percent) said they had the surgery in order to keep playing sports, while 91 percent cited pain as a reason. Swimming was the most common activity, followed by golf. Before their shoulder problems developed, patients had engaged in their activity or activities of choice 2.6 days a week.

Within a year of the surgery, people were engaging in their sport 1.7 days a week, on average, and reported that it took them 5.8 months to return to full activity.

Twelve of 13 people who had enjoyed fishing before surgery returned to the sport, while 37 of 43 swimmers did. Three-quarters of golfers and tennis players were able to play their sport again after surgery.

The sport people had the hardest time returning to was softball, with only 2 of 10 people returning to the sport after surgery.

Among the 48 adults who had the surgery at least in part to continue their athletic activity, 71 percent said the operation improved their ability, and half were participating in the sport more frequently after the surgery than before it.

Just four procedures were performed after the initial surgery, suggesting that the new joints functioned well even with repetitive activities such as swimming, the researchers note.

SOURCE: American Journal of Sports Medicine, August 8, 2008.

Copyright © 2008 Reuters Limited.

Antipsychotic drugs double stroke risk: study

August 30, 2008 on 1:41 pm | In Uncategorized | Comments Off LONDON (Reuters) - People taking antipsychotic drugs are nearly twice as likely to have a stroke compared to those not on the treatment, British researchers reported on Friday.

The risk is even higher -- about 3.5 times -- for men and women with dementia, which means doctors should only prescribe such medicine to these patients as a last resort, the researchers said.

Previously, stroke risk associated with older antipsychotic drugs was unclear but the study published in the British Medical Journal showed both old and new treatments carry increased risk.

"The risks associated with antipsychotic use in patients with dementia generally outweigh the potential benefits, and in this patient group, use of antipsychotic drugs should be avoided whenever possible," Ian Douglas and colleagues at the London School of Hygiene and Tropical Medicine wrote."

The researchers looked at the medical records of nearly 7,000 men and women and recorded the incidence of stroke among those who at some point had taken antipsychotic drugs.

They found that they were 1.7 times more likely to have a stroke and that the risk was much higher if people had dementia.

The most common older treatments included a drug class called phenothiazine and the generic medicines haloperidol and benperidol. The most widely used newer drug in the study was Johnson & Johnson's Risperdal, known generically as risperidone, the researchers said.

Other newer drugs in the study included Eli Lilly and Co's Zyprexa, or olanzapine, Sanofi-Aventis' Solian, or amisulpride and AstraZeneca Plc's Seroquel, known generically as quetiapine.

The researchers did not look at why people with dementia are at greater risk but one possibility may be that vascular causes of certain types of dementia may be involved, said Douglas, an epidemiologist.

"We don't know why this extra risk associated with antipsychotics is even greater in people with dementia," he said in a telephone interview.

Copyright © 2008 Reuters Limited.

Salmonella death adds to Canada food recall alarm

August 30, 2008 on 1:41 pm | In Uncategorized | Comments Off OTTAWA (Reuters) - One person has died and 87 are sick with salmonella food poisoning from tainted cheese in the Canadian province of Quebec, health officials said on Friday.

The outbreak comes amid consumer alarm over a massive recall by Maple Leaf Foods Inc of ready-to-eat meats. An outbreak of listeriosis food poisoning from deli meats produced at the company's Toronto plant has been linked to the deaths of 15 people.

Quebec public health director Horacio Arruda said the salmonella outbreak had no connection to the Maple Leaf case. Three brands of cheese were being recalled after an unusually high number of salmonellosis cases were reported.

"There was one fatality and 40 percent of the cases were hospitalized," Arruda told reporters in Montreal in a televised news conference.

The brands of cheese recalled are La Chaudiere, Polo and Tradition, bought between July 24 and Aug. 24, the health agency said in a statement.

Salmonella bacteria are a common cause of food poisoning, resulting in fever, chills, diarrhea and dehydration. Children, the elderly and those with weakened immune systems are most at risk.

Copyright © 2008 Reuters Limited.

Guidelines issued on battling ear wax

August 30, 2008 on 1:41 pm | In Uncategorized | Comments Off NEW YORK (Reuters Health) - When ear wax builds up to the point of causing symptoms, people should turn to their doctors rather than the old-fashioned cotton swab, according to new guidelines.

About 12 million Americans visit the doctor each year complaining of ear wax buildup. The new guidelines, issued by the American Academy of Otolaryngology - Head and Neck Surgery Foundation (AAO-HNSF), are the first comprehensive recommendations to help doctors determine which patients need treatment, and which treatments are best.

Ear wax -- known medically as cerumen -- is normal and necessary for healthy ears, the guidelines stress. Despite its name, ear wax is not "wax," but a mixture of secretions from the outer ear, along with dead skin cells and hair. It helps protect the ear, acting as a self- cleaning agent with lubricating and antibacterial properties.

Usually, the body takes care of excessive ear wax on its own; older ear wax is continually being transported from the ear canal -- assisted by motions of the jaw, such as chewing -- to the ear opening, where it dries out.

Sometimes, however, it accumulates inside the ear to the point where it causes an impaction and symptoms such including hearing loss, "ringing" in the ears, pain or a feeling of fullness in the ear. In these cases, a trip to the doctor may be in order.

"Unfortunately, many people feel the need to manually 'remove' cerumen from the ears," Dr. Peter Roland, the lead author of the new guidelines, said in a statement. "This can result in further impaction and other complications to the ear canal."

Effective treatments include wax-dissolving agents and ear "irrigation," where a doctor uses a jet of warm water to flush out the wax. In some cases, such as when a patient has a narrow ear canal or eardrum perforation, the doctor may need to use special instruments to manually remove the ear wax.

People should not use cotton swabs, which tend to only push the wax farther into the ear, according to the AAO-HNSF. They should also avoid home "oral jet irrigators" and so-called ear candling, which involves inserting a hollow cone-shaped device into the ear canal and lighting the exposed end.

There are no proven ways to prevent ear wax impaction, according to the guidelines. But people at high risk of the problem -- such as those with hearing aids and anyone who has had an impaction in the past -- may want to visit their doctor every six to 12 months for routine cleaning.

"The complications from cerumen impaction can be painful and ongoing, including infections and hearing loss," Roland said. "It is hoped that these guidelines will give clinicians the tools they need to spot an issue early and avoid serious outcomes."

SOURCE: Otolaryngology - Head and Neck Surgery, September 2008.

Copyright © 2008 Reuters Limited.