Alexander technique benefits back pain

Chronic back pain can be eased by teaching the Alexander technique, an alternative therapy involving learning better posture, British researchers said on Wednesday.

Until now, there has been no real evidence of the long-term benefits of the Alexander technique, although previous research has suggested it may offer short-term relief.

To find out more, a team of researchers from the University of Southampton and the University of Bristol compared the effectiveness of different therapies in more than 500 patients.

After a year of treatment, patients receiving 24 Alexander technique lessons reported experiencing just three days of back pain, compared to 21 days for those given normal care by their doctor, they wrote in the online edition of the British Medical Journal.

Back pain causes more disability than almost any other condition in Western societies but very few effective long-term treatments are available.

The technique was originally developed at the end of the 19th century by the Shakespearean actor Frederick Alexander.

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Joint surgery and cardio risk factors

In addition to confirming previously identified risk factors for cardiovascular complications after total joint replacement surgery, researchers have now found that bilateral (involving both sides of the body, such as two hip or knee replacements), as well as revision operations, are associated with increased risk.

"Revision joint replacement and bilateral surgery are much more prolonged operations than primary unilateral joint replacement," Dr. Jeffrey N. Katz, from Brigham and Women's Hospital in Boston, said in a statement. "These findings suggest an increased risk with more prolonged surgery."

The results, reported in the journal entitled Arthritis and Rheumatism, come from a study of 209 patients with a history of heart attack, heart failure, unstable angina (chest pain), arrhythmia (irregular heart beat), symptoms of low blood pressure, or a blot clot in the lung at admission for total joint replacement, and 209 patients matched to characteristics of the others, but did not have cardiovascular complications.

In line with prior findings, an increased risk of heart disease was 0.7-times greater in older patients, 2.6-greater in those with history of arrhythmia and 1.6-times greater in patients with a history of coronary artery disease, heart attack, heart failure, or valvular heart disease.

The strongest risk factor, however, was one of the newly identified ones, bilateral surgery, which increased the risk by 3.5-fold. Revision surgery also increased the risk by 2.2-fold.

"Clinicians can use this information to better estimate the risk of cardiovascular complications following total joint replacement surgery," Katz said, "and, ultimately, to prevent and better manage these complications."

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Pneumonia vaccination and diabetes

Researchers from Denmark say they have "strong evidence" that diabetes is associated with a 25 percent to 75 percent increase in the relative risk of hospitalization due to pneumonia.

Writing in the journal Diabetes Care, the researchers say these results "emphasize the value of influenza and pneumococcal immunization, particularly for patients with longer diabetes duration, and the importance of improved glycemic control to prevent pneumonia-related hospitalization among diabetic patients."

Using health care databases for northern Denmark, Dr. Jette B. Kornum from Aarhus University Hospital, Aalborg and colleagues identified 34,239 individuals with a pneumonia-related hospital admission and 342,390 individuals from the general population who served as a control group.

The analysis of these data revealed that individuals with diabetes had a 26 percent higher risk of pneumonia-related hospitalization compared with those without diabetes.

The risk of pneumonia-related hospitalization was increased by 4.4-fold in subjects with type 1 diabetes and by 1.2-fold in those with type 2 diabetes.

The longer duration of diabetes with poor glycemic control, the higher the risk of hospitalization for pneumonia became, Kornum and colleagues observed. Compared with the subjects without diabetes, having diabetes for 10 years or more was associated with a 37-percent greater risk.

Diabetes combined with an A1C level of 9 percent or greater, a standard measure of blood glucose, which should be 7 percent or lower, was associated with a 60 percent increased relative risk of pneumonia-related hospital admission, while diabetics who had an A1C of less than 7 percent had a 22 percent risk, compared with nondiabetic subjects.

"Our data extend previous studies suggesting that diabetes is a risk factor for pneumonia," Kornum and colleagues conclude.

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Mental illness may up risk of postpartum suicide

New mothers with a history of depression or other psychiatric disorders appear more likely than other women to attempt suicide soon after giving birth, a new study suggests.

Researchers found that among nearly 1,800 women who recently gave birth, those with a history of a psychiatric disorder were 27 times more likely to attempt suicide in the year after having their baby.

Similarly, women with a history of substance abuse had a six-fold increase in their risk of attempted suicide.

Postpartum suicide is rare, but the new findings point to a group of women who may be at greatest risk, the researchers note in the American Journal of Obstetrics & Gynecology.

Women, their families and their doctors should be aware that past psychiatric disorders and substance abuse are risk factors for postpartum suicide, lead researcher Dr. Katherine A. Comtois, of the University of Washington School of Medicine in Seattle, told Reuters Health.

The findings are based on hospital records from women who gave birth in Washington State between 1992 and 2001. The researchers identified 355 women who were hospitalized for a suicide attempt in the year after giving birth; they matched each of these women with another four who had given birth in the same year but did not attempt suicide.

Overall, Comtois and her colleagues found, the risk of postpartum suicide was markedly higher among women who'd been hospitalized with a psychiatric disorder, substance abuse problem or both 5 years before giving birth.

Such diagnoses are "clearly important risk factors" of which families and medical providers should be aware, Comtois said.

The American College of Obstetricians and Gynecologists recently recommended that women be screened for depression and other "psychosocial risk factors" during prenatal care, Comtois and her colleagues note in the report.

"Future studies," they write, "should evaluate the effectiveness of screening for psychiatric and substance use disorders on decreasing adverse outcomes such as suicide attempts during the postpartum period."

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West Nile patients recover

Patients infected with West Nile virus can develop long-term symptoms such as fatigue, fuzzy thinking and movement difficulties but these symptoms go away after about a year, doctors reported on Monday.

The mosquito-borne virus arrived in the Americas in 1999 and quickly began to sicken patients in New York. It has now spread across the United States, Canada and Mexico and continues to infect people in Africa, Australia, western Asia, Europe and the Middle East.

West Nile causes no symptoms in about 80 percent of cases. About one in 150 people infected with the virus develop severe illness with high fever, headache, neck stiffness, stupor, disorientation, vision loss, numbness, coma, paralysis and other symptoms.

Sometimes the neurological effects last for weeks or months and many doctors had feared this nerve damage was permanent.

Dr. Mark Loeb of McMaster University in Ontario, Canada, and colleagues wanted to see what the long-term effects were.

"This is the first study to comprehensively look at a large population of infected persons to study the long-term effects of West Nile virus," Loeb said in a statement.

"We found that both physical and mental functions, as well as mood and fatigue, seemed to return to normal in about one year."

Writing in the Annals of Internal Medicine, Loeb said his team studied 156 West Nile patients between 2003 and 2007.

They found symptoms and recovery times were similar among patients who had neurological effects and those who did not.
There is no human vaccine for West Nile virus, although one is sold to protect horses. The U.S. Centers for Disease Control and Prevention advises people to use repellents containing DEET and clothing to cover up as the best way to prevent mosquito bites and infection.


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Teens who lack sleep have high blood pressure risks

Poor sleep habits can do more than annoy parents and make teenagers drowsy in school -- they can lead to high blood pressure, U.S. researchers reported on Monday.

Teens who slept fewer than 6 1/2 hours a night had more than twice the risk of high blood pressure and those with troubled sleep had more than triple the risk, the team at Case Western Reserve University in Cleveland, Ohio found.

Writing in the American Heart Association journal Circulation, the researchers found the pattern held even when adjusted for sex, weight and socioeconomic status.

"Our study underscores the high rate of poor quality and inadequate sleep in adolescence coupled with the risk of developing high blood pressure and other health problems," said Dr. Susan Redline, the pediatrician who led the study.

"We also found that a low sleep efficiency may be more consistently associated with pre-hypertension than a shorter sleep period."

High blood pressure can damage arteries and kidneys, causing stroke, kidney disease and other illnesses.

Redline's team studied 238 13-to-16-year-olds and found 14 percent of the adolescents had high blood pressure or readings at the borderline, called pre-hypertension.

For adults, high blood pressure is defined as a reading of 140/90 or above, but for children it is defined as being in the 90th percentile for their age.

They had the volunteers fill out sleep diaries but also measured their movements while in bed to gauge whether they were really asleep. On average, the teens got just 7.7 hours of sleep a night, while they need nine hours at that age.

And 16 percent of the teens had low sleep efficiency, meaning they had trouble falling asleep much of the time or woke up too early. Another 11 percent slept less than 6 1/2 hours a night.

"These associations may have a large public health impact," Redline said in a statement.

"Part of the problem is the technological invasion of the bedroom with computers, cell phones and music," Redline said.

"There are teens who text message or listen to music all night, compounded by early school hours. Adolescents need nine hours of sleep. Parents should optimize sleep quality for their family with regular sleep and wake times and bedrooms should be kept quiet, dark and conducive to sleep."

The National Heart, Lung and Blood Institute said caffeine and too-warm temperatures also keep people awake.

"Signs of not getting enough sleep or sleeping poorly include consistently taking more than 30 minutes to fall asleep, awakening more than a few times or for long periods each night, feeling sleepy during the day, or having trouble concentrating at school or at work," the NHLBI, part of the National Institutes of Health, said in a statement.

Redline said the study may underestimate the problem because it excluded children with known sleep disorders and other illnesses.

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Armchair olympics causes obesity fear in China

Armchair athletics may not be an Olympic sport but it's the most popular activity in China this month, fuelling concerns about rising obesity rates.

Chinese media has even given its army of TV Olympic spectators a name -- otaku -- a Japanese word that means "venerable house" and usually refers to someone nerdy who is totally devoted to a hobby to the point of not leaving home.

Figures have shown about 840 million of China's 1.3 billion population tuned in to watch the August 8 opening ceremony of the Beijing Games and interest is expected to stay high to August 24.

Increased TV viewing, less physical jobs and a shift away from a traditional Chinese diet rich in vegetables and carbohydrates with little animal-sourced food to a more Western diet heavier in meat, eggs and dairy has piled on the pounds.

"Lots of mothers don't know what to feed their children anymore," said Zhao Hua, who was having lunch with her 6-year-old son Tanning at a massive McDonald's in the Olympics site.

"In the past it was good to be a bit fat because it was a sign of strength but now children are getting too fat."

Figures show about a quarter of Chinese adults are obese or overweight, which is lower than many other countries but has jumped from 13 percent in 1991 with forecasts it could double by 2028.

By comparison World Health Organization figures show 65 percent of adult Americans in 2005 were overweight or obese.

A University of North Carolina study, published in the July/August issue of the journal Health Affairs, showed of all developing countries, only Mexico's rate of obesity was growing faster than that of China.

The World Food Program says a 6-year-old boy in China is now 13 pounds (6 kgs) heavier and almost two-and-a-half inches (6.4 cms) taller than a 6-year-old was 30 years ago.

"We need to find the right investments and regulations to encourage people to adopt a healthy lifestyle, or we risk facing higher rates of death, disease, and disability and the related costs," warned researcher Barry Popkin.

The Chinese diet has changed, with hundreds of McDonald's and KFC outlets in China, but experts also blame a drop off in physical activity, with more cars and less bikes on the roads.

Chinese newspaper the People's Daily said China has fewer than seven training fields for every 10,000 Chinese, compared with 200 sports fields for every 10,000 people in United States, and Japan.

"Now all the teenagers just like to play video games and watch television and our children like McDonald's. It is not healthy," said Yu Yanbing who was tucking into some fries at McDonald's with his 3-year-old son Zixi.

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Obesity and diabetes increase heart disease risk

People who are both obese and have diabetes are highly likely to develop heart disease during their lifetime, a new study shows.

Researchers found that of more than 3,400 adults in a long-running U.S. heart study, women who were obese and diabetic had a nearly 80 percent chance of developing heart disease at some point. For their male counterparts, that figure was nearly 90 percent.

Lifetime risk was based on the likelihood that a 50-year-old would develop heart disease in the next 30 years.

Obesity and diabetes commonly go hand-in-hand. The new findings, published in the journal Diabetes Care, show that diabetes on its own significantly raises the lifetime risk of heart disease, and that obesity worsens the situation.

Dr. Caroline S. Fox of the National Heart, Lung and Blood Institute in Bethesda, Maryland, and her colleagues the lifetime heart disease risk of normal-weight women who did not have diabetes was 34 percent. The risk for normal-weight women with diabetes was 55 percent.

Among obese women, those who did not have diabetes had a 47 percent chance of developing heart disease, while the risk for those with diabetes was 79 percent.

The pattern was similar for men, with a lifetime heart disease risk of 49 percent among normal-weight, non-diabetic men, and a 77 percent risk for normal-weight men with diabetes. Obese men without diabetes had a 67 percent lifetime heart disease risk, while the risk for obese diabetic men was 87 percent.

The number of Americans with diabetes is expected to rise to 48.3 million by 2050, the researchers note, and heart disease due to diabetes appears to already be on the rise.

"This trend may continue to worsen if current trajectories do not change," they warn.

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Diabetes caused by exposure to PCB

People who have been exposed to high levels of toxic polychlorinated biphenyls (PCBs) may face an elevated risk of type 2 diabetes, a new study shows.

The findings, reported in the journal Diabetes Care, come from a long-term study of Taiwanese adults who, in the 1970s, had been poisoned by cooking oil contaminated with PCB pollutants.

Once used in products ranging from fluorescent lights and appliances to insulation and insecticide, PCBs were banned in the late 1970s as carcinogens and general health hazards. They linger in the environment, however.

In the new study, Dr. Yueliang Leon Guo, from the National Taiwan University in Taipei, and colleagues examined the incidence of type 2 diabetes among 378 Taiwanese "oil disease" victims and 370 of their neighbors who had not been poisoned.

They found that women who had been exposed to the PCB-laced oil were twice as likely as other women to develop type 2 diabetes over 24 years. And women who had been most severely affected by the PCB exposure had a more than five-times higher diabetes risk.

There were no similar risks seen in men, however.

Other studies have found that people with diabetes tend to have relatively higher levels of organic pollutants, such as PCBs, in their blood. In comments to Reuters Health, Guo said that since "everyone" has detectable PCB levels in his or her body, it's possible that exposure to such pollutants has helped feed the widespread rise in diabetes in recent decades.

"The public health implication of these findings can be huge," Guo added, "considering the burden of diabetes and its multiple long-term complications."

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Stroke treatment often delayed

Stroke victims frequently fail to seek emergency treatment promptly enough, and even when they do get to the ER quickly, their treatment is often delayed, a new study shows.

"Our study shows that most people with stroke symptoms still do not get to the hospital in a timely manner," lead researcher Dr. Kathryn R. Rose, of the University of North Carolina, Chapel Hill, told Reuters Health.

"This precludes them from being considered for time-dependent treatments that can reduce disability and death following a stroke."

In most cases, strokes are caused by a blood clot hindering blood flow to the brain. A drug called tissue plasminogen activator, or tPA, can be used to dissolve the clot and limit stroke damage, but it must be given within three hours of a person's first symptoms.

In their study, Rose and her colleagues found that of 15,177 patients in a North Carolina stroke registry, less than one-quarter arrived at the hospital within two hours of symptom onset. Of these patients, just 24 percent received a CT scan within the recommended time frame.

The researchers report the findings in the journal Stroke.

A CT scan is considered crucial to stroke diagnosis, and one must be done before tPA can be given. National guidelines call for running a CT scan within 25 minutes of a patient's arrival at the hospital, regardless of when their symptoms began.

Yet, Rose and her colleagues found, among stroke patients who arrived at the hospital more than two hours after their symptoms started, only 9 percent received a CT scan within 25 minutes.

"While patients that arrive to the hospital within 2 hours of symptom onset are more likely to receive a timely CT scan than those who do not," Rose said, "most do not. This points to areas where stroke systems of care within hospitals can be improved."
ne way stroke sufferers might improve their odds of prompt treatment is to call an ambulance, the study suggests.

Patients who arrived via emergency medical services were twice as likely to receive a timely scan as those who arrived on their own, the researchers found.

Given the implications of timely arrival, Rose said, "it is important for people to recognize the symptoms of stroke and promptly call emergency services when they occur."

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