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November 2000

Protect Toddlers From Holiday Hazards
November 21, 2000

Cox News Service

The weeks between Thanksgiving and New Year's Day can be a time of joy and celebration, but also a time of risk for children - from accidental poisoning to choking. Here are some ways to protect children during the holidays:  

  • Keep all hard candy and nuts off low coffee tables or end tables. Almost 3,000 people choke to death every year - most of them children. Nearly two-thirds of the children who die are 3 years old or younger. 

  • Make a place in high cabinets for any medications for visitors. Remind them not to keep medications in suitcases on the floor or next to the bed where children can find them. Almost 70 percent of poisonings involve children. Of those under 6 years old, 41 percent of poisonings involve pharmaceutical products. 

  • Lock up all silver cleaners and similar household products. Of the poisonings of children, the two top categories involve cosmetics (11.9 percent) and household products (11.4 percent). Plants were involved in 7.7 percent of the cases. Post in an accessible place the numbers of the local poison control center or children's hospital help line. 

  • To reduce the risk of electrocution, put plastic inserts or covers on exposed, easy-to-find electrical outlets and move hair dryers and curling irons away from bathtubs and sinks that might be filled with water. Every year, more than 3,000 children under age 10 are treated for electrical shock. 

  • Don't let children eat raw batter containing eggs, because of the possibility of salmonella contamination. 

Sources: Centers for Disease Control and Prevention, American Association of Poison Control Centers, U.S. Consumer Product Safety Commission, Children's Healthcare of Atlanta, www.kidssafe.com.  

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Women turn to the Internet for health information

NEW YORK, Nov 23 (Reuters Health) - More than half of American women who regularly surf the Web say they lead healthier lives because of medical information they have found online, according to results of a new survey. One in seven women say that it is actually easier to get such health information from a Web site than from their own physicians.

"We were not exactly surprised by the findings, but the depth of use of the Web for health information among women indicates that this tool is really becoming more and more mainstream," said Mark Olney, from Unilever's Interactive Brand Center, which sponsored the survey.

"There's a recognition that there can be some good quality information on the Web, particularly about issues that they might not be comfortable asking their family and friends about."

The survey was conducted by e-mail during 5 days in September. The researchers analyzed consumer use of--and confidence in--information found online, focusing on over 200 men and almost 600 women who regularly use the Internet. Of these participants, 460 women specifically answered questions on health issues.

Among "highly-active" users, the investigators found that females reported turning to the Web more often than to the TV, radio or newspaper when searching for health information. Almost 60% of women logged on in search of parenting and family advice--with over 70% of those women crediting the Web with improvements in their family situation.

Almost two thirds of the women and men said they sought health information online before they discussed a medical issue with their doctor, and 85% of women who did so said they felt confident in the content of their online research, the report indicates.

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Even in the cleanest mouths, bad breath may persist

NEW YORK, Nov 23 (Reuters Health) - A member of the American Dental Association (ADA) cautions that those who declare war on halitosis by stepping up their daily routine of brushing, flossing and rinsing out the mouth may be using the wrong weapons.

"Mouthwash is really just a perfume for your mouth when it really needs a bath," said Dr. Louis Malcmacher, a Bay Village, Ohio-based dentist. He notes that excellent oral hygiene will do nothing to extinguish bad breath if it does not also effectively rid the mouth of excessive bacterial build-up.

Malcmacher presented the latest science on the subject at the ADA's recent annual meeting in Chicago, Illinois.

Malcmacher acknowledged that many factors can contribute to the development of bad breath, including eating certain foods, food lodged between teeth, gum disease, tooth decay, smoking, dry mouth and certain illnesses.

But he noted that the primary culprit is found among certain types of bacteria that exist in the mouth of every individual. While ubiquitous, at abnormally high levels these bacteria produce a volatile sulfur compound that results in clinical bad breath.

"There's no way to prevent the bacteria from being in their mouth," Malcmacher told Reuters Health. "We don't know what the trigger is that causes bad breath. However, we do know how to correct the problem."

Malcmacher said that concerned individuals--with some kind urging on the part of their loved ones--might try a grassroots approach towards combating their breath issues by drinking a lot of water so as to keep hydrated and to ensure that their saliva is actively washing away excess bacteria. He also suggested brushing the back of the tongue where bacteria tend to build-up.

However, Malcmacher emphasized that a definitive answer is to be found in the comfort of a dentist's chair.

Dentists "can now make for patients special trays that custom-fit their mouth and--with the use of certain gels that use oxygen--can bathe the mouth in oxygen, which will kill the bacteria that cause bad breath," Malcmacher said.

He said that a commitment of 1 hour per day for approximately 2 weeks would be sufficient for most patients, with smokers perhaps requiring a longer treatment period. "Really it depends on the patient, but we found it's the most successful thing we've ever had. And it works in at least 80% to 85% of patients."

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Social phobia common and disabling, study suggests

NEW YORK, Nov 23 (Reuters Health) - About 7% of the general population could be diagnosed with social phobia, according to results of a study. For these people, speaking in public and meeting strangers are often frightening experiences.

Researchers from the University of California at San Diego and the University of Manitoba in Canada set out to find the prevalence of social phobias in the general population. In interviews with nearly 2,000 people, the investigators found that the most common fear, reported by 15%, was giving a speech. The rarest phobia was "eating or drinking where someone could watch," feared by 4.2%.

About 60% of the people surveyed said they had no social phobias, while 28% had one to three such fears. Only 3.4% had seven or more social fears.

"Lots of people have social fears," explained Dr. Laine Torgrud of the University of Manitoba in Winnipeg, one of the study's authors. "The key question is whether those fears interfere with their life--their social life, their work life, their everyday life--or whether the person is really disturbed about the fact that they have social fears." According to a classification system for mental illness, social phobia affected 7.2% of the people interviewed.

One in five people with social phobia reported that their fears interfered with their education, and almost half said their fears had caused them to drop a class, Torgrud's group reports in the Archives of General Psychiatry.

One-fifth also said their phobia had interfered with their job. Thirty-eight percent said their anxieties interfere substantially with at least one area of their lives. This translates to a prevalence of disabling social phobia of about 2.6%.

Considering that social phobia often begins in childhood or adolescence and is frequently accompanied by depression and substance abuse, this finding "should trigger a careful look at the possible merits of developing a coordinated public health approach to social phobia," the authors write.

Torgrud told Reuters Health that treatment for social phobia is effective. The two main strategies, he explained, are treatment with antidepressant drugs known as selective serotonin-reuptake inhibitors or a type of counseling called cognitive behavioral therapy.

"Approximately 50% to 60% of people treated with those medications report a significant improvement in their social anxiety symptoms," Torgrud said. Cognitive behavioral therapy has about the same success rate for people who complete it, he added.

SOURCE: Archives of General Psychiatry 2000;57:1046-1052.

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Teen smokers at increased death risk

BOSTON, Nov 23 (Reuters Health) - People as young as 15 years old who smoke are at increased risk of death from injuries, accidents, suicides and homicides, Dr. Bruce N. Leistikow told participants of the 128th annual meeting of the American Public Health Association held here recently.

"It's clear there are differences in outcomes already in young, healthy populations," Leistikow, of the University of California at Davis, told Reuters Health.

Data were drawn from a national 1993 survey. After taking into consideration alcohol use, drug use, marital status and education, smokers aged 15 to 19 years were twice as likely to die from an injury, 1.4 times as likely to die from homicide, and 4.5 times as likely to commit suicide.

Leistikow speculated that part of the association may be due to the addiction process itself. "The definition of addiction is that you engage in self-injurious behavior," he said, which may extend to putting oneself in harm's way.

He also suggested that "smoking debilitates people, weakens their bodies so that they're less able to dodge accidents, and less able to recover from accidents that do happen."

The poisonous effects of nicotine may also be implicated, Leistikow said. "Nicotine is used to fumigate greenhouses. But when it's used as an insecticide, it has all these warnings on it, which is very different than when it is sold as a cigarette."

Leistikow noted that this is the first study showing an elevated risk of fatalities in young smokers.

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Study: echinacea use safe during pregnancy

NEW YORK, Nov 15 (Reuters Health) - While some herbal medicines may not be recommended for use during pregnancy, the popular herb echinacea seems to be safe for expectant mothers, study results suggest.

The herb "was not shown to pose a risk in pregnancy," according to lead study author Michael Gallo, a toxicologist at the Hospital for Sick Children in Ontario, Canada.

Gallo and his colleagues studied 206 pregnant women who used echinacea during their pregnancy and another 206 women who did not use the herb.

There was no statistical difference between the two groups in terms of pregnancy outcome, delivery method, maternal weight gain, birth weight or fetal distress, the authors report in the November 13th issue of Archives of Internal Medicine.

Similarly, no great difference was seen between the two groups in regard to birth defects, the report indicates.

Gallo was surprised that "unlike with prescription and over-the-counter drugs, pregnant women were less cautious with the herb echinacea in pregnancy as they felt it posed little risk."

Healthcare providers were also less concerned, Gallo told Reuters Health. "Over half of them suggest(ed) echinacea was safe, even though previous studies showing safety were not available."

And although Gallo's study testifies to the safety of the herb, he stressed that further study is needed.

"As herbal medicine use continues to grow and use in pregnancy becomes more popular, the need for research at the basic and clinical level becomes more apparent," he said. "We should not rely on the potentially false assumption that 'natural' is synonymous with 'safe.'"

SOURCE: Archives of Internal Medicine 2000;160:3141-3143.

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Sleep helps memory

November 22, 2000

BOSTON (AP) - Forget about pulling an all-nighter before an exam - a study suggests it's more important to get a good night's rest.

Harvard Medical School researchers, led by assistant professor of psychiatryn Robert Stickgold, found that people who slept after learning and practicing a new task remembered more about it the next day than people who stayed up all night after learning the same thing.

The study, which will be published in the December issue of Nature Neuroscience, was released Tuesday. 

The study is another piece in a growing body of evidence that suggests proper rest is necessary for learning.   ``We think getting that first night's sleep starts the process of memory consolidation,'' Stickgold said. ``It seems that memories normally wash out of the brain unless some process nails them down.''   

The 24 participants were trained to identify the orientation of three diagonal bars flashed for one-sixtieth of a second on a horizontal-striped computer screen.  

Half of the participants went to sleep that night. The others were kept awake until the second night of the study. Both groups were allowed to sleep on the second and third nights.  

On the fourth day, both groups were tested on how proficient they had become at identifying the orientation of the diagonal bars. Those who slept on the first night performed better than they had the first day. Those who didn't sleep did not improve.

"We don't know a lot about sleep, but we do know that it's useful in terms of deciding what information is useful and what's superfluous and can be discarded,'' said Joseph Modrack, an assistant professor of sleep medicine at the University of Rochester. "This study makes a lot of sense.'' 

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Sexual Abuse May Affect Health For A Lifetime

November 21, 2000

(Center for the Advancement of Health) - Far from being a static experience, sexual abuse during youth may affect health even in old age, suggest the results of a study.

Two University of California researchers noted associations between early abuse and several health conditions in the elderly. “These associations are impressive in that they were still present in an older population,” said co-author Murray B. Stein, MD, of the University of California, San Diego’s Anxiety and Traumatic Stress Disorders Program.  

Stein and co-author Elizabeth Barrett-Connor, MD, analyzed health data on more than 1,300 elderly white, middle class study participants from a Southern California community. Study participants took a sexual assault questionnaire in which they were asked if they ever experienced unwanted sexual contact.  

More than 12 percent of the women and 5 percent of the men reported early sexual abuse. On average, the first experience of abuse occurred when the women were 16 years old and the men were 13.5 years old. Most of the respondents never received counseling for their experience.  

Past sexual assault was associated with an increased risk of breast cancer, arthritis and thyroid disease, Stein and Barrett-Connor found. The study results appear in the November/December issue of Psychosomatic Medicine.  

The findings varied by gender. In women, early sexual assault appeared to increase the risk of arthritis and breast cancer, with multiple abuse episodes increasing disease risk by two- to three-fold compared with a single episode. In men, early sexual assault appeared to increase the risk of thyroid disease.  

Although this study resembles others that found adverse health effects of sexual abuse, Stein and Barrett-Connor did not find the associations between sexual abuse and obesity or headaches observed in other studies.  

Their finding of an association between breast cancer and early sexual abuse was somewhat unexpected. Stein and Barrett-Connor were also surprised to find an association between early sexual abuse and a reduced risk of hypertension. This finding may reflect “a survivor bias,” meaning that individuals with conditions associated with hypertension -- such as cardiac disease and diabetes -- may have died before the study was conducted.  

Exactly how sexual abuse may contribute to health problems can’t be determined from this study. The effects of stress-related hormonal alterations may play a role, but further research is needed, noted the researchers.  

“It remains to be established from future research to what extent, and through what mechanisms, sexual assault is associated with adverse effects on health,” said Stein.  

The researchers also suggested an evaluation of the extent to which counseling may improve the health of those who experienced early sexual abuse.   

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Laughter may protect the heart

NEW ORLEANS, Nov 15 (Reuters Health) - A hearty sense of humor may help avoid heart problems, new study findings suggest. People with heart disease are less likely to laugh or find the humor in different situations.

It is not clear if the lack of humor contributed to the illness or that patients with heart disease fail to find much humor in life. However, Baltimore researchers report that those study participants who laughed the most were the least likely to be angry or hostile--two factors that can increase blood pressure, and possibly, heart risk.

In the study, Dr. Michael Miller and colleagues from the University of Maryland looked at 150 patients who had either a heart attack or bypass surgery and measured their sense of humor against 150 healthy people--frequently the spouses or relatives of the patients. To try to eliminate their illness as a factor in response, the researchers only selected patients if the critical phase of illness was past.

Both groups answered two questionnaires--one designed to assess how much humor they found in a series of 20 hypothetical situations, the other a standard tool designed to assess anger and hostility.

"Patients with heart disease had a 40% to 45% decreased likelihood of responding with laughter" to the situations in the first questionnaire, Miller reported. Meanwhile, "those who responded with laughter had the lowest likelihood of anger and hostility," Miller said. "There was an inverse relationship."

Miller explained that laughter has been shown to release opioid compounds from the brain that induce a feeling of euphoria. It also lowers pulse and blood pressure. Anger and hostility are known to constrict the blood vessels, so Miller and colleagues will now be looking to measure a blood vessel-dilating gas to determine if it is released during laughter.

"We're going to measure nitric oxide," Miller told Reuters Health. "It's in the same family as laughing gas."

Miller thinks laughter should be incorporated into every cardiac rehabilitation program, to be used as a form of exercise. "Much of our behavior is learned behavior," he said. "We can learn to regulate the laughing muscles."

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Low doses of aspirin-like drugs cut Alzheimer's risk

NEW YORK, Nov 20 (Reuters Health) - Even at low doses, aspirin and other anti-inflammatory drugs may stave off Alzheimer's disease in the elderly, Australian researchers have found.

Mounting evidence suggests that common anti-inflammatory drugs such as aspirin and ibuprofen may cut Alzheimer's risk, but the necessary dose has been unclear. Now, results of a study of more than 600 men and women age 75 and older suggest even low doses of the drugs can ward off Alzheimer's.

Dr. G. Anthony Broe and his colleagues at the University of Sydney report their findings in the November issue of Archives of Neurology.

There has been little data on whether only high doses of anti-inflammatory drugs cut Alzheimer's risk, according to Broe's team. Using high doses is dangerous since the drugs can trigger gastrointestinal bleeding or damage the liver.

But high doses do not appear necessary to combat Alzheimer's, the current findings suggest. Most study participants were taking anti-inflammatories only at the low doses necessary to protect their hearts. Still, anti-inflammatory use was linked to a lower prevalence of Alzheimer's, but not other forms of dementia.

Exactly why aspirin and similar drugs might protect against Alzheimer's is unclear. Although the natural assumption might be that they reduce inflammation in the brain, research has not borne this idea out, Broe's team writes. Instead, the authors add, the drugs' heart benefits may offer an explanation.

Aspirin and similar drugs improve blood flow to the heart by reducing the 'stickiness' of platelets, cells that help the blood clot. And the drugs may improve the function of cells lining blood vessels, Broe and his colleagues speculate.

SOURCE: Archives of Neurology 2000;57:1586-1591.

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