Archive for January, 2010

Report questions value of family health history

Saturday, January 30th, 2010

Getting a patient’s family history is widely regarded as a standard element of good medical care. But a report published today concludes that there isn’t much good evidence that obtaining such information improves doctors’ ability to predict and manage disease.

In addition, the report’s authors say the best way to collect family history data is unclear, as is the impact on patient outcomes and behaviors.

Dr. Brenda J. Wilson, from University of Ottawa, Ontario, Canada and colleagues did a study of previous studies on the subject, and report their findings in the online version of the Annals of Internal Medicine.

They found only two studies that tried to determine whether accurate family histories were likely to have an impact on care, and those studies had a number of limitations.

They found more studies of how patients reported their family histories. In 23 studies, they saw evidence that patients were more accurate about reporting the absence of disease in relatives than the presence of disease. Perhaps not surprisingly, patients were more accurate about their first degree relatives than their distant relatives.

The study was funded by the Agency for Healthcare Research and Quality.

Restless Legs May Vary by Race and Gender

Sunday, January 24th, 2010

Restless legs syndrome, a neurological disorder characterized by a strong urge to move the legs, is much more common among some racial groups than others, a new U.S. study has found.

Researchers interviewed 190 people being seen at a primary care clinic. About 12 percent of those who were black, compared with 36 percent of those who were not black, were found to have restless legs symptoms. Overall, the prevalence of restless legs was 23 percent among the clinic participants.

Among blacks, the prevalence of restless legs syndrome (RLS) was 12 percent for both men and women, compared with 40 percent for women and 29 percent for men among the others, most of whom were white.

“There are significant ethnic differences in the prevalence of restless legs syndrome, but the exact causes of higher prevalence among Caucasians are unknown,” study author Dr. Ammar Alkhazna, of the University of Missouri, said in a news release from the American College of Chest Physicians. “This likely reflects a combination of factors, including a genetic predisposition to RLS, diet, including iron intake, medications, and possibly culture.”

The study was scheduled to be presented at the annual scientific meeting of the American College of Chest Physicians, held Oct. 31 to Nov. 5 in San Diego.

Symptoms of restless legs also were seen more often in women than men, the study found.

“Some risk factors for restless legs syndrome appear to be more common among women,” Alkhazna said. “Women are more likely to be iron-deficient than men and have rheumatoid arthritis, which are known risk factors for RLS.”

TV May Increase Aggression in Toddlers

Sunday, January 17th, 2010

Yet another study has found that television viewing is linked to aggression in young children.

This research, published in the November issue of the Archives of Pediatrics & Adolescent Medicine, found that direct TV watching by young children or exposure to indirect viewing in the household were both associated with increased aggression in small children.

After controlling the data for other factors, such as maternal depression, living in an unsafe neighborhood and being spanked, “for every hour that a child watched TV directly, aggression went up 0.16 on a scale of zero to 30. For a TV being on in the house, it was 0.09,” said study author Jennifer A. Manganello, an assistant professor of health communication at the University of Albany School of Public Health, State University of New York.

And, she said, while the increase may not seem like a lot, when the researchers looked at all of the other factors, “TV was more likely than some other factors to increase aggressive behaviors.”

The American Academy of Pediatrics (AAP) is concerned enough about the media’s effect on children’s behavior that they recently updated their policy on media violence.

“Exposure to violence in media, including television, movies, music and video games, represents a significant risk to the health of children and adolescents. Extensive research evidence indicates that media violence can contribute to aggressive behavior, desensitization to violence, nightmares and fear of being harmed,” wrote the AAP Council on Communications and Media.

For the current study, Manganello and her colleagues collected data from the home and by telephone for 3,128 children born between 1998 and 2000. The children came from 20 large U.S. cities, and their mothers completed surveys when the child was born, and again at ages 1 and 3.

Because so many factors can influence a child’s behavior, the researchers tried to control for as many factors as they could, including maternal health and depression, maternal parenting attitudes and behaviors, maternal experience with violence, the safety of the neighborhood and demographic characteristics.

The researchers found that children who were spanked, lived in an unsafe neighborhood or had a mother who was depressed or stressed were more likely to exhibit aggressive behaviors.

But, after controlling for these and other factors, the study authors found that TV — both direct and indirect viewing — had a statistically significant effect on children’s aggressive behavior.

“A take-home message from this study is that parents should think about how much TV kids are watching themselves, but also think about the overall media environment in the home,” said Manganello.

“TV is not a benign influence. It does have impact,” said Richard Gallagher, director of the Parenting Institute at the New York University Child Study Center in New York City. And, while content may impact children, he pointed out that children’s behaviors may also be affected by the “opportunities lost.”

That means that when a child is watching TV, which is a passive behavior, the child doesn’t have the opportunity to interact with other people and may have reduced contact with his or her peers.

“The AAP guidelines that children under 2 shouldn’t watch any TV may be fairly strict and hard to carry out, but parents should be judicious about how much TV young children are watching, and be aware that it’s not likely to be appropriately stimulating,” he said.

He added that parents need to act as a TV filter for their children. For example, he said, parents should point out when something is silly on TV that it’s not a real-life scenario. Or, if they see something violent — say an anvil dropping on someone’s head in a cartoon — parents need to interpret that for their children, and let them know what would happen if that were a real situation.

Two U.S. deaths possible in beef recall

Monday, January 11th, 2010

An outbreak of food-borne illness, linked to dangerous bacteria in ground beef, sickened 28 people and caused at least one death, the U.S. Centers for Disease Control and Prevention said on Monday.

The CDC said a New York adult with underlying medical conditions had died and another possibly related death in New Hampshire was under investigation. State officials attribute the New Hampshire death to the O157:H7 E. coli bacteria.

All but three of the 28 cases listed by the CDC were in the U.S. Northeast and 18 were in the New England states. Sixteen hospitalizations were reported, said a CDC spokeswoman. The bacteria involved were from a common strain, so tests were under way to see if all of the reported cases were related.

Over the weekend, Fairbank Farms of Ashville, New York, recalled 545,699 lbs (248,450 kg) of ground beef products.

The Agriculture Department, which oversees meat safety, said an investigation led it to conclude “there is an association between the fresh ground beef products and illnesses in Connecticut, Maine and Massachusetts.” USDA worked with state and federal officials in examining a cluster of E. coli O157:H7 illnesses.

A potentially deadly bacteria, E. coli can cause bloody diarrhea, dehydration and, in severe cases, kidney failure. The very young, the elderly and people with weak immune systems are the most susceptible to foodborne illness.

A string of food-borne safety scares led the U.S. House of Representatives to pass legislation this summer to require more inspections and oversight of food manufacturers and would give the government new authority to order recalls.

Fairbank Farms announced the recall on Saturday. The beef was produced in mid-September and probably was labeled for sale before the end of the month, said USDA.

It went to retailers including Trader Joe’s, Price Chopper, Lancaster and Wild Harvest, Shaw’s, a unit of Supervalu, BJ’s, Ford Brothers and Giant, a unit of Ahold, in eight states — Connecticut, Maryland, Massachusetts, New Jersey, New York, North Carolina, Pennsylvania and Virginia.