Wednesday, July 20, 2011

CDC: Frogs tied to salmonella being sold again (AP)

ATLANTA � A California company has resumed selling a kind of pet frog that caused salmonella illnesses in more than 240 people, most of them children. And federal health officials are not happy.

Centers for Disease Control and Prevention officials on Wednesday warned consumers that Blue Lobster Farms in June had resumed shipping African dwarf frogs from its Madera County, California, breeding facility. They say the frogs may still pose a serious health risk.

The company voluntarily stopped shipping the frogs in April, after an investigation fingered them as the source of a salmonella outbreak that sickened people nationwide over two years. No one died, but many illnesses were in children under 5 years old � some hospitalized.

Company officials could not be reached for comment.

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http://www.cdc.gov/salmonella/water-frogs-0411/

http://www.cdc.gov/media/matte/2011/05_waterfrogs.pdf



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Progress is seen on a blood test for Alzheimer's (AP)

PARIS � Scientists are closing in on a long-sought goal: A blood test to screen people for Alzheimer's disease.

An experimental test did a good job of indicating how much of the telltale Alzheimer's plaque lurks in people's brains, Australian researchers reported Wednesday. If the test proves accurate in larger studies, it could offer a way to check people having memory problems to see who needs more definitive testing for the disease.

Many blood tests are being developed and a few are used in research settings now, but only the Australian one has been validated against brain scans and other accepted diagnostic tests with good accuracy in large groups of people, said Maria Carrillo, senior director of medical and scientific relations for the Alzheimer's Association.

The results, reported Wednesday at the Alzheimer's Association International Conference in France, "give us hope that we may be able to use a blood test in the near future," although that doesn't mean next year, she said.

More than 5.4 million Americans and 35 million people worldwide have Alzheimer's, the most common form of dementia. It has no cure and drugs only temporarily ease symptoms. Finding it early allows patients and their families to prepare, and ruling it out could lead to diagnosing a more treatable cause of symptoms, such as sleep problems.

Brain scans can show signs of Alzheimer's � sticky clumps of a protein called beta amyloid � a decade or more before it causes memory and thinking problems, but scans are too expensive and impractical for routine use. Doctors and patients need simple ways to screen people for the disease.

Samantha Burnham and others at Australia's national science agency, CSIRO, working with several universities, used a long-running study of more than 1,100 people � some healthy, some impaired � to develop the blood test.

They started with blood samples from 273 study participants and identified nine hormones and proteins that seemed most predictive of amyloid levels in the brain. A cutoff level was set for what was considered high.

"The belief is that people above that point will go on to get Alzheimer's disease, and the lag is about 8 to 10 years," Burnham explained.

When researchers used the nine-marker blood test on these same participants, they found that it separated healthy people from those with mild cognitive impairment or Alzheimer's as verified by their brain scans. The test correctly identified 83 percent of people with high amyloid levels and correctly ruled out 85 percent of people without this condition.

"That's pretty high," the Alzheimer's Association's Carrillo said of the test's accuracy.

More importantly, she said, the Australian researchers validated the test's accuracy in two additional groups: the other 817 folks in the Australian study and 74 people in a big U.S.-led study aimed at finding novel Alzheimer's disease biomarkers.

The test performed well in those situations, too, Burnham said.

CSIRO has patented the test and is talking with major companies about making it commercially available.

"It sounds like the Australians do have good clinical data" and that the markers they are testing for track with cases of the disease, said Creighton Phelps, a neuroscientist with the U.S. National Institute on Aging.

The next step is wider validation work and ensuring it can be standardized to give reliable results regardless of what lab or doctor would use it, he said.

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Online:

National Institute on Aging: http://www.nia.nih.gov/Alzheimers

Alzheimer's Association: http://www.alz.org

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP



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Tuesday, July 19, 2011

Over 65 and not worried about heat? You should be (AP)

CHICAGO � This week's heat wave may be uncomfortable, but you're healthy, active and feel just fine. So what if you're over 65? Think again. Feeling good doesn't mean you're safe.

There are changes in an older person that raise the risk for heat stroke and other problems. An older body contains far less water than a younger one. Older brains can't sense temperature changes as well, and they don't recognize thirst as easily.

Blistering summer heat is an underappreciated killer, claiming by some estimates as many as 1,000 U.S. lives each year � more than any other type of weather.

One federal study found 40 percent of heat-related deaths were in people 65 and older. Those numbers could be lower if more heeded heat warnings aimed at seniors. Yet research has shown many people over 65 don't think the warnings apply to them � because they don't think they're "old."

Don Worden is 79 and an avid tennis buff who prefers playing doubles on outdoor courts along Chicago's lakefront � even in oppressive 90-degree temperatures like those hitting the Midwest this week.

"I don't pay too much attention to those" warnings, Worden said. "I stay in pretty good shape, and I don't feel they apply to me."

Worden said he drinks a lot of water and would stop a match if he started feeling effects from the heat, "but that hasn't happened."

Scott Sheridan, who studies the effects of heat and climate on health at Kent State University, researched how people over 65 view heat warnings. In his 2006 study of more than 900 people, he found about 70 percent knew about advice to drink plenty of water on very hot days, avoid outdoor activities and stay inside with air conditioning. But only about half said they followed the advice.

"People well into their 70s would say old people should watch out but not them," he said. "People just didn't want to be thought of in that same category."

Dr. David Zich, an emergency medicine specialist at Northwestern Memorial Hospital, said he has colleagues in medicine that age who shun being thought of as "elderly." But those heat warnings apply to them, too.

As Dr. William Dale, geriatrics chief at the University of Chicago Medical Center explains it, "Any older adult has less reserve and is more likely to become dehydrated than others, just because their overall body water goes down with age no matter how healthy you are."

The amount of water in the body declines with aging, from about 80 percent in young adulthood to about 55 to 60 percent for people in their 80s, Dale said.

Temperature sensors in the brain become less sensitive as people age, so the body doesn't get the same signals to drink water in hot weather, and older people often don't feel thirsty even when they need to replenish, Dale said.

They also may not feel the typical symptoms of dehydration, such as headache or dizziness. Some complain of just feeling "bad" and think they're getting sick, he said.

Conditions were ripe for those types of complaints Tuesday as a dense dome of hot air remained parked over much of the nation's midsection, raising temperatures into the mid- to upper-90s from the Texas Gulf Coast to the Rockies and the northern Plains. Tropical-level humidity raised the heat index in many places to nearly 120 degrees.

In South Dakota, up to 1,500 head of cattle died across the state from the heat. And in eastern Iowa, the scorching sun caused a portion of Interstate 380 to buckle. The weather also sent dozens of people to hospitals, canceled outdoor sporting events and caused sporadic power outages.

In such conditions, dehydration can lead to heat exhaustion and potentially deadly heat stroke. During a heat wave, that can happen in a matter of hours in older people if they over-exert themselves, don't drink enough water or are frail and don't get out of uncooled homes, said Dr. Chris Carpenter, an emergency medicine physician at Washington University School of Medicine in St. Louis.

Heat exhaustion can cause muscle cramps, low blood pressure, rapid pulse and nausea. It can be treated at home, by drinking water, getting into an air-conditioned room or sitting in front of a fan and misting the body with cool water.

But affected people should be monitored for mental changes and to make sure their temperature does not rise above 102 because the condition can quickly lead to heat stroke. A medical emergency, heat stroke involves temperatures of 104 or higher and can cause seizures, loss of consciousness and death.

Medicines many older people take also may make them more vulnerable to the heat. These include diuretics for high blood pressure, which increase urination � and make it more important to drink plenty of water, Dale said.

Some types of drugs can interfere with sweating and raise body temperature, including some medicines for insomnia, nausea, prostate conditions, Parkinson's disease and even Benadryl. Many list "dry mouth" as a side effect � a tip-off to drink more water, Zich said.

There aren't specific guidelines on how much water older people should drink in a heat wave.

Dale said he generally tells his older patients to drink a quart of water throughout the day, and to drink even if they don't feel thirsty.

Doctors also advise older patients to avoid alcohol and coffee during extreme heat because they can cause the body to lose fluid and contribute to dehydration.

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Online:

Centers for Disease Control and Prevention: http://emergency.cdc.gov/disasters/extremeheat/elderlyheat.asp

American Geriatrics Society: http://www.healthinaging.org/public_education/hot_weather_tips.php

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner.



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Gov't advisers: Cover birth control for free (AP)

WASHINGTON � Millions of women may soon gain free access to a broad menu of birth control methods, thanks to a recommendation issued Tuesday by health experts advising the government.

An Institute of Medicine panel recommended that the government require health insurance companies to cover birth control for women as a preventive service, without copayments. Contraception � along with such care as diabetes tests during pregnancy and screening for the virus that causes cervical cancer � was one of eight recommended preventive services for women.

President Barack Obama's health care law already requires most health plans to provide standard preventive care for people of both sexes at no additional charge to patients. The women's health recommendations were considered so sensitive that the nonpartisan institute was asked to examine the issue and report back. IOM advises the government on complex issues related to medical science and health care policy.

A half century after the introduction of the birth control pill, the IOM recommendations may help to usher in another revolution. Medical experts say easier access could start a shift to more reliable forms of long-acting birth control, such as implants or IUDs, which are gaining acceptance in other economically developed countries.

First, expect a fight over social mores. Catholic bishops and some other religious and social conservatives say pregnancy is a healthy condition and the government should not require insurance coverage of drugs and other methods that prevent it.

However, short of repealing provisions of the health care law, it's unclear what opponents can do to block the recommendations. The final decision, by Health and Human Services Secretary Kathleen Sebelius, is expected to be issued quickly.

"We are one step closer to saying goodbye to an era when simply being a woman was treated as a pre-existing condition," said Sen. Barbara Mikulski, D-Md., who sponsored the women's health amendment. "We are saying hello to an era where decisions about preventive care and screenings are made by a woman and her doctor."

Birth control use is virtually universal in the United States, according to government statistics. Generic versions of the pill are available for as little as $9 a month at big drug store chains.

Yet about half of all pregnancies are unplanned. Many occur among women using some form of contraception, and forgetting to use it is a major reason. Experts say a shift to longer acting forms of birth control would help.

Birth control is about more than sheer prevention of pregnancy � it can help make a woman's next pregnancy healthier by spacing births far enough apart, generally 18 months to two years. Research links closely spaced births to a risk of such problems as prematurity, low birthweight, even autism.

Other preventive services recommended by the IOM panel include: HIV screening; support for breast- feeding mothers, including the cost of renting pumps; counseling about sexually transmitted infections; screening for domestic violence and at least one "well-woman" preventive care visit annually.

Although the services will be free of any additional charge to patients, somebody has to pay the cost. It's likely to be spread among other people with health insurance, resulting in slightly higher premiums.



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Study: Healthy living can help prevent Alzheimer's (AP)

PARIS � Taking care of your body just might save your mind. Millions of cases of Alzheimer's disease worldwide could be prevented by curbing risk factors such as high blood pressure, smoking, obesity and lack of exercise, new research suggests.

The study offers more than the usual pep talk about healthy living. Seven conditions or behaviors account for up to half of the 35 million cases of Alzheimer's around the world, it found. With no cure or treatment to reverse the mind-robbing disease, preventing new cases is crucial.

The study was presented Tuesday at the Alzheimer's Association International Conference in France, where sessions on prevention have been drawing standing-room-only crowds for several days.

"Prevention is a particularly attractive option given the state of therapy. That's why there's so much interest in it," said William Thies, the association's chief scientific officer.

The study was led by Deborah Barnes, associate professor of psychiatry at the University of California, San Francisco. Results also were published online by the British journal Lancet Neurology. The researchers have grants from the Alzheimer's Association and the U.S. National Institutes on Aging.

The study used a mathematical model to estimate the impact of top modifiable risk factors for Alzheimer's disease: smoking, depression, low education, diabetes, too little exercise, and obesity and high blood pressure in mid-life.

How much of an impact each one has on total Alzheimer's cases depends on how common it is and how strongly it affects dementia risk. Researchers calculated the impact globally and just for the United States.

Worldwide, the biggest impact on Alzheimer's cases is low education, because illiteracy is so common, they found. Low education can be a sign of many factors that harm minds, such as poor nutrition. But it also is harmful by itself, because there is less opportunity to develop "brain power" that can carry you into old age.

"Education, even at a young age, starts to build your neural networks," so being deprived of it means less brain development, Barnes explained.

Smoking had the second biggest impact on cases worldwide, followed by too little exercise.

In the United States, however, inactivity is the leading problem because a third of the population is sedentary, Barnes said.

Depression made the next biggest impact on Alzheimer's cases in the U.S., followed by smoking and high blood pressure in mid-life. Untreated or inadequately treated depression has long been known to raise the risk of developing Alzheimer's disease.

Reducing these seven risk factors by 25 percent could mean 3 million fewer cases of Alzheimer's worldwide, including half a million in the U.S., researchers estimated. Reducing risk factors by 10 percent would translate to 1.1 million fewer cases.

"It gives us a little bit of hope about things we could do now about the epidemic that is coming our way," Barnes said.

Alzheimer's cases are expected to triple by 2050, to around 106 million worldwide.

"We can do something about this," said Dr. Ronald Petersen, a Mayo Clinic dementia specialist who had no role in the study. A common misconception is that you're "dealt a deck of cards at birth," he said, but "people need not just sit back and watch this unfold."

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Online:

National Institute on Aging: http://www.nia.nih.gov/Alzheimers

Alzheimer's Association: http://www.alz.org

Lancet: http://www.thelancet.com/journals/laneur/article/PIIS1474-4422(11)70072-2/abstract

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP



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Monday, July 18, 2011

Poll: Obesity hits more boomers than others in US (AP)

WASHINGTON � Baby boomers say their biggest health fear is cancer. Given their waistlines, heart disease and diabetes should be atop that list, too. Boomers are more obese than other generations, a new poll finds, setting them up for unhealthy senior years.

And for all the talk of "60 is the new 50" and active aging, even those who aren't obese need to do more to stay fit, according to the Associated Press-LifeGoesStrong.com poll.

Most baby boomers say they get some aerobic exercise, the kind that revs up your heart rate, at least once a week. But most adults are supposed to get 2 1/2 hours a week of moderate-intensity aerobic activity � things like a brisk walk, a dance class, pushing a lawn mower. Only about a quarter of boomers polled report working up a sweat four or five times a week, what the average person needs to reach that goal.

Worse, 37 percent never do any of the strength training so crucial to fighting the muscle loss that comes with aging.

Walking is their most frequent form of exercise. The good news: Walk enough and the benefits add up.

"I have more energy, and my knees don't hurt anymore," says Maggie Sanders, 61, of Abbeville, S.C. She has lost 15 pounds by walking four miles, three times a week, over the past few months, and eating better.

More boomers need to heed that feel-good benefit. Based on calculation of body mass index from self-reported height and weight, roughly a third of the baby boomers polled are obese, compared with about a quarter of both older and younger responders. Only half of the obese boomers say they are are regularly exercising.

An additional 36 percent of boomers are overweight, though not obese.

The nation has been bracing for a surge in Medicare costs as the 77 million baby boomers, the post-war generation born from 1946 to 1964, begin turning 65. Obesity � with its extra risk of heart disease, diabetes, high blood pressure and arthritis � will further fuel those bills.

"They're going to be expensive if they don't get their act together," says Jeff Levi of the nonprofit Trust for America's Health. He points to a study that found Medicare pays 34 percent more on an obese senior than one who's a healthy weight.

About 60 percent of boomers polled say they're dieting to lose weight, and slightly more are eating more fruits and vegetables or cutting cholesterol and salt.

But it takes physical activity, not just dieting, to shed pounds. That's especially important as people start to age and dieting alone could cost them precious muscle in addition to fat, says Jack Rejeski of Wake Forest University, a specialist in exercise and aging.

Whether you're overweight or just the right size, physical activity can help stave off the mobility problems that too often sneak up on the sedentary as they age. Muscles gradually become flabbier until people can find themselves on the verge of disability and loss of independence, like a canoe that floats peacefully until it gets too near a waterfall to pull back, Rejeski says.

He led a study that found a modest weight loss plus walking 2 1/2 hours a week helped people 60 and older significantly improve their mobility. Even those who didn't walk that much got some benefit. Try walking 10 minutes at a time two or three times a day, he suggests, and don't wait to start.

"I don't think there's any question the earlier you get started, the better," says Rejeski, who at 63 has given up running in favor of walking, and gets in 30 miles a week. "If you allow your mobility to decline, you pay for it in terms of the quality of your own life."

When it comes to diseases, nearly half of boomers polled worry most about cancer. The second-leading killer, cancer does become more common with aging.

"It's the unknown nature, that it can come up without warning," says Harry Forsha, 64, of Clearwater, Fla., and Mill Spring, N.C.

Heart disease is the nation's No. 1 killer, but it's third in line on the boomers' worry list. Memory loss is a bigger concern.

"On a scale of one to 10, seven or eight," is how Barry Harding, 61, of Glen Burnie, Md., puts it. "It's more talked about now, Alzheimer's and dementia."

In fact, more than half of boomers polled say they regularly do mental exercises such as crossword puzzles.

After Harding retires, he plans to take classes to keep mentally active. For now, he's doing the physical exercise that's important for brain health, too. He also takes fish oil, a type of fatty acid that some studies suggest might help prevent mental decline.

Sanders, the South Carolina woman, says it was hard to make fitness a priority in her younger years.

"When you're younger, you just don't see how important it is," says Sanders, whose weight began creeping up when breast cancer in her 40s sapped her energy. Now, "I just know that my lifestyle had to change."

The AP-LifeGoesStrong.com poll was conducted from June 3-12 by Knowledge Networks of Menlo Park, Calif., and involved online interviews with 1,416 adults, including 1,078 baby boomers born between 1946 and 1964. The margin of sampling error for results from the full sample is plus or minus 4.4 percentage points; for the boomers, it is plus or minus 3.3 percentage points.

Knowledge Networks used traditional telephone and mail sampling methods to randomly recruit respondents. People selected who had no Internet access were given it free.

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EDITOR'S NOTE � Lauran Neergaard covers health and medical issues for The Associated Press in Washington. AP Writer Stacy A. Anderson, AP Polling Director Trevor Tompson, Deputy Polling Director Jennifer Agiesta and News Survey Specialist Dennis Junius contributed to this report.

Online:

http://health.lifegoesstrong.com/heart-vs-cancer



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