Children: Better Understanding of Radiation Risks

Simply giving parents informational handouts can improve their understanding of the potential increased risk of cancer related to paediatric computed tomography(CT), according to a recent study.29/08/2007
“Like many radiology departments around the country, we are concerned about the increasing radiation exposure to children caused by increased usage of CT. When we looked into it, our emergency physicians told us that parents' expectations may play a role,” said David B. Larson, MD, lead author of the study, from The Children’s Hospital in Denver. “The emergency room clinicians tell us anecdotally that a number of parents expect that their child will undergo CT even before the child is seen by a physician. Parents rarely seem to understand the associated risks, so we thought it might be helpful to our emergency room colleagues to provide a handout to parents to explain, in basic terms, the risks associated with CT,” said Larson.

The study consisted of 100 parents of children undergoing non-emergent CT studies who were surveyed before and after reading an informational handout that described radiation risks. Of the 100 parents surveyed, 66 percent believed that CT uses radiation; 99 percent afterwards.

13 percent of those surveyed before reading the handout believed CT increases the lifetime risk of cancer, versus 86 percent surveyed afterward. According to the study, after reading the handout, parents became less willing to have their child undergo a CT examination if their doctor believed that either CT or observation would be equally effective. Their willingness to have their child undergo CT recommended by their doctor did not significantly change.

No parent refused or requested to defer CT after reading the handout. “While most parents knew that CT uses radiation, we were surprised to find that most parents did not realize that this radiation exposure is associated with an increased risk of cancer,” said Larson. MEDICA.de; Source: American Roentgen Ray Society

Health Tip: Breast Self-Exams

(HealthDay News) -- Women should examine their breasts regularly to detect lumps or abnormalities that could signal breast cancer. An exam should be done once a month, several days after the last day of a woman's period.

Here are the five basic steps to a breast self-exam, courtesy of Breastcancer.org:
Standing with your shoulders straight and your arms on your hips, face a mirror. Look for any differences in size, shape, color, swelling or bulging of the skin, changes in the nipple, or any signs of redness or rash.

Raise your arms, and examine your breasts for any of those differences.

Gently squeeze each nipple to check for any discharge.

Lie down, and feel each breast with the hand of the opposite arm. Feel all the tissue, applying pressure to check deep tissue for any lumps or abnormalities.

Examine the breasts while you are standing or sitting, gently examining the entire breast. You may want to try this method in the shower, while the skin is slippery.

Social Stress Could Worsen MS

(HealthDay News) -- Chronic social stress may aggravate neurodegenerative diseases such as Multiple sclerosis (MS), U.S. researchers report.

The team at Texas A&M University also said certain interventions may prevent or halt stress-related inflammation, however.

In experiments on mice, the researchers found that social stress increased central nervous system (CNS) inflammation. Stress appeared to elevate levels of a cytokine called interleukin-6 (IL-6), which led to increased severity of MS-like illness in the mice.

Cytokines are pro-inflammatory proteins that regulate immune and inflammatory functions.
The researchers also found that giving the mice IL-6 neutralizing antibody treatments during stressful events prevented the stress-related worsening of the MS-like disease.

The findings were to be presented Friday at the American Psychological Association's annual convention, in San Francisco.

Lead researcher Dr. Mary Meagher noted that, "people exposed to chronic social conflict experience high levels of stress and consequent dysregulation of the immune system, thereby increasing vulnerability to infectious and autoimmune disease."

"The cytokine response during chronic stress appears to play a key role in exacerbating the acute CNS (central nervous system) infection and the development of subsequent autoimmune responses," she said in a prepared statement.

More information
The American Medical Association has more about MS.

Health Tip: Treating a Blister

(HealthDay News) -- Blisters are sore, swollen areas on the skin where fluid has collected beneath an outer layer of skin. Blisters are caused by friction, often from poorly fitted shoes or socks that rub against the skin.

Here are suggestions on caring for a blister, courtesy of the University of Michigan Health System:

Steps should be taken to avoid further irritating the problem area.

Large blisters can be carefully drained with a sterilized needle, then covered with antibiotic ointment and a bandage.

For extra protection, purchase a moleskin at a drugstore. Cut a hole that's larger than the blister in the moleskin, creating a moleskin "donut." Then apply the moleskin so that the hole is over the blister.

See your doctor about any blisters that don't heal in a reasonable amount of time, or look like they may be infected.

Obesity-Linked Woes Boost Kids' Lifetime Heart Risk

(HealthDay News) -- Obese children diagnosed with health problems collectively known as the "metabolic syndrome" are at higher risk for developing heart disease as adults, new research reveals.

Compared to healthier youngsters, school-age children with the condition face a 14.5 times greater risk of cardiovascular disease when they reached their 30s and 40s, the study found.
Components of the syndrome include high blood pressure, high body mass, high blood pressure and high triglycerides (blood fats).

"I wasn't exactly shocked, but this is the first time we have shown that children who have this constellation of factors known as metabolic syndrome are at an increased risk for cardiovascular disease in their adult years," said study lead author John A. Morrison, a research professor of pediatrics who also works in the division of cardiology at Cincinnati Children's Hospital Medical Center in Ohio.

The findings are published in the August issue of Pediatrics.

According to the American Heart Association, more than 50 million Americans have the metabolic syndrome. The condition is typically diagnosed on the basis of having at least three of the following characteristics: abdominal obesity; high blood pressure; insulin resistance (in which the body can't process insulin or blood sugar properly); a high risk for arterial plaque build-up due to high levels of triglycerides, low HDL ("good") cholesterol and high LDL ("bad") cholesterol; and a high risk for clotting and inflammation as indicated by the elevated presence of certain blood proteins.

Researchers long ago established that, for adults, having the metabolic syndrome increases their risk for both heart disease and diabetes. Physicians now recommend that patients combating the condition embark on a weight-loss program geared toward developing healthier eating habits and increased physical activity.

To explore a possible link between pediatric metabolic syndrome and adult heart disease, Morrison and his team cross-referenced data for contributing syndrome characteristics collected from a pool of 771 children between 1973 and 1978, and then again between 2000 and 2004.

The participants were drawn from the Cincinnati region and were between the ages of 6 and 19 in the first study and 30 and 48 in the follow-up study. A little less than three-quarters of the pool were white and a little more than a quarter were black.

Patient blood samples were taken the time of study enrollment and then 25 years later. The researchers gauged blood pressure; body mass index (BMI); and cholesterol. Blood triglyceride and glucose levels were also assessed.

The participants also reported any history of heart attack or stroke, or procedures such as coronary bypass or angioplasty.

Four percent of the participants -- 31 boys and girls -- had metabolic syndrome as children, while more than 25 percent had the condition 25 years later, the researchers reported.

Among those with pediatric metabolic syndrome, almost 70 percent still had the condition as adults, and almost 20 percent had gone on to develop cardiac disease in the intervening years.
In contrast, only 1.5 percent of the children who did not have the syndrome as kids went on to experience heart trouble as adults.

Furthermore, any rise or fall in BMI over the 25 years was linked to a concurrent rise or fall in risk for developing the metabolic syndrome. In that time frame, every BMI bump or drop of 10 points translated into a 24 percent risk increase or decrease for the syndrome, the team reported.

Morrison and his colleagues said their findings should help doctors and parents identify young patients who are at an increased risk for serious adult illness. They could also point the way toward ways to reduce that risk.

"So, there's some good news here," said Morrison. "Pediatric weight is not destiny. If you're obese as a child, you can do something to lose the pounds. And you must do something to lose the pounds, if you want to reduce risk."

Dr. Brenda Kohn, an associate professor of pediatrics at the New York University School of Medicine, added that proactive parental and physician intervention is critical to help children avoid behaviors that keep the syndrome going.

"The treatment has to be started in childhood, in adolescence," she advised. "Eating patterns, activity patterns, all start in infancy. Good habits have to start early."

"So, it's very, very important that a child is raised in an environment where physical exercise is encouraged on a routine basis and eating patterns are geared to healthy eating decisions," added Kohn, who is also a medical advisory board member with the Juvenile Diabetes Foundation.

"Children should be monitored at least once yearly by a physician in order to ensure that all these goals are being met," she said.

More information
For additional information on metabolic syndrome, visit the American Heart Association.

Protecting your Skin from the Sun

In our world of ozone holes and SPF-30 sunscreens, most people have come to think of the sun as a formidable enemy of the skin. Many doctors consider visible signs of aging of skin on fair-skinned people -- leathery texture, wrinkles and age-spots, for example -- mainly the result of ultraviolet radiation. Yet the sun, besides being the source of energy for mind and body, also nourishes the skin. It's the best natural source of Vitamin D, which is necessary for calcium absorption and healthy bones. Many doctors today recommend 15 minutes of direct exposure to gentle sun on the hands and face to absorb the minimum daily requirement of Vitamin D.
Over-protecting from sun is not a good idea. The challenge is to maximize the benefit from sun and at the same time protect it from damage.

People with Caucasian skin definitely should avoid direct exposure to strong sun, because their skin makes less melanin, the pigment that acts as a barrier to UV rays. However, short periods of exposure to very early morning sun are soothing and mild on the skin, and allow even very sensitive skin to absorb necessary Vitamin D.

The Council of Maharishi Ayurveda Physicians recommends avoiding long exposure to the sun whenever you are angry, hungry or emotionally upset, as these factors increase Pitta -- the fire element -- in the body and make the skin even more sensitive to sun damage. At these times, it's important to protect yourself by wearing a hat, protective clothing (full-sleeved shirts and pants, for example) and sunglasses. People with naturally more Pitta in their bodies should always take care to protect themselves from the midday sun.

Dietary TipsIt's also a good idea to cool the body from the inside if your skin is very photosensitive. Eating green leafy vegetables and fruits such as raisins, sweet juicy pears, sweet apples, and pomegranates, for instance, will help nourish and restore balance to the skin. Amla Berry, available as a supplement and also contained in Amrit, is also an excellent anti-oxidant and rasayana for the skin. Rose Petal Preserve, blended with boiled and cooled milk, is an excellent cooling beverage.

Cooking your food with a skin-protecting spice mixture to stimulate digestion but not overheat your skin helps. Sauté equal parts turmeric, coriander, fennel and cumin in ghee and add it to your vegetables and grains.

Even in winter, people with photosensitive skin should avoid eating too much ginger, garlic, aesofetida (hing), red chillies or any types of hot peppers as hot foods can increase sensitivity to the sun.

Herbs for the SkinWatermelon puree is an excellent mask to cool down facial skin. Apply it evenly, except in the eye area, and rinse off with room temperature or lukewarm water after 10-15 minutes. Cotton pads soaked in rose water can be placed over closed eyes.

Another good way to cool the skin is with a milk bath. Add a couple of drops of rose water to room temperature milk and either rinse your face with it, followed by room temperature water, or apply generously with cotton pads and rinse off after ten minutes with room temperature water.

The Youthful Skin Cream contains Butea monosperma (Flame of Forest), which is renowned in ayurveda for helping to boost the skin's natural long-term resistance to sun damage as well as antioxidants to fight free radical damage. This cream is not a sunscreen or sunblock, but it can help keep skin cells healthy and well-nourished.

Winter Tips -- Beyond SunscreenDrink plenty of water, and avoid very hot water for baths and showers if your skin is photosensitive to keep your skin properly moisturized and to protect it from the sun.

Take a warm bath before and after skiing or exposing your skin to freezing temperatures for a long period of time. Any time it's freezing outside, the pores of the skin freeze shut and heat is retained in the deeper layers. This heat dries out the skin and lowers its resistance to the sun. That is why many people get worse sunburns after skiing than at the beach, and it's also why some people's skin breaks out after a skiing trip. A warm bath before and after tackling the slopes helps dilate frozen channels and supports the skin in its effort to release heat trapped in the deeper layers.

TB Gene Tweak Could Bring Better Vaccines

(HealthDay News) -- Removing a key gene from the tuberculosis bacterium may lead to a more effective TB vaccine than the current shot, called Bacille Calmette-Guerin (BCG), new research suggests.

"Virtually all efforts to develop a better TB vaccine have focused on boosting BCG -- modifying it to elicit a stronger immune response in people," study co-senior author Dr. William Jacobs Jr., of Albert Einstein College of Medicine, New York City, said in a prepared statement. "But we feel that tweaking the marginally useful BCG vaccine is the wrong strategy."

Instead, Jacobs said, "we've started with virulent Mycobacterium tuberculosis, the organism that actually causes TB in humans, and are knocking out certain genes to yield a live, attenuated M. tuberculosis strain that still produces a strong immunological response that protects people."

TB, caused by M. tuberculosis, leads to three million deaths annually worldwide. The bacterium invades cells and then multiplies. Occasionally, invaded cells will die rather than multiply, exposing the tuberculosis bacteria to attacks from T-cells, key components of the body's immune system.

Researchers at the Albert Einstein College of Medicine of Yeshiva University located a gene called secA2 on M. tuberculosis that prevents the host cell from committing suicide. By removing the gene, the researchers gave cells an edge over the tuberculosis bacterium, potentially forging the way for future vaccine research.

BCG is the only currently available vaccine and is generally thought not to provide adequate long-term protection. It is a live, weakened strain of M. bovis, which causes TB in cattle.

Writing in the August issue of the Journal of Clinical Investigation, the researchers confirmed that when they injected the genetically altered strain of M. tuberculosis into mammalian cells, the cells were able to self-destruct, eliciting a strong and long-lasting T-cell response against the bacteria. The researchers estimated that human clinical trials for the vaccine could begin within three years.

"Our secA2 mutant TB vaccine elicited protective immunity that was measurably superior to the standard BCG vaccine," senior author Dr. Steven Porcelli said in a prepared statement.

"Two months after vaccination, significantly fewer bacteria persisted in the tissues of secA2 mutant-vaccinated animals than in the tissues of animals vaccinated with BCG. And compared with BCG, animals vaccinated with the mutant vaccine had much larger populations of the vital CD8+ memory T-cells that a vaccine must elicit to optimally protect against infection."

More information
For an overview of tuberculosis, visit the U.S. Centers for Disease Control and Prevention.