Health Tip: Even Babies Can Have Foot Problems

(HealthDay News) -- New parents are understandably concerned about the health of their baby. But while worrying about hearing, eyesight and other things, they might forget the feet.

The American Podiatric Medical Association warns that foot problems that flare up in adults often start in infancy.

The association says parents should report anything suspicious to the family doctor. To maintain healthy feet, parents should make sure blankets are loose and allow the baby to kick. Also, be sure to change the baby's position often because lying too long in one position can strain the legs and feet.

High HDL Levels Protect Heart Health

(HealthDay News) -- High levels of "good" HDL cholesterol protect against heart disease and stroke no matter what the blood levels of "bad" LDL cholesterol are, a new study shows.

The incidence of heart attack, stroke and other cardiovascular problems was 40 percent lower in the one-fifth of participants in a major trial who had the highest HDL cholesterol levels, regardless of their LDL cholesterol levels, according to a report in the Sept. 27 issue of the New England Journal of Medicine. The protective effect of high HDL readings was evident even in patients with an LDL reading below 70, well under the recommended level for heart health.

"The fundamental important message of the paper is that if you take HDL high enough, LDL doesn't matter," said study author Dr. Philip Barter, director of the Heart Research Institute in Sydney, Australia.

LDL cholesterol is involved in the formation of fatty plaques that eventually can block an artery; HDL cholesterol prevents the formation of those plaque.

"What we desperately need is a new drug to raise HDL levels," Barter said.

No such drug is in sight, however. Pfizer halted a 15,000-participant trial of an HDL-raising drug, torcetrapib, last year, because the death rate was higher in those taking the drug than in those taking a placebo. Pfizer had planned to market torcetrapib in combination with its LDL-lowering statin, Lipitor.

The only available HDL-raising drug therapy now available is large doses of niacin, which can increase HDL levels by about 20 percent, Barter said. But that treatment has annoying side effects, such as serious skin flushing and itching, he said. New formulations have lessened but not eliminated the side effects, he added.

Barter is now doing studies to determine whether the damage caused by torcetrapib is closely related to the drug's HDL-raising effect. "If the effect is unrelated to HDL, that class of drugs still has a future, because other members of the class might not have the problem," he said.

"That still has to be put to the test. New members of the class of drugs could be introduced into clinical trials, probably as early as next year."

The new study has settled one issue, Barter said. "We saw a residual cardiovascular risk in some people with low LDL levels," he said. "It now appears that the major cause of that risk was low HDL levels. The implication is that we should be treating HDL as well as LDL."

"There is a residual risk, and we think that a substantial proportion of this is mediated by low HDL levels," said Dr. Vera Bittner, a professor of medicine at the University of Alabama at Birmingham and one of the trial leaders. "We all agree that we need drugs that can raise HDL levels, so that we can test the hypothesis that raising HDL will reduce risk."

But Bittner said she was "not quite willing to make the leap of faith that an HDL intervention will work, and the premature discontinuation of the [Pfizer] trial proves my point."

More information
Learn about HDL and LDL cholesterol from the American Heart Association.

Many U.S. Women Unaware of Birth Defect Risks

(HealthDay News) -- American women of childbearing age commonly take prescription drugs that can cause birth defects, but only about half are receiving contraceptive counseling from their doctors or other health care providers, a new study finds.

Researchers at the University of Pittsburgh School of Medicine are calling for increased awareness of this issue among doctors and women who may become pregnant.

"We found that over the course of a year, one in six women of reproductive age filled a prescription for a medication labeled by the Food and Drug Administration as increasing risk of fetal abnormalities," first study author Dr. Eleanor Bimla Schwarz, assistant professor in the departments of medicine and obstetrics, gynecology and reproductive medicine, said in a prepared statement.

"Unfortunately, many women filling prescriptions that can increase the risk of birth defects remain at risk of pregnancy," Schwarz said.

The study involved an analysis of all prescriptions filled by more than 488,000 reproductive-aged women enrolled in a large managed health care plan during 2001.

The researchers also examined the use of contraception and pregnancy test results.

They found little difference in rates of contraceptive counseling, use of contraception or subsequent pregnancy test results when women took medications that increase the risk of birth defects versus safer medications.

About half of pregnancies in the United States are unintended, according to background information in the study, which was published in the Sept. 18 issue of the journal Annals of Internal Medicine.

"While efforts are needed to ensure that women get information about birth control and the risk of medication-related birth defects, it also is important to realize that different birth control methods are not equally effective," Schwartz noted. "Women who were using the most effective methods of contraception, such as the intrauterine device or IUD, were least likely to have a positive pregnancy test after filling a prescription for a potentially dangerous medication."

More information
The March of Dimes outlines drugs and herbs that pregnant women should avoid.

Hushed Genes Might Mean Higher Lung Cancer Risk

(HealthDay News) -- If the collective activity of 15 genes that protect against lung cancer is too quiet, it could mean that they're being suppressed -- a situation that may lead to lung malignancy, U.S. researchers warn.

A team at the University of Toledo, in Ohio, say a test for these genes in lung cells collected via bronchoscopy could help identify people genetically at risk for lung cancer.

The researchers analyzed the activity of these 15 genes in 25 people with lung cancer and 24 people without the disease.

By doing so, they were able to correctly identify those with lung cancer 96 percent of the time.

The findings were to be presented Tuesday at an American Association for Cancer Research Conference in Atlanta.

The genes included in the analysis encode a protective antioxidant and DNA repair proteins found in lung airway cells.

"Smoking causes about 90 percent of all lung cancer cases, yet only about 10 to 15 percent of heavy smokers will develop lung cancer," lead researcher Dr. James C. Willey, an associate professor of medicine and molecular biology at the University of Toledo's College of Medicine, said in a prepared statement.

"We are looking for new techniques that will allow us to pick out the 10 to 15 percent of individuals at highest risk for lung cancer from the enormous pool of current and former smokers," he said.

The findings from this study justify a larger, prospective study to determine whether this approach is useful in predicting lung cancer in current and former smokers, Willey and his colleagues believe.

More information
The U.S. National Cancer Institute has more about lung cancer risk.

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Cialis Eases Erectile Dysfunction After Spinal Cord Injury

(HealthDay News) -- The drug Cialis (tadalafil) appears to help treat Erectile dysfunction (ED) in men with spinal cord injuries, according to a French study of 197 male spinal cord injury patients.

The researchers, from Raymond Poincare Hospital in Garches, noted that only about 25 percent of men with spinal cord injuries are able to have erections that are adequate for intercourse.
For the first four weeks of the study, the men received no treatment. They were then randomly assigned to receive Cialis or a placebo for 12 weeks. The men, who averaged 38 years of age, were instructed to take the drug/placebo as needed before sexual activity, with a maximum of one dose daily.

After the 12-week treatment period, all the men filled out a questionnaire to assess erectile dysfunction. Men who took the drug had an average score of 22.6 (mild ED), while those who took the placebo had an average score of 13.6 (moderate ED).

On average, men who took Cialis were 75.4 percent successful when attempting penetration and 47.6 percent successful when attempting intercourse, compared with 41.1 percent and 16.8 percent, respectively, for men who took the placebo.

The most common side effects among the men who took Cialis were headache (8.5 percent) and urinary tract infection (7.7 percent).

The study, funded by Cialis' maker Lilly ICOS LLC, was posted online Sept. 10 and is expected to be published in the November print issue of the journal Archives of Neurology.

More information
The University of Alabama at Birmingham has more about sexual function for men with spinal cord injury.

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Experts Sort Out Good Fats From Bad

(HealthDay News) -- U.S. and Canadian experts have teamed up to create Dietary Fatty Acids, a comprehensive recommendation on how much of what types of fats people should include -- or avoid -- in their diets.

Both the American Dietetic Association and the Dietitians of Canada agree that the body needs some fat and that 20 percent to 30 percent of energy needs should be met by dietary fat. The key question is which kind of fats are most healthy.

"Of greatest importance is the type of fat one chooses," registered dietitian and co-author Penny Kris-Etherton said in a prepared statement. "The healthiest choices are unsaturated fats found in liquid vegetable oils, nuts and seeds, and omega-3 unsaturated fats found in fatty fish such as salmon, sardines and shellfish."

She warned against saturated fats and trans fats. Saturated fats are found in tropical oils, fatty meats and high-fat dairy products. Trans fats are found in commercial baked goods, crackers and high-fat snack foods. Consumers should read nutrition labels to find out what kinds of fats are in the foods they buy, said Kris-Etherton.

The Dietary Fatty Acids recommendations guide people to follow a food-based approach for achieving the following fatty acid recommendations:

Eat lots of vegetables and fruits, whole grains, legumes, nuts and seeds.
Eat lean protein such as meats, poultry and low-fat dairy products.
Eat fish, especially those high in omega-3 fatty acids such as salmon.
Use non-hydrogenated margarines and oils.

More information
For a consumer-friendly fact sheet on dietary fats, visit the Dietitians of Canada.

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Filtered Cigarettes Blamed for Huge Rise in Type of Lung Cancer

(HealthDay News) -- The introduction of filtered and low-tar cigarettes in the 1950s coincided with a steady rise in the incidence of a once-rare type of lung cancer that's now the most common form of the disease, a new study finds.

Decades ago, squamous cell carcinoma was the most common form of lung cancer. But between 1950 and 2007, adenocarcinoma became the most frequently diagnosed lung malignancy, as the market share of filtered cigarettes soared from just 1 percent to almost 100 percent, the study authors said.

Described as a "correlation of evidence," the apparent link was uncovered by study author Dr. Gary M. Strauss, medical director of the lung cancer program at Tufts-New England Medical Center in Boston. He presented the findings Wednesday at the 12th World Conference on Lung Cancer, in Seoul, South Korea.

Strauss and his colleagues suggest that the impact of filtered cigarettes on adenocarcinoma rates is due to the introduction of filter vents in filtered cigarettes, making it easier to draw in smoke. These vents allow smokers to take bigger and deeper puffs, thereby inhaling carcinogens further into the bronchial passages and lungs.

"The rise of adenocarcinoma is consistent with changes in cigarette design and composition -- which the cigarette industry indicated were safer -- that they introduced in response to mounting evidence that smoking causes other forms of lung cancer," Strauss said.

"And so the point is that the tobacco industry, through how they changed the cigarette over time and deceived the public for decades about its safety, has created an epidemic," he added.

Philip Morris USA's media affairs manager, David Sutton, said he could not comment on the findings. "We cannot comment on a study we have not had a chance to review. Smoking is addictive and causes serious diseases. There is no such thing as a safe cigarette," he said.

To explain the dramatic rise in diagnoses of adenocarcinoma, Strauss and his team of U.S, researchers first analyzed data concerning cancer rates that had been collected between 1975 and 2003 through the National Cancer Institute's "Surveillance Epidemiology and End Results" (SEER) program.

The study authors focused on information covering more than 307,000 black and white lung cancer patients, 75 percent of whom were 60 or older at the time of their diagnosis. And they focused on six time periods: 1975-1979, 1980-84, 1985-89, 1990-94, 1995-99 and 2000-03.

Statistics on four major types of lung cancer -- adenocarcinoma, squamous cell carcinoma, large cell carcinoma, and small cell carcinoma -- were tallied to reveal how common each disease had been at the six different time periods. The first three cancers fall into the "non-small cell" category of lung disease that accounts for about 85 percent of all lung cancers in the United States, according to the American Cancer Society.

The SEER figures showed that by the years 2000 to 2003, 47 percent of all lung cancers were adenocarcinoma, Strauss and his team observed.

While American Cancer Society numbers currently place adenocarcinoma at 40 percent of all cases, both ACS and SEER data confirm that adenocarcinoma is by far the most prevalent form of lung cancer today --- regardless of race, age and gender.

In 1950, adenocarcinoma constituted just 5 percent of all lung cancer cases, and a diagnosis of the disease was not typically considered to be due to cigarette smoking. Back in the mid-20th century, most lung cancer cases were squamous cell, the researchers said.

But the SEER data illustrate a sharp rise in adenocarcinoma cases beginning in the 1960s. And from the 1975-79 period to the 1995-99 period, adenocarcinoma cases skyrocketed 62 percent.

Adenocarcinoma surpassed squamous cell carcinoma as the most common form of lung cancer among women in the 1975-79 period and among men during the 1980-84 period.

Because the SEER database did not collect information on smoking demographics, the researchers said they subsequently sifted through a wide range of additional data covering 50 years of U.S. cigarette production and consumer habits in search of an underlying explanation.

Strauss and his colleagues said they found that the wide-scale adoption of filtered and low-tar cigarettes closely tracked the jump in adenocarcinoma rates.

Filtered cigarettes went from 1 percent of the U.S. market in 1950 to 64 percent by 1964. By 1986, filtered cigarettes had captured 95 percent of the market; by 2007 that figure was 98 percent.

"And while adenocarcinoma of the lung has always existed, it is now the most common form of lung cancer, and probably the second most common cause of cancer death," said Strauss. "Probably more people die specifically of smoking-related adenocarcinoma today than die of colon cancer."

"So while nothing is really new here, we're putting it all together," he said. And what emerges, he added, is the story of a tobacco industry that years back actively changed its product to minimize its known connection to certain types of cancers, thereby giving birth to a whole new carcinogenic threat and an even bigger lung cancer killer.

"And so now I'm hoping that there will be a recognition that the tobacco industry actually created this deadly epidemic of smoking-related adenocarcinoma through decades of deception," Strauss said.

The results of several other international studies were also presented this week at the South Korea conference, including a Norwegian finding that hand-rolled cigarettes are more carcinogenic than pre-packaged cigarettes, resulting in a higher risk for lung cancer.

Another study, out of Japan, showed that people with a family history of lung cancer are more likely to develop the disease -- particularly squamous cell disease -- later in life. However, a general family history of cancer was not associated with an increased risk for lung cancer.

More information
For more on lung cancer, visit the American Cancer Society.

Work Time Predicts Sleep Time

(HealthDay News) --The more hours adults work and the more hours they spend commuting to the job, the less time they spend sleeping.

That's the finding of new research that shows the impact of work on slumber.

Adults who sleep four-and-a-half hours or fewer worked an average of 93 minutes more on weekdays and 118 minutes more on weekends than the average sleeper, a University of Pennsylvania research team found. People sleeping 11-and-a-half hours or more worked an average of 143 minutes less on weekdays and 71 minutes less on weekends, they said.

Experts recommend that adults sleep between seven and eight hours a night.

"These cross-sectional results in a nationally representative sample suggest that compensated work time is the most potent determinant of sleep time, in which case work time should be considered an important factor when evaluating the relationship between sleep time and morbidity and mortality," lead researcher Dr. Mathias Basner said in a prepared statement.

In their study, published in the September issue of Sleep, the researchers gathered data from 47,731 respondents to the American Time Use Survey conducted in 2003, 2004 and 2005. The 15-minute telephone survey asks people how they spent their time between 4 a.m. the previous day and 4 a.m. on the day of the interview, including where they were and who they were with.

Results showed that the more daytime activities a person reported, the less he or she would spend sleeping. Time at work had the strongest effect on hours of sleep, the team reported.

The researchers said that the impact of travel time on sleep was unexpected and required further research to understand how people manage commute and sleep time, as well as other kinds of travel time for errands, socializing, worship and leisure activities.

Short sleep times were also related to time spent socializing, relaxing and participating in leisure activities on the weekends. People who slept less were spending more time in education, household activities and, for people with very little sleep, TV watching.

For most people, the researchers reported that increased TV time correlated with increased sleep time. All other activities decreased in time as sleep time increased.

On weekends, people with less sleep time also spent less time watching TV than average sleepers, while people with long sleep times spent less time socializing, relaxing and participating in leisure activities.

Age also affects sleep time, the researchers said, who noted longer average sleep times at both the older and the younger ends of the age spectrum. People between 45 and 54 years old were most likely to be working more and sleeping less.

More information
To learn more about getting a good night's sleep, visit Insomnia: How to Get a Good Night's Sleep.

Flaxseed May Relieve Hot Flashes

(HealthDay News) -- Flaxseed may be one way to reduce the bothersome hot flashes of menopause, Mayo Clinic researchers report.

A small pilot study found that postmenopausal women not on estrogen who used dietary flaxseed daily reported a 50 percent reduction in hot flashes over the course of six weeks.

"Flaxseed worked very well," said Dr. Sandhya Pruthi, director of the Mayo Breast Clinic at the Mayo Clinic in Rochester, Minn. "The women who used it said it really helped them."

But another expert, Dr. Wulf H. Utian, executive director of the North American Menopause Society, cautioned that the study was too preliminary to prove that flaxseed is effective.

While hormone replacement therapy, particularly estrogen, is effective against hot flashes, its long-term use has fallen out of favor since the large study known as the Women's Health Initiative found an increased risk of heart disease, breast cancer and other problems with long-term HRT use. So, Pruthi and her team were looking at options for women who suffered from hot flashes but didn't want to take estrogen.

They enrolled 29 postmenopausal women, median age 55, in the study. To join, the women had to have at least 14 hot flashes a week for at least one month.

"Flaxseed has some natural phytoestrogens," Pruthi said, explaining how it, like the hormone estrogen, could possibly have an effect on hot flashes.

Over the course of the study, the women sprinkled 40 grams of crushed flaxseed daily into yogurt or cereal or mixed it with orange juice or water.

In the end, 21 women completed the study; others had dropped out because of side effects. Of those who finished, the researchers said, the frequency of hot flashes declined 50 percent, and the hot flash score -- a combined measure of a flash's severity and frequency -- was found to have decreased about 57 percent.

"By the second or third week, most women noticed improvement," Pruthi said, adding that she is now planning a larger study to compare flaxseed to a placebo.

Until those results are in, Utian is not convinced the flaxseed is a proven treatment for hot flashes.

"This reduction [in the pilot study] could fall into the placebo effect," he said.

The study was also relatively brief, he added. And many women experiencing menopause suffer many more hot flashes than 14 a week. (Fifteen of the Mayo study women reported 10 or more a week, but 13 reported 2 to 9 a week.)

Utian added, however, that he was not aware of any harm in eating flaxseed.

And Pruthi said that because the fiber content gave some women in the study abdominal discomfort, those that find it hard on the stomach should consider starting at a lower dose and working up.

Her research was just published in the summer 2007 issue of the Journal of the Society for Integrative Oncology.

More information
To learn more about hot flashes, visit Breast cancer.org.