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Obesity Can Hurt Kids' Hearts

(HealthDay News) -- Obese children and those at risk for obesity show early signs of heart disease -- similar to that seen in obese adults, U.S. researchers say.

The study, by a team at Washington University School of Medicine, St. Louis, included 168 children ages 10 to 18. All of the children had undergone cardiac ultrasound to check on symptoms such as heart murmur, chest pain, acid reflux or high blood cholesterol. Of the children, 33 were obese, 20 were at risk for obesity, and 115 were normal weight.

The researchers used a new tissue Doppler imaging technique called "vector velocity imaging" that can track the movement of the heart's muscular wall.

"In the patients who are obese, the rate of motion of heart muscle changed," Dr. Angela Sharkey, an associate professor of pediatrics at Washington University School of Medicine and a pediatric cardiologist at St. Louis Children's Hospital, said in a prepared statement. "As a child's BMIA (body mass index for age) increases, we see alterations in both the relaxation and contraction phase of the heartbeat. Many of these changes that have been seen in adults were assumed to be from long-standing obesity, but it may be that these changes start much earlier in life than we thought."

"Based on this study, these subtle markers can help us predict who could be at risk for heart disease and heart attacks," Sharkey said.

The findings were published in the winter issue of the Journal of Cardiometabolic Syndrome.
Vector velocity imaging could help doctors follow obese children to see if these changes in the heart progress and to determine if interventions -- such as dietary changes, increased exercise, and the use of cholesterol-lowering statin drugs -- have any effect, Sharkey said.

About 19 percent of American children ages 6 to 11 and 17 percent of those ages 12 to 19 are overweight, according to the U.S. Centers for Disease Control and Prevention.

More information
The Nemours Foundation has more about overweight and obese children.

Vulnerability to Stress Linked to Brain Molecule

(HealthDay News) -- Researchers have identified molecular mechanisms in the brain that may explain why some people are less vulnerable to the stress caused by difficult situations.

While the research was done with mice, the findings could eventually lead to better treatments for chronic stress, depression and the post-traumatic stress disorder suffered by troops in Iraq and other battlefields, said study co-author Dr. Eric Nestler, chairman of psychiatry at the University of Texas Southwestern Medical Center at Dallas.

"One important lesson we have shown even in previous papers is that a series of genetically identical animals respond differently to chronic stress," Nestler said. "Thirty to 40 percent seemed to be resilient and did not develop bad symptoms. The clinical implications are that the ability to identify mechanisms of resistance can help provide new and novel approaches to stress."

The key lies in a pair of molecules used by some brain cells to communicate with one another, said Vaishnav Krishnan, lead author of the report and a student in a University of Texas Southwestern Medical Center program that leads to simultaneous M.D. and Ph.D. degrees.

"Under stress, vulnerable mice increase the frequency of nerve activity using the neurotransmitter dopamine," Krishnan said. "That subsequently causes release of a nerve growth factor called brain-derived neurotrophic factor [BDNF]. Resilient mice overcome these changes by increasing the expression of molecules that prevent the release of dopamine."

A neurotransmitter is a molecule that sends signals from one nerve cell to another.

Mice in the experiments were so inbred that they were genetically identical. Then they were put under stress by being placed in the territory of larger, more aggressive mice. Some of the test mice adjusted well to the stress of the situation, while others avoided contact and showed submissive behavior.

The researchers then made detailed studies of two brain regions -- the ventral tegmental area (VTA) and the nucleus accumbens (NAcc), which are part of the brain's reward area that promotes acts that aid in survival. They found that the excess BNDF production in vulnerable mice occurred in the VTA but not the NAcc region. Chemical signals sent by the protein from the VTA to the NAcc made the mice vulnerable to stress. Experimental compounds that blocked those signals turned vulnerable mice into resistant mice.

The findings, published online Oct. 18 in the journal Cell, raise the possibility of "tools to develop things in the brain that encourage resilience, to help people with stress," Nestler said.
"We have always tried to understand the changes in the brain that lead to such things as the symptoms of post-traumatic stress disorder," Krishnan added. "This study shows we can increase our understanding and development of new therapeutic measures to overcome those changes."

But new therapies might not be easy to develop, Nestler said, since a decrease of dopamine or BDNF activity might be helpful in one part of the brain but harmful in another area.

Dr. Thomas R. Insel, director of the U.S. National Institute of Mental Health, which funded the research, said the findings are "part of a large body of work coming out of Dr. Nestler's laboratory trying to understand what this important neurotrophic molecule, BDNF, does."

"What's exciting here is that it is important for resilience, being able to recover from a traumatic event," Insel added. "One of the great values of this work is to help us understand how mammals, including humans, might be able to recover from the traumas inherent in human existence."

More information
Learn more about the role of stress in sickness and health from the American Institute of Stress.

Reflux Can Precipitate Chest Pain, Cough

(HealthDay News) -- Severe chest pain and chronic cough are little known, but potentially serious, symptoms of gastroesophageal reflux disease (GERD), researchers say.

Many people with these symptoms don't realize they have GERD, the researchers noted in two studies presented this week at the annual scientific meeting of the American College of Gastroenterology, in Philadelphia.

In one study, a team at Brigham and Women's Hospital in Boston measured pH levels in the esophagus of 31 emergency department patients who complained of serious chest pain.

Abnormal reflux of acid into the esophagus that would fit the diagnosis of GERD was found in 57 percent of the patients.

More women than men had chest pain that wasn't related to the heart. Men more often had upright reflux (which occurs when a patient is awake), while women experienced both supine reflux (occurs during sleep) and upright reflux.

"Often the role of acid reflux has been overlooked as a potential factor in the diagnosis and treatment of patients with serious chest pain. But, it is important for patients never to assume their chest pain is caused by GERD, until they have been thoroughly evaluated by a physician to rule out heart disease. If they experience persistent chest pain, they should seek emergency medical care," study lead investigator Dr. Julia J. Liu said in a prepared statement.

The second study, by researchers at the Medical University of South Carolina in Charleston, included patients with persistent cough who took stomach acid-suppressing proton pump inhibitor drugs over a period of three years. The study was conducted to assess the cost-effectiveness of a device (MII-pH) that can detect non-acid reflux. Conventional pH testing only measures acidity.

"The use of MII-pH testing in patients who experience reflux of non-acid stomach contents is cost-effective by helping clinicians determine which patients would benefit from anti-reflux surgery and excluding those for whom surgery may have no benefit. This warrants further evaluation of widespread application of MII-pH testing in the diagnosis of patients with persistent chronic cough on adequate medical therapy," researcher Dr. Deepika Koya said in a prepared statement.

More information
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about GERD.

Chest Compressions Key to Revised CPR Guidelines

(HealthDay News) -- Maintaining blood flow to the brain and other vital organs is the key to simplified cardiopulmonary resuscitation (CPR) guidelines that emphasize chest compressions over rescue breathing, particularly for heart attack victims.

In fact, the revised recommended ratio is just two breaths per every 30 chest compressions.

That's twice as many compressions as was recommended in the past.

"Just doing chest compressions can make a difference," explained Dr. Shukri David, chief of cardiology at Providence Hospital of St. John's Health System, in Southfield, Mich. "When you compress the chest deep enough, you create a vacuum that pulls in air as you release."

However, David and other experts caution that in the case of drowning victims or people who were deprived of oxygen, rescue breaths are still necessary. Because health experts wanted to make the revised CPR guidelines as simple as possible, and they felt it might be difficult for lay people to differentiate who needed rescue breaths and who didn't, the guidelines include rescue breaths, as well as the rescue breaths-to-chest-compression ratio.

The need for simplified CPR was clear. Little progress had been made in the CPR survival rate over the past decade, according to the American Heart Association. And, it wasn't for lack of CPR opportunities. Four out of five heart attacks occur in the home, according to the American Heart Association, and many are witnessed by family members.

The biggest problem was that standard CPR allowed for too much time without chest compressions. Even health-care professionals, such as nurses or emergency workers, trained to do CPR often weren't providing an adequate number of chest compressions per minute, according to past studies. And, getting enough chest compressions can make the difference in survival. In animal studies, researchers have found that when animals in cardiac arrest receive 80 compressions per minute that 100 percent survive. When that number dropped below 80 compressions per minute, just 10 percent survived, according to a recent editorial in the Journal of the American Medical Association.

In a study of CPR given to people in cardiac arrest, the editorial reported that those who received "good" CPR from bystanders had about a 23 percent survival rate compared to less than 6 percent for poor or no CPR.

"The most common reason that many people die is because none of the people nearby knew CPR, and if they knew it, they didn't do it. One of the reasons is that the skill has been too complicated. [The revised] guidelines simplify the instructions and make them easier to remember," Dr. Michael Sayre, an associate professor of emergency medicine at Ohio State University School of Medicine, said in a prepared statement.

The revised guidelines, introduced in late 2005, emphasize chest compressions to restore blood flow. Rescuers should push hard and push fast and try to maintain a rate of 100 chest compressions per minute, according to the guidelines. The chest must be allowed to return to its normal position completely after each compression to allow the heart to fill with blood. And, the guidelines remind rescuers that every interruption in compressions stops the blood flow.

The updated guidelines also establish a universal compression-to-breath ratio of 30 compressions to two breaths, and that each breath should last just one second.

These changes are already starting to pay off. "In various studies, a clear improvement in outcomes in the community is becoming apparent," said Dr. Paul Pepe, chief of emergency medicine at the University of Texas Southwestern Medical Center at Dallas.

And, Pepe added, he expects CPR to improve even more with the introduction of faster, easier training of CPR, with more feedback. The American Heart Association has recently introduced its CPR Anytime Personal Training programs that teach CPR at home in less than a half-hour. "This will be a breakthrough in CPR. We will see a lot more lives saved," he said.

Other training programs are also available through the American Red Cross and local community groups.

"If you perform CPR, you can save someone's life. It's simple and easy to do. All you really need to do is put your hands in the middle of the breast bone and push down two inches," David said. "If you do CPR immediately on someone with cardiac arrest, the survival rate goes from 6 percent to 50 percent. This will really make a difference if the population pulls together."

More information
For more on the revised CPR guidelines, visit the American Heart Association.

Chronic Illness Often a Taboo Subject: Survey

(HealthDay News) -- Along with taboo topics such as politics and religion, many Americans are reluctant to discuss managing a chronic illness with family or friends, according to a new survey of more than 1,000 adults.

The survey, released Oct. 11, found that 82 percent of respondents said they knew someone with a chronic illness, but only 34 percent were likely to suggest ways for this person to better manage their care. That's about the same number who said they'd debate politics (37 percent) or religion (33 percent) with a loved one or friend.

Respondents were more likely to discourage friends or loved ones from buying the wrong house (65 percent), loan them a large amount of money (56 percent), advise them against taking a job they didn't think was right for the person (48 percent), and tell them their spouse was unfaithful (41 percent).

The survey was released by Evercare, a provider of health plans for people who have chronic illnesses, are older, or have disabilities.

The reasons why many Americans are reluctant to offer advice to chronically-ill friends or family include: They think the person has the situation under control (66 percent); they are not a health care professional (31 percent); they don't want to seem like a nag (31 percent) or rude (29 percent); they don't believe the person would listen to them (27 percent); or they didn't think the matter was that important (15 percent).

Other findings:

• Twenty percent of respondents said their spouse was the easiest person to give advice to about health, followed by a child (20 percent), mother (13 percent), and father (5 percent).
• Most respondents said they'd prefer to receive advice about managing a chronic illness from a health care professional (67 percent), followed by a spouse (10 percent) or parent (7 percent). Men were twice as likely as women (14 percent versus 7 percent) to have their spouse give them such advice.
• Men have an easier time offering health advice to their spouse (28 percent) than women (19 percent). Women have an easier time offering health advice to their children (24 percent) than men (16 percent).
• Thirty-four percent of respondents said the person closest to them with a chronic illness is a parent (34 percent), followed by another relative (16 percent), spouse (14 percent), friend (11 percent), sibling (8 percent), and child (6 percent).

Evercare offered tips on how to help family or friends with a chronic illness:

• Talk to them in order to get an understanding of their goals. Get the conversation started by discussing events or activities they used to enjoy or future events they want to be part of, such as a family reunion. Once you understand their goals, you can help them achieve them along with health care providers, doctors or community service agencies.
• Appoint an "ambassador" -- someone your friend or loved one feels comfortable talking with and respects enough to heed his or her advice. This person can help your friend or family member manage their condition.
• Increase your comfort levels by educating yourself about the person's chronic illness. This will make you feel more comfortable speaking with them about the condition and reinforcing the advice the patient has received from their doctors.

By 2020, about 157 million Americans will be afflicted by chronic illnesses, according to the U.S. Department of Health and Human Services.

More information
The American Psychological Association has more about coping with chronic illness.

Lyme Disease Relapse Often a New Infection

(HealthDay News) -- Many people who believe they're suffering a relapse of Lyme disease may actually have been bitten by another tick and have a second, completely new infection, a new study suggests.

"It is striking how often re-infection appears to occur," lead author Dr. Robert B. Nadelman, professor of medicine at New York Medical College, said in a prepared statement. "Our findings support clinical evidence that a surprising number of patients experience more than one episode of Lyme disease and that recurrent infections are unrelated to the original infection."

Lyme disease, which affects about 20,000 Americans a year, is caused by Borrelia burgdorferi, a bacterium that's transmitted to humans by deer ticks. About 95 percent of patients recover completely and quickly with two to three weeks of antibiotic treatment. Left untreated, the infection usually goes away within a month. However, untreated patients can relapse and/or develop late complications that affect the joints, heart, or nervous system, according to background information in a new release about the study.

Many patients who are diagnosed and successfully treated for Lyme disease develop the infection again, likely because they live in areas where deer ticks are common, the researchers said.

They analyzed B. burgdorferi genotypes from skin biopsies of 272 people diagnosed with Lyme diseases between 1991 and 2005. The team found that some of the patients had suffered separate Lyme disease-causing tick bites.

The findings "underscore the importance of preventing exposure to ticks, by covering exposed skin, using tick repellants, and performing self-examination for ticks on a regular basis during the tick season," Nadelman said.

The findings were to be reported Thursday at the annual meeting of the Infectious Diseases Society of America, in San Diego.

More information
The American Medical Association has more about Lyme disease.

Health Tip: Dyslexia in Adults

(HealthDay News) - Dyslexia is a common learning disability in which a person may have difficulty reading, spelling and interpreting words. It's often diagnosed during childhood, when a child is learning to read and write.

However, dyslexia can continue to make reading and writing difficult in adults who did not receive help in childhood.

The International Dyslexia Association lists these common symptoms of dyslexia in adults:

• Avoiding or hiding problems with reading and writing.
• Poor spelling.
• Problems with time management and organizational skills.
• Often relying on memory and speaking skills rather than reading and writing.
• Holding a job well below one's intellectual ability.

Health Tip: Quitting Smoking Has Immediate Benefits

(HealthDay News) - Most people know that in the long term, quitting smoking offers enormous health benefits.

But within weeks -- and even hours -- after quitting smoking, your body has already shown health improvements.

The Canadian non-profit organization Tobacco Facts lists some of the immediate health benefits when you quit smoking:

• Within eight hours, the level of carbon monoxide in the body drops, while oxygen levels rise to normal.
• After two days, taste and smell is enhanced, and the risk of heart attack decreases.
• Breathing becomes easier within three or four days, because of increased lung capacity.
• After two weeks, no nicotine is left in the body, and blood flow is improved.
• Within three months, circulation and lung function are improved, and physical activity is significantly easier.
• Within nine months, coughing, congestion, fatigue and shortness of breath are significantly reduced.