Research Probes Autism's Origins in the Brain

By Brenda Goodman
Click Here!">HealthDay Reporter

THURSDAY, Nov. 21, 2013 (Click Here!">HealthDay News) -- Two research teams say they have pinpointed how changes in genes linked to autism act together to disrupt normal brain development.

Their studies, published Nov. 21 in the journal Cell, represent a leap forward in understanding the complex condition, said an expert who was not involved with the research.

"This gives us a moment in time when genetic risk for autism actually gets put into motion," said Robert Ring, a neuroscientist and chief science officer for the nonprofit advocacy group Autism Speaks. "This is very important."

That two research groups looking at different sets of genes came to the same conclusion "gives a lot of validity to the finding," Ring said.

Autism -- which impairs the ability to communicate, regulate behavior and relate to others -- is thought to affect about 1 in 88 children in the United States.

The mutations appear to come into play in mid-pregnancy. They interrupt the formation of specific cells that connect brain layers in a region that controls movement, sensory perception, conscious thought and language.

The changes appear to cause a sort of faulty wiring of the brain before birth, the researchers said.

They also said their findings might explain why early intervention programs, which enroll kids as young as 1 year old, help children with autism. Since their brains are still developing, they might be capable of correcting or compensating for some of these bad connections.

For both studies, researchers took advantage of BrainSpan atlas, an ambitious public project to catalog the gene makeup of the brain at many different ages. The brains used in the project are from 57 Click Here!">healthy, deceased males and females. Their ages ranged from six weeks after conception to 82 years old.

The work is groundbreaking, said one expert.

"This is something we couldn't have done two years ago because we didn't have this dataset," said Jeremy Willsey, a graduate student in genetics at Yale University.

Willsey led one of the studies, in which researchers focused on rare "lightning strike" mutations that caused a loss of function in nine genes. These mutations are changes to DNA that occur randomly, and aren't passed from parent to child. But previous studies have shown that individuals with autism often share these same random mutations.

Focusing on the actions of these nine genes, the researchers checked the BrainSpan atlas to see if any were working together at the same time. They found that those genes and others associated with autism worked together at only three distinct places and periods in development. Those corresponded to the deeper layers of the front of the brain between 10 and 24 weeks after conception.

The gene mutations seem to interfere with the development of nerve cells that connect different brain regions.

"We know there's a disruption in the cells' development, but we don't know much more than that," Willsey said. "That's sort of the next step that our lab is addressing. That's what's going to help you progress toward treatment."

For the other study, researchers at the University of California, Los Angeles, took a different approach.

Using the BrainSpan data, they first looked at gene expression in normal brains from eight weeks after conception through 12 months of age. They then mapped hundreds of genes shared by individuals with autism and determined when and where those genes were active in the developing brain. Strikingly, although there were many autism risk genes, they all acted together at just a few points in brain development.

The researchers also compared the activity of autism risk genes to the genes involved in intellectual disability, or low I.Q. Although the conditions share many of the same risk genes, the study found that they were active in different ways at different times, adding more proof that the two conditions are distinct.

Their findings also pointed to a disruption in the brain's wiring, probably because of an error in the development of the brain-connecting nerve cells.

The researchers stressed, however, that the findings probably don't explain all cases of autism.

"These gene mutations definitely contribute to autism in some people," said Neelroop Parikshak, a graduate student at the University of California, Los Angeles, who led the second study. "[But] we don't know how much in a given individual."

Willsey agreed. He said that for the first time, however, these studies show the genetics of autism in action, something that should speed the path to better treatments.

"We feel this is a turning point," he said. "We're taking these genes and being able to tie them to a specific time point and a specific region in the brain, which really allows us to take the next step and follow this up in more detail. It's very exciting."

Copyright © 2013 Click Here!">HealthDay. All rights reserved. SOURCES: Rob Ring, Ph.D., chief science officer, Autism Speaks; Jeremy Willsey, graduate student, department of genetics, Yale University, New Haven, Conn., and department of psychiatry, University of California, San Francisco; Neelroop Parikshak, graduate student, neurobehavioral genetics, David Geffen School of Medicine, University of California, Los Angeles; Nov. 21, 2013, Cell

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Nail-Gun Injuries on the Rise Among Construction Workers

SATURDAY, Nov. 23, 2013 (Click Here!">HealthDay News) -- Nail-gun injuries are on the rise, and young, male construction workers are at greatest risk, according to a new study from Australia.

Researchers looked at 87 cases of nail-gun injuries that occurred in Australia between January 2007 and July 2012. Of those injuries, nearly 96 percent happened at work.

Fifty-eight percent of the patients required surgery, 32 percent were treated solely in the emergency room and 10 percent were transferred to a private facility. Among the patients who underwent surgery, 14 percent had tendon, joint or neurovascular damage, and 20 percent had foreign material in the wound.

Nail-gun injuries result in a significant loss of productivity, as well as having a significant financial cost, according to the authors of the study, which was published online Nov. 8 in the journal Emergency Medicine Australasia.

An analysis of data from the state of Queensland showed that there were 81 workers' compensation claims for nail-gun injuries on average each year during the past five years. Each case led to an average of 15 days off work, according to a journal news release.

Nail-gun injuries can cause immediate damage to soft tissues, tendons and bones, and can result in infections and septic arthritis, the researchers said. The non-dominant hand often is involved in such injuries.

"While nail-gun injuries involving the skull, chest and abdomen have been reported, the vast majority of injuries occur to the upper and lower limbs," wrote Dr. James Ling and colleagues from Princess Alexandra Hospital in Brisbane.

-- Robert Preidt
Copyright © 2013 Click Here!">HealthDay. All rights reserved. SOURCE: Emergency Medicine Australasia, news release, Nov. 11, 2013

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CPR Devices No More Effective Than Hands-On Method: Study

FRIDAY, Nov. 22, 2013 (Click Here!">HealthDay News) -- A mechanical device that delivers chest compressions during CPR does not improve short-term survival of cardiac arrest patients, compared to traditional hand compressions, a new study shows.

"Many factors affect the chances of survival after cardiac arrest, including early recognition of arrest, effective CPR and defibrillation, and post-resuscitation care. One important link is the delivery of high-quality chest compressions to achieve restoration of spontaneous circulation," wrote authors of the study published Nov. 17 in the Journal of the American Medical Association.

"The effectiveness of manual chest compressions depends on the endurance and skills of rescuers, and manual compressions provide only approximately 30 percent of normal cardiac output," Dr. Sten Rubertsson, of Uppsala University in Sweden and colleagues explained in the study.

Manual CPR involves prolonged "hands-off" time and its quality drops most when the patient is being transported, the authors report. To improve CPR, mechanical chest-compression devices have been developed.

However, the use of such devices in patients who suffer out-of-hospital cardiac arrests had not been tested in large clinical trials, the researchers noted.

This study included nearly 2,600 people who suffered out-of-hospital cardiac arrest in Sweden, Britain and the Netherlands between January 2008 and February 2013. Ambulance crews gave half of the patients CPR with a mechanical chest compression device and the other patients received CPR with hand compressions.

The mechanical device used an integrated suction cup designed to deliver compressions according to CPR guidelines.

The four-hour survival rates was 23.6 percent for patients who received mechanical CPR and 23.7 percent for those who received manual CPR. Among patients who were still alive after six months, 99 percent of those who received mechanical CPR and 94 percent of those who received manual CPR had good neurological outcomes, according to a journal new release.

The type of CPR given didn't appear to make a difference.

"In patients with out-of-hospital cardiac arrest, mechanical chest compressions in combination with defibrillation during ongoing compressions provided no improved four-hour survival vs. manual CPR according to guidelines. There was a good neurological outcome in the vast majority of survivors in both groups, and neurological outcomes improved over time," the researchers wrote.

-- Robert Preidt
Copyright © 2013 Click Here!">HealthDay. All rights reserved. SOURCE: Journal of the American Medical Association, news release, Nov. 17, 2013

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Health Tip: Stuff Your Turkey Safely

(Click Here!">HealthDay News) -- Make sure everyone has a good time during and after your Thanksgiving meal by taking steps to prepare all that food properly.

The University of Illinois Extension offers these holiday suggestions:

Stuff the turkey just before you plan to start cooking it.Mix the ingredients, wash the cavity of the turkey, and lightly stuff inside.Chop and prepare dry ingredients ahead of time, but add any moist ingredients just before cooking the turkey.Prepare about 1/2 cup of stuffing per pound of turkey. Since stuffing will expand as it cooks, don't overstuff. Cook any extras in a separate pan.Make sure stuffing is cooked to an internal temperature of 165 degrees Fahrenheit. Stuffing often contains eggs and other ingredients that can be harmful if undercooked.Before you carve the turkey, remove the stuffing.Make sure leftovers are refrigerated within two hours of serving, are reheated to 165 degrees Fahrenheit and are eaten within two days.

-- Diana Kohnle
Copyright © 2013 Click Here!">HealthDay. All rights reserved.

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Sports for Teens Are Beneficial -- Up to a Point

Too much time spent playing sports can be as bad as too little time for teens, a new study finds.
Swiss researchers found the greatest benefit seemed to be associated with 14 hours of sports a week. That's higher than European, American and World Health
Organization (WHO) recommendations of at least seven hours of physical activity a week for adolescents.
Researchers Arnaud Merglen, at the University of Lausanne, and colleagues reported their findings online Nov. 20 in the Archives of Disease in Childhood.
They asked more than 1,200 participants aged 16 to 20 in Switzerland about their levels of sports participation. In addition, they assessed the participants' physical and mental well-being using a WHO scale of zero to 25. Scoring below 13 indicated poor well-being.
Participants were evenly split between males and females and their average age was just under 18. About 9 percent were over weight
or obese. The average well-being score for all the teens was 17.
Weekly sports participation of zero to 3.5 hours was considered low and seen in 35 percent of teens. Between 3.6 and 10.5 hours was considered average and seen in 41.5 percent of participants. High levels of 10.6 to 17.5 hours were reported by 18.5 percent of participants, and very high levels of more than 17.5 hours were reported by 5 percent of tens.
Teens in the low and very high groups were more than twice as likely as those in the average group to score below 13 on the well-being scale, according to a journal news release.
Peak scores of well-being were seen among teens who did about 14 hours of sports a week. However, the protective effect was reversed after more than 17.5 hours of sports a week.
Regular exercise
is known to provide mental and physical benefits by reducing stress and anxiety, and by boosting self-esteem and brain power, the researchers said.
Although doubling the recommended weekly time spent playing sports to 14 hours seems to be good for the mental and physical health
of teens, going beyond this seems to be harmful, the researchers concluded.
-- Robert Preidt
Copyright © 2013 Health
Day. All rights reserved. SOURCE: Archives of Disease in Childhood, news release, Nov. 20, 2013

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Cash Incentives Spur Poor To Buy Healthier Foods

By Randy Dotinga
Click Here!">HealthDay Reporter

FRIDAY, Nov. 22, 2013 (Click Here!">HealthDay News) -- A recent program encouraged Click Here!">healthy eating by offering extra spending power to poor people who get government assistance to buy food. The only catch: They had to purchase Click Here!">healthier types of food at farmers' markets.

It's not clear if the thousands of San Diego-area participants in the federally funded program actually became Click Here!">healthier because they bought foods like produce, meat and bread.

But in the big picture, the program "increased access to Click Here!">healthy foods," said San Diego County public Click Here!">health officer Dr. Wilma Wooten, co-author of a new report on the findings. "And it helps the market vendors and the growers."

Wooten said local public Click Here!">health officials launched the program with money from two federal grants -- one from an anti-obesity fund in the Obama administration stimulus package and the other from an Affordable Care Act fund designed to fight chronic disease.

The study appeared in the Nov. 14 issue of Preventing Chronic Disease, published by the U.S. Centers for Disease Control and Prevention.

Obesity is common in the United States among people of all income levels, but the poor appear to be at special risk. A study published a year ago found that 5-year-old kids who live in the poorest neighborhoods were 28 percent more likely to be obese -- a step above just being overClick Here!">weight -- compared to children from the wealthiest areas.

Research also suggests that the poor often live in "food deserts" where Click Here!">healthier food like produce is hard to find and expensive compared to fast food.

The new project, called the Farmers Market Fresh Fund Incentive Program, ran from mid-2010 through 2011. It allowed people who get public food assistance like food stamps to buy tokens to use for Click Here!">healthier foods -- including produce, meat, bread and eggs -- at local farmers' markets. They'd get tokens worth the purchased amount plus a matching amount at no extra cost up to $10 a month.

In other words, participants would get $20 worth of tokens for Click Here!">healthier foods per month if they purchased $10 worth.

Nearly 7,300 people enrolled in the program, far more than the 3,000 that officials had expected, Wooten said. Most (82 percent) had never been to a farmer's market before.

Among the people who enrolled, 252 took part in surveys while using the program and a year later. The percentage of those who said their Click Here!">diet was "Click Here!">healthy" or "very Click Here!">healthy" rose from 4 percent to 63 percent. In addition, 93 percent said the program was "important" or "very important" in their choices to shop at a farmers' market.

The cost to manage the program wasn't available, but the extra food itself cost about $330,000, an average of $93 per participant.

The study doesn't examine why the participants took part in the program. Nor does it look at whether it would be cheaper to allow the participants to buy Click Here!">healthier foods at supermarkets and membership superstores instead of only farmers' markets. Wooten, however, said the program is specifically designed to boost farmers' markets.

Diane Whitmore Schanzenbach, chair of the program on child, adolescent and family studies at Northwestern University's Institute for Policy Research, said it's difficult to gauge the impact of the project. She noted that many participants didn't take the follow-up surveys, and those who did may have "found the subsidy to be most valuable."

A similar federal program showed excellent results by matching 30 cents on the dollar for food stamp recipients and allowing them to spend money on produce at grocery stores, she said. "When we subsidize Click Here!">healthy food, low-income families purchase and eat more Click Here!">healthy food. It's really Economics 101."

And, she said, "it makes sense to subsidize these goods where ever people shop, be that farmers' markets, corner stores, Costco, you name it."

In the San Diego area, federal funding through the county has ended, study co-author Wooten said. But an advocacy group for refugees, whose numbers are high in poor San Diego-area neighborhoods, is continuing to support the program, she said. However, federal funding for food stamps recently dipped.

"Our hope is that Congress in the future will recognize the importance of this project and create a national program that supports this kind of effort," Wooten said.

Copyright © 2013 Click Here!">HealthDay. All rights reserved. SOURCES: Wilma Wooten, M.D., M.P.H., public Click Here!">health officer, San Diego County, San Diego; Diane Whitmore Schanzenbach, Ph.D., associate professor, human development and social policy, and chair, program on child, adolescent, and family studies, Institute for Policy Research, Northwestern University, Evanston, Ill.; Nov. 14, 2013, Preventing Chronic Disease

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Blacks Less Likely to See Cancer Specialists, Study Finds

FRIDAY, Nov. 22, 2013 (Click Here!">HealthDay News) -- Black Americans with advanced colorectal cancer are less likely than white patients to see cancer specialists or to receive cancer treatments, according to a new study.

This may be a major reason blacks with advanced colorectal cancer -- cancer of the colon and rectum -- have a 15 percent higher death rate than whites, according to researchers from the University of California, San Diego.

The risk of death, however, was the same for patients who received the same cancer treatments, such as chemotherapy and surgery, regardless of their race, the researchers said.

The researchers analyzed data from more than 11,000 patients over age 66 who had metastatic colorectal cancer, which is cancer that has spread to other areas of the body. Blacks were 10 percent less likely than whites to have primary tumor surgery, 17 percent less likely to receive chemotherapy and 30 percent less likely to receive radiation therapy.

Chemotherapy was associated with a 66 percent lower risk of death, according to the study, which was published online Nov. 14 in the Journal of the National Cancer Institute.

Among patients who received chemotherapy, whites were more likely than blacks to receive more than one chemotherapy agent. Blacks typically began chemotherapy four days later after diagnosis than whites.

The researchers also found that almost half of the survival disparity between black and white patients was because of treatment differences. After accounting for these differences, the racial disparity in survival disappeared.

Possible reasons for the racial disparities noted in this study include conscious or unconscious biases from Click Here!">health care providers, patient mistrust and Click Here!">health literacy, the researchers said. Breakdowns in communication between patients and their doctors, barriers to Click Here!">health care access and differences in how the disease affects people of different races could also explain the disparities, they said.

"Further studies may answer the important question of why there are racial disparities in consults with cancer specialists and treatment among this population," Dr. James Murphy, chief of the radiation oncology gastrointestinal tumor service at the University of California, San Diego, Moores Cancer Center, said in a university news release. "The answers may lead to areas we can improve upon to close these gaps."

"I suspect that this pattern of disparity could be present in other underserved minority groups as well," he said.

-- Robert Preidt
Copyright © 2013 Click Here!">HealthDay. All rights reserved. SOURCE: University of California, San Diego, news release, Nov. 19, 2013

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Texting Your Way to Weight Loss

THURSDAY, Nov. 21, 2013 (Click Here!">HealthDay News) -- If you like texting and are trying to lose Click Here!">weight, a new study found that using texting to track Click Here!">diet and Click Here!">exercise habits may help you shed pounds.

Previous research has shown that keeping food and Click Here!">exercise diaries improves the likelihood of success when trying to shed excess Click Here!">weight. Using a computer or pen and paper to record information, however, can be a burden and cause some people to give up.

Duke University researchers said using text messages to stay on top of eating and Click Here!">exercise habits can save time and increase the chances that people will stick with their Click Here!">weight-loss regimen.

The study included 26 obese women with an average age of 38. The women used daily texting as part of their Click Here!">weight-loss program. The text messages focused on tracking personalized goals, such as avoiding sugary drinks or walking 10,000 steps a day. Messages also provided brief feedback and tips.

Every morning, the women received a text from an automated system that said, "Please text yesterday's # of steps you walked, # of sugary drinks and if you ate fast food." Based on the women's responses to the text message, the system sent another text with personalized feedback and a tip.

After six months, the women who used daily texting lost an average of nearly 3 pounds, while another group of women who used traditional methods to keep food and Click Here!">exercise diaries gained an average of 2.5 pounds, according to the study, which was published online Nov. 18 in the Journal of Medical Internet Research.

"Text messaging has become ubiquitous and may be an effective method to simplify tracking of Click Here!">diet and Click Here!">exercise behaviors," study author Dori Steinberg, a postdoctoral obesity researcher in the Duke Obesity Prevention Program, said in a university news release.

Steinberg said text messaging offers several advantages compared to other self-monitoring methods. Unlike Web-based Click Here!">diet and Click Here!">exercise diaries, data in a text message can be entered quickly on nearly all cellphone platforms. This provides more portability, nearly real-time tracking and more accessibility for receiving tailored feedback.

And because of the limited number of words used in text messages, it saves time and is not as mentally demanding, Steinberg said.

-- Robert Preidt
Copyright © 2013 Click Here!">HealthDay. All rights reserved. SOURCE: Duke University, news release, Nov. 18, 2013

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Health Tip: Stay Fit in Your 30s

(Click Here!">HealthDay News) -- You're in your 30s, but you're not too young to start protecting yourself from heart attack and stroke.

The Academy of Nutrition and Click Here!">Dietetics says staying fit in your 30s can help:

Lower high blood pressure and high cholesterol.Lower your risk of type 2 diabetes.Boost bone Click Here!">health.Maintain ideal Click Here!">weight.Alleviate stress.Lower your risk of dying at an early age.

-- Diana Kohnle
Copyright © 2013 Click Here!">HealthDay. All rights reserved.

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Lengthy Car, Plane Rides Pose Risk of Clots

SATURDAY, Nov. 23, 2013 (Click Here!">HealthDay News) -- Traveling long distances in cars and planes over the holidays could put you at risk for deep vein thrombosis -- potentially deadly blood clots in the deep veins of the lower legs and thighs, an expert says.

Sitting for long periods of time in cramped spaces can limit circulation in the legs, resulting in the formation of a blood clot. The clot can travel through the blood stream and lodge in the lungs, brain, heart and other areas. This can lead to severe damage to organs and possibly death.

However, it's easy to prevent deep vein thrombosis.

"If you plan to travel overseas or cross country, make sure you get up and walk around at least every two hours, and try not to sleep more than four hours at a time," Dr. Alan Lumsden, chief of cardiovascular surgery at Houston Methodist Hospital's heart and vascular center, said in a hospital news release.

"Drink plenty of water or juices, wear loose-fitting clothing, eat light meals and limit alcohol consumption," he added.

Elderly people and those with circulation problems should wear compression stockings that help prevent clots from forming in the deep veins, Lumsden suggested.

If you can't get up and move around every couple of hours, you can do the following Click Here!">exercises while sitting down:

Extend both legs and move both feet back and forth in a circular motion.Move the knee up to the chest and hold the stretch for at least 15 seconds.Put both feet on the floor and point them upward. Also, put both feet flat and lift both heels as high as possible.

If you are pregnant or have a history of heart disease, cancer or blood clots, you should always consult with your doctor before going on a long trip, Lumsden advised.

About 2 million Americans develop deep vein thrombosis every year, and nearly 200,000 die. "It's a very serious condition that can simply be avoided by getting up and moving around," Lumsden said.

"Symptoms include pain and tenderness, swelling, redness and increased warmth in one leg," Lumsden said. "In some cases, a physician might suggest that a patient go on blood thinners or simply take an aspirin before and during a long trip to avoid [deep vein thrombosis]."

-- Robert Preidt
Copyright © 2013 Click Here!">HealthDay. All rights reserved. SOURCE: Houston Methodist Hospital, news release, Nov. 11, 2013

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Kidney Procedure Might Help Ease Tough-to-Treat High Blood Pressure

WEDNESDAY, Nov. 20, 2013 (Click Here!">HealthDay News) -- A new therapy may help lower tough-to-treat high blood pressure in people with chronic kidney disease, a new study finds.

"Blood pressure that is difficult to control, even on multiple medications, in patients with chronic kidney disease is a significant issue," explained an expert who was not connected to the new study, Dr. Adam Auerbach.

"Poorly controlled blood pressure can lead to worsening kidney function, heart disease and stroke," said Auerbach, who is a cardiologist at North Shore University Hospital in Manhasset, and Long Island Jewish Medical Center in New Hyde Park, N.Y.

The new technique is called renal (kidney) denervation, and involves the interruption of a key nerve in the kidney. It is a minimally invasive, catheter-based procedure that uses radio waves to heat and remove tissue.

The study included 15 people averaging 66 years of age. All had chronic kidney disease along with high blood pressure that had proven resistant to standard drugs, even though the patients were taking at least three medications to lower their blood pressure.

All of the patients underwent renal denervation and were followed for one year. During that time, the patients were treated with an average of five different medications for high blood pressure.

The patients' blood pressure decreased significantly during the follow-up and their kidney function remained stable and did not further deteriorate, the researchers noted.

The small pilot study suggests that "treatment with renal denervation decreases blood pressure, and most important, slows or even halts the decline of [kidney] function in treatment-resistant patients with chronic kidney disease," study lead author Dr. Roland Schmieder said in a news release from the American Heart Association.

Auerbach cautioned that renal denervation "is in addition to taking medications, it does not replace them." He added that "this is a promising procedure, but the number of patients in this study was small and further investigation is needed."

Another expert was similarly cautious.

While the finding could be of "great clinical significance" to patients, "it remains to be seen if this stoppage of renal function decline by renal denervation therapy translates into lives saved or [heart attacks] prevented," said Dr. Sripal Bangalore, assistant professor in the department of medicine at NYU Langone Medical Center in New York City.

"Nevertheless, if these results are replicated in other large trials this could potentially be a game-changer for patients with kidney disease and resistant hypertension [high blood pressure]," Bangalore said.

The study is scheduled for presentation Nov. 20 at the annual meeting of the American Heart Association in Dallas. Findings presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

-- Robert Preidt
Copyright © 2013 Click Here!">HealthDay. All rights reserved. SOURCES: Adam Auerbach, M.D., cardiologist, North Shore University Hospital in Manhasset, N.Y. and Long Island Jewish Medical Center, New Hyde Park, N.Y.; Sripal Bangalore, M.D., assistant professor, department of medicine, Leon H. Charney Division of Cardiology at NYU Langone Medical Center, New York City; American Heart Association, news release, Nov. 20, 2013

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How to Slash Heart Risks Tied to Obesity

FRIDAY, Nov. 22, 2013 (Click Here!">HealthDay News) -- Obese or overClick Here!">weight people who lower their blood pressure, cholesterol and blood sugar levels could cut their risk of heart disease and stroke by more than half, a new study indicates.

Researchers analyzed 97 studies that included a total of more than 1.8 million people worldwide. They found that high blood pressure, cholesterol and blood sugar levels explain up to half of overClick Here!">weight and obese people's increased risk of heart disease. And those same factors account for three-quarters of their increased risk of stroke.

High blood pressure posed the greatest threat, accounting for 31 percent of the increased risk of heart disease and 65 percent of the increased risk of stroke, according to the study, published online Nov. 22 in The Lancet.

"Our results show that the harmful effects of overClick Here!">weight and obesity on heart disease and stroke partly occur by increasing blood pressure, serum cholesterol and blood [sugar]," senior study author Goodarz Danaei, an assistant professor of global Click Here!">health at Harvard School of Public Click Here!">Health in Boston, said in a school news release. Therefore, controlling these risk factors -- for example, through better diagnosis and treatment of high blood pressure -- can prevent some of the harmful effects of overClick Here!">weight and obesity, he added.

Obesity has nearly doubled worldwide since 1980. More than 1.4 billion adults aged 20 and older are overClick Here!">weight or obese. Click Here!">Health problems associated with overClick Here!">weight and obesity include heart disease and stroke -- the leading causes of death worldwide -- diabetes, and several types of cancer.

Moreover, about 3.4 million people worldwide die each year because of overClick Here!">weight and obesity, according to the researchers.

Study co-author Majid Ezzati, a professor of global environmental Click Here!">health at Imperial College London, said controlling blood pressure, cholesterol and diabetes will be "an essential but partial and temporary response" to the obesity epidemic.

"As we use these effective tools, we need to find creative approaches that can curb and reverse the global obesity epidemic," Ezzati said in the news release.

-- Robert Preidt
Copyright © 2013 Click Here!">HealthDay. All rights reserved. SOURCE: Harvard School of Public Click Here!">Health, news release, Nov. 21, 2013

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Nexavar Approval Expanded for Common Thyroid Cancer

FRIDAY, Nov. 22, 2013 (Click Here!">HealthDay News) -- U.S. Food and Drug Administration approval for the anti-cancer drug Nexavar (sorafenib) has been expanded to include late-stage differentiated thyroid cancer, the most common type of thyroid cancer.

In a Friday news release about the approval, the agency said thyroid cancer will be diagnosed in an estimated 60,220 Americans this year, and an estimated 1,850 will die from the disease.

Nexavar is designed to inhibit proteins that prompt cancer cells to divide and grow. The new approval is meant for people with differentiated thyroid cancer that no longer responds to radioactive iodine treatment.

The drug was approved for this new use based on clinical studies involving 417 people whose thyroid cancer did not respond to treatment. The drug increased the time recipients lived without cancer progression by about 41 percent compared to those who took a placebo, the FDA said.

The most common side effects of Nexavar included diarrhea, fatigue, infection, hair loss, skin reactions, Click Here!">weight loss, loss of appetite, abdominal pain and high blood pressure. The agency also warned that increased production of thyroid stimulating hormone -- a potential promoter of thyroid cancer -- was possible among the drug's users.

Nexavar was FDA-approved to treat advanced kidney cancer in 2005, followed by approval to treat advanced liver cancer in 2007, the agency said.

The drug is marketed by Bayer Click Here!">HealthCare Pharmaceuticals, based in Wayne, N.J.

-- Scott Roberts
Copyright © 2013 Click Here!">HealthDay. All rights reserved.

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Start at the Healthier End of the Buffet

THURSDAY, Nov. 21, 2013 (Click Here!">HealthDay News) -- Putting Click Here!">healthier foods at the start of a buffet table can help diners pass up more fattening fare, according to a new study.

Researchers found that when Click Here!">healthy foods are seen first, people are more likely to select them and less likely to crave higher-calorie foods that may be farther down the buffet line.

"Each food taken may partly determine what other foods a person selects," the researchers said. "In this way, the first food a person selects triggers what they take next."

For the study, published recently in the journal PLoS One, the researchers provided two breakfast buffets to 124 people. In the first buffet, the participants encountered Click Here!">healthy foods, such as fruit, low-fat yogurt and low-fat granola, first. In the second buffet, high-calorie foods, such as cheesy eggs, fried potatoes and bacon, were at the start of the line.

The study revealed that when Click Here!">healthy foods were offered first, 86 percent of the diners selected fruit. But when more fattening foods were seen first, only 54 percent took the fruit. Similarly, when high-calorie foods were at the front of the buffet line, 75 percent of the participants chose cheesy eggs, compared to 29 percent of those on the Click Here!">healthy buffet line.

"The first three food items a person encountered in the buffet comprised 66 percent of their total plate, regardless of whether the items were high- or low-calorie foods," behavioral economist Brian Wansink, of Cornell University, said in a university news release.

The order of foods in a buffet played a role in what the participants chose to add to their plate, said the researchers, who dubbed this a "trigger effect."

"There's an easy take-away for us: Always start at the Click Here!">healthier end of the buffet," Wansink said. "Two-thirds of your plate will be the good stuff."

-- Mary Elizabeth Dallas
Copyright © 2013 Click Here!">HealthDay. All rights reserved. SOURCE: Cornell University, news release, Nov. 7, 2013

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Does Caffeine in Coffee Perk Up Heart Health?

By Dennis Thompson
Click Here!">HealthDay Reporter

WEDNESDAY, Nov. 20, 2013 (Click Here!">HealthDay News) -- Coffee seems to offer a mysterious benefit to heart Click Here!">health -- one that doctors have been at pains to explain.

Now, a small, new study from Japan suggests that the caffeine in a cup of coffee might help your small blood vessels work better, which could ease strain on the heart.

A cup of caffeinated coffee caused a 30 percent increase in blood flow through the small vessels of people's fingertips, compared with a cup of decaf, according to the research, which is scheduled for presentation Wednesday at the American Heart Association's annual meeting in Dallas.

These microvessels regulate the ease with which blood flows through the circulatory system and the body's tissues, said lead researcher Dr. Masato Tsutsui, a cardiologist and professor in the pharmacology department at the University of the Ryukyus, in Okinawa.

Previous studies have shown an association between coffee drinking and lower risk of heart attack, heart disease and stroke, said Dr. Gordon Tomaselli, chief of cardiology at the Johns Hopkins University School of Medicine. Researchers found that high doses of caffeine may improve the function of larger arteries.

But scientists have not been able to figure out why this is, given that coffee also can increase blood pressure. High blood pressure can damage arteries.

"This is an intriguing observation that may help us understand why consumption of coffee may be beneficial," said Tomaselli, former president of the American Heart Association.

The study involved 27 Click Here!">healthy adults, aged 22 to 30, who did not regularly drink coffee. They were asked to drink a 5-ounce cup of either caffeinated or decaffeinated coffee. Researchers then measured their finger blood flow using a noninvasive laser technique for gauging blood circulation.

Two days later, the experiment was repeated with the other type of coffee. Neither the researchers nor the participants knew when they were drinking caffeinated coffee.

The researchers found that blood flow in the small blood vessels improved by nearly one-third among the people who drank caffeinated coffee. The effect continued in those people over a 75-minute period.

Heart rate levels remained the same between the two groups, although caffeinated coffee slightly raised blood pressure.

The improved blood flow is likely because of improved function of the inner lining of the blood vessels, Tsutsui said. Researchers have linked the function of the lining of blood vessels -- also known as endothelial function -- to future heart attacks, heart disease and strokes.

By opening blood vessels and reducing harmful inflammation, caffeine may create favorable conditions for good heart Click Here!">health, he said.

But how much coffee is too much? Tsutsui pointed to a landmark U.S. National Institutes of Click Here!">Health study that showed that, overall, drinking six or more cups of coffee a day reduced men's risk of early death by 10 percent and women's risk by 15 percent.

That study, published last year in the New England Journal of Medicine, found that risk of heart disease and stroke either remained low or went even lower as people drank more coffee during the day.

The new study was co-sponsored by the All Japan Coffee Association, which might raise some Click Here!">healthy skepticism were it not for the large body of evidence that already shows coffee's heart Click Here!">health benefits, Tomaselli said.

That said, the study's small sample size does not conclusively explain why coffee is so good for the heart. "I don't think this answers any questions for us," Tomaselli said.

Data and conclusions presented at meetings typically are considered preliminary until published in a peer-reviewed medical journal.

Copyright © 2013 Click Here!">HealthDay. All rights reserved. SOURCE: Masato Tsutsui, M.D., Ph.D., cardiologist and professor, pharmacology department, University of the Ryukyus, Okinawa, Japan; Gordon Tomaselli, M.D., past president, American Heart Association, and chief of cardiology, Johns Hopkins University School of Medicine; abstract, Nov. 20, 2013, American Heart Association, annual meeting, Dallas

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Concussion's Damage to Brain Lingers After Symptoms Fade: Study

By Maureen Salamon
Click Here!">HealthDay Reporter

WEDNESDAY, Nov. 20, 2013 (Click Here!">HealthDay News) -- Months after concussion symptoms such as dizziness, headaches and memory loss fade, the brain continues to show signs of injury, a new study suggests.

Comparing 50 concussion patients with the same number of Click Here!">healthy people, researchers found that the brains of those suffering concussions showed abnormalities four months later. This happened despite the fact that their symptoms had already eased to some degree.

The findings may sway conventional thinking about when it's safe to resume physical activities that could produce another concussion, the study authors said.

"This is a very different population than professional athletes going out and having concussions on a fairly [frequent] basis, as well as jostling their brain around their skull on a regular basis in practice," said study author Andrew Mayer, an associate professor of translational neuroscience at the Mind Research Network in Albuquerque, N.M. It's hard to predict an outcome based on these findings, he said, "but just because you feel you're healed doesn't mean you are."

The study, which was funded by the U.S. National Institutes of Click Here!">Health, is published in the Nov. 20 online edition of the journal Neurology.

Considered a mild traumatic brain injury that occurs from a sudden blow to the head or body, a concussion has symptoms that range from headache and blurry vision to difficulties in sleeping or thinking clearly. Most occur without losing consciousness, according to the U.S. Centers for Disease Control and Prevention.

Mayer and his team matched 50 patients with mild concussions to 50 Click Here!">healthy people of similar age and education levels. They tested all participants in memory and thinking skills, as well as other symptoms such as anxiety and depression.

Special brain scans using technology that is not available in standard brain scans were also given. All tests and scans were repeated two weeks after the concussion, and again four months later.

While concussion symptoms were reduced by up to 27 percent four months after injury, brain scans of those with concussions showed abnormalities in the frontal cortex area of both sides of the brain. These abnormalities may have resulted from changes in location of fluid around brain cells or changes in the shape of certain brain cells in response to damage, Mayer explained.

The findings, he noted, suggest that the recommendation that athletes suffering concussions should refrain from play for one to two weeks may not be sufficient.

"In one or two weeks, most people typically report feeling better," he said. "But when we start talking about it in an analogy of a burn or knee injury, it becomes a little more clear when the doctor says we need to wait a bit longer [to return to prior activities]. It makes sense that the brain would be similar to those tissue types," added Mayer.

Kenneth Podell, co-director of the Houston Methodist Concussion Center, said the study strengthens the understanding that physical changes within the brain after concussion are separate from mental symptoms. But Podell, who was not involved in the research, added that the study couldn't offer implications for potential long-term concussion effects such as depression or dementia.

"Everyone seen at four months should be followed in another four, six or eight months and then re-scanned," he said. "One of the biggest problems we have looking at concussions is we try to predict long-term effects from short-term findings. This injury is very difficult to commit the type of resources needed to do that kind of very expensive and time-consuming study."

Copyright © 2013 Click Here!">HealthDay. All rights reserved. SOURCES: Andrew Mayer, Ph.D., associate professor, translational neuroscience, Mind Research Network, and adjunct assistant professor, neurology, University of New Mexico Click Here!">Health Science Center, Albuquerque; Kenneth Podell, Ph.D., co-director, Houston Methodist Concussion Center, and director, neuropsychology section, Houston Methodist Neurological Institute; Nov. 20, 2013, Neurology, online

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Health Disparities Persist in America: Report

By Steven Reinberg
Click Here!">HealthDay Reporter

THURSDAY, Nov. 21 (Click Here!">HealthDay News) -- Despite progress in some areas, Click Here!">health disparities remain for many Americans, Click Here!">health officials reported Thursday.

These inequalities are related to income, education, sex, race, ethnicity, employment and sexual orientation, and they all affect Americans' Click Here!">health and well-being, according to the U.S. Centers for Disease Control and Prevention.

"The purpose of the report is to highlight disparities in Click Here!">health that still exist in the country," said Dr. Chesley Richards, director of the CDC's Office of Public Click Here!">Health Scientific Services, which produced the report.

"If you look at Click Here!">health in the country over the last 50 years, there has been a dramatic improvement in Click Here!">health," he said. "We have seen an increase in life expectancy in the last 20 or 30 years."

Across the 29 categories in the report there has been improvement, but many disparities persist, Richards said.

"For example, we have seen a decrease in tobacco use, but it's not even. In people who have lower educational status, the disparity has actually widened -- not improved," he said.

"Although we have seen pretty dramatic improvement in Click Here!">health for the population overall, you really have to look at particular groups to see that there are still tremendous disparities in Click Here!">health outcomes," Richards said.

The report is published in a Nov. 22 supplement to Morbidity and Mortality Weekly Report, a CDC publication.

The report covers a variety of areas, including disparities in deaths and illness, use of Click Here!">health care, lifestyle risk factors, environmental hazards and social aspects of Click Here!">health.

Key findings include the following:

A dramatic drop occurred in the rate of teen births -- by 18 percent from 2007 to 2010, with significant decreases seen among whites, blacks and Hispanics. There was substantial variation across states, from no significant change to a 30 percent reduction in Arizona.Hispanics, low wage earners, those with only a high school education, men and those born outside the United States are those most likely to take high-risk jobs -- jobs where workers are likely to be injured or sickened.Binge drinking is more common among people aged 18 to 34, men, whites and people with higher household incomes.Despite a 58 percent drop in new cases of tuberculosis between 1992 and 2010, the disease remains disproportionately high among racial and ethnic minorities and those born outside the United States. Diabetes rates are higher among Hispanics and blacks than among Asians and whites. Higher rates are also seen among people without a college degree and who have lower household incomes. The infant death rate for blacks is more than double the rate for whites. The highest rates are in the South and Midwest.Men are nearly four times more likely to commit suicide than women, regardless of age, race or ethnicity. The highest rates for both men and women are among American Indians/Alaska Natives and whites.Cardiovascular disease is the leading cause of death in the United States, with blacks at least 50 percent more likely to die of heart disease or stroke prematurely than whites.

The report also covers 10 new areas involving Click Here!">health disparity. These are: access to Click Here!">healthy foods, activity limitations due to chronic diseases, asthma attacks, fatal and nonfatal work-related injuries and illnesses, Click Here!">health-related quality of life, gum disease in adults, living close to major highways, tuberculosis and unemployment.

It also highlights the need to collect more consistent Click Here!">health data that have been lacking in surveys, such as disability and sexual orientation, the authors noted.

"This report is a timely reminder that the United States has vast resources that are very unevenly distributed," said Dr. David Katz, director of the Yale University Prevention Research Center.

"We have huge disparities in Click Here!">health, because we have huge disparities in everything from income to education," he said.

Katz said that Click Here!">health care reform must extend beyond the doctor's office and hospital.

"We will best eliminate Click Here!">health disparities not by improving disease care, but by improving equity," he said.

Copyright © 2013 Click Here!">HealthDay. All rights reserved. SOURCES: Chesley Richards, M.D., M.P.H., director, Office of Public Click Here!">Health Scientific Services, U.S. Centers for Disease Control and Prevention; David Katz, M.D., M.P.H., director, Yale University Prevention Research Center, New Haven, Conn.; Nov. 22, 2013, Morbidity and Mortality Weekly Report

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Joblessness May Age You, Study Suggests

By Steven Reinberg
Click Here!">HealthDay Reporter

WEDNESDAY, Nov. 20, 2013 (Click Here!">HealthDay News) -- Men who are unemployed for an extended time may age more quickly, a new study suggests.

That aging is evident in their DNA, the British researchers reported. More specifically, it is found in the length of the gene tips or caps, referred to as "telomeres." The shortening of telomeres has long been seen as an indicator of aging.

"Shorter telomeres are linked to a higher risk of age-related conditions, such as heart disease and type 2 diabetes," said study author Jessica Buxton, a research associate in the department of medicine at Imperial College London. "It seems that long-term unemployment is the latest example of a stressful life experience that may trigger permanent changes to the cell's DNA.

"It's important to note that other studies have shown too much work can be as harmful as too little," she said. "Work-related exhaustion and the holding of multiple jobs have also been linked to shorter telomeres."

The report was published Nov. 20 in the online journal PLoS One.

Constant stress over a long time changes the hormones in one's body, said Curtis Reisinger, a clinical psychologist at Zucker Hillside Hospital in Glen Oaks, N.Y. This may be what is causing these changes in telomere length.

"You see the same thing with depression and high stress levels," he said. "The consequence is that you wind up looking and feeling older."

Reisinger said seeing a mental-Click Here!">health professional can help relieve stress. But having a positive attitude also is important.

"This is not the end of the world," he said. "You have to stay focused and have faith that if you keep at it and have a positive outlook, chances are you will be more likely to get a job than if you're down in the dumps and pessimistic."

For the study, Buxton and her colleagues examined DNA from more than 5,600 men and women born in Finland in 1966.

Specifically, they looked at telomere length in DNA samples collected in 1997, when the participants were 31 years old.

The researchers found that men who were unemployed for more than two out of the previous three years were more than twice as likely to have short telomeres compared with men who were employed.

To be sure their findings resulted from unemployment alone, the researchers accounted for other social, biological and behavioral factors that could cause shortened telomeres.

"It's interesting that unemployment itself appears to have a negative effect on Click Here!">health, even after accounting for the potential effects of smoking, physical-activity levels, Click Here!">weight, illness, education and marital status," Buxton said.

Buxton's team found this effect among men and not women, which might be because there were fewer unemployed women in the study, she said.

Although the study found an association between unemployment and faster aging, it did not prove a cause-and-effect link.

Copyright © 2013 Click Here!">HealthDay. All rights reserved. SOURCES: Jessica Buxton, Ph.D., research associate, department of medicine, Imperial College London, United Kingdom; Curtis Reisinger, Ph.D., clinical psychologist, Zucker Hillside Hospital, Glen Oaks, N.Y.; Nov. 20, 2013, PLoS One, online

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Sodas, Other Sweet Drinks Tied to Higher Risk for Endometrial Cancer

FRIDAY, Nov. 22, 2013 (Click Here!">HealthDay News) -- Older women who drink lots of soda and other sugary beverages may be at higher risk for endometrial cancer, a new study suggests.

Endometrial cancer involves tumors in the lining of the uterus, and typically affects women in their 60s or 70s, according to the U.S. National Cancer Institute (NCI).

In the new NCI-funded study, researchers looked at data from more than 23,000 postmenopausal women in Iowa who were followed from 1986 to 2010.

They found that those who drank the largest amounts of sugar-sweetened beverages had a 78 percent higher risk for a tumor known as estrogen-dependent type I endometrial cancer.

The more sugar-sweetened beverages a woman drank, the greater her risk, according to the study published online Nov. 22 in the journal Cancer Epidemiology, Biomarkers & Prevention.

There was no link between endometrial cancers and consumption of sugar-free soft drinks, sweets/baked goods and starch.

In a journal news release, study author Maki Inoue-Choi said she wasn't surprised that increased intake of sugary drinks was tied to this estrogen-linked cancer.

"Other studies have shown increasing consumption of sugar-sweetened beverages has paralleled the increase in obesity," explained Inoue-Choi, who was a research associate at the University of Minnesota School of Public Click Here!">Health when the study was conducted. "Obese women tend to have higher levels of estrogens and insulin than women of normal Click Here!">weight, [and] increased levels of estrogens and insulin are established risk factors for endometrial cancer."

Inoue-Choi is currently a postdoctoral fellow at the NCI and the U.S. National Institute on Minority Click Here!">Health and Click Here!">Health Disparities.

A group representing the beverage industry took issue with the findings.

In a statement from the American Beverage Association, Dr. Richard Adamson, former director of the NCI's Division of Cancer Etiology and now a consultant to the group, said that, "this study does not show that sugar-sweetened beverage consumption causes endometrial cancer."

Adamson said that, "in fact, its findings conflict with the results of several other published studies that showed no association between consumption of sugar and risk for endometrial cancer."

He also stressed that the study only showed an association between sweetened beverage intake and endometrial cancer risk, and it could not show cause-and-effect. And he noted that people in the upper one-fifth of sweetened beverage intake had levels ranging from 1.7 to 60.5 servings per week.

That is "the difference between 1 can and more than three 12-packs a week [in 8-ounce servings]," Adamson said. " This is a very broad range."

For her part, Inoue-Choi said that since these are the first findings of their kind, they do need to be reproduced in other studies.

But, she added, "research has documented the contribution of sugar-sweetened beverages to the obesity epidemic. Too much added sugar can boost a person's overall calorie intake and may increase the risk of Click Here!">health conditions such as obesity, diabetes, heart disease and cancer."

-- Robert Preidt
Copyright © 2013 Click Here!">HealthDay. All rights reserved. SOURCES: Cancer Epidemiology, Biomarkers & Prevention, news release, Nov. 22, 2013; statement, American Beverage Association, Nov. 22, 2013

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Steroids for Preemies May Raise ADHD Risk, Study Says

FRIDAY, Nov. 22, 2013 (Click Here!">HealthDay News) -- Giving steroid injections to pregnant women before premature birth may increase the child's risk of developing attention-deficit/hyperactivity disorder and other behavioral and emotional disorders, a small study suggests.

Pregnant women who are expected to give birth prematurely often receive glucocorticoids, which mimic the natural hormone cortisol. This treatment is important to help a premature baby's lungs mature, the researchers explained.

However, their findings suggest that steroid injections may also increase a child's risk of developing ADHD and other mental Click Here!">health problems.

Children with ADHD have trouble paying attention and following through on tasks. They may also talk excessively and behave impulsively.

The study included 37 children whose mothers were given synthetic glucocorticoids before they gave birth and 185 children who were born at the same gestational age but were not exposed to glucocorticoids.

At ages 8 and 16, the children who were exposed to glucocorticoids before birth had poorer scores on general mental Click Here!">health and were more likely to have symptoms of ADHD, compared to the other children.

The findings were confirmed in a comparison group of more than 6,000 children, according to the study, published Nov. 22 in the journal PLoS One.

"There are a lot of studies that have found links between stress in pregnancy and effects on children's mental Click Here!">health, especially ADHD, and this might be related to cortisol," study senior author Alina Rodriguez, a visiting professor at the School of Public Click Here!">Health at Imperial College London in England, said in a college news release.

"Synthetic glucocorticoids mimic the biological reaction when the mother is stressed, so we wanted to see if babies who were exposed to this treatment are affected similarly in terms of mental Click Here!">health outcomes," she explained.

Although the findings suggest that the use of glucocorticoids may pose long-term risks to children's mental Click Here!">health, they don't prove a cause-and-effect relationship. The number of children in the study who were exposed to glucocorticoids was relatively small, and more studies are needed to confirm the findings, Rodriguez noted.

"We would like to reassure parents that in light of all available evidence to date, the benefits of steroid treatment on immediate infant Click Here!">health and survival are well-established and outweigh any possible risk of long-term behavioral/emotional difficulties," she said. Parents who are concerned that their child might have behavioral or emotional difficulties should contact their child's doctor, she added.

-- Robert Preidt
Copyright © 2013 Click Here!">HealthDay. All rights reserved. SOURCE: Imperial College London, news release, Nov. 22, 2013

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Teens' Mental Disorders Often Untreated in U.S., Study Finds

THURSDAY, Nov. 21, 2013 (Click Here!">HealthDay News) -- Less than half of American teens with mental Click Here!">health disorders receive treatment, and those who do get help rarely see a mental Click Here!">health specialist, a new study indicates.

The findings underscore the need for better mental Click Here!">health services for teens, said study author E. Jane Costello, associate director of the Duke Center for Child and Family Policy in Durham, N.C.

"It's still the case in this country that people don't take psychiatric conditions as seriously as they should," Costello said in a Duke news release. This remains so, despite a wave of mass shootings in which mental illness may have played a role, she and her colleagues noted.

The analysis of data from more than 10,000 teens aged 13 to 17 across the United States also showed that treatment rates varied greatly for different types of mental Click Here!">health problems.

For example, teens with attention-deficit/hyperactivity disorder, conduct disorder or oppositional defiant disorder received mental Click Here!">health care more than 70 percent of the time, while those with phobias or anxiety disorders were least likely to be treated.

The researchers also found that blacks were much less likely than whites to be treated for mental disorders, according to the study, published online Nov. 15 in the journal Psychiatric Services.

In many cases, teens received treatment from pediatricians, school counselors or probation officers, rather than mental Click Here!">health specialists. This is because there are not enough qualified child mental Click Here!">health professionals to handle the demand, said Costello, who is also a professor of psychology and epidemiology at Duke University.

"We need to train more child psychiatrists in this country," Costello said in a university news release. "And those individuals need to be used strategically, as consultants to the school counselors and others who do the lion's share of the work."

As many as one in five children living in the United States experiences a mental Click Here!">health disorder in any one year, according to a U.S. Centers for Disease Control and Prevention report.

-- Robert Preidt
Copyright © 2013 Click Here!">HealthDay. All rights reserved. SOURCE: Duke University, news release, Nov. 18, 2013

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White House Extends Enrollment Deadline for Health Insurance

By Karen Pallarito
Click Here!">HealthDay Reporter

FRIDAY, Nov. 22, 2013 (Click Here!">HealthDay News) -- Consumers who want to enroll in a Click Here!">health insurance plan through Click Here!">HealthCare.gov will get a few extra days to sign up for coverage that will take effect on Jan. 1.

The deadline for buying insurance through the federal Click Here!">health insurance exchange will be pushed from Dec. 15 to Dec. 23, a spokeswoman for the Centers for Medicare and Medicaid Services (CMS) said during a Friday news conference.

People who sign up by Dec. 23 and pay their first month's premium by Dec. 31 will have coverage effective Jan. 1.

"This extension will allow consumers more time to review plan options, to talk to their families, providers or enrollment assisters and to enroll in a plan," said Julie Bataille, director of the Office of Communications at CMS.

"We understand that technical challenges have made comparing plans more difficult in these first months, and we want to give consumers as much time as possible," she said.

Also Friday, published reports said President Barack Obama plans to delay the second-year start of enrollment for Affordable Care Act Click Here!">health plans. Doing so would let insurers adjust to the demands of the Click Here!">health-reform law and possibly avert premium increases before the 2014 congressional elections.

The second-year enrollment period, previously set to start Oct. 15, 2014, will now start Nov. 15, said an anonymous U.S. Department of Click Here!">Health and Human Services official who spoke with Bloomberg News.

The Oct. 1, 2013, launch of the federal and state Click Here!">health insurance exchanges was intended to be a major milestone in the Affordable Care Act's implementation, offering millions of Americans a venue to compare Click Here!">health plans and enroll in coverage, often with the help of federal subsidies. But with the federally run Click Here!">HealthCare.gov website experiencing troubles from the start, many people have been thwarted from signing up for coverage.

Further complicating matters, millions of Americans with Click Here!">health coverage have been told by their insurers that their plans are being cancelled because they don't meet minimum coverage standards set by the Affordable Care Act. Some of those minimum standards include maternal Click Here!">health care, mental Click Here!">health care and pediatric dental and vision care, according to Pew Charitable Trusts.

Click Here!">HealthCare.gov is being used by consumers in 36 states. The remaining states and the District of Columbia are running their own insurance enrollment sites.

The exchanges are designed to serve as the gateway for enrolling some 30 million uninsured Americans in Click Here!">health insurance coverage under the Affordable Care Act, President Obama's chief domestic policy achievement.

Under the law, most Americans must have Click Here!">health insurance coverage by 2014 or pay federal tax penalties. It is also designed to protect all Americans from abusive Click Here!">health insurance practices, like being dropped from coverage due to pre-existing Click Here!">health conditions.

During Friday's news conference, Jeffrey Zients, an advisor to the team of consultants working to fix the Click Here!">HealthCare.gov website, said the team was "on track" to have the site working smoothly for the vast majority of users by the end of November.

By then, he said, the website will be able to accommodate 50,000 simultaneous users -- the number that the federal government had originally intended to log on at one time.

In addition, the team is working to double the site's overall capacity, Zients said.

"This means the system will be able to accommodate more than 800,000 visits a day from consumers who are seeking information, filling out applications, shopping and enrolling," he said.

Anticipating peak periods when the number of users exceeds that level of capacity, the team is building what Zients called a "customer-friendly cueing system" to send consumers an e-mail message notifying them of better times to come back to the site.

Last week, the Obama administration reported that a disappointing number of people had enrolled for Click Here!">health insurance coverage through the new federal and state insurance exchanges.

Just over 106,000 Americans had enrolled in Click Here!">health plans through the new marketplaces from Oct. 1 through Nov. 2, U.S. Click Here!">Health and Human Services Secretary Kathleen Sebelius said. Another 975,000 people had applied for coverage and received a determination of eligibility for coverage "and are currently still shopping for a plan," she said.

Copyright © 2013 Click Here!">HealthDay. All rights reserved. SOURCES: Nov. 22, 2013, news conference with: Julie Bataille, director, Office of Communications, U.S. Centers for Medicare and Medicaid Services, and Jeffrey Zients, advisor to U.S. Centers for Medicare and Medicaid Services and the U.S. Department of Click Here!">Health and Human Services; Bloomberg News

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'Mixing' of Senses More Common in Autism: Study

FRIDAY, Nov. 22, 2013 (Click Here!">HealthDay News) -- People with autism are more likely to have a condition called synesthesia -- a "mixing of the senses" -- a small new study finds.

For example, people may see colors when they hear sounds, or notice different tastes when they hear musical notes.

Researchers tested 164 adults with autism and 97 adults without the disorder. They found that nearly 19 percent of those with autism had synesthesia, compared with about 7 percent of those without autism.

Among the 31 people with autism who also had synesthesia, 21 said that sound caused them to see colors. Meanwhile, 18 saw black and white letters as colored, and 18 said that tastes, pain or smells caused them to see colors, according to the study published Nov. 20 in the journal Molecular Autism.

"I have studied both autism and synesthesia for over 25 years and I had assumed that one had nothing to do with the other," study leader Professor Simon Baron-Cohen, of the Autism Research Center at Cambridge University, in England, said in a university news release.

Now, he said, the new findings "will refocus research to examine common factors that drive brain development in these traditionally very separate conditions."

Autism, a neurodevelopment disorder that affects communication and social skills, is estimated to affect about one in 88 children in the United States.

"This has major implications for educators and clinicians designing autism-friendly learning environments," study co-author Donielle Johnson, who carried out the study as part of her master's degree in Cambridge, said in the news release.

-- Robert Preidt
Copyright © 2013 Click Here!">HealthDay. All rights reserved. SOURCE: University of Cambridge, news release, Nov. 19, 2013

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Vitamin D Deficiency Might Be Overdiagnosed in Blacks, Study Suggests

By Amy Norton
Click Here!">HealthDay Reporter

WEDNESDAY, Nov. 20, 2013 (Click Here!">HealthDay News) -- Black adults typically have low levels of vitamin D in their blood, but they are on par with whites when it comes to the "active" form of vitamin D used by the body's cells, a new study finds.

Experts said the findings go a long way toward explaining a paradox: Blacks usually have fairly low vitamin D levels, but have greater bone mass than whites. Vitamin D is needed to maintain strong bones.

What's more, the results suggest that doctors may be overdiagnosing vitamin D deficiency in black patients, said lead researcher Dr. Ravi Thadhani, chief of nephrology at Massachusetts General Hospital, in Boston.

"We're suggesting that the definition of vitamin D deficiency needs to be rethought," said Thadhani, whose report appears in the Nov. 21 issue of the New England Journal of Medicine.

Right now, doctors use a blood test that measures a person's total 25-hydroxyvitamin D level. And if you consider just that total level, Thadhani said, up to 90 percent of black Americans would be labeled vitamin D deficient.

Among the nearly 1,200 black adults in his study, the average total vitamin D level was just shy of 16 nanograms per milliliter (ng/mL), versus almost 26 ng/mL among 900 white adults.

In general, levels below 20 ng/mL are considered a vitamin D deficiency.

But then Thadhani's team looked at study participants' levels of vitamin D-binding protein, which basically locks up the vitamin, away from body cells' use. It turned out that blacks also had lower levels of vitamin D-binding protein. So on balance, black and white adults had similar levels of "bioavailable" vitamin D -- the kind that their bodies can actually use.

And just like in past studies, black adults typically had greater bone mass and higher calcium levels than their white counterparts.

Why the discrepancy? Thadhani said that gene variations appeared to explain most of the difference in people's levels of the vitamin D-binding protein. Most blacks adults carried a gene variant linked to lower levels of the protein, while fewer than half of whites did.

"This highlights the role of genetics in determining our vitamin D status," Thadhani said. "Treating different populations as one big whole doesn't necessarily serve people well."

He said his team is not suggesting that doctors treat low vitamin D levels based on race. But, he added, "we shouldn't treat just based on total (vitamin D) levels alone."

Instead, Thadhani said, doctors could look at whether a black patient with low vitamin D has any other indicators of a problem -- such as low calcium levels or a very high level of parathyroid hormone.

Right now, there is no commercially available test that specifically gauges bioavailable vitamin D levels. Thadhani said he thinks it would be helpful to get such a test on the market.

But an expert not involved in the study said that while the results are "very interesting to scientists," it's not clear how they should be used in medical practice.

"We've known for a long time that blacks have lower levels of total vitamin D, but don't seem to show the consequences," said Dr. Michael Holick, a vitamin D researcher at Boston University Medical Center who wrote an editorial published with the study.

"This study may give us an explanation," Holick said.

But he added that as far as testing for and treating vitamin D deficiency, "it's not clear yet what it all means."

Holick noted that low levels of total vitamin D have been linked to Click Here!">health problems other than brittle bones. And, he said, some of those conditions, including diabetes and heart disease, are more common in blacks -- though it's not known whether vitamin D has anything to do with that.

Still, Holick said more research is needed before anyone diagnosed with vitamin D deficiency should stop taking supplements. "We can't make any definite comment yet on what people should do with this," he said.

In general, experts recommend that most adults get 600 international units (IU) of vitamin D per day. Meanwhile, those older than 70 should aim for 800 IU. The body makes vitamin D when the skin is exposed to the sun. The process is less efficient in darker-skinned people, which is why blacks typically have low total levels of vitamin D.

Fatty fish such as mackerel and salmon are the main sources of natural vitamin D. But certain foods -- including milk, orange juice and breakfast cereals -- are fortified with the vitamin.

Copyright © 2013 Click Here!">HealthDay. All rights reserved. SOURCES: Ravi Thadhani, M.D., M.P.H., chief, nephrology, Massachusetts General Hospital, Boston; Michael Holick, M.D., Ph.D., professor, medicine, dermatology and physiology, Boston University School of Medicine; Nov. 21, 2013, New England Journal of Medicine

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