Low-dose CT scans find lung cancer before X-rays, save lives

Low-dose computed tomography, commonly known as CT scans, are reducing lung-cancer deaths by finding the cancer early before it spreads to other parts of the body, UK HealthCare reports. Used as a screening tool, the American College of Radiology says CT is "the only test ever shown to reduce mortality in high-risk smokers."

This is good news for Kentucky, which leads the nation in both lung cancer and deaths from it.  It also leads, by some estimates, in smoking, the leading cause of cancer.  An estimated 25 to 28 percent of Kentuckians are smokers, compared to 18 to 19 percent nationally.

Low-dose CT screening for lung cancer is recommended for high-risk patients, defined in a Mayo Clinic article as someone 55 to 79 who's smoked the equivalent of a pack of cigarettes every day for 30 years, or those 50 and older who have smoked a pack a day or more of cigarettes for 20 years or longer and have one additional risk factor for lung cancer.

Chest X-rays, the other screening technique, typically are not done until a person has symptoms because studies have shown that they are not effective in detecting lung cancer early. However, researchers have found that heavy smokers screened with low-dose CT scans can pick up much smaller tumors than chest X-rays and have a "20 percent lower risk of dying from lung cancer than those screened with chest X-rays," UK HealthCare reports.

A recent study found that nearly one in five lung tumors detected on CT scans are probably so slow-growing that they would never cause problems, reports Lindsey Tanner of The Associated Press. These tumors are not false positives, but cancerous tumors without symptoms, which are unlikely to become deadly, according to the research. However, National Lung Cancer Screening Trial results conclude that the benefits from low-dose CT scans significantly outweigh the "comparatively modest rate of over-diagnosis," according to the American College of Radiology. "Overdiagnosis is an expected part of any screening program and does not alter the benefits you get from the screening,"

Dr. Paul Ellenbogen, chair of the American College of Radiology Board of Chancellors, said in the release, "Physicians should certainly discuss the risk and benefits of CT lung-cancer screening with patients – including that of overdiagnosis. However, for high-risk patients, the group in which CT lung cancer screening is proposed, the lifesaving benefit outweighs the risks."

A byproduct of cholesterol that acts like estrogen explains the link between high cholesterol and breast cancer

The link between high cholesterol and breast cancer can now be explained.

It is not the cholesterol itself, but a "byproduct of cholesterol (that) functions like the hormone estrogen to fuel the growth and spread of the most common types of breast cancer," researchers at the Duke University Cancer Institute report, according to Newswise.

Estrogen is known to "feed an estimated 75 percent of all breast cancers," Newswise reports. So basically, cholesterol creates a "byproduct" that acts like estrogen and "feeds" the breast cancer, the researches concluded.

This is the first time a link between high cholesterol and breast cancer has been explained, especially in post-menopausal women, according to the study, which also suggests that changes in diet or taking statins and other medication to reduce cholesterol may offer "simple ways to reduce breast cancer risk," Newswise reports.

Although studies have shown a connection between obesity and breast cancer, as well as high cholesterol and breast cancer, the reason for these connections had not been explained, said senior author Donald McDonnell, chair of the Department of Pharmacology and Cancer Biology at Duke: “What we have now found is a molecule – not cholesterol itself, but an abundant metabolite of cholesterol, called 27HC – that mimics the hormone estrogen and can independently drive the growth of breast cancer.”

The researchers also found that the more enzyme that makes the cholesterol byproduct that is present, the more aggressive the tumor.

When test animals took anti-estrogen drugs such as tamoxifen, or when they quit receiving the cholesterol byproduct, the cancer was inhibited, according to Newswise.

Nelson said in the article that there was also a potential association between the cholesterol byproduct and the development of resistance to the anti-estrogen tamoxifen. Data also suggest the cholesterol byproduct may reduce the effectiveness of commonly used breast cancer therapies.

These findings suggest that women who have breast cancer and high cholesterol who take statins will  have increased benefit, Newswise reports, because it will decrease their resistance to commonly used breast cancer therapies.

Further research will "include clinical studies to verify the suggested potential outcomes and to determine if this cholesterol byproduct plays a role in other cancers," McDonnel said.

UK is first in U.S. to conduct clinical trial for new Parkinson's treatment that shows improvement in all five patients so far

A new treatment strategy for Parkinson's disease at the University of Kentucky could change the way the ailment is treated, manage symptoms better and halt or reverse the progressive degeneration of the brain that comes with the disease, the university announced Monday.

Dr. Craig van Horne demonstrated a deep-brain stimulation
remote control unit on Parkinson's patient Rodney Parsons.
(Lexington Herald-Leader photo by Charles Bertram)

Read more here: http://www.kentucky.com/2013/11/18/2939114/uk-researchers-making-progress.html#storylink=cpy

UK is the first U.S. university to conduct a clinical trial of the strategy, led by principal investigator Dr. Craig van Horne, associate professor of neurosurgery in the College of Medicine, according to a news release from the university.

Parkinson's, a progressive and degenerative disease, affects around 1 million Americans and 10 million people worldwide, according to the release. Symptoms include both motor and non-motor symptoms including tremor, rigidity, slow movement and unstable posture. No cure exists.

The first course of treatment is medication, but any medication loses its effectiveness over time.The second line of treatment is deep brain stimulation, a surgical procedure that works like a "brain pacemaker." Electrodes are surgically implanted into the malfunctioning part of the brain where cells have died to emit electrical impulses to regulate the brain's abnormal impulses, according to the release.

Deep brain stimulation has improved the quality of life for many people with Parkinson's, but while it manages symptoms, it does not change the course or outcome of the disease, according to the release. UK's clinical trial explores an additional treatment option, and possibly a way to alter the course of the disease.

"They are conducting an innovative clinical trial that builds upon the established deep brain stimulation procedure by supplementing it with a nerve graft of patients’ own peripheral nerves," the release says. "The nerves in the brain do not regenerate when they are damaged, but peripheral nerves—nerves outside of the brain and spinal cord—can regenerate." The trial will "aim to use the regenerative capacity of peripheral nerves to allow the brain to heal itself."

The procedure will implant a small piece of a patient's peripheral nerve from just above an ankle. This can be done at the same time as deep brain stimulation, so the patient will get the benefit from both procedures, the release says. The effect of the implant will be tested by simply turning off the deep brain stimulator. The hope is that the peripheral nerve will "stimulate regeneration in the parts of the brain that have been damaged by Parkinson's disease."

So far, five Parkinson’s patients have undergone the combined procedure. The trial calls for six. All five have shown consistent improvement in symptoms and "were able to entirely go off the medication one month later, relying on the deep brain stimulation device to manage their symptoms," the release says. Normally, deep-brain stimulation patients are able to reduce their medication but not eliminate it.

"The patients can have more consistent 'on' times—fewer ups and downs with their symptoms," Van Horne said. "They’re not fluctuating due to meds if they’re just using the stimulation."

The trial has progressed quickly because it uses the patient's own tissue, with no risk of rejection or need for immuno-suppressant drugs, and takes only 30 minutes longer than standard deep brain stimulation.  If successful, this procedure could significantly change the treatment of Parkinson’s disease, the release says, and could have an impact on other neuro-degenerative disorders. To learn more click here.

University of Louisville announces global licensing agreement with Novartis for collaboration to help transplant patients

The University of Louisville's Suzanne Ildstad 

is shown with research coordinator Thomas Mille

The University of Louisville announced Wednesday a research collaboration agreement between one of its researchers, Suzanne Ildstad, representing Regenerex LLC, with Novartis. The agreement will provide access to stem cell technology that could help transplant patients avoid taking anti-rejection medicine for life and may also serve as a platform for treatment of other diseases.

This global licensing agreement between Regenerex and Novartis will significantly enhance the university’s ability to carry out cutting edge research related to the Facilitating Cell, a novel cell discovered by Ildstad, CEO of Regenerex and director of U of L's Institute for Cellular Therapeutics, says a U of L news release.

"Being a transplant recipient is not easy. In order to prevent rejection, current transplant recipients must take multiple pills a day for the rest of their lives. These immunosuppressive medications come with serious side effects with prolonged use including high blood pressure, diabetes, infection, heart disease and cancer, as well as direct damaging effects to the organ transplant," Ildstad said in the release. "This new approach would potentially offer a better quality of life and fewer health risks for transplant recipients."

Ildstad published results of "Facilitating Cell Therapy," which is undergoing Phase II trials, in March 2012 in Science Translational Medicine. The results say the therapy enables five of eight kidney transplant patients to stop taking about a dozen pills a day to suppress their immune systems; this is the first study in which the donor and recipient did not have to be biologically related or immunologically matched.

Ildstad was originally recruited to U of L under the state's "Bucks for Brains" initiative for endowed professorships, advanced in by then-Gov. Paul Patton in 1998. Along with her research team, she began examining the facilitating cell platform technology for the treatment of kidney transplant recipients.

"Dr. Ildstad was among the first faculty members hired utilizing seed funds from the state to help us attract highly talented researchers through the Bucks for Brains program," U of L President Dr. James Ramsey said. "Regenerex demonstrates the potential for that vision to be realized bringing new jobs to the city, adding to the revenue from the Tax Increment Financing district and providing funding to U of L in support of our academic mission," he said.

The collaboration with Novartis provides for investments in research and applications of new technology as well as milestones and royalty payments from Regenerex to the university.

"The 'holy grail' of transplantation is immune tolerance, that is making the body recognize a transplanted organ as 'self' and not reject it as foreign tissue, but without the need for immunosuppressive drugs with their numerous serious side effects," said Dr. David L. Dunn, executive vice president for health affairs at U of L. "Dr. Ildstad and her team may well have solved this puzzle."

Every Kentucky county has a local group working on health issues, foundation finds in compiling Health Coalitions Directory

For the first time, the Foundation for a Healthy Kentucky has documented that every Kentucky county has a local group working on health issues.

All 120 counties are listed in the Kentucky Health Coalitions Directory, which includes 208 groups. Last year’s first-ever directory listed fewer than 150. "Whether they are called health coalitions, collectives, consortia, associations or networks, people are joining forces to work on health-related challenges," the foundation said in a news release. "The groups have differing levels of organization and are pursuing various goals. Some are increasing access to healthy food and physical activity; others are planning needed screenings and education for people at risk for serious health problems like cancer, diabetes and other chronic diseases; yet others are improving working conditions through smoke-free ordinances."

The foundation said it would periodically update the directory. “These are local residents working on solutions to health issues where they live, work and raise their families,” said Susan Zepeda, president and CEO of the foundation. “Their work spans a broad spectrum of issues that contain a common thread: to improve health in the community and our state. These groups represent local health change efforts.”

The directory is designed to raise awareness of local efforts and "foster collaboration, build local capacity, provide technical assistance to these groups and celebrate their successes," the foundation said. State and national coalitions, and international coalitions doing work that affects Kentucky, are included in the directory. To get a PDF of it, visit the foundation's newsroom at www.healthy-ky.org.

Study says loss of smell may help sniff out Alzheimer's disease

A small pilot study of patients displaying signs of cognitive decline found that peanut butter can help identify those with Alzheimer’s disease, which is often accompanied by a loss of smell.

The results indicate that loss in sense of smell may help in diagnosing Alzheimer's. Loss of smell can be detected long before classic clinical symptoms, and it may not only be an early warning sign of Alzheimer's, but it is also an indicator for Parkinson’s disease and some other neurological disorders, writes Richard Doty of the Smell and Taste Center at the University of Pennsylvania’s Perelman School of Medicine.

Alzheimer’s is an irreversible, progressive brain disease that slowly destroys memory and thinking skills, but early diagnosis is usually beneficial. It can tell people whether their symptoms are from Alzheimer’s or another cause, such as stroke, tumor, Parkinson’s or other conditions that may be treatable. In most people with Alzheimer’s, symptoms first appear after age 60, and estimates suggest that as many as 5.1 million Americans may have it, says the National Institute on Aging.

The study of 96 patients was conducted by the McKnight Brain Institute Center for Smell and Taste at the University of Florida. Eighteen of the patients had probable Alzheimer's, 24 had a mild cognitive impairment, 26 had some form of dementia, and the other 26 patients were used as a control group.

The researchers measured the distance from the nose at which patients, whose eyes were closed, could smell a tablespoon of peanut butter one nostril at a time. Early-stage Alzheimer's patients had different smell sensitivity between the right and left nostrils, with the left regularly being more severely impaired. The other patients displayed no such difference in smell sensitivity, says the study, published in the Journal of Neurological Sciences.

“This non-invasive and inexpensive left–right nostril odor detection test appears to be a sensitive and specific test for probable Alzheimer's disease,” graduate student Jennifer Stamp, one of the researchers, told Jef Akst of The Scientist magazine. More research is needed to validate the approach, she added: “We plan to study patients with mild cognitive impairment to see if this test might be used to predict which patients are going to get Alzheimer’s disease.”

Click here to read Doty's “Smell and the Degenerating Brain” for a deeper look at the link between smell and neurodegeneration. Click here for more information about Alzheimer's disease.

Using food labels and other guidance helps you control weight and reduce risk of cardiovascular disease, FDA study finds

Food labels and dietary guidance help consumers make healthier choices and lose weight, according to a study for the U.S. Food and Drug Administration.

The FDA's Joanna Parks used data from the National Health and Nutrition Examination Survey to estimate the effect of labels and guidance on the intake of 18 nutrients. She found that people who used the Nutrition Facts panel on food labels consumed about 120 fewer calories per day, enough to explain at least an 11-pound difference in body weight between them and those who didn't use the information.

Parks also found that using health claims, ingredient lists and serving-size information appears to reduce risk of cardiovascular disease, including high blood pressure, and help weight-control efforts; and using the MyPyramid meal panel decreases the average daily intake of cholesterol.

"Unfortunately," Parks writes, "it appears that many individuals only use these tools and information once they have developed diet-related diseases that necessitate changes in diet and lifestyle." A PDF of her paper can be downloaded here.

UK, with magnet of National Cancer Institute designation, attracts 4 researchers and their $17 million in funding from U of L

"A month after the University of Kentucky announced it is home to the state’s first National Cancer Institute-designated cancer center, an internationally recognized research team studying the role metabolism plays in cancer is leaving the University of Louisville for its chief in-state rival," Laura Ungar reports for The Courier-Journal. "The four researchers . . . will bring with them more than $17 million in federal funding over five years."

UK officials told Ungar they didn't recruit the researchers, and a U of L official said the school made "a significant counter-offer." But one of the researchers told Ungar that UK offered new equipment, new laboratory space and an opportunity to work with a wider group of collaborators.

"One area the scientists have been researching is lung cancer, which strikes and kills Kentuckians at the nation’s highest rate," Ungar writes. "Their work includes a newly funded project from the National Cancer Institute on biochemistry in lung cancer." (Read more)

Markey Cancer Center at UK gets National Cancer Institute designation, opening up new treatment options for patients

The University of Kentucky annouced Friday that its Markey Cancer Center has earned a prestigious National Cancer Institute designation. With this designation, the center becomes one of 68 in the U.S., and the only one in Kentucky, with special access to clinical trials, new treatments and new drugs for patients.

Kentucky ranks first in the nation in cancer deaths per 100,000 residents, and cancer is especially problematic in Appalachia, where the overall cancer rate is 12 percent higher than in the United States.

The designation signifies national excellence in clinical care and cancer research, a UK news release said. It allows Markey patients to join specialized drug or treatment trials that are open only to NCI centers, and it also opens up funding for researchers at UK, said Michael Karpf, UK's executive vice president for health affairs.

"It's the ultimate recognition for academic cancer centers," Markey Executive Director Mark Evers said. It will help UK battle cancers that plague the state, particularly lung and colorectal cancers, Evers said in a story by Linda Blackford of the Lexington Herald-Leader. To earn the designation, the center had to pass a rigorous review that began four years ago and will be renewed every five years, says the UK release.

UK officials said the designation will boost the state and local economy through research funding, and advanced cancer research could also generate more high-tech, health care jobs in the state.  "It strengthens Markey’s reputation as a frontrunner in cancer treatment and research," the UK release said.

Parents should walk the walk, not just talk the talk, when it comes to healthy eating and exercise, study shows

A new study highlights the influential role parents have in shaping their children's eating and exercise habits. Children of mothers who encourage them to exercise and eat well, while doing likewise themselves, are more likely to be active and healthy eaters, says a Duke University study.

Both exercise and healthy diets are critical in fighting childhood obesity, a significant problem in Kentucky, where more than one in four kids aged 2 to 5 are already overweight or obese, says a report by the College of Public Health at the University of Kentucky.

At the same time parents are setting a good example for their children, they can keep themselves healthy; being overweight or obese greatly increases the risk of developing chronic diseases like diabetes, arthritis, heart disease and cancer.

The Duke study is a reminder that parents are influential role models in shaping their children's habits, whether that's good or bad. "It’s hard for parents to change their behaviors, but not only is this important for you and your own health; it is also important for your children because you are a role model for them,” said Marissa Stroo, a co-investigator on the study. “This might be common sense, but now we have some evidence to support this.”

To promote healthy dietary and physical behaviors in children, a healthy home environment and parental role modeling are important, the researchers say. They recommend limiting access to junk foods, providing access to fruits and vegetables at home, setting parental policies to support family meals and increased consumption of healthy foods, and encouraging children to play outside to increase their physical activity.

“Obesity is a complex phenomenon, which is influenced by individual biological factors and behaviors,” said study author Dr. Truls Østbye, professor of community and family medicine at Duke. “But there are variations in obesity from one society to another and from one environment to another, so there is clearly something in the environment that strongly influences the obesity epidemic.”

These findings are important because they show that being overweight doesn't just come from your genes, and parents can be actively involved in improving the health and well-being of Kentucky's children. In this study, Østbye and his colleagues examined the relationship between the home environment and behaviors related to obesity, such as dietary and exercise habits, among 190 preschoolers. The study was published online in the International Journal of Obesity. (Read more)

Study finds that daily use of sunscreen prevents aging of skin

Sunscreen doesn't just prevent sun burns and skin cancer; using it daily can slow down your skin's aging too, says a study published in the Annals of Internal Medicine. 

Australian researchers found that when adults regularly used broad-spectrum sunscreen, they were less likely to show increased wrinkling over a four-and-a-half-year period compared to adults who used sunscreen every once and a while, reports Barbara Mantel of NBC News.

This is the first study showing that sunscreen prevents skin aging, and the results show year-round use of sunscreen significantly slows the aging of skin caused by the sun's ultraviolet rays, Dr. Adele Green of Royal Brisbane Hospital in Queensland told the Gupta Guide.

"Previous research has shown that skin aging is associated with an increased risk of actinic keratoses and melanoma, and now we have the first randomized trial to show that sunscreen retards skin aging," Green said.

The sunscreen used in the study had a SPF of 15, which blocks about 94 percent of ultraviolet B rays. Stronger preparations have only a small additional effect; one with an SPF of 40 filters about 97.5 percent, Green told Mantel.

"The more important issue is applying the sunscreen well and reapplying it often," and you should make sure that sunscreen is broad spectrum, he said. The study also found that daily beta-carotene supplementation had no effect on skin aging.

The study shows that just 15 minutes of sun on any part of your body can age the skin, and it is never too late to start using sunscreen, said Dr. Nancy Snyderman of NBC News. Even in middle age, if you start using sunscreen, you can role back the aging of your skin, she said. Here's NBC's video clip:

Death rates for heart and pneumonia patients at critical-access hospitals are rising nationally, study finds

Death rates are rising at rural critical-access hospitals for Medicare patients who have heart attacks, heart failure and pneumonia, according to a study published in the Journal of the American Medical Association.

Hospitals designated as critical-access get slightly higher Medicsare and Medicaid reimbursements in exchange for limiting their size, procedures and patient stays. In 2002, they had a death rate of 12.8 percent for such ailments, under the 13 percent rate at other hospitals. But from 2002 to 2010, mortality rates at critical-access hospitals increased 0.1 percent each year, to 13.3 percent, while the rates at other hospitals fell 0.2 percent each year, to 11.4 percent.

There are 1,331 hospitals in the critical access program, Jordan Rau reports for USA Today. "Congress started the critical access program in 1997 to stave off hospital closures in places where patients had no good alternative because the next hospital was at least 35 miles away by regular roads or 15 miles by secondary roads. To qualify hospitals need 25 or fewer beds."
 
The authors of the study "suggested that the hospitals' care may suffer because they don't have the latest sophisticated technology or specialists to treat the increasingly elderly and frail rural populations," Rau reports. "Since hospitals are not required to submit performance evaluations to Medicare, the government may not realize that facilities could need additional assistance in caring for sicker patients."

Brock Slabach of the National Rural Health Association told Rau that the statistics don't always tell the complete story and that "The association's own research has found that rural hospitals do better in patient satisfaction surveys than do urban hospitals," Rau writes.

Study suggesting that coal is a cause of health problems in E. Ky. is disputed by industry and politicians, defended by researcher

By Molly Burchett
Kentucky Health News

A heated debate centers on new research showing that residents in Floyd County, where coal is stripped from the tops of mountains and ridges, report more health problems than those in two nearby communities without such mines, Elliott and Rowan.

The study, published in the online Journal of Rural Health, is the latest by Dr. Michael Hendryx of West Virginia University to suggest that residents of mining areas have poorer health conditions and experience more serious illness. It is available to readers of Kentucky Health News by clicking here.

Unlike some of his West Virginia research, Hendryx does not say there is a correlation between mining and poorer health outcomes in Eastern Kentucky. He does suggest the possibility of a connection by showing residents' self-reported health problems like asthma, chronic obstructive pulmonary disorder and hypertension are more common in mining areas. And in an interview, he said he believes there is a connection.

Stonecrest Golf Course at Prestonsburg in Floyd County,
built on a reclaimed mountaintop-removal coal mine.

The study and its critics highlight the challenges and pitfalls of discussing and reporting such research. The study's underlying motives and methodology are contested. The president of the Kentucky Coal Association, Bill Bissett, said Hendryx has reached a conclusion and is seeking evidence to support it.

"Bissett's accusation is completely false," Hendryx replied. "On the contrary, he is obviously the one with the biased perspective and has a strong financial motivation to try to discredit this work."

Bissett questions the study's use of self-reported health measures that did not consider medical history. Self-reporting is susceptible to bias, which can be reduced by using other sources of data/. This study only included data collected from interviews conducted by volunteers, which may have introduced more bias, Bissett said.

Hendryx replied, "We used undergraduate students from Christian colleges who were trained to be fair and objective in the survey procedures, and to use the same procedures in both the mining and non-mining communities." He said Peter Illyn, who runs the Christian organization Restoring Eden, approached him to do the survey because Illyn "wanted to give the students this experience, and he wanted to replicate the survey that we had done the previous year in West Virginia, this time in Kentucky."

The volunteers interviewed 544 participants lived in Floyd County and 351 in Rowan and Elliot counties, where coal is not mined. It used standard statistical devices to control for factors that might influence health status: age, sex, education, marital status, work as a coal miner, weight and tobacco habits. However, there was no consideration of health behaviors such as drug and alcohol use, wellness measures, exercise or other healthy lifestyle habits that could have positive influences.

"The survey had to be brief with the time and resources we had," said Hendryx. "We did measure overweight and obesity, which is a reflection of diet and exercise. We measured tobacco use. We did not measure alcohol use in this survey but in other studies we have found that heavy alcohol use is not common and is not an explanation for the findings."

Kentucky House Speaker Greg Stumbo, who is from Floyd County, said he disagreed with the use of Rowan County, home of Morehead State University, as a control group due to the higher rates of education attainment and per capita income, reported Ronnie Ellis of Community Newspaper Holdings Inc.

Stumbo told Ellis, “Everybody in the world knows that you can take a population that is less well educated and that has a lower per capita income and you’ll see their health habits are (worse) and hence their rates of diseases are attributable to those two things.” Rowan has a much better health status than surrounding counties, according to the latest national County Health Rankings.

Hendryx defended his research controls and the process of relying on self-reported medical histories. He said the health problems may be caused by tiny particles of dust from coal mining, which have been linked to health problems, can penetrate the lungs to cause health impacts, reported James Bruggers of The Courier-Journal. Hendryx said there are also concerns about polluted water and soil.

The study's data only hint at a connection between surface coal mining and poor health. Hendryx said he can’t prove that mountaintop removal is causing people to get sick, but he believes it is. What is needed, he told Bruggers, is a more thorough and expensive “gold standard” study of air and water quality near residences, and samples of blood, hair and toenails that can reveal exposure to pollutants.

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Common beliefs about obesity and weight loss found to be myths

Think going to gym class drives weight loss, or that breastfeeding protects a child from obesity? Think again, because these are among seven popular myths about obesity myths, according to an international team of researchers.

The seven popular but largely inaccurate beliefs, which lead to poor policy decisions, inaccurate public-health recommendations and wasted resources, were identified by the team led by David Allison, associate dean for science in the School of Public Health at the University of Alabama at Birmingham.

Here are the seven myths:

• Myth 1: Small, sustained changes in how many calories we take in or burn will accumulate to produce large weight changes over the long term.
Fact: Small changes in calorie intake or expenditure do not accumulate indefinitely. Changes in body mass eventually cancel out the change in calorie intake or burning.

• Myth 2: Setting realistic goals in obesity treatment is important. Otherwise, patients become frustrated and lose less weight.
Fact: Some data suggest that people do better with more ambitious goals.

• Myth 3: Gradually losing weight is better than quickly losing pounds. Quick weight losses are more likely to be regained.
Fact: People who lose more weight rapidly are more likely to weigh less, even after several years.

• Myth 4: Patients who feel “ready” to lose weight are more likely to make the required lifestyle changes, do health-care professionals need to measure each patient’s diet readiness.
Fact: Among those who seek weight-loss treatment, evidence suggests that assessing readiness neither predicts weight loss nor helps to make it happen.

• Myth 5: Physical-education classes, in their current form, play an important role in reducing and preventing childhood obesity.
Fact: Physical education, as typically provided, does not appear to counter obesity.

• Myth 6: Breastfeeding protects children against future obesity.
Fact: Breastfeeding has many benefits for mother and child, but the data do not show that it protects against obesity.

• Myth 7: One episode of sex can burn up to 300 Kcals per person.
Fact: It may be closer to one-twentieth of that on average, and not much more than sitting on the couch.

The research team also defined six “presumptions" that are generally held to be true even though more studies are needed before conclusions can be drawn, such as the idea that regularly eating versus skipping breakfast contributes to weight loss. Studies show it has no effect.

The same goes for the idea that eating vegetables by itself brings about weight loss, or that snacking packs on the pounds. According to Allison and colleagues, these hypotheses have not been shown to be true, and some data suggest they may be false.

The researchers also identified nine research-proven facts about weight loss. For example, weight-loss programs for overweight children that involve parents and the child’s home achieve better results than programs that take place solely in schools or other settings.

Also, many studies show that while genetic factors play a large role in obesity, “Heritability is not destiny.” Realistic changes to lifestyle and environment can, on average, bring about as much weight loss as treatment with the most effective weight-loss drugs on the market. (Read more)

Poor, rural mothers-to-be have high levels of stress, and few resources to help them handle it, small-scale study concludes

Low-income pregnant women in rural areas experience high levels of stress, but lack the appropriate means to manage their emotional well-being, according to a small-scale study at the University of Missouri. The authors suggest that rural doctors should link these women with resources to help manage stress, Medical Xpress reports.

"Many people think of rural life as being idyllic and peaceful, but in truth, there are a lot of health disparities for residents of rural communities," Mizzou nursing professor Tina Bloom told Medical Xpress. "Chronic, long-term stress is hard on pregnant women's health and on their babies' health. Stress is associated with increased risks for adverse health outcomes, such as low birth weights or pre-terms deliveries, and those outcomes can kill babies."

Researchers studied about 25 rural pregnant women. Through interviews, researchers discovered that financial problems were one of the biggest stressers for them. Financial stress was exacerbated by the women's lack of employment, reliable transportation and affordable housing. The women also said that small-town gossip, isolation and interdependence of their lives with extended family members also increased stress. Almost two out of three women showed symptoms of depression, and one in four displayed symptoms of post-traumatic stress disorder. (Read more)

Poll shows depth of prescription drug abuse in Kentucky

By Molly Burchett and Al Cross
Kentucky Health News

One-third of Kentucky adults have friends or relatives who have experienced problems from abusing prescription pain relievers, and 8 percent have used pain medicine when it wasn't prescribed or for the feeling it caused, according to a statewide poll conducted last fall.

The Kentucky Health Issues Poll found that in Eastern Kentucky, 45 percent reported that prescription drug abuse have caused problems for friends or family members. In the 17-county Bluegrass Area Development District, which includes some Appalachian counties, the figure was 37 percent. It was 32 percent in Northern Kentucky, 31 percent in the seven-county Louisville area and 25 percent in Western Kentucky.

The poll found that young adults are more likely to have the problem. Among those 18 to 29 years old, 13 percent said they had used pain medicine when it wasn't prescribed or for the feeling it caused, and 49 percent said they had a friend or relative who had been affected.

The Foundation for a Healthy Kentucky, which co-sponsored the poll, noted that drug-overdose deaths in Kentucky correspond to a steep increase in the sales of opioid prescription pain relievers, which include OxyContin, Vicodin, Percocet and codeine. More than half of Kentucky adults in the poll reported being prescribed such drugs.

“While these types of medications are important for controlling pain in patients who need them, opioids also carry the potential for abuse,” said Dr. Susan Zepeda, President and CEO of the foundation. “Our state ranks sixth in the nation for prescription pain reliever overdose deaths, and these data provide a window on how many Kentuckians are impacted – directly or indirectly – by prescription misuse.” (Read more)

The poll was conducted for the foundation and The Health Foundation of Greater Cincinnati from Sept. 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults throughout Kentucky was interviewed by landline and cell telephones. The poll's margin of error is plus or minus 2.5 percentage points.

Kentucky Health News is an independent service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Health Kentucky.

Childhood obesity is linked to more immediate health problems than doctors formerly realized

While a plethora of research on childhood obesity has linked it to long-term health problems, a new UCLA study focuses on the condition's more proximate consequences, showing that obese children are at a greater risk for immediate health problems than previously thought. That's important for Kentucky, which ranks poorly in many health measures and is third highest in child obesity. (Photo by Tara Kaprowy)

"This study paints a comprehensive picture of childhood obesity, and we were surprised to see just how many conditions were associated with childhood obesity," said lead author Dr. Neal Halfon, a professor of pediatrics, public health and public policy at UCLA.

Compared to kids who are not overweight, the study found that obese children have nearly twice the risk of having three or more reported medical, mental or developmental conditions. Specific medical conditions included bone, joint and muscle problems; asthma; allergies; headaches; and ear infections. Obese children also reported a greater tendency toward emotional and behavioral problems, higher rates of grade repetition, missed school days and other school problems, ADHD, conduct disorder, depression, learning disabilities, and developmental delays.

The study provides the first comprehensive national profile of associations between weight status and a broad set of associated health conditions, a UCLA release said. Halfon said these findings should serve as a wake-up call to physicians, parents and teachers, who should be better informed of the risk for health conditions associated with childhood obesity. (Read more)

Report: Electronic health records haven't cut health costs

The conversion to electronic health records isn't producing savings in health-care costs predicted by a 2005 report, and it's had mixed results in improving efficiency and patient care, according to a RAND Corporation report. The company's 2005 predictions helped drive growth in the EHR industry and encourage billions of dollars in subsidies from the federal government to hospitals and doctors to implement such systems, Reed Abelson and Julie Creswell of The New York Times report.

The 2005 report predicted that widespread use of EHRs could save the U.S. health care system at least $81 billion a year. "But evidence of significant savings is scant, and there is increasing concern that electronic records have actually added to costs by making it easier to bill more for some services," Abelson and Creswell write. Health care costs have risen $800 billion since the 2005 report, according to federal data.

Authors of the new report, published in this month's issue of Health Affairs, said they didn't attach dollar amounts to how much electronic record keeping has helped or hurt efforts to reduce costs. "But the firm's acknowledgement that its earlier analysis was overly optimistic adds to a chorus of concern about the cost of the new systems and the haste with which they have been adopted," Abelson and Creswell report.

There are several factors why the switch has not created significant savings, report authors said. Those factors include use of commercial record systems, slow rates of system adoption, and the fact that electronic records "do not address the fact that doctors and hospitals reap the benefits of high volumes of care," Abelson and Creswell report. (Read more)

Painkiller epidemic was driven in part by drug makers' financial relationships with researchers who discounted the risks

For almost a decade, medical officials and experts claimed OxyContin rarely posed problems of addiction for patients. The drug's label, which was approved by the Food and Drug Administration, said addiction risks were small. Research published in the New England Journal of Medicine also said OxyContin wasn't addictive; so did a study in another journal, which OxyContin manufacturer Purdue Pharma reprinted 10,000 times. Since the drug first hit the market, it has fueled a large-scale swath of prescription pain killer addiction, beginning in Central Appalachia, that has grown into a national epidemic, especially in rural areas.

The epidemic was driven in no small part by doctors' lack of knowledge about OxyContin, which was perpetuated by the drug's manufacturer through false claims that became scientific consensus. But now, "Many in the medical profession have rediscovered the destructive power of opiates," and are calling that consensus into question, Peter Whoriskey of The Washington Post reports. "A closer look at the opioid painkiller binge, in which retail prescriptions have roughly tripled in the past 20 years, shows that the rising sales and addictions were catalyzed by a massive effort by pharmaceutical companies to shape medical opinion and practice."

Doctors were wary of prescribing painkillers to any patient except those with cancer for years. But manufacturers and some pain specialists "helped create a body of scientific research assuaging the long-standing worries about opioids and pushed to expand the use of the drugs in people with chronic pain: bad backs, arthritis, sore knees," Whoriskey reports.

Through an examination of key scientific papers, court documents and FDA records, the Post found that many of the studies claiming OxyContin wasn't addictive were supported by Purdue Pharma. The conclusions those studies reached were sometimes not supported by data, and when the FDA needed to develop an opioid policy, it turned to a panel of doctors who had financial relationships with Purdue Pharma and other drug makers. (Read more)

Deaths from drug overdoses in Kentucky hit new high in 2010; more than half involved prescription drugs

Deaths from drug overdoses in Kentucky jumped to a new high in 2010, and "rose a staggering 296 percent from 2000 to 2010," Bill Estep of the Lexington Herald-Leader reports. "A tidal wave of prescription-drug abuse drove the steep increase," with just over half of the deaths involving prescription drugs, according to a study by researchers at the University of Kentucky.

As usual, the problem is worst in Appalachian Kentucky, as illustrated by this Herald-Leader map:

"The increase in deaths might have been even greater because information was not available for Kentucky residents treated in neighboring states, and because some death certificates might not have listed an overdose as the cause of a person's death when in fact it was," Estep reports. "The report did not measure the impact of changes Kentucky lawmakers made this year aimed at confronting the prescription-drug problem, though it will provide a way to help measure the impact of the law."

Read more here: http://www.kentucky.com/2012/12/20/2451315/drug-overdose-deaths-up-296-percent.html#storylink=cpy

Read more here: http://www.kentucky.com/2012/12/20/2451315/drug-overdose-deaths-up-296-percent.html#storylink=cpy

Read more here: http://www.kentucky.com/2012/12/20/2451315/drug-overdose-deaths-up-296-percent.html#storylink=cpy