Tag Archives: boston

Newer whooping cough vaccine not as protective

A newer version of the whooping cough vaccine doesn't protect kids as well as the original, which was phased out in the 1990s because of safety concerns, according to a new study. During a 2010-2011 outbreak of whooping cough in California, researchers found that youth who had been vaccinated with the newer, so called acellular vaccine were six times more likely to catch whooping cough than those who had received a series of the older whole-cell vaccine. “This is an ongoing saga,” said Dr. H. Cody Meissner, a pediatric infectious diseases specialist from Tufts University School of Medicine in Boston. The rate of whooping cough, or pertussis, has been climbing in recent years, he said - to the point where “we're worried about losing control of pertussis in the United States.” The pertussis vaccine is given in combination with vaccines for diphtheria and tetanus. Originally the shot contained whole pertussis bacteria, which triggered reactions in some babies - including prolonged crying, fever and a “shock-like state,” said Meissner, who wasn't involved in the new research. So in the 1990s, the U.S. switched over to an acellular version of the vaccine, which has reduced the rate of side effects. “But the price we've paid to get more safety is that we have less effectiveness,” Meissner told Reuters Health. “It doesn't protect as well against pertussis.” The U.S. Centers for Disease Control and Prevention recommends four doses of the diphtheria, tetanus and pertussis vaccine (DTaP) be given to babies between two and 18 months, and a fifth dose by age six. A booster was recently added to the vaccine schedule for 11- to 12-year-olds. For the new study, researchers from the Kaiser Permanente Northern California health system compared the vaccination history of 138 teenagers and preteens who tested positive for whooping cough and about 55,000 who did not during the state's 2010-2011 outbreak. Over the course of the outbreak, 78 out of every 100,000 adolescents were infected per year. Almost all of the kids had received the newer acellular vaccine as their fifth DTaP dose. But Dr. Nicola Klein and her colleagues found that teens who'd been vaccinated with the acellular version for each of their first four doses as well were six times more likely to contract whooping cough than those who'd received four doses of the whole-cell vaccine. Each extra acellular rather than whole-cell dose increased a child's risk of later developing whooping cough by about 40 percent, the researchers reported Monday in Pediatrics. Klein said there seem to be some differences in the initial immune response to the whole-cell vaccine versus the acellular vaccine, which may persist as children get older. Her team's study, she said, suggests there needs to be more of a focus on developing a third pertussis vaccine. But any new shot for whooping cough that could address both safety and effectiveness concerns is still years away, Meissner said. “So now we're confronted with this difficult problem,” he said. “It's very hard to recommend a vaccine that is known to be associated with more side effects than another vaccine that's safer, even though the first vaccine gives better protection. It's a dilemma.” The findings do not mean parents shouldn't get their children fully vaccinated against pertussis, the researchers agreed. “In the short run, we have to keep vaccinating kids on the recommended schedule because that's definitely the best way to protect kids,” Klein told Reuters Health. “The acellular vaccine does work, it just doesn't last as long as we hoped,” she said. “It's the best tool we have right now to protect against pertussis.”source : http://www.foxnews.com/health/2013/05/20/newer-whooping-cough-vaccine-not-as-protective/

Hysterectomy not tied to heart risk factors, study shows

Despite evidence suggesting that women whose uterus has been removed may be more likely to experience heart troubles, a new study finds that the usual signs of heart disease risk are not more severe in middle-aged women after hysterectomy. After following more than 3,000 women for about 11 years, researchers found that heart risk factors like cholesterol, markers of inflammation and blood pressure were not significantly worse in women in the years following an elective hysterectomy, compared to women who did not have the procedure. “I think it's encouraging to women and clinicians that this is not something they have to worry about if they're considering hysterectomy (in) midlife,” said Karen Matthews, the study's lead author from the University of Pittsburgh. Hysterectomy, the surgical removal of the uterus, is the second most common surgery among U.S. women, after cesarean-section deliveries. Often the procedure is used to remove or prevent cancer, especially among younger women. But many women may elect to have the surgery for other reasons, including to treat painful benign growths in the uterine wall known as fibroids or to staunch heavy bleeding. Hysterectomies can involve removal of the uterus only, or the ovaries as well. Ovary removal in particular has been linked to increased cardiovascular risk because it takes away the main source of estrogen in a woman's body and plunges her abruptly into menopause. Even the gradual decline of estrogen following natural menopause has been linked to women's increased heart risks, so researchers have investigated whether hysterectomy raises those risks. But studies of the connection have produced mixed results. For the new study, Matthews and her colleagues used data from the Study of Women's Health Across the Nation, which followed a large, multiethnic group for more than a decade to understand the experience of American women during and after menopause. The 1,952 women included in the study were between 42 and 52 years old and not yet in menopause when tracking began. They were followed from 1996 through 2008, receiving annual checkups that recorded information about their health, surgeries and whether or not they had started menopause. Specifically, the researchers looked at physical measurements that are markers for heart and cardiovascular disease. They included various components of cholesterol, blood pressure, blood clotting factors and molecules that are signals of inflammation. Overall, the researchers report in the Journal of the American College of Cardiology that none of those measurements in the 183 women who chose to have their uterus removed - with or without their ovaries - were significantly worse, compared to the 1,769 women who went through menopause naturally. Matthews said their findings apply to women who are finished having children, in their forties and are considering a hysterectomy to help with excessive bleeding or other factors that cause a quality of life problem. She said they couldn't make a conclusion for women who need to have their uterus and ovaries removed because of cancer. “Our study really couldn't examine that question because we had too few women who had gynecological cancers, and the equation changes when you have gynecological cancer,” said Matthews. But Dr. JoAnn Manson, who has researched women's health after hysterectomy but was not involved in the new study, suggested the results don't mean that women who have hysterectomies are in the clear, because past studies only saw a difference in heart risks after 10 to 15 years. Manson, who is chief of preventive medicine at Brigham and Women's Hospital in Boston, told Reuters Health that the abrupt transition to menopause after a hysterectomy may only reverberate years later because “atherosclerosis takes a while to develop… That seems to take up to 10 and 15 years for clear differences to emerge.” For that reason, “This isn't totally surprising that there wasn't a difference in risk factors during the follow up period,” Manson said. Matthews said that's one potential explanation for why their results differ from previous studies, but she said there could be other reasons, including that modern women are somehow different from women included in past research. “It may be that it's emerging much later, but I would be surprised,” Matthews said.source : http://www.foxnews.com/health/2013/05/15/hysterectomy-not-tied-to-heart-risk-factors-study-shows/

Small restaurants serving big calories, salt, studies find

Despite public health progress in cutting calories, as well as salt and fat from fast foods and supermarket products, neighborhood restaurants are still packing big helpings of each into their meals, a trio of studies suggests. Small independent eateries are not required to display nutritional information for consumers - if they did, the researchers report, patrons would routinely see single meals containing nearly a full day's worth of calories and fat plus one and half times the daily recommended intake for salt. “It's really a disgrace. Every day the newspapers say things about the obesity epidemic… To a large extent, you can trace that to too many calories,” said Susan Roberts, director of the U.S. Department of Agriculture Energy Metabolism Lab and professor of nutrition at Tufts University, in Boston. About two thirds of Americans are considered overweight or obese, according to the U.S. National Institutes of Health. And as American waistlines continue to expand, public health policy has focused on the quality of food available in supermarkets and restaurants. President Barack Obama's 2010 Affordable Care Act, for example, contains a requirement that restaurants with at least 20 outlets in the U.S. make their nutritional information available to customers. But one of three new studies published in JAMA Internal Medicine on Monday points out that policy only applies to about half of the nation's restaurants. The other half is made up of smaller chains or independent restaurants exempt from the requirement. For their analysis, Roberts and her colleagues measured the calories in 157 meals at small Mexican, American, Chinese, Italian, Japanese and Thai restaurants in and near Boston between June and August 2011. Overall, the researchers found the average meal at those restaurants contained 1,327 calories. That's about 66 percent of the 2,000 daily calories recommended by the U.S. Food and Drug Administration. About 8 percent of the meals exceeded 2,000 calories. The meals from small restaurants also contained up to 18 percent more calories than comparable dishes from larger chains - suggesting the requirement to display nutritional information is keeping the large-chain restaurant meals healthier, according to the researchers. In another of the studies published Monday, Canadian researchers led by Mary Scourboutakos from the University of Toronto found similarly high calorie counts in more than 3,500 meals from Ontario restaurants they analyzed. What's more, Scourboutakos and her fellow researchers found that individual meals contained an average of 89 percent of the daily recommended amount of fat and 151 percent of the daily recommended amount of salt. A third study also zeroed-in on salt as a major area of concern. Several organizations, including the U.S. Department of Agriculture, the Department of Health and Human Services, the American Medical Association, the American Heart Association and the World Health Organization have all called for reductions in the amount of sodium people consume. The Institute of Medicine recommends that most healthy people get 1,500 milligrams (mg) of sodium per day, with an upper limit of 2,300 mg. But the average American eats closer to 3,600 mg each day, largely in processed foods. For their new study, Dr. Stephen Havas of the Northwestern University Feinberg School of Medicine in Chicago and his colleagues analyzed 402 processed foods and 78 fast-food products to see if their salt content had changed between 2005 and 2011. They found a small decrease in the amount of salt in processed foods over that period but also a similarly-sized increase in the amount of salt in fast-food products. The differences in each category, however, were small enough that they could have been due to chance. Havas said the results show that the calls for voluntary reductions in salt have been a “total failure.” “The only thing that will solve this problem is for the amount of salt in our food to be regulated,” he added. But regulating food and what goes into it has been a controversial topic, according to Dr. Mitchell Katz, from the Los Angeles County Department of Health Services in California. Instead, he suggests in a commentary accompanying the three studies that doctors should advocate for their patients' right to know what they're eating. “As we debate the controversial role of government in stemming the interrelated endemics of obesity, diabetes mellitus, and heart disease, we must insist on the right of our patients (as well as ourselves) to know what we are eating, whether fast food or slow, whether large chain, small chain, or individual restaurant,” he wrote. One encouraging finding from the study of Toronto restaurant meals highlighted by Scourboutakos and her colleagues is that entrees identified on the restaurant menus as “healthy” were generally at least healthier - with about 474 calories, 20 percent of the day's value of fat and 50 percent of the recommended daily intake of sodium. Roberts told Reuters Health she'd like to see restaurants add a few healthy choice options to their menu to at least give people an alternative. “That would mean the restaurant doesn't have to calculate the whole menu and that would give people choices,” she said.source : http://www.foxnews.com/health/2013/05/14/small-restaurants-serving-big-calories-salt-studies-find/

Gene offers clues to new treatments for a harmful blood clotting disorder

The research, which was led by Yanming Wang, a Penn State University associate professor of biochemistry and molecular biology, and Denisa Wagner, senior author with decades of research on thrombosis at the Boston Children’s Hospital and the Harvard University Medical School, will be published in in the Online Early Edition of the journal Proceedings of the National Academy of Sciences during the week ending 10 May 2013. The team’s new findings are an extension of previous research by Wang and other scientists. In earlier studies, Wang and his colleagues had revealed that a gene in mice called Pad4 (peptidylarginine deiminase 4) produces an enzyme that plays an important role in protecting the body from infection. The researchers discovered that cells with a functioning PAD4 enzyme are able to build around themselves a protective, bacteria-killing web that is dubbed a NET (neutrophil extracellular trap)…