Caryl Schivley says her son, Brenton, was always very careful about what he ate — until last September 1, when he was at a friend’s house and took a cookie from a bowl on the kitchen table. “He took a bite of the cookie and he said to his friend, ‘I shouldn’t have eaten that,’” said his mother. Severely allergic to peanuts, the 16-year-old from western Massachusetts made the dire mistake of not asking about the ingredients. Within minutes he developed a severe allergic reaction to the cookie, which contained peanuts. Within an hour, he was dead. ”He should have asked [about the ingredients] but he didn’t,” Caryl Schivley said. A new study published in the Journal of Allergy and Clinical Immunology suggests Brenton’s case may not be unique. Researchers analyzed 31 allergy deaths, finding most who died from food-related reactions were teenagers or young adults and were away from home when they ate the item that killed them. (Interactive: Living with food allergies) “We were surprised that so few people had gotten correct information about ingredients in restaurant settings, which accounted for about half of these fatal reactions,” said study author Anne Muñoz-Furlong, founder and CEO of the Food Allergy and Anaphylaxis Network, a nonprofit advocacy and education group. Read the full story

Zimbabwe’s health system, once the envy of many African nations, is “in a state of collapse” — with many hospitals either completely shut down or unable to admit new patients, a leading doctors’ group said Thursday.

Doctors and nurses in Harare protest at the state of Zimbabwe's collapsing health system.

Doctors and nurses in Harare protest at the state of Zimbabwe’s collapsing health system.

The failure of medical services has forced doctors to turn away pregnant women and the sick. And with a cholera epidemic sweeping through the capital city of Harare and surrounding areas, medical officials say they fear they will be faced with hundreds of normally preventable deaths in the coming days.

The four main hospitals in Harare have stopped admitting patients because of a medicine shortage, said the Zimbabwe Association of Doctors for Human Rights. Another hospital in the second largest city of Bulawayo — 439 km (272 miles) from Harare — is facing a similar shortage.

“Sick people in need of attention are being turned away,” the group said.

In many hospitals, maternity services have been scaled back — meaning women who need to deliver babies by Caesarian section “will needlessly die during childbirth,” it said.

The hospitals, like everything else in the country, are a victim of the country’s collapsing economy under President Robert Mugabe, the group said.

With the political crisis showing no signs of abating, the country’s inflation rate has skyrocketed to the world’s highest: 230 million percent. Independent analysts put the figure in billions.

Doctors and nurses are reluctant to come to work because of the poor pay and poor equipment. Those who can are leaving Zimbabwe for neighboring countries or to Europe and Australia, the group said.

The group held Mugabe’s government responsible for the cholera epidemic that broke out early last month in the capital city and has since spread to other parts of the country.

The government has not been able to dispose of sewage properly, nor has it been able to provide chemicals to treat water to make it potable, the group said.

Research increasingly supports the notion that emotional, mental and physical health are very closely linked and that psychological therapy can improve a person’s overall health by effectively decreasing depression, anxiety and related symptoms, such as pain, fatigue and nausea. It can also have a positive effect on the body’s immune system. Nine out of 10 Americans surveyed by Consumer Reports said that psychological counseling helped them. Counseling is used in many situations including smoking cessation, weight management, pain management, and coping with a chronic illness. Counseling has been found to increase survival time for heart surgery patients, and a new study shows that may hold true for breast cancer patients as well. 

Dr. Barbara L. Andersen and colleagues at the Ohio State University followed 227 breast cancer patients for an average of 11 years. At the start of the study, all had undergone breast surgery, but the cancer had not spread. All patients received their usual medical treatment, but half were also randomly assigned to psychological intervention groups. Led by a psychologist, the 26 sessions were held over the course of a year and included relaxation techniques, advice on how to avoid becoming too tired and how to approach family and friends for support. The sessions also included some diet and exercise advice and information on how to cope with the side effects of cancer treatment.

Overall, by the end of the follow-up period, cancer had recurred in 62 of the 212 women for whom data was available and 54 of the total group had died. Patients receiving counseling had about half, 55 percent, the risk of recurrence compared with the control group. Those who did suffer a recurrence had been cancer-free for an average of six months longer than the patients in the control group, a 45 percent risk reduction. And among the 54 women who died, those who took part in the counseling sessions lived longer than the others. The study also found patients receiving counseling had less than half the risk, 44 percent, of death from breast cancer compared to those who did not receive the intervention, as well as a reduced risk of death from all causes, not just cancer. “Many of the strategies patients learned in the intervention program, such as stress reduction, may have protected them from heart disease and other causes of death,” Dr. Andersen said.

In a follow-up analysis, the researchers excluded people who were put in the intervention group, but who attended fewer that 20 percent of the sessions (16 of 114 participants fit this requirement). When the infrequent attendees were excluded, the remainder had a 68 percent reduced risk of breast cancer death, compared to the 55 percent risk reduction for the whole participant group.

Cancer patients undergo a great deal of stress before, during and after treatment. The researchers theorize that psychological interventions may affect immune system changes that are secondary to stress hormones and that may promote cancer growth or metastasis. They recommend that, in addition to powerful antitumor medications, cancer patients should be treated for psychological distress as well. “If efficacious psychological interventions to reduce stress are delivered early, they will improve mental health, health and treatment-relevant behaviors, and potentially, biologic outcomes,” the authors wrote. “If so there is the possibility for improved survivorship and survival for cancer patients.”

However, other experts are wary. Dr. Michael Stefanek, of the American Cancer Society, said other studies had come to the opposite conclusion. “Psychological interventions have been found in the majority of well-controlled studies to enhance quality of life and reduce distress. It would not be reasonable for patients to participate in psychological interventions with the goal of extending survival,” he said in a statement. “We should not conclude that psychological interventions increase survival among women with early stage breast cancer,” he added.

There are many approaches to outpatient psychological counseling and various ways for it to take place, including individual, group or family sessions. But regardless of where it takes place, sessions that concentrate on mood improvement, effective coping and health behavioral changes appear to reduce stress and help breast cancer patients live longer. “The results suggest that we can help breast cancer patients make positive steps that may help them live longer and make recurrence less likely,” Dr. Andersen said in a prepared statement. “We already knew a psychological intervention program could help breast cancer patients to handle their stress, function more effectively, and improve their health. Now we know it does even more.”

The study will be published in the December 15 issue of the journal Cancer, and is currently available to subscribers online.

The drug known as Alemtuzumab, the first monoclonal antibody made for use in humans, may offer new hope in treating early Multiple Sclerosis (MS), even though it was developed and approved for the treatment of chronic lymphocytic leukemia. Alemtuzumab works by seeking out and destroying certain immune cells that, when functioning normally, protect against infection. Since is believed that MS as well as other autoimmune diseases damage these cells, the result is the destruction of healthy tissue.

Initially, Cambridge University scientists tried treating patients suffering from advanced multiple sclerosis with Alemtuzumab, but they had little success. However, patients suffering from early relapsing-remitting MS who were treated with Alemtuzumab experienced significantly fewer relapses as well as a reduced the number of episodes of fatigue and physical impairments that indicate progression of the disease when compared with those patients treated with the currently approved treatment known as interferon beta-1a.

Surprisingly, three years after entry into the study, some patients who received the experimental drug suffered from less disabilities associated with MS than they were experiencing prior to the beginning of the study. This finding offers hope that the treatment may play a role in stopping the progression of the disease and preventing victims from ever reaching its crippling late stages. According to study co-author Alasdair Coles, Ph.D., “The ability of an MS drug to promote brain repair is unprecedented.” He went on to explain, “We are witnessing a drug which, if given early enough, might effectively stop the advancement of the disease and also restore lost function by promoting repair of the damaged brain tissue.”

The success of Alemtuzumab in fighting against MS does not come with out risks. Almost one in four of the patients treated with Alemtuzumab developed thyroid complications, and the disabilities of some patients worsened. In addition, 3 percent of the patients treated with the drug developed a potentially life-threatening autoimmune condition, resulting in the loss of one of the patient’s lives.

According to Genzyme Medical Director Susan Moran, M.D., the patient who passed away during the study died from an autoimmune-mediated blood condition known as idiopathic thrombocytopenic purpura (ITP). Moran said the death could have been avoided if the condition had been recognized as an adverse effect of the treatment. She stated, “Unfortunately, the patient had symptoms of ITP but did not seek medical attention prior to diagnosis because this was not recognized as an adverse event.” The five additional cases were identified and managed with treatment due to close monitoring of study patients once the risk was known.

Coles said that Phase III trials will soon begin and will determine if the benefits of Alemtuzumab outweigh the risks for MS patients. Eighty-five percent of people who are first diagnosed with MS suffer from relapsing-remitting MS according to the National MS Society. Coles noted, “The Phase II results are very exciting, but this is not ready for routine use.” He also acknowledged, “We need to know more about the long-term effectiveness and adverse effects. That is our challenge over the next few years.”

MS has no cure and affects about 400,000 people in the United States as well as almost 100,000 in Britain and millions around the world. The disease is caused by the body’s immune system attacking nerve fibers in the central nervous system. Few effective treatments exist for MS. Symptoms of the disease may include depression, fatigue, cognitive problems and loss of sight and mobility.

Advances in medical science now allow limbs to be reattached, organs to be replaced, and babies to be born to women with fertility issues who had previously been unable to conceive. These advances prolong and provide life, but at times there is a cost to these medical miracles. One such cost is that infants conceived through the use of assisted reproductive technology (ART) are at two to four times greater risk of being born with certain birth defects when compared to babies who are conceived naturally.

According to a report from U.S. Centers for Disease Control and Prevention (CDC), children conceived through ART have a greater likelihood of having heart wall defects, gastrointestinal defects and a condition known as cleft lip.  ART refers to any procedure involving the surgical removal of eggs from a woman’s womb followed by combining the eggs with sperm in a lab, and then returning them to the woman’s body or donating them to another woman.

The study centered on in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) and the effects were observed solely in single births. This could be due the fact that high risks for birth defects are already associated with multiple births, according to the researchers led by Jennita Reefhuis, Ph.D., of the CDC’s National Center on Birth Defects and Developmental Disabilities. The findings of the CDC study were recently published in the advance online edition of Human Reproduction.

The use of ART is becoming more and more common. In a news release, Reefhuis stated, “Today, more than 1% of infants are conceived through ART and this number may continue to increase.” Reefhuis noted that the chances of birth defects for babies conceived through the use of ART are low yet “it is still important for parents who are considering using ART to think about all of the potential risks and benefits of this technology.” The CDC is not making any recommendations about the use of ART.

According to the CDC, the use of ART in the United States began in 1981 and the number of infants conceived through ART doubled from 1996 through 2004. About 12 percent of U.S. women between the ages of 15 and 44 reported using infertility services in 2002. In 2005, over 134,000 ART procedures were performed in the United States that resulted in about 52,000 births.

During the study, the researchers evaluated data from the mothers of babies born on or after Oct. 1, 1997, and on or before Dec. 31, 2003. About 13,500 of the babies were born with birth defects and just over 5,000 of the babies were born without birth defects. Mothers of the infants were interviewed by telephone between six months and two years after the date of delivery. The infants were born throughout 10 states including Arkansas, California, Georgia, Iowa, Massachusetts, New Jersey, New York, North Carolina, Utah, and Texas.

Of the babies who were conceived through ART, 2.4 percent had birth defects while only about 1percent had no birth defects, according to interviews with the mothers. Among the ART babies, Septal heart defects were found to be twice as common, Cleft lip and/or cleft palate was found to be 2.4 times as common, Esophageal atresia (birth defect of the esophagus) was found to be 4.5 times more common and Anorectal atresia (birth defect in the anal/rectal area) was 3.7 times more common than in normally conceived children.

It must be noted that the study does not prove that ART actually causes the birth defects. The authors of the study report acknowledged this by stating, “Sub-fertile women might have a higher risk of having a child with a birth defect regardless of whether infertility treatments are used.” Additional research will be necessary to determine whether or not ART has an impact on birth defect risk.

Several times a day there are many people who brave the elements, wind, rain, morning fog, an evening chill, even snow, to go outside and have a smoke. Some people forgo flying on a plane because it robs them of a few hours in which they need their nicotine fix. A smoking addiction can not only add to travel time for some, but it steals lives, creating tragedy instead of memories. Every November, the American Cancer Society (ACS) stages the “Great American Smokeout” challenging the over 45 million nicotine-addicts just in the United States alone to put the cigarettes down for good.

Today, November 20th, marks the 33rd annual Smokeout where members of the American Cancer Society strive to get as many smokers to quit as they can by offering free resources to make quitting easier. Started in 1976, the Smokeout encourages people to stop smoking for one day out of the year in the hopes that one clean day will inspire smokers to quit for good. ACS has a great success rate with over 44 percent of American smokers who have quit for at least one day in the past year.

By establishing the Quitline* in 2000, people struggling to stop smoking are able to use the toll free hotline to speak to a trained counselor in order to receive educated advice and confidential counseling about their addiction. The Quitline has shown to more than double someone’s chances of quitting and has already given support to more than 380,000 smokers. The ACS website also lays out resources for smokers and their families and loved ones to start a long-term plan to stop the nicotine addiction.

Social networking sites have also proved to be helpful in encouraging smokers to quit by getting friends and family actively involved in their progress and support says a study from the New England Journal of Medicine. A spokesman from ACS says, “…social networks are helpful in quitting smoking…. Friends and family can help the most by being aware and supportive of the struggle to quit, and the American Cancer Society has resources to help them show support for their loved one who is trying to quit.”

Tobacco prices are continuing to rise and the tolerance around cigarette smoke is diminishing because many states have enacted anti-smoking laws inside public places including bars. Though it may seem that smoking is more prevalent in Europe than in the states, our awareness of smoking is heightened and because of the dangers of second hand smoke as well as lung disease, cancer, and early death, a stigma has grown around tobacco in the United States.

The American Cancer Society’s plan includes ways to help smokers transform their entire life from grocery shopping tips to healthy recipes, weight control elements, and ways to keep active. Hours after quitting, former smokers can experience a range of health benefits that accumulate over time such as an immediate drop in heart rate and blood pressure, better circulation and lung function, lower heart disease and stroke risk, and eventually a lowered risk for a lung, throat, mouth, esophagus, pancreas, bladder and cervical cancers. Just smoking 3 cigarettes a day adds up to 1,065 cigarettes or 54 packs smoked and over 200 dollars thrown away per year. Calculate your smoking numbers with the ACS cigarette calculator  and shed some light on your habit. Do yourself and your loved ones a favor and reduce your risk now, join the ACS’ Great American Smokeout and plan on today being your first day as a non-smoker.

People in their 30s and 40s are much less likely than teens to use condoms when having sex with someone for the first time, new research from the UK shows.

While 68 percent of 16- to 19-year-olds said they used protection for the first sexual encounter with a new partner, just 38 percent of men and 29 percent of women aged 35 to 44 reported doing so, Dr. Catherine H. Mercer of University College London and her colleagues found. Read the full story

A few years ago, with my LDL cholesterol pushing 125, I decided to start myself on Lipitor with the approval of my own internist. Despite the fact that my father has heart disease, I knew that I was in the category of patients where there were no clearcut guidelines. In fact I knew at the time that most cardiologists would probably say that I was jumping the gun and erring on the side of overtreating. But the latest research would suggest that I was probably right.

As most of my readers know by now, a new landmark study just published in the New England Journal of Medicine, Known as JUPITER, looked at more than 17,000 healthy men and women at multiple centers in the U.S. and Europe with normal cholesterols (LDL less than 130 mg/dl) but with elevated C-Reactive Protein levels. Many scientists believe that high levels of this protein correlates with a high risk of heart disease, though there is by no means a consensus on this.

Previous studies who shown that patients with multiple cardiac risk factors have less heart attacks and strokes when taking a statin drug, but this is the FIRST large study in people with relatively normal cholesterol where taking a statin dramatically affected outcome.

The JUPITER trial was stopped after 2 years because the results were so dramatic - there were half as many heart attacks and almost half as many strokes and unstable angina in the group which received Rosuvastatin (Crestor). I’m sure that these results will lead more doctors to prescribe more statin drugs, expecially Crestor. But the real question is, who should receive the drug and who shouldn’t? Detractors of the study will point out that Astra Zeneca, which makes Crestor, was a sponsor of the study and that it was only two years long. But this doesn’t take away from the dramatic results.

Patients and their doctors who have previously been very conscious of muscle aches that they ascribe to the drug, or are now aware of the possible slight increase risk of diabetes that the study detected, will still have to consider the fact that Crestor and likely other statin drugs appear to dramatically decrease cardiac risk. Here is my take:

*  I will have a much lower threshold for prescribing statin drugs, especially in patients older than 50. (the study looked at men in their 50s and women in their 60s).
*  I will be more inclined to prescribe statins for primary prevention (patients who have no known heart disease) on the basis of cardiac risk factors (family history, smoking, high blood pressure, etc) even when their cholesterol is only mildly elevated (LDL cholesterol between 110 and 130).
*  I will follow CRP levels in patients over 50 years old, especially in those with cardiac risk factors, but I continue to reserve judgment on the specific significance of these results.
*  I will continue to emphasize diet modification, stress reduction, and increased exercise as mainstays of primary prevention of heart disease.

My mother always tells the story that my brother and I didn’t want to be Fall babies as predicted and were stubborn enough to be born in the Summer months. Although my older brother and I are three years apart, we were both born three months early, the preemie-preemies. Hospitals have come a long way since the 1980s but premature birth is still a huge risk for babies and for those that survive, just the fact that the babies weren’t fully developed in the womb before birth can cause health and mental problems down the line.

One in every 8 babies born in the United States are premature. (Premature is defined as delivery prior to 37 weeks of gestation.) A lot of babies are kept in the hospital weeks or months after delivery until they are able to go home, throwing families into turmoil waiting for their little one to get released, hopefully without any lingering health problems.

New studies on the subject have been cropping up in November, as it is Prematurity Awareness Month, and today, Tuesday, November 18th, is Prematurity Awareness Day put in place by the March of Dimes  to occur every third Tuesday in November annually. An entire month devoted to the health of your baby may not be enough, but the March of Dimes has a goal to inform parents-to-be as well as couples already graced with the presence of a baby to understand the importance of staying healthy during the pregnancy.

The March of Dimes suggests there are ways to tell if you might be going into preterm labor. The major warning signs include: abdominal contractions every ten minutes or more, advanced pressure on your pelvis, period-like cramps with or without diarrhea, a low backache, or a change in vaginal discharge like fluid or blood. If you do have these symptoms, go to your doctor’s office immediately or go directly to the hospital, drink two or three glasses of water or juice but no coffee or soda, and rest on your left side for one hour.

Another contributory symptom to prematuare birth that has been garnering a lot of attention lately is depression. A recent study published in Human Reproduction shows that women with signals of sadness and depression are twice as likely to deliver preterm babies as women without the symptoms. With early delivery being the leading cause of infant sickness and death in America, more than 40 percent of women admit to having feelings of depression. Doctors at Kaiser Permanente who conducted the study say that depression during pregnancy is widely undiagnosed and although pregnant women have been prescribed anti-depressants, the study’s authors aren’t sure of their safety. The researchers hope that more investigation into these claims will inspire doctors and the patient’s family to help curb depression if that means reducing the risk of sending the mother into an early birth that will threaten the life of her and her baby.

Premature babies are born everyday and while some are lucky enough to incur no health problems. A lot of preterm babies end up with initial health problems such as blindness, mental retardation, chronic lung disease and cerebral palsy (which can provide a mental and physical handicap to the child). Later in life, preterm babies can also develop learning disabilities that can affect education and social interaction.

Having a baby is supposed to be the happiest day of any couple’s life and complications during pregnancy are any parent’s worst fear. The March of Dimes have released a Premature Birth Report Card showing how poorly our 50 states fared in the rankings in order to bring the awareness to Prematurity Awareness Day this week. By staying educated on the dangers of preterm pregnancies and their potential causes, maybe the United States can come together to raise their grades and lower the premature baby rate in the hopes that birthdays stay joyous occasions. Through therapy as an infant, multiple surgeries, and lots of love my brother learned to work with his mild form of cerebral palsy and has since gone on to have his own healthy family. I survived premature birth with dozens of IV scars and a strong will. After months in the hospital, thousands in bills, and years of worrying on behalf of our parents, we were relatively unscathed, but all preemies aren’t as lucky.

If you have had a strong family history of breast cancer, even if you do not carry the genes yourself, you might want to pay close attention to this subject as it could affect you more than you know. Women that have had a strong family history of breast cancer that do not have the genes with increased risk for the disease have a fourfold greater chance of developing it than the average woman.

Senior author of the study, Steven Narod, M.D. from the University of Toronto, said that the findings of the most recent study could help doctors detect breast cancer earlier in women of high-risk and lead to more and earlier preventive treatments. Women that have several blood relatives who have breast cancer have been known for years to be at a higher risk themselves. “Today, when we see families like this, we will be able to offer them better advice about their actual risk. It is very clear that the risk is going to be high enough that we need to discuss options, such as getting a breast MRI for screening and chemoprevention with raloxifene or tamoxifen. Our hope for the future is to be able to prevent or detect breast cancer soon enough to stop patients from dying.”

The new findings also suggest that additional hormones, genes, and other factors, perhaps environmental, are also responsible for the cause of breast cancer. This seems apparent from the study’s finding that women that have a strong family history were still at a higher risk of developing breast cancer even if they did not have BRCA gene mutations.

Kelly Metcalfe, R.N., Ph.D., who is also from the University of Toronto, said that only 5% of women that have breast cancer have a BRCA mutation, and this has been making it very difficult to counsel women that do not have that mutation about their risk of breast cancer. :For women that we do find a mutation, she has and 80% risk of developing breast cancer. For the women that have had a significant family history of breast cancer, that do not have the BRCA 1-2 mutation, we can now say that she has a 40% chance of getting breast cancer. This data can be compared to a 10% risk that a woman has for breast cancer in the general population.”

So what are the options for women that have a family history of breast cancer? The “take-away” message from this study, in which 1,492 women that have first-degree breast cancer relatives were studied, is this, Metcalf stated: “Having a BRCA mutation is the greatest risk factor for developing breast cancer. However, we still need to be very aware of a woman’s family history of breast cancer, even without a mutation.” Narod adds that despite a negative test for the BRCA mutations, women are still not cleared.

He says that he could recommend that women without the BRCA mutations who have three or more relatives that have breast cancer should undergo MRI screenings and consider taking a medication called tamoxifen. The findings of this study do not call for preventative surgery—which is removal of the breasts—but he does say that some women may wish to consider that option.

He adds that we have to take tamoxifen more seriously as a society as a preventative measure for breast cancer. This medication can reduce the risk of breast cancer from 40% to 20% which are pretty dramatic figures. Any woman that has a 40% risk of breast cancer should seriously consider this option. However, researchers say that they are no ready yet to recommend that all women with a family history of breast cancer get tested for the BRCA genes. This is considered a personal decision whether or not to have genetic testing done, Metcalfe states. However, for women that do have a family history of breast cancer, genetic testing can offer information about their own risk of developing ovarian or breast cancer, and if the woman is found to have the BRCA genes, options are now available to significantly reduce their risk of breast cancer.

The director of breast and gynecologic cancer for the American Cancer Society, Debbie Saslow, Ph.D., said that it is important that women with a family history of breast cancer who have no genetic markers to know that they are still at an increased risk that is very significant. She also says that the study suggests that other genes, that are yet to be identified, could put women at a higher risk for breast cancer.

Women that have a family history of breast cancer should start screening at the age of 30 and make sure that their physicians know that they have relatives who have been diagnosed.

Genetic testing is not for everyone, but counseling can help women to make an informed decision. The American Cancer Society says many clinical studies have shown that raloxifene and tamoxifen could reduce that risk of breast cancer in women that are high risk.