Stem Cell Therapy Fixes Post-Surgical Airway Abnormality

By Steven Reinberg

HealthDay Reporter

WEDNESDAY, Dec. 31, 2014 (HealthDay News) — Using stem cells derived from a patient’s own bone marrow, researchers have repaired a fistula — a potentially fatal tissue abnormality — in the man’s lower airway.

“This is another interesting new therapeutic approach for stem cells,” said lead researcher Dr. Francesco Petrella, deputy director of thoracic surgery at the European Institute of Oncology in Milan, Italy.

The patient, a 42-year-old firefighter, developed the fistula after surgeons removed a lung as part of treatment for mesothelioma cancer. A fistula is abnormal tissue connecting an organ, blood vessel or intestine to another structure. In this case, the fistula developed between the lower airway and the tissue that surrounds the lungs.

“Our clinical experience supports the idea that stem cells could be effectively used to close some tissue defects developing after very complex surgical procedures, thus restoring a functioning airway,” Petrella said.

A fistula that develops after chest surgery is serious and even deadly, Petrella said. Current treatments involve removing ribs and taking medications for months or years, he explained.

“Less invasive approaches like endoscopic glue injections have only poor results, so our proposed techniques could improve quality of life in these patients,” Petrella said.

Sixty days after stem cell therapy, the firefighter’s fistula was healed, the researchers said. The hole seen before stem cell therapy was no longer visible, having been replaced by new tissue created by the stem cell implant, they explained.

Some people are born with a fistula. Other causes of fistulas include complications from surgery, injury, infection and diseases, such as Crohn’s disease or ulcerative colitis.

Petrella believes that this same stem cell technique could be used to treat fistulas that develop elsewhere in the body.

“For example, I think it could be used to treat fistulas in the esophagus as well as in the stomach or colon, and fistulas that connect the lower portion of the large intestine with the rectum and vagina,” he said.

Petrella describes the process in the Jan. 1 issue of the New England Journal of Medicine.

Mariano Garcia-Arranz, a senior researcher at the Health Research Institute Foundation Jimenez Diaz in Madrid, Spain, said the article confirms the effectiveness of stem cells in the treatment of fistulas.

But the type of fistula treated in this study is very rare, he said, adding that more study is needed before stem cells are routinely used as a treatment.

“However, so far, all cases that have been treated with stem cells have been successful,” he said.

More information

For more about fistulas, visit the U.S. National Library of Medicine.

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Defective Hormone Linked to Chronic Obesity in Baby

By Dennis Thompson

HealthDay Reporter

WEDNESDAY, Dec. 31, 2014 (HealthDay News) — A small number of extremely obese people may be fat because their bodies produce a malfunctioning form of the appetite-controlling hormone leptin.

That’s the conclusion of a case study that appears in the Jan. 1 issue of the New England Journal of Medicine.

The researchers base this new theory on a 2-year-old boy of Turkish descent with an insatiable appetite. He was chronically obese for much of his short life.

At first doctors were puzzled by the case, since the boy appeared to have high blood levels of leptin, the hormone the body releases when a person has eaten enough, said Dr. Martin Wabitsch, a researcher in the Division of Pediatric Endocrinology and Diabetes at the University of Ulm in Germany.

A genetic sequencing test revealed that the boy produces a mutated form of leptin that can’t effectively signal to the central nervous system that no more food is needed, Wabitsch said.

“The leptin is produced and secreted in a normal way, but it does not bind and does not activate the satiety receptor in the central nervous system, due to the mutation,” he said.

When doctors treated the boy with injections of synthetic leptin, he started eating less and experienced substantial weight loss, the study authors reported.

Wabitsch said this condition likely is very rare, but added that he already has identified a second and third case that he will write about in another upcoming article.

“I am sure there are many other patients who have this disease with biologically inactive leptin, and they are not detected because doctors test the leptin in their blood and find there is no deficiency,” he said.

Doctors have known about the role that leptin plays in appetite since the 1990s, Wabitsch said, but studies aimed at treating obesity through leptin injections have tended to fail.

That’s because some people who have leptin-associated obesity have receptors that don’t receive the hormone’s signal properly, he said. It doesn’t matter how much healthy leptin is circulating in their system — their nervous system can’t receive the message that the person is full.

Dr. Mitchell Roslin, chief of obesity surgery at Lenox Hill Hospital in New York City, agreed with Wabitsch, and added that the wider clinical implications of this case study are “minimal.”

“Leptin therapy itself has had little efficacy for obesity, but still may be important as part of a cocktail,” Roslin said. “For most, obesity is related to environmental factors that are altering our genetic expression. Pharmaceutical [drug] solutions are coming, but are not yet ready to make a significant impact.”

Wabitsch said future research should focus on the “feedback circle” of appetite that’s driven by hormones like leptin and ghrelin, which increases appetite when the body needs fuel.

“In the future, people will focus on stimulating the leptin receptor with other drugs,” he said. “Our body weight and our appetite is regulated by hormones, and this feedback circle is very important. An individual has only limited possibilities in controlling appetite and body weight by their own willpower. Anything you can interfere with in this circle will really have an effect on your appetite and your body weight.”

In the meantime, doctors faced with an obese child who can’t stop eating should consider the possibility that the child might have this leptin mutation, Wabitsch added.

More information

For more on childhood obesity, visit the U.S. Centers for Disease Control and Prevention.

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Common Breast Biopsy Finding May Be More Dangerous Than Thought

By Kathleen Doheny

HealthDay Reporter

WEDNESDAY, Dec. 31, 2014 (HealthDay News) — Women who have a pre-cancerous condition known as atypical hyperplasia of the breast are at higher risk of developing breast cancer than experts had believed, a new study finds.

Hyperplasia is an overgrowth of cells. When it occurs in a distorted pattern, it’s called atypical hyperplasia. This condition is found in about one-tenth of the more than one million breast biopsies with benign findings done in the United States each year, according to researchers from the Mayo Clinic.

In the new study, the researchers found that about 30 percent of the women with atypical hyperplasia developed breast cancer in the 25 years after the diagnosis.

While experts have always known that atypical hyperplasia increases the risk of breast cancer, the new finding gives women with the condition more solid information about the extent of the risk, said study researcher Dr. Lynn Hartmann, a professor of oncology at the Mayo Clinic in Rochester, Minn.

Before the study, experts believed that women with atypical hyperplasia had about a four times higher risk of breast cancer, she said. That doesn’t tell women their specific individual risk, however, Hartmann noted.

In the study, Hartmann’s team followed nearly 700 women diagnosed with atypical hyperplasia at the Mayo Clinic between 1967 and 2001. After an average follow-up of more than 12 years, 143 women had developed breast cancer.

Hartmann’s team validated the findings with a separate group of women with the condition at Vanderbilt University. Both sets of data found that around 30 percent of the women with atypical hyperplasia developed breast cancer.

As the extent of the hyperplasia increased, so did the risk, the investigators found.

The new research gives women some valuable information, according to two experts who reviewed the findings. One strength of the study was the “sizable sample of women followed for a long time,” said Robert Smith, director of cancer screening for the American Cancer Society.

“We’ve always known their risk was higher,” Smith said of women with the condition. However, the new study provides long-term data, he said, and shows a risk higher than most experts believed it to be.

Dr. Laura Kruper, a breast surgeon and co-director of the Breast Cancer Program at City of Hope Cancer Center in Duarte, Calif., added, “I think the news is atypical hyperplasia is much more serious than we have been taking it. When you say a cumulative risk of 30 percent at 25 years, that is pretty serious,” Kruper said.

Overall, about one in eight U.S. women, or 12 percent, will develop breast cancer in their lifetime, according to estimates from the American Cancer Society.

“We as a medical community need to pay more attention to this,” Kruper said of the higher risk finding.

What should women do who are diagnosed with the condition? They can discuss with their doctor whether to use chemopreventive medicines, such as tamoxifen or aromatase inhibitors, which are given to women who have a higher than average risk of breast cancer, the experts agreed.

Many of the women in the study developed a type of cancer known as estrogen receptor-positive, which requires estrogen to grow, Hartmann noted. That would suggest that taking the chemopreventive medicines — which work by reducing estrogen — would lower that risk, she said.

Women can also discuss with their doctor whether to get a screening MRI in addition to a mammogram, the experts suggested. Under the current guidelines from the American Cancer Society, Smith said, women with atypical hyperplasia are put into an intermediate-risk group. The guidelines currently say there isn’t enough evidence to recommend for or against MRI as an additional screening, Smith said.

The new research provides additional data, however, he said. Under current ACS guidelines, a yearly mammogram and MRI are suggested for women who have a lifetime breast cancer risk of 20 to 25 percent, using standard risk models.

Hartmann is hopeful that the new findings will trigger review of the guidelines by the society and other groups.

Meanwhile, she said, women’s screening decisions should be based on their other individual risk factors. “If a 70-year-old woman has atypical hyperplasia but fatty breasts, she may not need a screening MRI, because her mammogram is so easy to interpret,” she said. Having non-fatty, or dense, breasts, can make it difficult to spot cancer on a mammogram.

On the other hand, a woman in her 60s with dense breasts and atypical hyperplasia might consider a screening MRI in addition to a mammogram, she said.

More information

To learn more about hyperplasia, visit the American Cancer Society.

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Exercise May Cut Fall Risk for Some Parkinson’s Patients

By Amy Norton

HealthDay Reporter

WEDNESDAY, Dec. 31, 2014 (HealthDay News) — Exercises that focus on balance and leg strengthening may help some people with Parkinson’s disease avoid falls, according to a new clinical trial.

The study, reported online Dec. 31 in Neurology, found that the benefits were limited to people with milder Parkinson’s symptoms. The exercise program — done mostly at home — cut their risk of falling by about 70 percent over six months.

But experts said that doesn’t mean exercise is no help to people with more advanced Parkinson’s.

It’s possible they may need an exercise program with more supervision, said lead researcher Colleen Canning, an associate professor at the University of Sydney in Australia.

That possibility still needs to be studied, Canning added. But what seems clear, she said, is that “one size does not fit all” when it comes to exercise therapy for Parkinson’s.

Parkinson’s disease is a chronic movement disorder that causes tremors, stiffness in the limbs, and problems with balance and coordination, according to the Parkinson’s Disease Foundation. About 60 percent of people with the disorder fall at least once a year, according to Canning’s team — and that can have consequences ranging from serious injury to fear of being active.

Yet physical activity is important for people with Parkinson’s, said Dr. Roy Alcalay, a neurologist and medical advisor to the Parkinson’s Disease Foundation in New York City.

That’s partly because people with Parkinson’s — who are typically older than 50 — should exercise for the sake of their cardiovascular health and mental well-being, explained Alcalay, who was not involved in the study.

“So we usually recommend exercise, just like we do for the general population without Parkinson’s,” said Alcalay.

Plus, he added, there is evidence that exercise could provide particular benefits for people with Parkinson’s. In lab animals, physical activity seems to shield brain cells from some of the damage seen in Parkinson’s, Alcalay noted.

And recent studies of Parkinson’s patients have found that cardiovascular exercise, such as walking, can help ease physical and mental symptoms — including stiffness, balance problems and depression.

“This study provides a couple new pieces,” Alcalay said. “One is that for people with less severe Parkinson’s, exercise does reduce falls. For people with more severe disease, though, this minimal-supervision program probably doesn’t apply.”

For the study, Canning’s team randomly assigned 231 Parkinson’s patients to either stick with their usual care or add an exercise program. That group took a monthly class with a physical therapist, where they learned balance and leg-strengthening exercises.

But most of the time, Canning said, the exercisers were on their own; they were told to fit in 40 to 60 minutes of exercise, three times a week — with some of those sessions guided by a therapist who visited them at home.

After six months, the researchers found, there was no clear benefit for the study group as a whole. The picture looked different, however, when they focused on the 122 patients with milder Parkinson’s symptoms.

Among those patients, 52 percent of exercisers had a fall over six months. That compared with 76 percent of those who did not exercise.

“This large effect was achieved with only 13 percent of exercise sessions supervised by a physical therapist,” Canning said. “The results of our study suggest that early intervention for people with Parkinson’s disease should be extended to include minimally supervised balance and strengthening exercises as a falls-prevention strategy.”

“Early” is the key word, according to Canning. “We should not be waiting until the person has already fallen,” she said.

Only an association was found between exercise and risk of falling among Parkinson’s patients; the study did not prove cause and effect.

Alcalay noted that in the United States, the “minimal supervision” approach is typically how physical therapy works: Insurers pay for a limited number of sessions, where therapists teach people exercises they should continue at home.

Canning said more research is needed to know whether a program with closer supervision can help prevent falls among people with more advanced Parkinson’s.

“Patients with Parkinson’s disease should engage in exercise for better health outcomes,” said Dr. Ergun Uc, a neurologist at the University of Iowa Hospitals & Clinics in Iowa City. Uc also recently led a study that found brisk walking can help improve Parkinson’s symptoms.

“However,” he added, the current study’s “exercise regimen has to be tailored to [patients’] abilities, to maximize benefit and prevent injury from exercise itself.”

Uc agreed that it would be worthwhile to study the effects of a closely supervised program for people with more severe Parkinson’s.

More information

The Parkinson’s Disease Foundation has more on Parkinson’s disease.

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Little Change in Fast Food Calorie Counts, Salt Content

WEDNESDAY, Dec. 31, 2014 (HealthDay News) — An investigation into the nutrition offered in meals from three major fast food chains finds little change in calories, salt or saturated fat from 1996 to 2013.

A team led by Alice Lichtenstein, director of the U.S. Department of Agriculture’s Cardiovascular Nutrition Laboratory, looked at the nutrition of four popular fast food menu items — fries, cheeseburgers, grilled chicken sandwiches and regular cola. Overall, the researchers focused on 27 items, including small, medium and large fries and cola beverages, a grilled chicken sandwich, and 2-ounce and 4-ounce cheeseburgers.

According to the researchers, the average calorie content, salt content and saturated fat content of these items stayed more or less the same over the 17-year period.

Two positive trends were noted, however. First, levels of unhealthy trans fats in French fries declined over time, the team found. That was probably due to changes in frying fat, and “the decline in trans fat we saw between 2005 and 2009 appears to be related to legislative efforts,” Lichtenstein said.

Second, “there is a perception that restaurants have significantly expanded their portion sizes over the years, but the fast food we assessed does not appear to be part of that trend,” Lichtenstein, who is also a professor at the Friedman School of Nutrition Science and Policy at Tufts University, Boston, said in a Tufts news release.

According to Lichtenstein, the real danger in terms of obesity and other health issues comes when fast food items are ordered together.

Levels of calories, salt and saturated fat “are high for most of the individual menu items assessed, particularly for items frequently sold together as a meal,” she said, and this is “pushing the limits of what we should be eating to maintain a healthy weight and sodium intake.”

Nutritionists recommend that most people eat around 2,000 calories a day. “Among the three chains, calories in a large cheeseburger meal, with fries and a regular cola beverage, ranged from 1,144 to 1,757 over the years,” Lichtenstein said.

This means a single meal could add up to 88 percent of a person’s daily caloric requirements for an entire day. “That does not leave much wiggle room for the rest of the day,” Lichtenstein said.

What’s more, salt content in the cheeseburger meal averaged 91 percent of a person’s recommended daily intake, the researchers found.

Still, there was wide variance among chains, Lichtenstein’s team found. Depending on where you ate, small orders of fries could vary by 110 calories and by 320 milligrams of sodium.

Those differences matter, Lichtenstein pointed out, because “a 100-calorie difference per day can mean about a 10-pound weight change per year.”

The fast food industry can do more to help boost Americans’ health, she said.

“Restaurants can help consumers by downsizing portion sizes and reformulating their food to contain less of these overconsumed nutrients. This can be done, gradually, by cutting the amount of sodium, and using leaner cuts of meat and reduced-fat cheese,” Lichtenstein said.

“From what we hear, some fast food chains are heading in that direction and also introducing new healthier options,” she added. “If taken advantage of, these changes should help consumers adhere to the current dietary recommendations.”

Results of the investigation, funded by the USDA, were published Dec. 31 in Preventing Chronic Disease.

More information

There’s more on maintaining a healthy weight at the U.S. Centers for Disease Control and Prevention.

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Preventing Diaper Rash

WEDNESDAY, Dec. 31, 2014 (HealthDay News) — Diaper rash is a common problem for babies, but parents can take steps that help keep skin from getting red and inflamed.

“The best way to prevent and treat diaper rash is to keep your baby’s skin as dry and clean as possible,” Dr. Lawrence Eichenfield, chief of pediatric and adolescent dermatology at the University of California, San Diego, said in an American Academy of Dermatology news release.

“With the right care, diaper rash should clear in about three to four days,” he added.

The most important preventive measure is to change wet or dirty diapers as soon as possible. This reduces moisture on the skin, which can inflame a rash. Be gentle when cleaning the diaper area and use water and a soft washcloth or baby wipes that are alcohol- and fragrance-free.

After cleaning, let your baby go diaper-free for as long as possible so that the skin can dry and heal.

Use zinc oxide diaper cream. If your baby has severe diaper rash, apply the cream as if you’re frosting a cake, Eichenfield said. You don’t need to remove the cream with each diaper change. You can fully remove it at the end of the day.

If the baby develops signs of a skin infection, call a doctor or dermatologist. Signs of infection may include fever, blisters, pus that drains from the rash, a rash that does not go away or worsens after treatment, and a baby who is in pain or hard to console.

“Babies have very delicate skin, and sometimes despite our best efforts, diaper rash still occurs,” Eichenfield said. “If your baby’s diaper rash is not going away, or if you have questions or concerns about caring for your baby’s skin, consult a board-certified dermatologist.”

More information

The American Academy of Family Physicians has more about diaper rash.

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3 Health Tips You Can Totally Ignore

Photo: Getty Images

Some popular pieces of health advice are a bit outdated. Here’s what you should forget, and want to do instead.

To stop a nosebleed, tip your head back

Try this instead: Tilt your head forward and pinch your nose with your thumb and forefinger for 10 minutes, until the blood clots. Nosebleeds can occur in winter from breathing dry, heated indoor air. Don’t lean your head back; it allows blood to drain down your throat, which can lead to an upset stomach.

RELATED: 10 Winter Health Myths Busted

To make a workout routine stick, do it in the morning

Try this instead: Exercise when you can, whether it’s during your lunch hour or in the evening. The idea behind morning workouts is that you’ll start the day off on the right foot, but it’s more important to find a time that you can actually stick with, no matter when that is.

RELATED: 20 Ways to Stick to Your Workout

To beat dry skin, drink lots of water

Try this instead: Use moisturizer. Sorry, chugging water won’t do a thing for normal dryness. Though one of the signs of dehydration is dry, sallow skin, this happens only when you’re seriously low on H2O. Invest in a good moisturizer with hyaluronic acid and slather it on after every shower.

RELATED: 10 Surprising Beauty Uses for Coconut Oil

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New Year Often Ushers in Pledge to Quit Drinking

WEDNESDAY, Dec. 31, 2014 (HealthDay News) — People with drinking problems often make a New Year’s pledge to stop or cut back on their drinking, but actually doing it can be a struggle, an addiction expert says.

“Twenty percent of the people who make New Year’s resolutions revert back to their old behaviors within a month,” Janina Kean, president and CEO of High Watch Recovery Center in Kent, Conn., said in a center news release.

She offered advice for people who want to bring their drinking under control.

“Drinking problems are overcome through residential inpatient rehabilitation programs, outpatient programs and Alcoholics Anonymous, so it is best to seek help via these avenues,” Kean said.

“Always seek treatment from evidence-based programs. These consist of a program with a medical license, and a clinical team run by a psychiatrist board-certified in addiction medicine, master’s prepared therapists, and a registered nurse team to administer medications. The program should also be able to recognize and treat co-occurring disorders as well as have an educational treatment program for families,” she advised.

The level of care required by a person is determined by the severity of their drinking problem.

“Someone with a severe substance use disorder will more than likely need a residential rehabilitation program, whereas people with a mild to moderate issue may be able to achieve remission with an outpatient program and Alcoholics Anonymous,” Kean said.

If you relapse during the holiday season, don’t be too hard on yourself. Instead, learn to forgive yourself. If you can’t bring your drinking under control again, you may have to go back into treatment, she said.

“Oftentimes, problem drinking is a symptom of a greater underlying problem. Just stopping to drink can bring these issues to the surface, so you must seek treatment for these issues as well, whether they are depression, anxiety, etcetera,” Kean said.

More information

The U.S. National Institute on Alcohol Abuse and Alcoholism has more about alcohol use disorders.

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Falling Cancer Death Rate Means 1.5 Million Lives Saved Over 20 Years

By Dennis Thompson

HealthDay Reporter

WEDNESDAY, Dec. 31, 2014 (HealthDay News) — Progress in the war against cancer has triggered a 22 percent drop in U.S. deaths over the past two decades, translating to about 1.5 million lives saved, a new American Cancer Society report finds.

Even so, the annual report also predict that within a few years, cancer will overtake heart disease as the leading killer of Americans.

That’s because “the decrease in mortality rates from heart disease has been much larger than the decrease in mortality from cancer,” said Dr. Ahmedin Jemal, the cancer society’s vice president of surveillance and health services research.

“Cancer is a collection of maybe 200 diseases,” he explained. “It’s not like heart disease, where you have maybe some variation but it is a single entity compared to cancer.”

In 2011, the most recent year for which statistics are available, heart disease claimed the lives of more than 308,000 men and 288,000 women in the United States, while cancer killed more than 302,000 men and 274,000 women.

The cancer report estimates there will be more than 1,658,000 new cancer cases and over 589,000 cancer deaths in the United States in 2015 — about 1,600 cancer-related deaths a day.

However, those numbers are still a significant improvement on the past: The report found that cancer death rates declined from about 215 per every 100,000 people in 1991 to about 169 per 100,000 in 2011.

Convincing Americans to quit smoking has been the major driver in reducing cancer deaths, Jemal said. The number of smokers has been cut in half, and now represents fewer than one of every five people in the United States.

As a result, the lung cancer death rates dropped 36 percent between 1990 and 2011 among males, and 11 percent between 2002 and 2011 among females.

Increased use of early detection tools — such as mammography, colonoscopy and cervical exams — has also had a tremendous impact on the war against cancer, Jemal said.

Gains for men slightly exceeded those for women. Between 2007 and 2011, the average annual decline in cancer death rates was larger for men (1.8 percent) than women (1.4 percent), the report found.

Jemal also noted that during the past two decades, deaths from colon and prostate cancer have been nearly cut in half, and breast cancer deaths have dropped by a third.

“Really, it’s due to screening, as well as improved treatment,” he said. “It’s really remarkable.”

Progress varied by geographic region, however. The smallest declines in cancer deaths generally occurred in the South, where drops were about 15 percent. The biggest advances took place in Northeastern states, with the cancer death rate dropping 25 percent to 30 percent in Maryland, New Jersey, Massachusetts, New York and Delaware.

States that made less progress in fighting cancer likely have large populations of people who are poor or uninsured, which means they don’t have access to the kind of health care that can detect or prevent cancer, Jemal believes.

In addition, these states often have policies that hamper cancer prevention — for example, cigarette taxes may be too low to discourage smoking. “If you look at the southern states, their excise taxes on tobacco are the lowest in the nation,” Jemal said.

The overall rate of cancer cases (incidence) remained stable for women between 2007 and 2011, but declined by 1.8 percent per year for men.

Men experienced relatively rapid declines in cases of colon cancer (3.6 percent per year), lung cancer (3 percent per year) and prostate cancer (2.1 percent per year) during that period, the report found.

But there’s been no change in incidence rates for breast cancer. And the report found that certain cancers are even on the rise. For example, thyroid cancer cases increased an average 4.5 percent per year between 2007 and 2011, and liver cancer cases have increased by more than 3 percent.

The increase in liver cancer cases is largely due to hepatitis C infection, mainly through intravenous drug use and sharing needles in the 1960s, 1970s and 1980s, Jemal said.

The rise in thyroid cancer cases cannot be easily explained, Jemal said. Some suspect the condition may be now overdiagnosed due to the overuse of imaging scans and ultrasound, he said, but there’s also been an increase in the size of cancerous lesions found.

“For thyroid, it’s very difficult to explain what’s occurring,” he said.

More information

To learn more about cancer, visit the American Cancer Society.

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Parent’s Suicide Attempt Makes Child’s Much More Likely: Study

TUESDAY, Dec. 30, 2014 (HealthDay News) — When a parent has a history of attempting suicide, the odds of a suicide attempt in their child rises fivefold, compared to the offspring of people without such histories, a new study finds.

Reporting in the Dec. 30 online edition of JAMA Psychiatry, researchers led by Dr. David Brent of the University of Pittsburgh Medical Center tracked more than 700 young and adult-aged children (ages ranged from 10 to 50) of 334 parents with mood disorders, such as depression or bipolar disorder.

A total of 191 of the parents had attempted suicide in the past. Forty-four of the offspring had attempted suicide in the past. Another 29 of the offspring attempted suicide during the study’s nearly six-year follow-up period, according to the report.

The investigators found that a history of suicide attempts in a child was strongly associated with a similar history in that child’s parent — even after they accounted for any mood disorder that might be shared by both parent and child.

Behaviors involving “impulsive aggression” were closely tied to mood disorders, Brent’s team found, “and could be targeted in interventions designed to prevent youth at high familial risk from making a suicide attempt.”

Two experts said the study puts the spotlight on “at risk” children.

“For parents who have a history of depression, bipolar disorder and/or suicide attempts, they should be aware of the potential risk for their children and be proactive in having an evaluation if the child is experiencing depression or other psychiatric symptoms,” said Dr. Jeffrey Borenstein, president and CEO of the Brain & Behavior Research Foundation in New York City.

“Just as parents seek professional help if they are concerned about their child’s physical health, parents should be proactive in observing their children’s mental health and seeking a professional evaluation if they are concerned,” Borenstein said.

Dr. Scott Krakower is assistant unit chief of psychiatry at Zucker Hillside Hospital in Glen Oaks, N.Y. He said, “if adolescents show signs or symptoms of a mood disorder, it is important that they receive treatment for this as soon as possible. Parents battling with a mood disorder should also seek treatment, to help foster a better relationship with their children.”

As for warning signs, Krakower said that “impulsive aggression is often overlooked and can raise the risk for suicide. So, it is important to make sure that youth receive treatment to help learn better ways to regulate their emotions.”

More information

There’s more on the warning signs of suicide at the National Suicide Prevention Lifeline.

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Walmart Will Trade You for Other Merchants’ Gift Cards

Photo: Getty Images

Don’t worry if you don’t like some of the gift cards you receive this Christmas. The AP reports that Walmart will trade store credit for gift cards from more than 200 different retailers, restaurants, and airlines.

Shoppers can trade in any eligible gift card for a Walmart gift card of similar value. How much you get depends on what kind of card you’re trading in. An Amazon card will fetch 95% of its value, a Gap card will be worth 85%, and some cards will be matched with just 70% of their original value. The exchange program is being done in partnership with CardCash, the largest platform for buying and selling gift cards. Walmart says this exchange is a test but could be made permanent if there is heavy demand. (Watch the video above to learn more.)

To exchange their gift cards, shoppers don’t even need to leave the house. Walmart’s card exchange website, Walmart.CardCash.com, lets users input their gift card’s information, and a Walmart gift card will be emailed to them once the original card’s balance is verified.

The motivation for Walmart’s gift exchange is probably to increase store traffic, but there are many reasons retailers love getting their gift cards into the hands of shoppers. As MONEY’s Kara Brandeisky points out, shoppers are likely to overspend when given what seems like fake money. In addition, researchers have found that consumers buy items they don’t need when they use a stored-value certificate; the CEB TowerGroup consultancy has found that 65% of gift card users spend 38% more than the face value of the card.

The CEB also reported that customers tend to forget about their gift cards and don’t spend the full balance, resulting in more than $1 billion in unused store credit this year alone. But that appears to be less true in the case of Walmart: A company spokesperson told the AP that 95% of Walmart holiday gift cards are usually redeemed by February.

Who do you side with in the Great Gift Card Debate?
Why gift cards are the only present that makes sense

Why gift cards are a crime against Christmas

Discover smart ideas for how to invest sensibly, plan wisely, and spend smartly from the editors and writers of Money magazine and Money.com.

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Drug to Treat Serious Infections May Harm Kids’ Kidneys, Study Says

TUESDAY, Dec. 30, 2014 (HealthDay News) — Treating children who have drug-resistant bacterial infections with high doses of the antibiotic vancomycin may raise the risk of kidney damage, a new study says.

Researchers said the drug should be used cautiously.

“Our results bear out the difficult balancing act between ensuring the dose is high enough to successfully treat these serious and, at times, life-threatening infections against the small but real risk for kidney damage,” said the study’s senior investigator, Carlton Lee, a pediatric clinical pharmacist at the Johns Hopkins Children’s Center in Baltimore.

“Ultimately, what we really need are new drugs that achieve the same therapeutic effect without taking a toll on the kidneys and other organs,” Lee said in a Hopkins news release.

Vancomycin is only used to treat infections that don’t respond to other medications. One of these bacteria is MRSA (methicillin-resistant Staphylococcus aureus), which led to new dosing guidelines for the antibiotic in 2009.

At high doses, vancomycin can reach levels in the blood necessary to fight resistant germs and prevent serious complications associated with drug-resistant infections. This study was launched to assess the effects of these high doses on children.

Researchers examined data on 175 children treated with vancomycin between 2009 and 2010. The kids had invasive drug-resistant infections in the skin, bone, heart, lung and brain, or bloodstream infections caused by MRSA. While taking the drug they underwent routine blood tests to assess their kidney function. Fourteen percent developed kidney damage, the study authors found.

The higher the dose of vancomycin, the greater the risk for kidney damage, the researchers reported in the December issue of Annals of Pharmacotherapy.

How long the children were treated with vancomycin also played a role. On average, the children in the study who developed kidney damage were treated with vancomycin for eight days — twice as long as those who did not have kidney damage.

For each additional day on the drug, the risk of kidney damage increased by 11 percent. Simultaneous use of vancomycin with certain other drugs also raised the risk of kidney damage, the study concluded.

The researchers noted, however, that vancomycin has been used for three decades and can save lives. They added that kidney damage associated with the drug is often reversible once treatment ends.

But they cautioned that newer and safer treatments are needed for drug-resistant bacterial infections in children.

“The results of our study highlight the need for trials that provide pediatric experts with the evidence needed to make informed treatment and dosing decisions, ones that are based on solid data in children rather than on extrapolation from adult patients,” study lead author Elizabeth Sinclair, a pediatric clinical pharmacy specialist at Texas Children’s Hospital who conducted the research while at Hopkins, said in the news release.

More information

The U.S. National Institutes of Health has more about the antibiotic vancomycin.

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from Health News / Tips & Trends / Celebrity Health http://news.health.com/2014/12/30/drug-to-treat-serious-infections-may-harm-kids-kidneys-study-says/

Better Pain Relief After Knee Replacement Surgery?

TUESDAY, Dec. 30, 2014 (HealthDay News) — Postoperative pain is always a concern after knee replacement surgery, but a new study suggests a strategy that might give patients another way to ease discomfort.

Researchers at Henry Ford Hospital in Detroit note that the painful recovery process following knee replacement surgery is a persistent problem.

However, the research team found that injecting a newer, long-acting numbing medicine, known as liposomal bupivacaine, into the area surrounding the knee helps patients recover more quickly and boosts their satisfaction with the procedure.

“Patients had pain relief for up to two days after surgery and better knee function compared with the traditional method,” said the study’s senior author, Dr. Jason Davis, a joint replacement surgeon at Henry Ford West Bloomfield Hospital, in a hospital news release.

The study involved more than 200 patients who underwent knee replacement surgery and were then tracked for pain control during the first two days after their procedure.

Half of the patients received traditional pain control, in which a common numbing medicine is injected via a pump into the groin area. Although this method can cause leg weakness, it prolongs pain control for two days after surgery, the researchers said.

“Pain control [using this method] came at the price of weakness and made patients somewhat tentative when walking during their hospital stay,” Davis noted.

The rest of the patients received the liposomal bupivacaine injection, targeted to the site of their surgery. Unlike the traditional pain control method, the newer, long-acting numbing medicine enabled patients to begin walking comfortably just hours after surgery, the study showed.

This technique “optimizes pain control early on,” said Davis. “Function-wise, it was a lot easier for patients to move around more confidently. In the past decade, we’ve made major advancements in pain control for knee replacement surgery. This option is a promising, viable one for our patients.”

Two experts not connected to the study had mixed opinions about the results.

“Innovative approaches to pain control have markedly improved the early recovery after knee replacement,” said Dr. Matthew Hepinstall, an orthopedic surgeon at Lenox Hill Hospital in New York City.

“This study confirms prior studies showing that local anesthetic injections can provide analgesia similar to nerve blocks after knee replacement, without the delayed rehabilitation that some patients experience with femoral [leg] nerve blocks,” he said.

But Hepinstall stressed that only further research will let doctors know for sure that the more expensive liposomal drug is better than conventional methods at reducing postoperative pain.

Dr. Jan Koenig is chief of joint replacement surgery at Winthrop-University Hospital in Mineola, N.Y. He said that one “underreported problem with the liposomal bupivacaine time-release analgesia is that we see a lot of rebound pain about day three when it wears off.”

The study was presented recently at the American Association of Hip and Knee Surgeons annual meeting in Dallas. Findings presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

More information

The U.S. National Institutes of Health provides more information on what to expect during recovery from knee replacement surgery.

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from Health News / Tips & Trends / Celebrity Health http://news.health.com/2014/12/30/better-pain-relief-after-knee-replacement-surgery/