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Monthly Archives: February 2017

Head Injuries Carry Long Term Death Risk

The risk of death after head injury remained significantly increased for as long as 13 years, irrespective of the severity of the injury, results of a case-control study showed.

Overall, patients with a history of head injury had more than a twofold greater risk of death than did two control groups of individuals without head injury.

Among young adults, the risk disparity ballooned to more than a fivefold difference, Scottish investigators reported online in the Journal of Neurology, Neurosurgery and Psychiatry.

“More than 40% of young people and adults admitted to hospital in Glasgow after a head injury were dead 13 years later,” Dr. Thomas M. McMillan, of the University of Glasgow, and coauthors wrote in the discussion of their findings. “This stark finding is not explained by age, gender, or deprivation characteristics.”

“As might be expected following an injury, the highest rate of death occurred in the first year after head injury,” they continued. “However, risk of death remained high for at least a further 12 years when, for example, death was 2.8 times more likely after head injury than for community controls.”

Previous studies of mortality after head injury have focused primarily on early death, either during hospitalization or in the first year after the injury. Whether the excess mortality risk persists over time has remained unclear, the authors noted.

Few studies have compared mortality after head injury with expected mortality in the community. To provide that missing context, McMillan and coauthors conducted a case-control study involving 757 patients who incurred head injuries of varying severity from February 1995 to February 1996 and were admitted to a Glasgow-area hospital.

For comparison, the investigators assembled two control groups, both matched with the cases for age, sex, and socioeconomic status and one matched for duration of hospitalization after injury not involving the head.

One control group was comprised of persons hospitalized for other injured and other comparison group included healthy non-hospitalized adults.

The cases comprised 602 men and 155 women who had a mean age of 43, and almost 70 percent were in the lowest socioeconomic quintile.

At the end of follow-up, 305 of the head-injured patients had died, compared with 215 of the hospitalized control group, and 135 of healthy, non-hospitalized adults.

Mortality after one year remained significantly higher in the head-injury group—34 percent versus 24 percent among the hospitalized comparison group and 16 percent for the healthy non-hospitalized adults.

Overall, the head-injury group had a death rate of 30.99/1,000/ year versus 13.72/1,000/year in the community controls and 21.85/1,000/year in the hospitalized-other injury control group.

The disparity was greater among younger adults (15 to 54), who had a rate of 17.36/1,000/year versus 2.21/1,000/year in the community controls. Older adults in the head injury group had a death rate of 61.47/1,000/year compared with 39.45/1,000/year in the community controls.

“Demographic factors do not explain the risk of death late after head injury, and there is a need to further consider factors that might lead to health vulnerability after head injury and in this way explain the range of causes of death,” the authors wrote in conclusion. “The elevated risk of mortality after mild head injury and in younger adults makes further study in this area a priority.”

Facebook Effect For Your Health

Is it us, or are news headlines about Facebook’s impact on our health popping up more and more these days? Considering that 51 percent of Americans over age 12 now have profiles on the social networking site compared to 8 percent just three years ago, according to new data from Edison Research, it’s no wonder there are entire scientific journals devoted to the psychology of social networking, and piles of studies analyzing such sites’ effects on our moods, body image, friendships, and marriages.

Negative conditions such as “Facebook depression” or Facebook-fueled divorces bear the brunt of the media blitz, but much of the body of research actually points to positive perks from Facebook use. Here, a deeper look at how all those “likes,” “pokes,” and status updates are really affecting you and your family’s well-being, and how you can outsmart some of the potentially negative side effects.

Health Benefits of Facebook

Research shows that Facebook can:

  1. Fuel self-esteem. In a Cornell University study, students felt better about themselves after they updated their Facebook profiles; a control group of students who didn’t log onto the site didn’t experience such a mood lift. The very act of posting something about yourself — regardless of what you write — can boost your self-confidence because you control the image you present to your network of friends, according to researchers.Similarly, according to a Michigan State University study, students with low self-esteem and happiness levels who used Facebook more frequently felt more connected to friends and campus life than those who logged on less often.
  2. Strengthen friendship bonds. In a small study of heavy Facebook-using young British adults between ages 21 and 29, Lancaster University researchers found that the site helped cement positive interactions among friends. Both private messages and wall posts allowed Facebook users to confide in their friends, surf down memory lane, and laugh out loud, promoting happy feelings.
  3. Stamp out shyness and loneliness. In a soon-to-be-published Carnegie Mellon study, researchers who surveyed more than 1,100 avid Facebook-using adults found that receiving messages from friends and consuming info from friends’ news feeds boosted feelings of connectedness, especially in people with self-described “low social skills.” Authors say that for shy people, gleaning information from news feeds and profiles can help start conversations they otherwise might not be comfortable enough to strike up. “People who are uncomfortable chatting face to face gain more through their use of the site,” says study co-author Moira Burke, a PhD candidate in the university’s Human-Computer Interaction Institute.Similar benefits hold true for tweens and teens: Australian researchers who studied more than 600 students between age 10 and 16 found that communicating online helped improve communication skills for lonely adolescents, giving them an outlet to talk more comfortably about personal topics.

Health Risks of Facebook

Research also shows that Facebook can:

  1. Cause depression. A recently published American Academy of Pediatrics (AAP) paper made a major splash when it described Facebook depression — a condition said to result when tweens and teens spend too much time on social media, leading them to turn to “substance abuse, unsafe sexual practices, or aggressive or self-destructive behaviors.”However, the phenomenon is more anecdotal than based on solid science, and some experts suggest that it’s more of a correlation — that people who are depressed may simply be more likely to use Facebook. “People who are already feeling down or depressed might go online to talk to their friends, and try and be cheered up,” wrote John M. Grohol, PsyD, founder and editor-in-chief of PsychCentral.com on his blog. “This in no way suggests that by using more and more of Facebook, a person is going to get more depressed.”

    In one of the papers cited by the AAP report, researchers found that the more time first-time Internet users spent online, the more likely they were to experience loneliness and depression but a follow-up study showed such effects disappeared a year later, according to Dr. Grohol. “It may simply be something related to greater familiarity with the Internet,” he wrote. In another paper referenced by the AAP report, the depression-Facebook link only held true among people with “low-quality” friendships; people with good pals did not experience depression with increasing Facebook use.

  2. Trigger eating disorders. The more time adolescent girls spent on the social networking site, the more likely they were to develop eating disorders such as anorexia, bulimia, and extreme dieting, Israeli researchers recently found. Exposure to online fashion and music content, as well as watching TV shows like Gossip Girl, were also associated with an increased risk for eating disorders.But researchers aren’t saying that social networking sites necessarily cause eating disorders; as with Facebook depression, it may be that people prone to eating disorders spend more time online. What’s more, the researchers found that parents can help protect their daughters from harmful effects of media: The children of parents who were aware of what their daughters were viewing online — and talked to them about what they saw and how much time they spent — were less prone to develop eating disorders, according to study authors.
  3. Split up marriages. Facebook was referenced in 20 percent of divorce petitions processed in 2009 by Divorce-Online, a British law firm. Time magazine reported that feuding spouses use their Facebook pages to air dirty laundry, while their lawyers use posts as evidence in divorce proceedings. Sexual health expert Ian Kerner, PhD, recently blogged on CNN that he’s seen many relationships destroyed by “Facebook bombs” — people reconnecting with high school sweethearts or other blasts from the past that can lead to emotional, if not actual, cheating.

    “The mistake I often see is when someone gets friended or messaged by an ex and doesn’t tell their partner,” Kerner told Everyday Health. “It’s a slippery slope from the moment you don’t disclose information.”

    He warns that it’s easy to over-romanticize the past, which can cause people to check out of their current relationship. Kerner advises couples to not keep secrets about whom they’re chatting with on Facebook. And while the site certainly makes it easy to reconnect with old flames and flirt behind the façade of your computer, the potential damage it can do depends on the stability of your relationship in the first place. “It all depends on your level of trust in your spouse,” says Kerner. “Have a dialogue, set some rules. The key is transparency.”

8 Simple Tips to Cut Your Cell Phone Cancer Risk

Does the World Health Organization’s statement that cell phones may cause cancerhave you thinking twice about making that phone call?

Of course it’s alarming to think that something that’s become such a can’t-live-without can be linked to brain cancer, but there’s a lot even the most cell phone-addicted people can do to minimize health risks.

Any potential links to cancer stem from the low levels of radiation cell phones emit. Lower your exposure to the radiation, and you’ll reduce the potential links to cancer or other health problems:

  1. Use a headset. Sounds obvious, but headsets emit much less radiation than cell phones do, according to the Environmental Working Group (EWG), and they keep your cell phone away from your head. The farther away you are from a source of radiation, the less damage it can do.
  2. Text when you can. Your constantly texting teens are onto something: Cell phones use less energy (and emit less radiation) when you text than when you talk, says the EWG. Texting also keeps the radiation source farther away from your brain.
  3. Use cell phones for FYI-only calls. Don’t use your cell phone for that long overdue, hour-long catch-up with your sister. Keep calls as short as possible —Do you need me to get the dry cleaning, honey? — and switch to a landline if they’re veering off into chitchat territory.
  4. Watch the bars. Can you hear me now? If you’re struggling to maintain a connection, ditch the call and wait until you have better service. When your phone has fewer signal bars, it has to work harder (and, therefore, emit more radiation) to connect.
  5. Keep the phone away from your ear when you can. EMF-Health.comrecommends waiting for the call to connect before you bring the phone to your ear, which minimizes radiation exposure. And when you talk, tilt the phone away from your ear and bring it in close when you’re listening. That’s because the radiation levels are “significantly less when a cell phone is receiving signals than when it is transmitting,” Lin Zhong, assistant professor of electrical and computer engineering at Rice University in Houston, told The New York Times.
  6. Don’t make calls in elevators or cars. You already it’s dangerous to talk and drive; EMF-Health.com says that cell phones use more power to establish a connection in enclosed metal spaces like cars and elevators.
  7. Make sure your kids use the landline. It seems like even toddlers are using cell phones today, but experts say kids are the most vulnerable to potential radiation dangers. The EWG says children’s brains absorb twice as much cell phone radiation as adults. According to The New York Times, health authorities in Britain, France, Germany, and Russia all have warnings against letting children use cell phones.
  8. Buy a low-radiation phone. Some cell phones emit more radiation than others; if you’re in the market for a new phone, EMF-Health.com recommends that you consider the phone’s SAR (specific absorption rate), a way of measuring the radiation absorbed by the body. It’s usually listed in the phone’s instruction manual. You can also look at the EWG’s report of cell phone SARs here — from the LG Quantum’s 0.35 W/kg on the low end to the Motorala Bravo’s 1.59 W/kg on the high end.

Exercise and Talk Help Ease Chronic Fatigue Syndrome

Patients with chronic fatigue syndrome who participated in programs aimed at helping them overcome their symptoms — a combination of exercise and counseling— improved more than those whose treatment was intended to help them adapt to the limitations of the disease, a large randomized trial found.

Mean fatigue scores among patients treated with graded exercise therapy — a tailored program that gradually increases exercise capacity — were 3.2 points lower than scores in patients who received specialist medical care alone, according to Dr. Peter D. White, of Queen Mary University of London, and colleagues.

Furthermore, fatigue scores were lower by 3.4 points among patients receiving cognitive behavioral therapy, in which a therapist works with the patient to understand the disease, alleviate fears about activity, and help overcome obstacles to functioning.

In contrast, among patients who were treated with a program known as adaptive pacing therapy, which emphasizes energy limitations and avoidance of excess activity, scores differed by only 0.7 points the researchers reported online in The Lancet.

In a press briefing describing the study findings, co-investigator Dr. Trudie Chalder, of King’s College London, said, “We monitored safety very carefully, because we wanted to be sure we weren’t causing harm to any patients.”

“The number of serious adverse events was miniscule,” she added.

Another co-investigator, Dr. Michael Sharpe, of the University of Edinburgh, commented that a difficulty in the management of chronic fatigue syndrome has been ambiguity — about the causes and whether these treatments recommended by NICE actually are effective.

“The evidence up to now has suggested benefit, but this study gives pretty clear-cut evidence of safety and efficacy. So I hope that addresses the ambiguity,” Sharpe said during the press briefing.

However, the investigators conceded that the beneficial effects of these treatments were only moderate, with less than one-third of participants being within normal ranges for fatigue and functioning, and only about 40 percent reporting that their overall health was much better or very much better.

“Our finding that studied treatments were only moderately effective also suggests research into more effective treatments is needed,” they wrote.

In addition, they stated that their finding of efficacy for cognitive behavioral therapy “does not imply that the condition is psychological in nature.”

The importance of cognitive behavioral therapy was further emphasized by Dr. Benjamin H. Natelson, of Albert Einstein College of Medicine in New York.

“This approach of encouragement of activity and discouragement of negative thinking should be a tool in every physician’s armamentarium,” he said.

“We know that cognitive behavioral therapy and gentle physical conditioning help people cope with any chronic disease — even congestive heart failure and multiple sclerosis,” Natelson said in an interview with MedPage Today.

Chronic fatigue syndrome is characterized by persisting or relapsing fatigue for at least six months that cannot be explained by any other physical or psychiatric disorder.

The fatigue is debilitating, and often is accompanied by joint and muscle pain, headaches, and tenderness of the lymph nodes.

In an editorial published with the study, Dr. Gijs Bleijenberg, and Dr. Hans Knoop, of Radboud University in Nijmegen, the Netherlands, explained the differences in these types of treatment for chronic fatigue.

“Both graded exercise therapy and cognitive behavior therapy assume that recovery from chronic fatigue syndrome is possible and convey this hope more or less explicitly to patients. Adaptive pacing therapy emphasizes that chronic fatigue syndrome is a chronic condition, to which the patient has to adapt,” Bleijenberg and Knoop wrote.

Graded exercise therapy and cognitive behavioral therapy have both been recommended by the U.K. National Institute for Health and Clinical Excellence, although evidence supporting these approaches remains sparse.

Some patient groups have expressed strong disagreement with these recommendations, arguing that cognitive behavioral and graded exercise therapies actually have caused harm to some patients.

These groups advocate exercise pacing and specialist medical care, according to the investigators.

To address this controversy, White and colleagues conducted the largest trial thus far of treatment for chronic fatigue, enrolling 641 patients from six U.K. specialty clinics.

Patients were randomized to receive specialist medical care alone, or specialist medical care plus cognitive behavioral therapy, graded exercise therapy, or adaptive pacing therapy for 24 weeks.

More than three-quarters were women, average age 38, and most had been diagnosed with chronic fatigue syndrome almost three years before entering the study.

At week 52, these percentages of patients improved by at least two points on the fatigue scale and by eight points or more on a physical function scale:

  • Cognitive behavioral therapy, 59 percent
  • Graded exercise therapy, 61 percent
  • Adaptive pacing therapy, 42 percent
  • Specialist medical care, 45 percent

The investigators also looked at percentages of patients who were in the normal range for fatigue and functioning at 52 weeks:

  • Cognitive behavioral therapy, 30 percent
  • Graded exercise therapy, 28 percent
  • Adaptive pacing therapy, 16 percent
  • Specialist medical care, 15 percent

Better outcomes also were seen for cognitive behavioral therapy and graded exercise therapy in a number of secondary outcomes such as social adjustment and sleep disturbances.

Serious adverse events were seen in 2 percent of patients in the cognitive behavioral therapy group, and in 1percent of each of the other three groups.

White’s group acknowledged that the trial had certain limitations, including the exclusion of patients unable to attend the therapy sessions, self-rating by participants, and the unblinded structure of the study.

They plan further study of factors such as cost-effectiveness of the treatments, possible differences in response among subgroups of patients, and long-term outcomes.