(HealthDay News) — Malaria sickens thousands of Americans and leads to millions of dollars in health care costs each year, a new study finds.
Transmission of the mosquito-borne disease in the United States was stamped out decades ago. But it still affects Americans who travel to regions where it remains common, such as Africa, Asia and Latin America, and then bring it back home.
Between 2000 and 2014, about 22,000 people were admitted to U.S. hospitals with complications of malaria, researchers found in their review of federal government data.
Their findings were published April 24 in the American Journal of Tropical Medicine and Hygiene.
“It appears more and more Americans are traveling to areas where malaria is common and many of them are not taking preventive measures, such as using anti-malarial preventive medications and mosquito repellents, even though they are very effective at preventing infections,” study lead author Diana Khuu said in a journal news release. Khuu is an epidemiologist at the University of California, Los Angeles.
More than 4,800 patients at U.S. hospitals were diagnosed with severe malaria over the 15-year period, according to the study. That means they had kidney failure, coma, acute respiratory distress or other complications that significantly increase the risk of death. Of those patients, 182 died.
And, the study found, hospitalizations for malaria were far more common than for other travel-linked diseases. For example, hospitalizations for dengue fever averaged nearly 260 a year, compared to nearly 1,500 for malaria.
About 7 of 10 Americans who get malaria need hospital treatment. Based on that figure, the researchers estimated the United States has 2,100 malaria cases each year. That’s slightly more than the U.S. Centers for Disease Control and Prevention’s estimate of 1,500 to 2,000.
The difference may be because the CDC bases its count on reports from hospitals or doctors, while hospital admission records used in Khuu’s study may identify additional cases that were not reported to CDC, the researchers said.
Khuu’s team also found that the average cost per malaria patient in the United States is about $25,800. Total bill for treating malaria patients in the United States over the study period: about $555 million.
“Hospitalizations in the United States from malaria remind us that we live in an interconnected world,” said Dr. Patricia Walker, president of the American Society of Tropical Medicine and Hygiene.
“For this reason, the U.S. must continue to invest in tropical medicine research efforts and programs, even for diseases like malaria that we don’t think of as American diseases,” she said.
SOURCE: American Journal of Tropical Medicine and Hygiene, news release, April 24, 2017
(HealthDay News) — That spare tire you’re toting around could be increasing your risk of an early death, a new study suggests.
What’s more, the increased risk associated with having a larger waistline occurs even if a person’s body-mass index (BMI) indicates a healthy weight, said lead researcher Emmanuel Stamatakis. He’s an associate professor with the University of Sydney in Australia.
People who carry extra weight around the middle — also called “central obesity” — but have a normal BMI have a 22 percent higher risk of death than people whose fat is stored elsewhere in their bodies, the study found. In folks with a BMI that indicates obesity, the risk of early death was 13 percent higher for those with central obesity.
The study also found that a large gut poses an even greater hazard for heart health. The risk of heart-related death is 25 percent higher for someone with central obesity and a normal BMI. It’s 26 percent greater for those with an overweight BMI and extra abdominal girth, and 56 higher percent for an obese BMI and central obesity, the study found.
BMI is a rough estimate of a person’s body fat based on height and weight measurements. Normal BMI is 18.5 to 24.9, according to the U.S. Centers for Disease Control and Prevention. Overweight is 25 to 29.9, and obese is 30 and over. Someone who’s 5 feet, 9 inches tall is considered normal when weight is between 125 and 168 pounds. Overweight is 169 to 202 pounds. Obese is 203 pounds or higher.
Waist-to-hip ratio is a measurement used to determine if there is excess belly fat. Stamatakis said waist-to-hip ratio is calculated by dividing your waist measurement by your hip measurement.
“If a person’s waist-to-hip ratio is over 0.85 if they are female, or over 0.90 if they are male, then they should be concerned and look into ways to alter their lifestyle to lose or reduce the ‘paunch,’” Stamatakis said.
Ruth Loos is director of the genetics of obesity and related metabolic traits program at the Charles Bronfman Institute of Personalized Medicine at Mount Sinai in New York City.
She said these findings jibe with previous studies indicating that belly fat may be more detrimental to a person’s health than fat stored elsewhere in the body.
“Studies have been fairly consistent in showing that waist-to-hip ratio contributes to disease,” Loos said.
For this latest study, researchers looked at almost 43,000 participants in the Health Survey for England and the Scottish Health Survey. Each person’s BMI and waist-to-hip ratio was compared against their health history during 10 years of follow-up.
The study participants’ average age was 58. And, just over half had central obesity. Forty four percent were overweight. One quarter were obese. Folks who were overweight and obese were much more likely to have central obesity than people with a normal BMI.
Researchers found that the risk posed by a big belly was the same for men and women, Stamatakis noted.
However, men are more likely to store fat around their middle, which could mean they are more likely to develop this risk, Loos said. Women tend to store fat in their hips and buttocks.
“It is indeed true that men have more of the one type of body shape, and women the other,” Loos said.
Excessive fat around the waist has been linked to insulin resistance, high cholesterol and increased inflammation, Stamatakis said. These all are risk factors for heart disease.
A high waist-to-hip ratio also can indicate less muscle mass in the legs, which also increases heart disease risk, Stamatakis added.
“In fact, people who have high BMI often have larger amounts of fat stored in the hips and the legs, and this appears to be better for metabolic and cardiovascular health for reasons we cannot fully understand,” he said.
Loos said belly fat might be more harmful than fat stored in the hips because it more directly affects the central organs of the body.
“If you store fat around your belly and around your organs, it’s going to affect your liver function, it’s going to affect your heart function,” Loos said.
Both Stamatakis and Loos said people with belly fat should take steps to improve their health, by eating right, exercising and cutting out other risk factors like smoking or drinking.
Unfortunately, weight loss efforts will not necessarily eliminate your spare tire. Weight loss tends to occur evenly across the entire body, and cannot be directed toward any exact store of fat, Loos noted.
“There’s no way of specifically targeting that belly fat,” Loos said. “Even exercises like doing sit ups are not going to specifically help you lose fat in your belly.”
The new study was published April 24 online in the Annals of Internal Medicine.
SOURCES: Emmanuel Stamatakis, Ph.D., associate professor, University of Sydney, Australia; Ruth Loos, Ph.D., director, genetics of obesity and related metabolic traits program, Charles R. Bronfman Institute of Personalized Medicine, Mount Sinai, New York City; April 24, 2017, Annals of Internal Medicine
(HealthDay News) — Sometimes the treatment for heart problems may be more aggressive than it needs to be, according to Consumer Reports.
Heart disease requires emergency medical attention when someone is having active symptoms, such as chest pain and shortness of breath. But excessive heart screening tests associated with false alarms can cause unnecessary anxiety and lead to a series of costly and risky procedures, the new report stated.
Overtreatment for heart disease can lead to complications and worse outcomes, cautioned Dr. Marvin Lipman, the chief medical adviser at Consumer Reports.
Low-risk patients with no worrisome symptoms who’ve been told they should undergo certain heart-screening tests should speak up and ask their doctor why these tests are necessary, he advised.
“If you don’t get a satisfactory answer, politely decline it or ask for a second opinion,” Lipman said in a news release from the organization.
The following is a list of heart tests and who would most likely benefit from them, according to Consumer Reports:
- Electrocardiogram (EKG or ECG): This test may be needed for people who have warning signs of heart disease, including chest pain. Anyone at risk for heart disease who’s starting an exercise program may also benefit from this test.
- Exercise stress test: This test may be done along with an EKG. It also might be done if you’ve had unusual EKG results.
- Abdominal aortic aneurysm test: This test may be useful for men aged 65 to 75, especially current or former smokers. It might also be helpful for those with detectable lumps in their belly. The benefits of this test aren’t as clear for women. But it may be considered useful for women 65 or older with a history of smoking.
- Peripheral artery disease test: Anyone who suffers from cramping in the hips, thighs or calves while walking or exercising may need this test.
- Carotid artery imaging: This test may be helpful for people who’ve had a stroke or a mini-stroke.
- CT angiography: This test may be useful for people who receive inconclusive EKG or stress test results, and those with chest pain.
The report was published online April 6, and is in the May print issue of Consumer Reports.
(HealthDay News) — Kids are more likely to develop childhood epilepsy — a seizure disorder — if their mothers were overweight or obese early in pregnancy, a new study suggests.
The risk of epilepsy in children goes up as a mother’s weight goes up — reaching as high as 82 percent among kids of severely obese women, the researchers said.
“This means more severe grades of obesity correspond to increasingly higher risk,” said study co-author Dr. Eduardo Villamor. He’s a professor of epidemiology with the University of Michigan School of Public Health.
However, Dr. Steven Wolf, director of the pediatric epilepsy program at Mount Sinai Health System in New York City, pointed out that the overall risk of childhood epilepsy still remains relatively low, even if a woman is overweight or obese.
It’s also important to note that this study wasn’t designed to conclusively show a direct cause-and-effect relationship between a pregnant woman’s weight and her child’s risk of epilepsy.
About 50 million people worldwide have epilepsy, according to the study authors. In 60 percent of those cases, no known cause is found.
The current study included medical data for more than 1.4 million babies born in Sweden between 1997 and 2011. Of all those children, more than 7,500 kids were diagnosed with epilepsy between birth and age 16, the researchers said.
The investigators found that the odds a child would develop epilepsy corresponded to their mom’s body mass index (BMI) at around 14 weeks of pregnancy. BMI is a rough estimate of body fat based on a person’s height and weight.
A normal BMI is between 18.5 and 24.9. Someone between 25 and 29.9 is considered overweight. Anyone above 30 is classified as obese.
For someone who is 5 feet, 9 inches tall, a BMI of 25 to 29.9 (overweight) means a weight that’s between 169 and 202 pounds. A BMI of 30 or more (obesity) is a weight above 202 pounds for someone of that height, the U.S. Centers for Disease Control and Prevention says.
This study also included separate classifications of obesity. From 30 to 34.9 was grade I obesity. From 35 to 39.9 was grade II obesity. And, grade III obesity included anyone with a BMI of 40 or more.
For childhood epilepsy, compared with normal-weight women, the researchers associated:
- 11 percent increased risk with overweight.
- 20 percent increased risk with grade I obesity.
- 30 percent increased risk with grade II obesity.
- 82 percent increased risk with grade III obesity.
Neda Razaz, the study’s lead author, said, “Given that overweight and obesity are potentially modifiable risk factors, prevention of obesity in women of reproductive age may be an important public health strategy to reduce the incidence of epilepsy.” She’s a postdoctoral fellow at the Karolinska Institute in Stockholm, Sweden.
There are several potential ways a mother’s excess weight could increase risk of childhood epilepsy, Razaz and Villamor said.
Excess weight increases the risk of preterm birth and birth defects, which in turn increase risk of epilepsy, the researchers said. The baby also is more likely to suffer from trauma or low oxygen levels during birth with an overweight or obese mother. These factors might raise epilepsy risk.
Overweight or obesity also spurs on general inflammation in the mother’s body. This could possibly have an effect on their baby’s developing brain, Villamor added.
Dr. William Bell is a neurologist with Ohio State University’s Wexner Medical Center. He agreed that inflammation could be the culprit behind this increased risk.
“Pregnancy is already an inflammatory state, and so is obesity. When you add those two together, a lot of bad things can happen,” Bell said. He wrote an editorial accompanying the new study.
However, Razaz said it’s likely that excess weight interacts with other genetic and environmental factors that might contribute to epilepsy risk. These include smoking or drinking, vitamin deficiency, or problems related to a woman’s social or economic status.
Wolf said the findings are fascinating, and mothers’ weight hasn’t been considered a risk factor for childhood epilepsy.
“We take care of a lot of kids with epilepsy, and that’s not one of the variables that pop up,” Wolf said.
However, Wolf thinks these findings need “a little more validation.”
“A study like this makes us pause and stop and think, but my sense is this isn’t a significant variable at this moment,” he said.
But there are plenty of reasons women thinking about pregnancy might want to control their weight, including pregnancy complications, Wolf and Bell said.
The study was published online April 3 in the journal JAMA Neurology.
SOURCES: Eduardo Villamor, M.D., M.P.H., Dr.PH., professor of epidemiology, University of Michigan School of Public Health; Steven Wolf, M.D., director of pediatric epilepsy program, Mount Sinai Health System, New York City; Neda Razaz, M.P.H., Ph.D., postdoctoral fellow, Karolinska Institute, Stockholm, Sweden; William Bell, M.D., neurologist, Ohio State University’s Wexner Medical Center, Columbus, Ohio; April 3, 2017, JAMA Neurology, online
(HealthDay News) — Americans of South Asian and Hispanic descent who aren’t overweight may be more at risk for heart disease, stroke and diabetes than normal-weight white people are, a new study finds.
“Clinicians using overweight/obesity as the main criteria for [heart disease and diabetes] screening, as currently recommended by the U.S. Preventive Services Task Force, may fail to identify [heart disease and diabetes] abnormalities in many patients from racial/ethnic minority groups,” said study first author Unjali Gujral.
She is a postdoctoral fellow at Emory University in Atlanta.
The study was done by researchers at Emory and the University of California, San Francisco (UCSF).
The new research included nearly 7,000 people between 45 and 84 years old. More than 800 were of South Asian descent from India, Pakistan, Nepal, Bangladesh or Sri Lanka. The rest were identified as white, black, Hispanic and of Chinese descent.
The study included body mass index (BMI) information. BMI is a rough estimate of body fat based on height and weight. In general, a normal BMI range is from 18.5 to 24.9, according to the U.S. Centers for Disease Control and Prevention. This study used a narrower range for normal BMI for people of Chinese and South Asian descent — 18.5 to 22.9, the researchers said.
The researchers also looked at four risk factors — high blood pressure, elevated blood sugar, low levels of “good” HDL cholesterol and high levels of blood fats called triglycerides — associated with heart disease, stroke and diabetes.
Those with two or more of the risk factors were considered to have heart disease or diabetes-linked (cardio-metabolic) abnormalities.
Among normal-weight people, those of South Asian descent were two times more likely to have heart disease or diabetes abnormalities.
Normal-weight people of Hispanic descent were 80 percent more likely to have these potential problems than whites, the study found.
And blacks and Chinese-Americans were 50 percent more likely to have these metabolic abnormalities at a normal weight, researchers said.
These abnormalities showed up at much lower BMIs for non-white people, the study found.
For example, for non-whites to have a similar number of heart and diabetes risk factors as a white person with a BMI of 25, someone of Chinese or South Asian descent had a BMI of 19.6. For a woman who’s 5 feet 5 inches, a BMI of 25 is equivalent to 150 pounds. A BMI of 19.6 is 118 pounds, the researchers said.
“These differences are not explained by differences in demographic, health behaviors or body fat location,” Gujral said in a UCSF news release.
Study senior author Dr. Alka Kanaya is a professor of medicine, epidemiology and biostatistics at UCSF. “We hope the results will enable patients and their health care providers to see that race/ethnicity alone may be a risk factor for cardio-metabolic health in minority Americans,” she said.
The study was published April 3 in the journal Annals of Internal Medicine.
(HealthDay News) — Babies are far less likely to develop whooping cough if their mother was vaccinated while pregnant, a new study reveals.
The study included nearly 149,000 infants born in California between 2006 and 2015. The percentage whose mothers received the Tdap booster vaccine for tetanus, diphtheria and pertussis (“whooping cough”) while pregnant rose from less than 1 percent in 2006-2008 to more than 87 percent by 2015.
In early 2013, the U.S. Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) recommended the Tdap shot for pregnant women regardless of prior Tdap vaccination. The vaccine can be given at any time during pregnancy, preferably between 27 and 36 weeks’ gestation.
Babies whose moms got the Tdap shot during pregnancy had a 91 percent lower risk of whooping cough during the first two months of life. That’s the critical period before babies get their first whooping cough shot, the Kaiser Permanente researchers said.
Babies whose moms got the vaccine during pregnancy also had a 69 percent lower risk of whooping cough in their first year of life, the findings showed.
“The strategy of immunizing pregnant women to boost maternal antibody transfer appears to be more effective for protecting young infants against pertussis than are attempts at ‘cocooning,’ in which mothers and other persons in close contact with newborns are vaccinated after the birth,” study senior author Dr. Nicola Klein said in a Kaiser news release. Klein is director of the Kaiser Permanente Vaccine Study Center.
“The results of this study demonstrate that maternal Tdap administered during pregnancy provides the best protection against pertussis, which strongly supports ACIP’s current recommendation to administer Tdap during each pregnancy,” she said.
The study was published online April 3 in the journal Pediatrics.
(HealthDay News) — Pacemakers, defibrillators and other medical devices have saved the lives of millions of people worldwide.
Someone you know probably has received one of these heart-health enhancers, although not all have become household words.
The U.S. Food and Drug Administration evaluates and regulates these and other medical devices in the United States. Below, the agency provides a brief glossary of terms that might come in handy when a doctor recommends a cardiac tool:
Heart pacemakers: These small, battery-powered devices are implanted in the body. They deliver an electric shock to restore normal heart rhythm when the heart beats too slowly.
Implantable cardioverter defibrillators: These deliver a shock to restore normal heart rhythm when the heart beats too fast.
Automated external defibrillators: These portable, automatic devices are found in many public locations. They help restore normal heart rhythm when someone’s heart suddenly and unexpectedly stops pumping blood (cardiac arrest).
Cardiac ablation catheters: These are long, thin flexible tubes that are threaded into or onto the heart to treat abnormally rapid heartbeats. They work by modifying small areas of heart tissue that are causing abnormal heart rhythms.
Cardiovascular angioplasty devices: These long, thin, flexible tubes are threaded into a heart or other blood vessel to open narrowed or blocked areas in order to increase blood flow to the heart, reduce chest pain and treat heart attacks.
Prosthetic (artificial) heart valves: These are used to replace diseased or dysfunctional heart valves, which direct blood flow through the heart. There are mechanical valves made of man-made materials and valves made from tissue taken from animals or human cadavers.
Stents: These are small tubes inserted permanently into an artery to improve blood flow. Some also contain drugs that reduce the chance that arteries will become blocked again.
Ventricular assist devices: These mechanical pumps help weak hearts pump blood effectively. While originally intended for short-term use until a donor heart became available, the devices are now also used as long-term treatment in patients with severe heart failure who do not qualify for a heart transplant.
Heart disease is the leading cause of death in the United States, according to the U.S. Centers for Disease Control and Prevention.
SOURCE: U.S. Food and Drug Administration, news release
(HealthDay News) — Spring can rain misery on allergy sufferers, but there are a number of ways to ease your agony, a physician expert says.
“Allergies affect millions in the U.S., and while there is no way to avoid irritants like pollen entirely, there are simple solutions to mitigate allergic reactions,” said Dr. Joseph Cooke.
Cooke is chair of the department of medicine at NewYork-Presbyterian Hospital Queens.
In the springtime, trees and plants release pollen into the air to fertilize other plants. This pollen can enter your nasal passages and trigger an immune response, he explained.
“As winter evolves into spring, sometimes it just makes sense to stay indoors,” Cooke said in a hospital news release.
“Allergy sufferers should pay attention to the pollen index, use vacuums designed to better pick up common irritants, and close their windows when the pollen count is high,” Cooke advised.
Pollen counts are regularly reported by weather and news agencies, so get in the habit of checking pollen counts daily, he said. When the pollen count is high, try to limit your time outdoors.
Be cautious with so-called herbal or natural remedies, which could actually be harmful, Cooke added.
Doctors from the hospital’s Division of Allergy and Immunology offer these other suggestions for minimizing allergy discomfort:
- Use a vacuum cleaner with HEPA-filtration technology to help remove pollen and other irritants indoors and reduce the chance of breathing them in.
- When pollen counts are high, close your windows and consider turning on the air conditioner. Also, change your home’s air and furnace filters regularly.
- During allergy season, shower often and wash your clothes on a regular basis. Pollen can collect in your hair and on your clothes and body.
- Take antihistamines two hours before spending an extended amount of time outdoors. Try not to go outside at midday, when pollen counts are highest.
- Rinse your nasal passages with a saline solution to reduce congestion and drainage.
(HealthDay News) — Substance abuse exacts a heavy toll on the American workplace, a new analysis shows.
Employees who struggle with drinking and drug addiction miss many more days of work, have higher health care costs and are less productive than those without these disorders, researchers report.
An analysis revealed that employees with substance use disorders miss nearly 50 percent more work days than their colleagues, and up to six weeks of work a year, according to the National Safety Council, NORC at the University of Chicago and Shatterproof. Shatterproof is a national nonprofit that works to end the devastation that addiction causes families.
However, a companion survey from the council found that while 71 percent of employers reported issues with worker prescription drug use, only 39 percent consider it a safety threat and only 24 percent believe it’s a problem.
“Businesses that do not address the prescription drug crisis are like ostriches sticking their heads in the sand,” said council president and CEO Deborah Hersman.
“The problem exists, and doing nothing will harm your employees and your business,” she added in a council news release.
The analysis and survey also found that: construction, entertainment, recreation and food service businesses have twice the national average number of workers with substance use disorders; business sectors with large numbers of women or older adult workers have a two-thirds lower rate of substance abuse; and business sectors with higher numbers of workers with alcohol use disorders also have more illicit drug, pain medication and marijuana use disorders.
The cost of an untreated substance use disorder ranges from $2,600 per employee working in agriculture to more than $13,000 per employee in the information and communications sector.
Health care costs for workers who misuse or abuse prescription drugs are three times higher than for other workers.
Workers in recovery from substance abuse have lower turnover rates and are less likely to miss work days, less likely to be hospitalized and have fewer doctor visits.
Among employers, far fewer were concerned about prescription drug abuse (67 percent) or illegal drug sales (61 percent) than about the costs of benefits (95 percent), the ability to hire qualified workers (93 percent) and the costs of worker’s compensation (84 percent) — even though drug misuse affects those three areas.
Getting a worker into substance abuse treatment can save an employer as much as $2,607 a year, and workers are more likely to undergo treatment if it is initiated by an employer, the researchers added.
SOURCE: National Safety Council, news release, March 22, 2017
Copyright (c) 2017 HealthDay. All rights reserved.
(HealthDay News) — U.S. teens with autism are four times more likely to visit an emergency room than those without the disorder, a new report says.
The Penn State College of Medicine researchers said the likelihood of an ER visit for a teen with autism increased five-fold from 2005 to 2013.
The findings suggest that young people with autism may require better access to primary and specialist care, the researchers said.
“We believe if their regular medical and behavioral specialist services served them better, a big portion of them would end up with fewer emergency department visits,” said study author Guodong Liu, an assistant professor of public health sciences at Penn State.
In the United States, it’s estimated that 1 in 68 children has an autism spectrum disorder. This is the term for a range of conditions that may involve problems with social skills, speech and nonverbal communication, and repetitive behaviors, according to Autism Speaks. Frequently, other medical and mental health issues accompany the disorder.
Liu’s team analyzed nine years of private insurance health-care claims of 12- to 21-year-olds. The researchers found that ER use by adolescents with autism rose from 3 percent in 2005 to 16 percent in 2013. During that same time, ER use by teens without autism held steady at about 3 percent.
Older teens with autism were much more likely to visit an ER than younger ones — one-third vs. 10 percent, the study found.
The researchers also discovered that the proportion of ER visits by teens with autism for a mental health crisis rose from 12 percent in 2005 to 22 percent in 2013.
Liu said puberty and the transition to adulthood may be especially difficult for children with autism, and their parents and other caregivers might not be aware that they need extra guidance and support during this vulnerable time.
In response to stress, some teens with autism may harm themselves, Liu said.
“The consequence is they’re more likely to end up in the emergency department,” he said in a Penn State news release.
The study was partly funded by the U.S. National Institutes of Health. It was published recently in the Journal of Autism and Developmental Disorders.
SOURCE: Penn State, news release, Feb. 28, 2017