Computer-Based Psychotherapy Not as Effective as Standard Care

THURSDAY, Nov. 12, 2015 (HealthDay News) — Computer-assisted cognitive behavioral therapy probably won’t replace standard person-to-person therapy any time soon, new research suggests.

The British study found that people did not follow through on computer-assisted therapy. Fewer than one in five completed six computer sessions, the researchers reported.

Cognitive behavioral therapy — a form of talk therapy — is an effective treatment for depression. However, in-person therapy is not always available, so computer-assisted therapy was developed as a substitute.

But until now, the effectiveness of computer-assisted therapy hadn’t been studied.

The study included almost 700 British patients with depression who were randomly assigned to receive either standard care from their doctor or standard care with one of two computer-assisted therapy packages — one a commercial product and the other a free online product.

The computer-assisted therapy programs offered either six or eight one-hour sessions, respectively. Both programs also encouraged patients to do homework between the sessions.

The study found that computer-assisted therapy packages offered little or no benefit over standard care. After four months, 44 percent of patients in the standard care group were still depressed. Fifty percent of those in the commercial product group, and 49 percent of those in the free online product group remained depressed, the study reported.

The findings were published this week in the journal BMJ.

The main reason for the low levels of success with computer-assisted therapy packages may have been that many patients didn’t use them, the researchers said. Only 18 percent of those in the commercial product group completed all eight sessions, and only 16 percent of those in the online product group completed all six sessions. Nearly one-quarter of patients dropped out of the study by four months.

The study showed that patients were “generally unwilling to engage with computer programs, and highlighted the difficulty in repeatedly logging on to computer systems when clinically depressed,” wrote Simon Gilbody, professor of psych medicine at the University of York, and his colleagues.

“Participants wanted a greater level of clinical support as an adjunct to therapy, and in absence of this support, they commonly disengaged with the computer programs,” the researchers explained.

More information

The American Academy of Family Physicians has more about therapy and counseling for mental health.

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Nearly Half of Americans With High Blood Pressure Not Controlling It: CDC

By Dennis Thompson
HealthDay Reporter

THURSDAY, Nov. 12, 2015 (HealthDay News) — Nearly half of Americans with high blood pressure are not properly controlling their condition, increasing their risk of heart attack, stroke and heart disease, a new government report shows.

About 47 percent of people with high blood pressure have not brought their numbers to a normal range, through either lifestyle changes or medications, according to data published Nov. 12 from the U.S. Centers for Disease Control and Prevention.

That’s actually a huge improvement: Back in 1999, more than 68 percent did not have their blood pressure under control, the report found.

But it’s far short of the federal Healthy People 2020 goal, which calls for fewer than 40 percent of people with high blood pressure to have it uncontrolled by that date, according to the CDC researchers.

Experts agreed that the problem is still significant.

“I don’t think we have enough positive information to be cheering,” said Dr. Patrick O’Gara, executive medical director of the Carl J. and Ruth Shapiro Cardiovascular Center at Brigham and Women’s Hospital in Boston. “Although the trend is positive, the magnitude of the problem is self-evident. We have a lot of work to do.”

High blood pressure is defined as 140 or higher systolic pressure (the top number) and 90 or higher diastolic (the bottom number). Systolic is the pressure of blood in the vessels when the heart beats, and diastolic is the pressure between beats.

The overall rate of high blood pressure in the United States has remained constant, hovering between 28 percent and 29 percent, the new report found.

Two in three people over the age of 60 have high blood pressure, and one in three people between the ages of 40 and 59 have the condition.

What improvements there have been in controlling high blood pressure have not benefitted all groups in the United States.

Whites are most likely to have their blood pressure under control, close to 56 percent, the CDC report showed. Blacks (48 percent under control), Asians (43 percent) and Hispanics (47 percent) are all more likely to be living with uncontrolled high blood pressure.

A large part of the problem is getting people to start taking blood pressure medications, and then to stay up with them, said Dr. Richard Stein, director of the Urban Community Cardiology Program at the New York University School of Medicine.

“Patients don’t like to take drugs,” Stein said. “I don’t like to take drugs. Drugs that don’t have an obvious beneficial effect for me, it’s easier for me to forget to take them.”

High blood pressure is called the “silent killer” because people often have no immediate symptoms. Prescribing medication to a person who feels well can be difficult, Stein said.

“When you start on medication, you’re usually prescribed at least two different drugs,” he said. “Suddenly you’re going from nothing to two or more drugs, and now we’ve turned you from a person who was healthy and now you think you’re sick.”

Stein said doctors are going to need to figure out better ways of counseling patients to keep taking their medications, possibly by drawing attention to other members in their family who died of conditions related to high blood pressure.

“If you don’t do anything different than he did, you’re probably going to have the same problems that he did,” Stein said.

O’Gara said that doctors will need to rely on other health care professionals, including nurses and pharmacists, to keep up the pressure on patients to take their blood pressure medications.

“Can we expand the number of providers who would supervise the treatment of hypertension?” he said. “If I had 10 pharmacists who worked with me, I could reach 100 people more effectively. Primary care is shifting to where people go to buy their toiletries and toothpaste, out there in the community for these patients with chronic illnesses. It’s not coming to an academic medical center to have me take their blood pressure.”

However, it’s probably going to take a concerted effort to teach the next generation healthy habits before a big difference is seen in America’s blood pressure rates, O’Gara concluded.

“I think it may take a generational change, to alter our proclivity to overeat and use too much salt, to not exercise and spend too much time in front of a screen,” he said.

More information

For more information on blood pressure, visit the U.S. National Institutes of Health.

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Adult Obesity Still Growing in U.S., Youth Rates Hold Steady: CDC

By Steven Reinberg
HealthDay Reporter

THURSDAY, Nov. 12, 2015 (HealthDay News) — Although obesity rates continued to climb among U.S. adults over the past decade, they stabilized for children and teens, federal health officials reported Thursday.

More than 36 percent of adults and 17 percent of America’s kids were obese between 2011 and 2014, said researchers from the U.S. Centers for Disease Control and Prevention. These are the latest years for which national statistics are available.

Analyzing weight trends since 1999, researchers found the ranks of obese adults have swelled significantly in the last 10 years.

Adult obesity rates climbed from slightly over 32 percent in 2003-04 to almost 38 percent by 2013-14, said lead researcher Cynthia Ogden, an epidemiologist in the CDC’s National Center for Health Statistics.

Among youths aged 2 to 19, she said, 17.2 percent of children were obese in 2014, compared with 17.1 percent in 2003. “There is basically no difference [in the obesity rate in this group],” she said.

Obesity is a major cause of chronic disease, including heart disease, cancer, stroke, diabetes, dementia and arthritis, said Dr. David Katz, director of the Yale University Prevention Research Center, in New Haven, Conn.

“Where there is a high prevalence of obesity, there are high rates of preventable chronic disease,” Katz said.

Widespread efforts to encourage people to eat healthy and exercise may be having a positive effect, Katz said.

“But we will not really know if these are working until obesity rates and the rates of related diseases dip decisively,” he said. “While there is some encouragement in these new data, clearly, we are not there yet.”

For the report, researchers used data from National Health and Nutrition Examination Surveys. Other key findings for 2011-2014:

• More women (about 38 percent) were obese than men (about 34 percent). No gender difference was observed among children and teens.
• Obesity was higher among middle-aged (about 40 percent) and older (37 percent) adults than younger adults (about 32 percent).
• More whites, blacks and Hispanics were obese than Asians.
• Nearly 9 percent of preschoolers were obese, versus more than 17 percent of kids aged 6 to 11. Among teens, more than 20 percent were obese.

Adult obesity was defined as having a body mass index (BMI) of 30 or more. BMI is a calculation of body fat based on height and weight. For example, someone 5 feet 9 inches who weighs 203 pounds or more has a BMI of 30. Among youth, a BMI in the 95th
percentile or higher for their age and sex was deemed obese, the CDC said.

Katz, who is also president of the American College of Lifestyle Medicine, wasn’t overwhelmed youth obesity statistics. “Stable obesity rates over much of the past decade is the proverbial glass half-full or half-empty, depending on one’s perspective,” he said.

The glass is half-full because stabilization is an improvement over obesity increases seen for decades, he said. “The glass is half-empty, because stable rates are not falling rates, and obesity prevalence remains alarmingly high,” Katz said.

What’s unclear, Katz added, is whether stable rates mean the obesity epidemic is being treated effectively or that everyone who is vulnerable to obesity is already obese. “I suspect a bit of both [is true],” he said.

More information

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

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Everything You Think You Know About Herpes Is Wrong

Photo: Getty Images

Hate to break it to you, but you probably have herpes.

Turns out, nearly two-thirds of the global population is infected with herpes simplex virus type 1 (HSV-1), according to a recent report released by the World Health Organization (WHO). The WHO researchers estimated that 3.7 billion people under the age of 50 are infected with HSV-1, which is best known as a cause of cold sores.

Another 417 million people worldwide aged 15-49 have HSV-2, the type most often thought of as a sexually transmitted disease. But get this–140  million adults have genital infections caused by HSV-1, meaning half a billion people could sexually transmit either virus.

While this news may be shocking—don’t freak out. Herpes has been seriously stigmatized for years, but the fact is, if you don’t have one type of herpes already, you’re very likely to be exposed to it eventually. Below, we bust eight big myths about this common infection. Here’s what you need to know.

RELATED: Top 10 Myths About Safe Sex and Sexual Health

Myth: Cold sores and genital sores are way different

Many people wrongfully believe that cold sores don’t count as “real” herpes, explains Raquel Dardik, MD, a clinical associate professor at NYU Langone’s Joan H. Tisch Center for Women’s Health. This big misconception stems from the general patterns of the two types.

While it’s true that in most people, HSV-1 tends to affect mouths, and HSV-2 usually manifests in symptoms on the genitals, all it takes for either one of these viruses to spread is skin-to-skin-contact. This means that sores from either one can appear anywhere on the body.

To really break it down, let’s say you touch an infected person’s genitals with your mouth while they’re shedding the virus, but there’s no genital-to-genital touching. You can then be infected with either HSV-1 or HSV-2 (whichever your partner has) and go on to develop lesions at the site of the infection (in this case, your mouth).

Myth: I’ve never had an outbreak, so I definitely don’t have herpes

Unfortunately, the lack of a visible outbreak doesn’t mean you’re herpes-free. Many people infected with the virus never experience an outbreak, says Mary Rosser, MD, PhD, director of obstetrics and gynecology at Montefiore Medical Center. And when they do, it frequently isn’t recognized. This explains why, according to the U.S. Centers for Disease Control and Prevention (CDC), 87.4% of infected individuals have no clue.

“Outbreaks can be very mild and even confused with things like heat rash, jock itch, yeast infections, [and] allergic reactions,” adds Fred Wyand, director of communications for the American Sexual Health Association (ASHA). “So while some cases do involve pronounced symptoms, most never do.”

Myth: Well, I got tested for STDs recently, so I still know I’m in the clear

Even if you’ve been hyper-responsible about getting tested—that’s irrelevant when it comes to herpes. The guidelines from the CDC don’t recommend testing for the virus, so it’s typically not included with the routine “STD panel.” This is because a blood test for herpes only tells you whether you’ve been exposed to the virus, explains Dr. Dardik, MD. And a positive result only “raises a whole host of concerns of ‘when?’ and ‘how?’ and ‘where?,’ which are not answerable by that test. It’s not going to change your management and provide more answers, which is why it’s not routinely offered.”

Complicating things further is that the herpes virus is very similar to the virus that causes shingles and chicken pox, and so if you’ve had either of those, that can often skew your results as well, Dr. Rosser adds.

So how do you know if you have herpes? The best way to tell is to wait until you have an outbreak of lesions. Then your doctor can run tests on the sores or lesions to determine whether it is in fact herpes, and what type you’re dealing with.

RELATED: 16 Signs You May Have HIV

Myth: Without a visible outbreak, herpes isn’t contagious

Since outbreaks aren’t always obvious, it’s not always clear when you’re contagious. “There are a few days a year when herpes is active, and possibly transmitted without any symptoms present,” explains Wyand. This is known as viral shedding. “This doesn’t happen on most days, but it’s tricky, because there’s no real way to know.”

All this sounds really scary, but what it boils down to is the importance of practicing safe sex. While the risk of transmission will never be zero, there are some steps you and your partner can take to significantly reduce the risk of transmission: avoiding sex during an outbreak, using condoms, and suppressive therapy (antiviral medications like Valacyclovir). Rosser agrees that condoms are your best friends, for any kind of sex. “People still look at me like I have two heads when I suggest condoms for oral sex,” says Rosser. “But if there’s any question, then use them.”

Rosser adds that communication is not only essential when it comes to having great sex, but also when preventing the spread of herpes. If you’re infected, be honest and considerate—let your partner know, “hey this is an issue.”

RELATED: Things You Must Tell Your Gynecologist

Myth: People with herpes must be promiscuous

The reality of any STD is you don’t need to sleep around to get infected. This is especially true for herpes, considering there’s such a large population of “asymptomatic carriers,” Dr. Dardik says. She also points out: “While having more partners obviously increases your risk of any kind of any kind of sexually transmitted infection, the reverse doesn’t always hold.” In other words, all it takes is one partner.

Myth: I can’t have kids if I have herpes

“When my patients find out they have herpes, they often ask me, ‘Oh my god, can I still have children?'” Dr. Rosser shares. The answer? Absolutely. Herpes doesn’t affect your fertility in any way and there are plenty of safe delivery options to ensure the virus isn’t transferred to your baby, she says. (Genital herpes can increase the risk of miscarriage, preterm birth, or in rare cases, a potentially dangerous infection in newborns if the mother is experiencing symptoms at the time of birth.)

Myth: If my partner suddenly shows signs of herpes, he/she must have cheated 

If you’ve been monogamous with your partner for 5, 10, even 20 years, then out of the blue he or she has a visible herpes outbreak, the only logical explanation is cheating, right? Not necessarily. Similar to HIV or chicken pox, herpes has viral latency, or the ability to lie dormant in your body for years without showing any signs or symptoms.

“You could have been infected in your 20s, and the virus might show up again when you’re 40,” Dr. Dardik explains. “The virus stays in your system even if it isn’t active.” In some cases, people won’t have any kind of outbreak unless it’s triggered by a significantly stressful life event, like another illness.

RELATED: 19 Medical Tests Everyone Needs

Myth: We’re all doomed to get herpes

Now for some good news: just because herpes is super common, that doesn’t mean you’ll definitely get it. It is pretty unsettling that so much of the population has the virus, someone has the disease doesn’t mean they’re going to transmit it, Dr. Dardik explains. In fact, most outbreaks usually occur in the first 1 to 2 years, and after that many people’s bodies suppress the virus for the most part.

Having herpes or dating someone with the virus doesn’t mean your sex life is doomed, either. Smart safe sex practices can cut the risk of spreading or catching the virus to nearly zero.

And finally, if you do have herpes, there are effective treatments for helping with outbreaks, so you shouldn’t feel hopeless. “Many people have this idea that people with herpes are dirty and taboo, but they’re not,” Rosser reminds us. “It’s very common. Anyone can get herpes.”

RELATED: 9 Biggest Emergency Contraception Myth

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Campbell’s Cuts MSG (and More) Out of Their Chicken Soup

Photo: Getty Images

On Monday, Campbell’s Soup announced that they’re going to be eliminating 10 ingredients from their chicken broth in an effort to appeal to healthy eaters.

The catch: the new recipe will only roll-out in their Healthy Kids Shaped Pasta with Chicken in Chicken Broth, in the cans featuring Star Wars and Frozen characters, NPR reported. The company does not yet have plans to change their Classic Chicken Noodle.

For increasingly health-conscious consumers looking to “eat clean,” this is sure to be a welcome change. The new recipe will contain 20 ingredients (down from the original 30), many of which can be found in the average kitchen. Ingredients that got the boot include hard-to-pronounce flavorings and preservatives such as disodium insonitate and maltodextrin, as well as onions, vegetable oil, and celery (kids didn’t like the flavor, a spokesperson told the New York Times). Another notable loss is monosodium glutamate (you probably know it as MSG).

 But just how different will the new soup taste?

“It’s a delicate balance [to change the recipe] because these products are beloved,” Charles Vila, vice president for consumer and customer insights at Campbell, explained to the Times. “Their profile has become very defined in the consumer mind over the years, so any change we make is very carefully considered.”

RELATED:

7 Healthy Chicken Soup Recipes

The 10 Most Ridiculous Myths About the Flu

How to Pick the Right Over-the-Counter Cold Remedy

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Angioplasty May Not Boost Survival for Some Heart Disease Patients

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, Nov. 11, 2015 (HealthDay News) — Angioplasty — the procedure used to open narrowed or blocked arteries — doesn’t seem to lengthen life for people with stable heart disease and chest pain, a new study finds.

After 15 years of follow-up, the study found that people who had angioplasty fared no better than those who had their heart disease treated with medication and lifestyle changes alone.

“[Angioplasty and] stenting is effective and improves survival when performed early in the course of a heart attack,” said lead researcher Dr. Steven Sedlis, an associate professor of medicine at NYU Medical School in New York City. “But the benefits of routine [angioplasty and] stenting for patients with stable heart disease have been uncertain and highly controversial.”

During the angioplasty procedure, a small tube may be placed in the blood vessel to keep it open. This is called stenting.

Routine angioplasty and stenting don’t improve long-term survival, and this study supports current guidelines that recommend medications first, Sedlis said. Angioplasty and stenting should be reserved for patients whose symptoms cannot be controlled by medications, he explained.

Co-author Dr. William Boden, a professor of medicine at Albany Medical College in Albany, N.Y., said, “We know that in heart attack patients, angioplasty can be lifesaving.”

But in patients with stable heart disease — even those with chest pain — medication and lifestyle changes (or “medical therapy”) may be the best way to minimize the risk of heart attacks and heart-related death, he said.

Boden explained that medical therapy includes drugs to lower blood pressure and cholesterol, and aspirin to reduce the risk of blood clots. In addition, patients may receive lifestyle counseling to help them quit smoking, and improve their weight through exercise and eating a healthy diet.

About one million angioplasties are done each year in the United States, and about 500,000 are done in patients with stable heart disease, Boden said.

Stable heart disease refers to chest pain that occurs in a predictable pattern, such as when you’ve been exercising for a certain period of time. Stable heart disease is usually relieved by rest or with medication, the American Heart Association (AHA) says. Unstable heart disease is unpredictable or surprising chest pain. It usually occurs when you’re resting. Unstable chest pain often leads to a heart attack, according to the AHA.

“Patients need to understand what they are getting an angioplasty for,” Boden said. “If they are being told that it’s going to reduce the risk of heart attack or it’s going make them live longer, they’re getting the wrong message.”

The report was published in the Nov. 12 issue of the New England Journal of Medicine.

For the study, researchers looked at the long-term survival of more than 1,200 patients who took part in the COURAGE trial (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation).

In that trial, people were randomly assigned to have an angioplasty plus medication, or receive medical therapy alone to manage their heart disease and relieve their chest pain (angina).

During the 15-year follow-up, 561 patients died: 180 died during the initial four-year follow-up period in the original trial, and 381 died during the remaining follow-up period.

Among those who had undergone angioplasty, 284 people died. And 277 people died in the group treated with medical therapy alone, the researchers reported.

Dr. Gregg Fonarow, a spokesman for the American Heart Association, explained that “while angioplasty for patients with stable heart disease has often been perceived by patients and their doctors to reduce the risk of heart attacks and death, clinical trials have shown no such benefit compared with medical therapy alone.”

The findings of this study reinforce that the most effective way to prevent heart attacks and premature death in men and women with stable heart disease is medical therapy, including aspirin, ACE inhibitors, beta blockers and statins, along with lifestyle modification, added Fonarow, who is also a professor of cardiology at the University of California, Los Angeles.

“Angioplasty alone, while potentially reducing symptoms, provides no detectable benefit in terms of survival in patients with stable coronary artery disease,” he said.

More information

For more about angioplasty and other heart procedures, visit the American Heart Association.

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Swiss Report Highlights Danger of Drug-Resistant Tuberculosis

By Alan Mozes
HealthDay Reporter

WEDNESDAY, Nov. 11, 2015 (HealthDay News) — A new report on a patient in Switzerland who nearly died after catching a highly drug-resistant strain of tuberculosis illustrates exactly what public health officials around the world fear most.

Although antibiotics have largely eradicated tuberculosis in the United States in recent decades, experts say evidence is mounting that the bacteria is becoming increasingly resistant to these medications.

Details of the Swiss case are reported in the Nov. 12 issue of the New England Journal of Medicine by lead investigator Sebastien Gagneux, head of tuberculosis research with the Swiss Tropical and Public Health Institute at the University of Basel, and colleagues.

Normally, Gagneux said, tuberculosis patients are treated for six months with a daily drug “cocktail” comprised of four different first-line medications.

The goal: to hem in tuberculosis (TB) while reducing the risk of drug resistance.

Even so, “antibiotic resistance is inevitable,” he added. “Bacteria fights for its life, and does what it has to do, adapting to survive. And with time, overuse or inappropriate use of antibiotics also plays a role. And in the case of TB, this has been happening while pharmaceutical companies have essentially come out with no new antibiotic treatments for TB for more than 40 years.”

The result: almost half a million patients are now infected with multidrug-resistant TB every year, according to the medical organization Doctors Without Borders. This means their illness is impervious to the two strongest first-line antibiotics typically used.

Even worse, the organization projects that roughly 10 percent of multidrug-resistant patients are actually infected with extensively drug-resistant TB, which renders many first- and second-choice antibiotics ineffective.

Although American cases involving drug resistance remain rare, mounting concern about drug-resistant TB prompted the U.S. Food and Drug Administration to issue limited approval for the clinical use of an experimental antibiotic known as bedaquiline (Sirturo) in 2012. At the same time, another experimental medication called delamanid was given provisional approval by the European Medicines Agency. Both are still undergoing testing for safety and effectiveness, and they are intended for use only in cases when all other options fail.

Such was the case with the patient in Switzerland, who was diagnosed in 2010 with a strain of TB that was resistant to seven different first- and second-choice antibiotics.

Between 2011 and 2012, the patient was given bedaquiline, alongside four standard antibiotics, and by 2013 he was considered to be free of the disease, the researchers said.

However, five months after his treatment ended, the patient had a relapse, at which point his infection was deemed to be bedaquiline-resistant.

In 2014, he was then given delamanid. But again, resistance developed within a matter of months, the researchers said.

The patient then had surgery to remove the affected part of his lung, “and that is really what saved his life,” said Gagneux.

“So really, this case suggests that we’re dealing with a serious public health threat,” he added. “It’s rare. Most people won’t get drug-resistant TB. But for those who do, the risk of drug failure is real. And frankly, it has been such a long time since we last saw new and proven drugs coming online that it’s going to be quite difficult to play catch up.”

Dr. Philip Tierno, a professor of microbiology and pathology at the NYU School of Medicine in New York City, agreed.

“Yes, this kind of drug resistance is very, very rare. But TB affects huge swaths of the world’s population. Literally billions of people are infected. It blows the mind. Now, most will never have symptoms and will not pose an infection risk to others. But that still means millions will get sick,” Tierno said.

“And the fear is that they increasingly get sick with strains of TB that are resistant to the drugs we have available before we have time to develop new drugs,” he added. “That’s a real problem. No question about that.”

More information

There’s more on drug-resistant tuberculosis at the U.S. Centers for Disease Control and Prevention.

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FDA Wants Public Comment on Use of Word ‘Natural’ on Food Labels

WEDNESDAY, Nov. 11, 2015 (HealthDay News) — Plenty of foods in U.S. grocery stores have the word “natural” on their labels, but there is no government definition of the term and little control over its use.

That could change soon, as the U.S. Food and Drug Administration is now seeking public input on the use of the word “natural” on food product labels.

The agency has received three citizen petitions asking it to define the term “natural” on food labels and another petition asking it to ban the use of the word on food labels.

And some federal courts have asked the FDA to determine whether food products that contain genetically modified ingredients or those with high fructose corn syrup can be labeled as “natural.”

“Because of the changing landscape of food ingredients and production, and in direct response to consumers who have requested that the FDA explore the use of the term ‘natural,’ the agency is asking the public to provide information and comments on the use of this term in the labeling of human food products,” the FDA said Tuesday in a news release.

“Although the FDA has not engaged in rulemaking to establish a formal definition for the term ‘natural,’ we do have a longstanding policy concerning the use of ‘natural’ in human food labeling,” the agency said.

“The FDA has considered the term ‘natural’ to mean that nothing artificial or synthetic [including all color additives, regardless of source] has been included in, or has been added to, a food that would not normally be expected to be in that food,” according to the news release.

“However, this policy was not intended to address food production methods, such as the use of pesticides, nor did it explicitly address food processing or manufacturing methods, such as thermal technologies, pasteurization or irradiation,” the FDA said.

The agency also has yet to take a position on whether “natural” should be linked to any nutritional or other health benefit.

The FDA is seeking comment on issues such as whether and how it should define the term “natural,” and how to determine the appropriate use of the term on food labels.

Public comments will be accepted beginning Nov. 12.

More information

Here’s where you can go to submit comments about the use of the term “natural” on food labels.

To submit comments by mail, the address is:

Division of Dockets Management
HFA-305

Food and Drug Administration

5630 Fishers Lane, Room 1061

Rockville, MD 20852

The FDA asks that you include docket number FDA-2014-N-1207 on each page of your written comments.

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Too Few Psychiatric Patients Screened for Diabetes: Study

WEDNESDAY, Nov. 11, 2015 (HealthDay News) — Despite guidelines, diabetes screening rates are low among adults with severe mental illness who take antipsychotic medications, researchers find.

In a new California study, fewer than one-third of mental health patients were screened for type 2 diabetes, despite an elevated risk for the disorder, the researchers reported in the Nov. 9 online edition of the journal JAMA Internal Medicine.

Treatment with antipsychotic drugs contributes to this risk, the researchers explained. This class of drugs includes clozapine (Clozaril), olanzapine (Zyprexa) and risperidone (Risperdal), among others. Anyone taking them should undergo diabetes screening every year, the American Diabetes Association says.

These drugs often cause weight gain, a contributing factor to type 2 diabetes, the study authors noted in a journal news release.

“To improve care for persons with serious mental illness, it will be necessary to break down the silos that separate the mental health and physical health care systems,” journal deputy editor Dr. Mitchell Katz wrote in a related editor’s note. Katz is director of the Los Angeles County Department of Health Services.

Researchers looked at diabetes screening at different points between 2009 and 2011 among nearly 51,000 people in the California public mental health care system. All had severe mental illness, such as schizophrenia or bipolar disorder, and were taking antipsychotic medicines.

The study found that about 30 percent of the patients received diabetes-specific screening; about 39 percent received nonspecific diabetes screening; and 31 percent received no screening.

The strongest factor associated with diabetes-specific screening was having at least one outpatient visit to a primary care provider during the study period.

The findings support “efforts to integrate behavioral health and primary care,” Dr. Christina Mangurian, of the University of California, San Francisco, and colleagues wrote in the report.

“Growing evidence supports the value of screening for diabetes mellitus in higher-risk populations, such as those receiving treatment with antipsychotic medications, including first-generation and second-generation agents that commonly result in co-occurring obesity. Future studies should explore barriers to screening in this vulnerable population,” the researchers concluded.

More information

The American Diabetes Association has more about type 2 diabetes.

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Brain Scans May Reveal Which Coma Patients Will Recover

WEDNESDAY, Nov. 11, 2015 (HealthDay News) — Brain scans may help identify coma patients who are most likely to regain consciousness, a new French study suggests.

The research included 27 coma patients with severe brain injuries and 14 healthy people of the same age. All of the participants underwent functional MRI scans to assess the connections between areas of the brain involved in regulating consciousness.

The coma patients underwent brain scans after all sedative drugs were out of their bodies. Three months after their brain injuries, four had regained consciousness, while the others had minimal consciousness or were still in a coma.

The brain scans showed that coordination of activity between two particular areas of the brain was much different between the patients who later recovered from a coma and those who didn’t.

The coma patients who recovered had the same coordination between these two brain areas as in healthy people, the study reported.

The study was published online Nov. 11 in the journal Neurology.

Further research is needed before these results might be used to help guide care for coma patients, study author Dr. Stein Silva, of INSERM (French National Research Institute) in Toulouse, said in a journal news release.

“We need to do more studies with larger numbers of patients to substantiate these results, but the findings are promising,” Silva said. “We could be able to predict better who is more likely to recover from a coma and eventually develop innovative networks-based personalized treatments for people with brain injuries.”

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about coma.

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