Researchers Uncover Surprises About Celiac Disease

TUESDAY, May 31, 2016 (HealthDay News) — New research has revealed some surprising findings about who develops celiac disease in the United States.

The study found that it’s most common among people whose ancestors came from India’s Punjab region. Previously, experts thought celiac mostly affected white people with European ancestry.

Celiac also seems to affect men and women equally, regardless of ethnicity, the researchers said.

“It is now recognized as one of the most common hereditary disorders worldwide,” said the study author, Dr. Benjamin Lebwohl, in a news release from the American Gastroenterological Association. Lebwohl is an assistant professor of medicine and epidemiology at the Celiac Disease Center at Columbia University Medical Center, in New York City.

Celiac is an immune-based disorder that causes damage to the small intestine if genetically susceptible people eat foods containing gluten, according to the Celiac Disease Foundation (CDF). Gluten is a protein found in wheat, barley and rye, as well as foods containing these substances.

Celiac disease affects about 1.8 million Americans, the researchers said.

But the disease is often misdiagnosed, the CDF said. The diagnosis is confirmed through a biopsy of tissue from the small intestine, the researchers said.

“Our findings help shed light on the distribution of celiac disease in the U.S. and will aid gastroenterologists in diagnosing their patients,” Lebwohl said.

For this study, the researchers looked at data from more than 400,000 intestinal biopsies. The researchers also used patient names to help them figure out the distribution of the disease. The distribution included a number of ethnicities, such as North Indian, South Indian, East Asian, Hispanic, Middle Eastern, Jewish and other Americans.

Along with finding high rates of the disease in people from the Punjab region of India, the researchers also found the condition was much less common among Americans from South Indian, East Asian and Hispanic ancestry.

Meanwhile, people with Jewish and Middle Eastern ethnicities had rates of the disease similar to that of other Americans.

The study also showed no difference in male and female rates of celiac disease across all ethnic groups. That’s important because previous studies have suggested that celiac may be more common in women. Researchers said doctors might not look for the disease as much in men.

“Based on our findings we recommend that physicians consider celiac disease in men as often as they consider it in women,” Lebwohl said.

The study was published in Clinical Gastroenterology and Hepatology.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases provides more information on celiac disease.

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Money, Language Barriers Can Affect Kids’ Brain Injury Care

TUESDAY, May 31, 2016 (HealthDay News) — Children with traumatic brain injuries may be less likely to receive rehabilitation care if they come from poor families with a limited grasp of English, a new study suggests.

After a traumatic brain injury, children require services such as physical therapy and mental health treatment for months or years. But University of Washington researchers found that it’s very hard for some patients to get this care.

The researchers surveyed almost 300 health care providers around Washington state. These included providers of physical and occupational therapy; speech, language and cognitive therapy; and mental health services. The researchers found that less than 20 percent accepted Medicaid and also provided language interpretation to children with traumatic brain injuries.

Only 8 percent provided mental health services to those children. Spanish-speaking families had to travel much further than English speakers to get services for their children, the study found.

The study also found that only 46 percent of providers accepted children with Medicaid. They also showed that children covered by Medicaid had access to fewer rehabilitation services than those covered by private insurance.

The results show that already disadvantaged children who suffer traumatic brain injuries are further harmed by limited access to rehabilitation services that can significantly improve long-term outcomes, said lead author Megan Moore. She’s an assistant professor in direct practice, School of Social Work at the University of Washington. She’s also a faculty member at the UW Harborview Injury Prevention and Research Center in Seattle.

“Rehabilitation after a brain injury is incredibly important, especially for kids with moderate to severe brain injuries. Ultimately, that limited availability is going to impact children’s outcomes,” Moore said in a university news release.

Most brain injury rehabilitation occurs outside of hospitals, so hospital staff should try to connect parents with rehabilitation services before the child leaves the hospital, she said.

“We need to be thinking more critically about how we transition kids back to the community, particularly children we know have limited access to services. We really have to do a thorough job of linking them to these services on the outpatient side,” she added.

The study was published recently in the American Journal of Physical Medicine & Rehabilitation.

More information

The Center for Parent Information and Resources has more about children and traumatic brain injury.

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Scans Spot Brain Region That Misfires in Depressed People

TUESDAY, May 31, 2016 (HealthDay News) — A part of the brain that responds to bad experiences acts in an unexpected way in people with depression, a small study finds.

One theory suggested that the pea-sized structure called the habenula was overactive in people with depression, so researchers decided to test that hypothesis.

The investigators scanned the brains of 25 people with depression and 25 people who never had depression while they were shown images associated with receiving or not receiving a shock.

“Surprisingly, we saw the exact opposite of what we predicted,” said study senior author Jonathan Roiser.

“In people with depression, habenula activity actually decreased when they thought they would get a shock. This shows that in depressed people the habenula reacts in a fundamentally different way,” he explained.

“Although we still don’t know how or why this happens, it’s clear that the theory needs a rethink,” said Roiser. He is a professor at the Institute of Cognitive Neuroscience, University College London.

Average habenula size was the same in both groups. However, participants in both groups with a smaller habenula were more likely to have a loss of interest or pleasure in life, according to the study published May 31 in the journal Molecular Psychiatry.

“The habenula’s role in depression is clearly much more complex than previously thought,” lead author Rebecca Lawson, from the Center for Neuroimaging at University College London, said in a university news release.

She added that “one possible explanation is that the habenula may help us to avoid dwelling on unpleasant thoughts or memories, and when this is disrupted you get the excessive negative focus that is common in depression.”

More information

The U.S. National Institute of Mental Health has more on depression.

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Most Smokers Don’t Stick With E-Cigarettes

By Randy Dotinga
HealthDay Reporter

TUESDAY, May 31, 2016 (HealthDay News) — Some smokers turn to e-cigarettes with the hope that the electronic nicotine delivery devices will help them give up regular cigarettes.

But new research suggests that for most smokers, e-cigarettes aren’t an acceptable alternative.

The good news from the study is that e-cigarettes helped at least a small group of smokers quit tobacco cigarettes.

Ideally, study lead author Terry Pechacek said, e-cigarettes would be both appealing and less dangerous than traditional cigarettes. “Even if they’re only half as risky, there would be a huge public health benefit if we could switch 40 million smokers to them,” he said.

But the study suggests smokers who’ve tried them are saying “that’s possible but we’re not there yet,” said Pechacek, professor and interim division director of Health Management and Policy at Georgia State University in Atlanta.

For the study, the researchers surveyed more than 5,700 Americans in 2014. They focused on 729 current and former smokers who’d tried e-cigarettes. Of those, 144 were former smokers — 101 had quit all smoking and 43 had switched from traditional cigarettes to e-cigs.

However, of the 585 current smokers, 58 percent (337 people) said they’d tried e-cigarettes but didn’t use them anymore. The rest of the current smokers, 248 people, had decided to smoke both traditional cigarettes and e-cigs, the study found.

The findings suggest that e-cigarettes aren’t satisfying to most smokers, Pechacek said. Follow-up research to be released later suggests that the problem is the ability of the devices to deliver nicotine, he said.

Smokers may find e-cigarettes less appealing because they pack less of a quick “hit” of nicotine, said Thomas Wills, professor and interim director of the Cancer Prevention and Control Program at the University of Hawaii Cancer Center. The smell and flavor may also be stumbling blocks to quitting regular cigarettes, he said.

In the big picture, Wills said, “e-cigarettes may help a few people to quit, but mostly they don’t. And the suspicion from these data is that they help keep people smoking. That is not something that the e-cigarette advocates want to hear.”

Gregory Conley, president of the American Vaping Association, took issue with some of the study’s findings. For example, he said, one weakness of the study is that the survey participants may have tried e-cigarettes years ago, before more recent innovations that make them more appealing.

He also noted that the study found that smokers who switched to e-cigs were more likely to use the “tank-style” devices, which are larger, with an attached nicotine liquid tank, and last longer than the devices that look more like cigarettes.

Earlier this month, the U.S. Food and Drug Administration took action to regulate the e-cigarette industry. Among the measures: The agency said it was banning the sale of e-cigarettes to minors.

And manufacturers of e-cigarettes will be required to submit new and existing products to the FDA for review and evaluation, unless the product was sold prior to Feb. 15, 2007.

“The bad news for public health is that the FDA’s regulations will treat tank-style vapor products far harsher than traditional e-cigarettes,” Conley said. This kind of action, he added, will weaken innovation of e-cigarettes.

The study authors pointed out that it’s clear smokers are interested in e-cigarettes, as more than half of smokers tried them. Pechacek suggested that the appeal of traditional cigarettes should be “degraded” in order to force smokers to seek alternatives, such as e-cigarettes. Currently, he said, smokers are drawn to tobacco cigarettes because of their price, ease of access and appeal.

The study was published in the journal Nicotine & Tobacco Research.

More information

For more about e-cigarettes, visit BeTobaccoFree.gov.

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Zika Infections Through Sex More Common Than Thought: WHO

By Steven Reinberg
HealthDay Reporter

TUESDAY, May 31, 2016 (HealthDay News) — Women planning to become pregnant should wait at least eight weeks before trying to conceive if they or their partner live in — or are returning from — areas where Zika virus infections are occurring, U.N. health officials now recommend.

Mosquito bites remain the most common source of infection of the virus that causes the severe birth defect microcephaly, which results in babies with abnormally small heads and brains. But transmission of the virus through sex is more common than previously thought, World Health Organization officials said Monday. They had previously recommended a four-week abstinence before trying to conceive.

And if the male partner has had symptoms of Zika infection, couples should wait six months before trying to have a baby, the WHO officials said.

Four out of five people infected with Zika don’t develop any symptoms. Those who do most often suffer from mild symptoms that include fever, rash, joint pain or red eyes.

The true risk of Zika is to a developing fetus.

The vast majority of Zika infections have occurred in Latin America, with Brazil the hot zone with an estimated 5,000 cases of microcephaly. There have been no reports of Zika-induced microcephaly contracted in the United States. But U.S. health officials have said they expect to see Zika infections in Gulf Coast states such as Florida, Louisiana and Texas as mosquito season picks up.

Earlier this month, U.S. health officials reported that the number of pregnant women in the United States infected with the Zika virus had tripled because cases were now being counted in a more comprehensive way.

So far, an estimated 280 infected women are being followed in the United States and its territories, according to two registries that have been created by the U.S. Centers for Disease Control and Prevention.

Previously, only cases of pregnant women who had Zika-related symptoms or pregnancy complications were being tallied, CDC officials said. But recently published reports have found that some pregnant women show no symptoms of Zika infection, yet still give birth to babies with microcephaly.

To limit any potential spread of Zika virus via mosquitoes, health officials on the federal, state and local level are deploying a three-pronged strategy: improving mosquito control; expanding their ability to test for Zika; and urging the public to protect themselves against mosquitoes.

Women of child-bearing age who live in an active Zika region should protect themselves from mosquito bites by wearing long-sleeved shirts and long pants, using mosquito repellent when outside, and staying indoors as much as possible, according to the CDC.

President Barack Obama has asked Congress to allocate $1.9 billion to combat the Zika threat, but lawmakers have yet to agree on a spending package.

More information

Visit the U.S. Centers for Disease Control and Prevention for more on the Zika virus.

This Q&A will tell you what you need to know about Zika.

To see the CDC list of sites where Zika virus is active and may pose a threat to pregnant women, click here.

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Migraines Take Toll on Spouse

TUESDAY, May 31, 2016 (HealthDay News) — If you suffer from migraines, your spouse probably suffers, too.

That’s the conclusion of researchers who surveyed more than 4,000 people with the debilitating headaches and their spouses/domestic partners.

“This study highlights the significant burden that migraine can have on a wide range of family activities, parenting responsibilities, spousal relationships and family finances,” said lead author Dawn Buse, director of behavioral medicine at Montefiore Headache Center in New York City.

More than two out of five people with migraines and 23 percent of their spouses/partners said they believed the person with migraines would be a better parent if they did not have the condition. About half of the people with migraines had missed at least one family activity in the past month because of a migraine, the study found.

About one-third of migraine sufferers and 21 percent of their spouses/partners said migraines made them worry about the long-term financial security of their family. This concern was highest among those with chronic migraines (15 or more days a month) and those with more frequent attacks.

“Respondents with migraine and their partners noted a great deal of emotional distress related to how this condition affects their family member, including guilt, worry and sadness,” Buse said in a Montefiore news release. “These findings underscore the challenges and negative impact that people with migraine and their family members’ experience.”

The consequences of migraines can be devastating and far-reaching for people with migraines and their families, agreed Dr. Richard Lipton, director of Montefiore Headache Center.

“As a next step, we are analyzing responses from the children of those with migraine, who are 13 and older,” he added.

According to the American Migraine Foundation, about 12 percent of Americans suffer from migraine headaches. And one in four U.S. households has a member with migraines.

The study findings were published recently in the journal Mayo Clinic Proceedings.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more on migraine headaches.

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Most Americans Aware of Zika Threat, But Gaps in Knowledge Remain

By Dennis Thompson
HealthDay Reporter

TUESDAY, May 31, 2016 (HealthDay News) — Americans are becoming more informed about the Zika virus, but there are still some large gaps in their knowledge of the mosquito-borne illness that can cause devastating birth defects, a new HealthDay/Harris Poll finds.

Three out of four adults know Zika is mainly transmitted by mosquito bites. And, more than four out of five are aware that pregnant women are most at risk from the virus, the poll results show.

Most adults also know the main precautions to be taken to protect against contracting Zika from a mosquito bite — good news, given that mosquito season is now under way.

But there’s a significant lack of understanding regarding the other ways Zika can be transmitted, the poll found.

Humphrey Taylor, chairman emeritus of The Harris Poll, said public health officials are, by and large, doing a good job of informing the public about Zika.

“While there is a fair amount of confusion and misinformation about the Zika virus, most Americans are aware of how it is transmitted, what the main risks are, and of steps that can be taken to protect themselves and the public,” Taylor said.

There have yet to be any cases of mosquito-transmitted Zika infections in the continental United States. So far, the epidemic has been confined to Latin America and the Caribbean.

But, U.S. public health officials expect at least small outbreaks in areas laden with the breeds of mosquitoes that can spread the virus. Gulf Coast states — such as Florida, Louisiana and Texas — have the highest risk of an outbreak, officials say.

An estimated 80 percent of people infected with Zika do not develop any symptoms. Those who do most often suffer from mild symptoms that include fever, rash, joint pain or red eyes.

Zika virus is worrisome, however, because it’s the first mosquito-borne illness known to cause microcephaly and other brain-related birth defects if an expectant mother becomes infected. Microcephaly results in babies born with abnormally small heads and brains. Nearly 5,000 babies have been born with microcephaly in Brazil, the epicenter of the Zika epidemic, according to the World Health Organization.

The new poll found that three out of four Americans are very or somewhat familiar with the Zika virus, and 84 percent are aware that pregnant women are at high risk.

In addition, 76 percent of adults understand that Zika can be transmitted through a mosquito bite.

However, only 48 percent understand that a fetus can contract Zika from an infected mother, and only 57 percent are aware that Zika can cause brain damage in the womb.

A majority of adults also aren’t aware that Zika can be spread by sexual contact. Only 45 percent understand that having sex with an infected person can spread the virus. And, only 51 percent cited “barrier methods” such as condom use as a way to prevent Zika infection.

“I find it worrisome that a minority of people understand that Zika can be sexually transmitted,” said Dr. Jeffrey Duchin, chair of the Infectious Diseases Society of America’s Public Health Committee. “Women can get Zika from their male sexual partners. We need to continue to improve our messaging around the risk of sexual transmission, because this is such a devastating disease for a developing fetus.”

On the upside, large majorities of Americans understand the best ways to prevent Zika infection via mosquito: Getting rid of pools of standing water (73 percent); using insect repellent (73 percent); wearing clothing that covers as much skin as possible (71 percent); avoiding travel to infected areas (68 percent); and using insecticide (68 percent).

Half of adults living in the South understand that their region is most at risk for Zika outbreaks. Fifty percent of southerners said it’s “very” or “somewhat” likely that Zika will infect people in their area over the next 12 months, compared to 44 percent of people nationwide.

Duchin expects that Americans’ knowledge of Zika will improve once outbreaks of the virus begin in the country.

“I do believe the public pays attention when they feel they are at risk,” said Duchin, a professor of infectious diseases at the University of Washington School of Public Health.

“Without having Zika on the mainland currently, we have a bit of a communication challenge. Once we have local transmission in the United States, which is likely, people will perk up their ears a little bit more,” added Duchin, who’s also health officer for Public Health-Seattle & King County.

The HealthDay/Harris Poll was conducted online, in English, within the United States, May 17-19 among 2,026 adults 18 and older. Figures for age, sex, race/ethnicity, education, region and household income were weighted, where necessary, to bring them into line with their actual proportions in the population. “Propensity-score weighting” was also used to adjust for respondents’ likelihood to be online.

More information

To learn more about Zika virus, visit the U.S. Centers for Disease Control and Prevention.

This Q&A will tell you what you need to know about Zika.

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Lupus a Tough Disease to Spot, Treat

MONDAY, May 30, 2016 (HealthDay News) — Lupus is difficult to diagnose and treat, but scientists are working to learn more about its genetic causes and to develop better treatments.

The autoimmune disease affects between 300,000 and 1.5 million people in the United States, and as many as 24,000 are diagnosed with lupus each year, according to the U.S. Food and Drug Administration.

“With treatment, the disease may quiet down, but it also may relapse eventually. Although it may be controlled with medications, once you get it, you will always have it,” Dr. Sarah Yim, a rheumatologist at the FDA, said in an agency news release.

“Technologies have been developed in recent years that can make our medicines more targeted, to address the specific molecule or molecules in the immune system that may be causing the problem,” Yim added.

The disease often begins between the ages of 15 and 44, and 10 times more women than men have lupus, according to the American College of Rheumatology.

The underlying cause of the disease is not fully understood. And, it can damage many parts of the body, including the joints, skin, kidneys, heart, lungs, blood vessels and brain, Yim said.

Treatments include aspirin, corticosteroids, the anti-malarial drug Plaquenil (hydroxychloroquine) and a drug called Benlysta, the first targeted therapy for lupus, she said.

“Older medicines tend to suppress the whole immune system, which works, but it’s a little bit like shooting a fly with a cannonball, and can be associated with many undesirable side effects,” Yim explained.

While scientific advances over the last several decades have led to people with lupus living longer, more treatment options are needed, according to the FDA.

May is National Lupus Awareness Month.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more on lupus.

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New Test Helps Identify Rare Genetic Diseases in Newborns

MONDAY, May 30, 2016 (HealthDay News) — New gene screening methods may greatly improve doctors’ ability to quickly diagnose rare genetic diseases in newborns, researchers say.

The new test includes all of the more than 4,800 genes currently known to be linked with rare diseases. Canadian researchers used the test to try to diagnose 20 newborns who had a variety of medical problems. Half of the infants had neurological symptoms, such as seizures. The babies were all being treated in neonatal intensive care units (NICUs).

The gene sequencing panel provided a genetic diagnosis for eight of the infants (40 percent). For two babies, their diagnoses directly affected their medical care, the study authors said.

The findings were published online May 30 in the CMAJ (Canadian Medical Association Journal).

“Next-generation sequencing has the potential to transform the practice of clinical genetics rapidly,” Dr. David Dyment, of Children’s Hospital of Eastern Ontario, and colleagues wrote.

“In particular, newborns admitted to the NICU with rare and complex diseases may benefit substantially from a timely molecular diagnosis through next-generation sequencing,” the study authors added.

Currently, infants with suspected rare genetic diseases typically undergo a large number of tests. It can take a long time, possibly even years, before a diagnosis is made, the researchers said.

“This technique can be performed in a hospital-based laboratory,” Dyment stated. “This will allow for diagnoses to be made quickly, providing answers to anxious families and potentially life-saving interventions in some cases.”

Dr. Sarah Bowdin, of the clinical and metabolic genetics division at the Hospital for Sick Children in Toronto, wrote in an accompanying commentary: “Enabling the family to understand why their baby is ill can help to assuage the almost universal guilt felt by parents that they did something wrong to cause their baby’s illness.”

And, Bowdin added, “It can also indicate whether other family members may be at risk of the same disease and provide an accurate recurrence risk for future pregnancies.”

More information

The U.S. National Institute of Child Health and Human Development explains newborn screening tests.

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Even Kiddie Pools Pose Danger

MONDAY, May 30, 2016 (HealthDay News) — Just a few inches of water in a kiddie pool are enough to drown a child.

“When we think of pool risks, we think of the big pools, complete with deep ends, diving boards and swim parties,” said Dr. Nina Shapiro, director of pediatric otolaryngology at Mattel Children’s Hospital of the University of California, Los Angeles.

“But more than 10 percent of pool-related deaths in young children occur in what are best known as ‘kiddie pools.’ These include inflatables, plastic wading pools and larger above-ground pools,” she said in a university news release.

Shapiro cited a 2011 study in the journal Pediatrics that concluded portable pools at homes pose a major threat of drowning injury or death to children, especially those younger than 5 years old.

Whether the pool is small or large, there are steps adults should take to reduce children’s risk of drowning, she said. For instance:

• Constantly supervise children when they’re in and around a pool.
• Have a phone by the pool in case of emergency.
• Around large pools, make sure there’s a fence that’s at least 4 feet high with a latched gate.
• Have life preservers by the pool and learn CPR.
• Drain kiddie pools when they’re not in use and remove toys from kiddie pools when children aren’t in them. Toys can be irresistible to small children, who have no concept of personal risk, Shapiro said.

“There is no magic bullet to prevent these horrors. So stock your safety arsenal with layers of prevention so that summer fun doesn’t turn tragic,” Shapiro concluded.

More information

The American Red Cross has more about summer water safety.

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