Allegra

Distracted driving — including driving while talking on the phone, trying to answer the phone or texting — is a dangerous habit.

The U.S. Department of Transportation offers these suggestions to avoid distractions while driving:
Never text or talk on your cell phone while you’re behind the wheel.
Turn off the ringer or your phone, and set it out of reach while you’re driving.
Never eat, drink, primp yourself, use a GPS device, read or surf through radio stations or CD tracks while you drive.
If you happen to call someone who is driving, suggest that the driver call you back upon arrival.

Among children and teenagers with asthma, those who also have peanut allergies may have more or more-severe asthma attacks, a new study suggests.

Researchers found that among 160 5- to 18-year-olds with asthma seen at their center, the 46 with peanut allergies generally had more hospitalizations for asthma exacerbations than children without the food allergy. They also had a higher rate of treatment with oral corticosteroids — anti-inflammatory drugs given for a short period to control severe asthma symptoms.

Of children and teens with peanut allergy, 23 percent had ever been hospitalized for asthma after the age of 3. That compared with 16 percent of those without peanut allergy.

When it came oral steroids, only 28 percent of kids with peanut allergy had never needed treatment after age 3. That figure was 37 percent among those without the food allergy, according to lead researcher Dr. Alyson Simpson, of Alfred I. duPont Hospital for Children in Wilmington, Delaware.

When she and her colleagues accounted for other factors — like family history of asthma and any other allergies the children had — peanut allergy remained linked to higher risks of hospitalizations and oral steroid use.

The goal in children’s asthma care is to avoid hospitalizations and oral steroids whenever possible, Simpson noted in an interview with Reuters Health, so any increase in those rates is concerning.

She said that parents of children with both asthma and peanut allergy should be particularly sure to work with their child’s doctor to keep the asthma well-controlled. That typically means minimizing kids’ exposure to their particular asthma triggers, helping them maintain a healthy weight and, often, giving them medications that prevent asthma attacks.

Simpson and her colleagues report the findings in the Journal of Pediatrics.

Asthma symptoms arise when the airways become inflamed; that inflammation is most commonly triggered by exposure to allergens, such as pollen, mold or animal dander. Food allergies can also spur asthma symptoms.

It is not clear, however, why study patients with peanut allergy tended to have more problems with asthma control, according to Simpson. Her team’s findings point to an association between peanut allergy and more asthma exacerbations, but do not prove that the food allergy is the cause.

“The exact link is still being studied,” Simpson said.

Understanding the connection is important, she and her colleagues note, as recent studies suggest that both peanut allergy and asthma are on the rise among children — for reasons that are unclear.

It’s estimated that just over 1 percent of U.S. children have peanut allergy, while roughly 9 percent have asthma, according to the American Academy of Asthma, Allergy & Immunology.

SOURCE: Journal of Pediatrics, online.

Cell phones, televisions and computer games aren’t giving teenagers headaches, researchers say, but listening to one or two hours of music daily may make their heads throb.

The authors of a study published online Feb. 9 in the journal BMC Neurology looked at a group of 13- to 17-year olds — 489 who said they had headaches and 536 who didn’t. No association was seen between electronic media devices and headaches.

“Excessive use of electronic media is often reported to be associated with long-lasting adverse effects on health, like obesity or lack of regular exercise, or unspecific symptoms like tiredness, stress, concentration difficulties and sleep disturbances,” said study co-author Astrid Milde-Busch of Ludwig-Maximilians-University Munich in Germany. “Studies into the occurrence of headaches have had mixed results and for some types of media, in particular computer games, are completely lacking”.

As for a link between music-listening and headaches, it’s not clear if listening to music causes the headaches or is something teens do to soothe themselves when they get a headache.

SOURCE: BioMed Central

A few months of moderate aerobic exercise may not rev up obese teenagers’ ability to burn calories, even though it may increase thinner teens’ ability to burn dietary fat, new research suggests.

In a study of 28 obese and normal-weight teenagers, researchers found that after 12 weeks of treadmill and exercise-bike sessions, the heavier teens showed no changes in their bodies’ calorie- and fat-burning throughout the day.

Their thinner peers likewise showed no changes in daily calorie expenditure. However, their dietary-fat metabolism did increase, on average.

The findings, reported in the American Journal of Clinical Nutrition, do not mean obese kids should throw in the towel on exercise, given previous research. In an earlier study of the same workout regimen, the researchers found improvements in obese teenagers’ sensitivity to the blood-sugar-regulating hormone insulin; decreased insulin sensitivity often occurs before type 2 diabetes.

The teens also showed reductions in the deep layers of abdominal fat that surround the organs — the body fat that is considered especially important in the risk of diabetes and other health problems.

So together, the findings suggest that obese teenagers can get “important health benefits” from aerobic exercise even without changes in their calorie and fat metabolism, according to Dr. Agneta L. Sunehag, an associate professor of pediatrics at Baylor College of Medicine in Houston and the lead researcher on the new study.

In an email, she also pointed out that the study looked at one moderate-exercise regimen alone; the participants did not alter their eating habits or lose weight. It’s possible, Sunehag said, that exercise along with weight loss would affect obese teens’ metabolism.

It’s a common perception that exercise not only burns calories during the workout, but also leads to lasting changes in a person’s metabolism at rest. However, studies suggest that any effects may depend on the type and intensity of exercise, and on a person’s body composition.

Recent research has found, for example, that a few months of strength training may increase resting metabolism and daily calorie- and fat- burning in overweight women. Another study found that any exercise — strength training or aerobic — was related to a higher resting metabolism in women, but only for those who regularly worked out at a high intensity.

Until now, though, little has been known about the effects of exercise on obese teenagers’ calorie- and fat-burning, Sunehag said.

The study included 15 obese and 13 normal-weight Hispanic-American teenagers who completed a 12-week exercise program — walking on a treadmill or using an exercise bike for 30 minutes, four times per week.

At the beginning and end of the study, the researchers measured the teens’ total calorie expenditure over 24 hours. Each participant stayed in a room where a device measured their oxygen consumption and carbon dioxide production; that allows researchers to estimate a person’s calorie expenditure, as well as the proportions of fat, carbohydrates and protein they are burning.

In general, neither obese nor normal-weight teenagers showed changes in their overall calorie expenditure at the end of the study, but the thinner teens did show an increase in fat burning.

The reason for that discrepancy is not clear, according to Sunehag’s team, but studies of adults have had similar findings. One possibility, the researchers suggest, is that obese teenagers have an “impaired metabolic flexibility” that blunts their fat-burning response to exercise.

SOURCE: American Journal of Clinical Nutrition

Since animal bites can lead to infection, rabies or internal injury, they should always be taken seriously.

The American Academy of Orthopaedic Surgeons says it’s time to visit the doctor if an animal bite shows these signs:
Heat or warmth to the touch.
Swelling around the bite.
Pain around the bite.
Pus discharge.
Red skin surrounding a bite.
Difficulty straightening or bending a finger.
Numbness at the tip of a finger.

Frostbite occurs when the skin is exposed to extremely cold temperatures, says the U.S. National Safety Council.

Symptoms of frostbite include skin that looks waxy, pale white or gray-yellow in color. Affected skin also may feel numb, and very cold to the touch. The top layer of skin may feel stiff.

Frostbite can be superficial or a more serious form known as “deep frostbite” that frequently affects hands and feet.

To prevent frostbite, the council suggests wearing many layers of clothing whenever you’re exposed to very cold weather, and immediately removing clothing that becomes wet.

You should also eat healthy foods and drink plenty of liquids that don’t contain alcohol or caffeine.

Your body needs the mineral magnesium to properly contract and relax muscles, to produce proteins and to help enzymes function, the U.S. National Library of Medicine says.

Its experts offer this list of dietary sources for magnesium:
Whole grain foods, such as brown rice.
Vegetables and fruits, such as avocados, bananas and dried apricots.
Nuts, including cashews and almonds.
Seeds, beans and peas.
Soy-based foods, such as tofu and soy flour.

Some new parents have a tough time figuring out when their crying baby is truly hungry.

The Nemours Foundation says these are signs that a baby wants to eat:
Turning the head from side to side.
Opening the mouth and sticking out the tongue.
Putting hands, fingers or a fist in or near the mouth.
Puckering the lips.
Turning to the mother’s breast.
Moving the mouth in the direction of something that’s touching the cheek (the “rooting” reflex).

FDA Updates Earlier Guidance on Respiratory Treatment Spiriva HandiHaler
Current data do not support increased risks for stroke, heart attack, or death

The U.S. Food and Drug Administration today announced that data from a recent review of the Spiriva HandiHaler, a long-acting respiratory treatment for chronic obstructive pulmonary disease (COPD), do not support an increased risk of stroke, heart attack, or death in patients using the medicine.

COPD is a serious and chronic lung disease that restricts air flow in the lungs resulting in shortness of breath. In the United States, COPD includes two main conditions – emphysema and chronic bronchitis. Spiriva HandiHaler consists of capsules and an inhalation device approved for once daily use in COPD.

A March 2008 FDA Early Communication had described data submitted by the manufacturer of Spiriva HandiHaler as suggesting a small increased risk of stroke in patients treated with tiotropium, the medicine’s active ingredient. In October 2008, an Updated Early Communication highlighted two additional publications suggesting an increased risk of stroke, heart attack, and death in patients using tiotropium.

Today’s update of those communications is based on an FDA review of the Understanding the Potential Long-Term Impacts on Function with Tiotropium (UPLIFT) study that compared Spiriva HandiHaler with a placebo in 5,992 COPD patients. In November 2009, the FDA Pulmonary – Allergy Drugs Advisory Committee also reviewed the data and voted that findings from the UPLIFT study resolved the potential safety concerns for Spiriva Handihaler.

The U.S. Food and Drug Administration on Thursday said it found no good evidence that the Spiriva HandiHaler boosts heart risks in patients who use it to help control chronic obstructive pulmonary disease (COPD).

The announcement comes after data released in early 2008 by the drug’s maker, “suggesting a small increased risk of stroke in patients treated with tiotropium [Spiriva], the medicine’s active ingredient,” the FDA noted in a statement.

In October of 2008, the agency released an “Updated Early Communication” that pointed to two other studies suggesting a boost in risk of stroke, heart attack and death among users of the Spiriva HandiHaler.

But a study published in the January 2010 issue of Chest found the opposite: that tiotropium might lower users’ risk of heart problems and death.

Spiriva is one of the most commonly prescribed daily treatments for COPD, a progressive respiratory illness combining bronchitis and emphysema that is often linked to smoking. COPD is the fourth-largest killer in the United States.

The Spiriva HandiHaler consists of a capsule used with an inhaler, to be taken once daily. Spiriva is from the class of drugs known as anticholinergics, which also includes the widely used ipratropium bromide (Atrovent).

Thursday’s FDA announcement should come as a relief to COPD patients who rely on the Spiriva HandiHaler. In its statement, the FDA said its review of the data does “not support an increased risk of stroke, heart attack, or death in patients using the medicine.”

“Today’s update is based on an FDA review of the Understanding the Potential Long-Term Impacts on Function with Tiotropium [UPLIFT] study that compared Spiriva HandiHaler with a placebo in 5,992 COPD patients,” the agency said. “In November 2009, the FDA Pulmonary-Allergy Drugs Advisory Committee also reviewed the data and voted that findings from the UPLIFT study resolved the potential safety concerns for Spiriva HandiHaler.”

The safety status of Atrovent remains unclear, however, because research released Jan. 7 suggested that the drug raises patients’ risk for heart attack and heart failure.

“The short-acting form [Atrovent] seems to increase cardiovascular risk, while the long-acting form [Spiriva] seems to decrease it,” Dr. Norman H. Edelman, chief medical officer of the American Lung Association, told HealthDay at the time. “It is important to point out, however, that the difference is an indirect inference,” he added.

“To prove beyond scientific doubt that the two forms of anticholinergic drugs are different in this or other ways there would have to be a head-to-head comparison; a study which is not likely to be done,” Edelman said.

In one of the two studies in Chest, researchers led by Todd A. Lee, from the Hines VA Hospital in Illinois, collected data on almost 83,000 U.S. veterans with COPD. Among these patients, 44 percent were using Atrovent at some point during the study.

Those patients were followed until they had a cardiovascular event, died or until the study’s end in September 2004. During the follow-up, more than 6,200 patients had a cardiovascular event: 44 percent suffered heart failure, 28 percent had heart attacks or chest pain, and 28 percent had irregular heart rhythms, the researchers reported.

Lee’s team also found that during the first six months of Atrovent therapy, patients were at an increased risk for these cardiovascular events, although those who took the drug for more than six months without an incident did not have an increased risk of heart attack or heart failure.

“These findings are consistent with previous concerns raised about the cardiovascular safety of ipratropium bromide,” the researchers concluded.

Boehringer Ingelheim, the makers of Atrovent, said the drug is safe and the latest findings do not prove there is an increased risk of heart failure or other heart-related problems associated with the drug.

“Atrovent has been widely used in the U.S. for more than 20 years,” said company spokeswoman Susan Holz. “The findings described in the paper are not consistent with the Boehringer Ingelheim clinical trial and safety database for Atrovent, which do not support evidence of an increased risk for cardiovascular events among patients using Atrovent.”

In the second paper, Dr. Bartolome Celli, from Caritas-St. Elizabeth’s Medical Center in Boston, and colleagues looked at the results of 30 clinical trials that included more than 19,500 patients, some of whom received Spiriva while others were given a placebo.

The researchers found patients taking Spiriva had a lower risk of dying compared with patients receiving placebo. In addition, those taking Spiriva had fewer respiratory events. This study was funded by the pharmaceutical giants Boehringer Ingelheim and Pfizer.

“There is a benefit of tiotropium in terms of mortality when data from all of the trials with tiotropium are pooled together. This is in contrast to a previous scare that anticholinergics could be associated with poor outcomes,” Celli said at the time of the study’s release. “Tiotropium is by and large a safe medication that can really help most patients with COPD.”

Inhaled anticholinergics ease breathing in patients with COPD by preventing the airways from constricting.

Speaking earlier this month, Dr. Neil Schachter, a professor of pulmonary medicine at Mount Sinai Medical Center in New York City, said that he currently prescribes Spiriva more often than Atrovent.

“Spiriva is certainly a very useful drug,” he said. “My personal experience is that it has relatively few side effects. It is generally well-tolerated, and patients seem to have a good response to it.”

SOURCES: Bartolome Celli, M.D., Caritas-St. Elizabeth’s Medical Center, Boston; Norman H. Edelman, M.D., chief medical officer, American Lung Association; Susan Holz, spokeswoman, Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, Conn.; Neil Schachter, M.D., professor, pulmonary medicine, Mount Sinai Medical Center, and director, Mount Sinai COPD Program, New York City; January 2010, Chest; Jan. 14, 2010, statement, U.S. Food and Drug Administration