CDC announce 2014 adult immunization schedule

The Center for Disease Control and Prevention's Advisory Committee on Immunization Practices has announced its recommended adult immunization schedule for 2014. Each year, the committee reviews the schedule, ensuring that current clinical recommendations are appropriately reflected.
Among the key changes to the schedule for 2014 include revised notes on administering vaccines for flu; tetanus, diphtheria, and accellular pertussis; human papillomavirus (HPV); zoster virus; pneumococcal disease and meningococcal disease.
The recommendations for flu have been amended to show that the recombinant influenza and inactivated influenza vaccines can now be used among people with a hives-only allergy to eggs, as these vaccines contain no egg protein.
New guidelines for the Haemophilus influenza type b (Hib) vaccine say it is recommended for adults at risk of Hib who have not been vaccinated before, with the exception of patients with HIV as their risk for Hib infection is low.
Patients who have undergone successful hematopoietic stem cell transplantation, meanwhile, are recommended to have a three-dose series of Hib vaccines, regardless of whether they have previously been vaccinated for Hib or not.
Hematopoietic stem cell transplantation is a procedure used to treat conditions that cause defects to the immune system or bone marrow, such as multiple myeloma, non-Hodgkin Lymphoma and Hodgkin disease.
The language concerning tetanus, diphtheria, accellular pertussis (Tdap) and tetanus, diphtheria (Td) vaccines has been adjusted to fit with the recommendations given in the Center for Disease Control and Prevention's (CDC's) pediatric immunization schedule.
The guidelines now recommend a single dose of the Tdap vaccine for patients aged 11 or older, who have not previously been vaccinated. It is also now suggested that the TD booster should be administered every 10 years after the initial vaccination.

HPV, shingles, pneumococcal disease and meningococcal disease

Although no changes have been made to the HPV recommendations, additional information has clarified timing between the second and third doses, and again the language has been modified to minimize discrepancies with the pediatric immunization guidelines.
In addition, it is no longer considered necessary for health care workers to receive the HPV or zoster virus (shingles) vaccines, and the guidelines have been updated to reflect this.
Elsewhere on Medical News Today, we look at a study addressing concerns from some parents that the HPV vaccine could lead to '"risky sexual behavior" in teenagers and young people.
For pneumococcal disease - the condition caused by the Streptococcus pneumoniae bacteria that can lead to pneumonia, blood infections and meningitis - there has been some clarification on the order vaccines should be administered, depending on whether people require both the pneumococcal conjugate (PCV13) and pneumococcal polysaccharide (PPSV23) vaccines.
Similarly, for meningococcal disease, further distinctions have been made between who should receive the meningococcal conjugate (MeanACWY-D) or meningococcal polysaccharide (MenACWY-CRM) vaccines.
Those who are interested in viewing the full schedule can do so on the website for the Annals of Internal Medicine.

Continue to Read more ...

Most parents fail to recognize if their child is overweight

In the idyllic town of Lake Wobegon, all the children are above average.
And, judging by a new study by University of Nebraska-Lincoln researchers, none are obese.
Even though childhood obesity rates in the U.S. have tripled during the past 30 years, more than half of parents do not recognize that their child is overweight, according to a meta-analysis study conducted by UNL graduate student Alyssa Lundahl and her adviser, Timothy Nelson, an assistant professor of psychology.
Seeking a clear answer on when and whether parents realize their children are overweight, Lundahl combined and analyzed data from 69 studies conducted worldwide between 1990 and 2012, involving children aged 2 to 18.
In an article published online in Pediatrics, Lundahl found that more than 50 percent of parents underestimate the weight of their overweight or obese child.
"This is a topic that has a lot of implications for children and their weight," Lundahl said. "Parents who underestimate their children's weight may not encourage healthy eating and physical activities that can optimize their children's health and reduce their risk of obesity."
Surprisingly, parents' perceptions about whether their children are overweight have not changed as childhood obesity rates increased, Lundahl notes. Nor are they influenced by obesity rates in the place where they live.
"No matter where you are and no matter what the rate of obesity is in that area, parents are still underestimating the weight of their overweight children," she said.
Parents of younger children, ages 2 to 5, are less likely to perceive their children as overweight or obese.
"Perceptions grow more accurate with age," Lundahl said. "Parents realize it's not just baby fat any more and they're not going to grow out of it."
Parents also are less accurate in judging the size of their sons, believing that normal weight sons are actually underweight.
"There is a belief that boys are supposed to be big and strong," she said. ""If they're not a little bit bigger, they're seen as being too small."
Parents who are overweight also are less likely to accurately assess their children's weight
The study has important implications for pediatricians, Nelson said. Overweight 2- to 5-year-olds are five times more likely than their nonoverweight counterparts to be overweight at 12 years of age. Obesity in adolescence is highly predictive of adult weight problems.
"The cases that are missed by parents are actually really unfortunate because those are the cases where early intervention can have some good effects," Nelson said.
If pediatricians recognize that many parents don't accurately judge whether their child has a weight problem, they can help parents improve their children's health by encouraging healthy eating and physical activity, Lundahl said.

Continue to Read more ...

Blue light exposure may be a countermeasure for fatigue, during the day and night

Researchers from Brigham and Women's Hospital (BWH) have found that exposure to short wavelength, or blue light, during the biological day directly and immediately improves alertness and performance. These findings are published in the February issue of Sleep.
"Our previous research has shown that blue light is able to improve alertness during the night, but our new data demonstrates that these effects also extend to daytime light exposure," said Shadab Rahman, PhD, a researcher in BWH's Division of Sleep Medicine and lead author of this study. "These findings demonstrate that prolonged blue light exposure during the day has an an alerting effect."
In order to determine which wavelengths of light were most effective in warding off fatigue, the BWH researchers teamed with George Brainard, PhD, a professor of neurology at Thomas Jefferson University, who developed the specialized light equipment used in the study. Researchers compared the effects of blue light with exposure to an equal amount of green light on alertness and performance in 16 study participants for 6.5 hours over a day. Participants then rated how sleepy they felt, had their reaction times measured and wore electrodes to assess changes in brain activity patterns during the light exposure.
The researchers found that participants exposed to blue light consistently rated themselves as less sleepy, had quicker reaction times and fewer lapses of attention during the performance tests compared to those who were exposed to green light. They also showed changes in brain activity patterns that indicated a more alert state.
"These results contribute to our understanding of how light impacts the brain and open up a new range of possibilities for using light to improve human alertness, productivity and safety," explained Steven Lockley, PhD, neuroscientist at BWH and senior investigator of the study. "While helping to improve alertness in night workers has obvious safety benefits, day shift workers may also benefit from better quality lighting that would not only help them see better but also make them more alert."
Researchers note that the next big challenge is to figure out how to deliver better lighting. While natural light is ideal, many people do not have access to daylight in their schools, homes or work places. In addition to improvements in daylight access, the advent of new, more controllable lighting technologies may help enable researchers to develop 'smart' lighting systems designed to maximize the beneficial effects of light for human health, productivity and safety.

Continue to Read more ...

Insight into why cancer incidence increases with age

The accumulation of age-associated changes in a biochemical process that helps control genes may be responsible for some of the increased risk of cancer seen in older people, according to a National Institutes of Health study.
Scientists have known for years that age is a leading risk factor for the development of many types of cancer, but why aging increases cancer risk remains unclear. Researchers suspect that DNA methylation, or the binding of chemical tags, called methyl groups, onto DNA, may be involved. Methyl groups activate or silence genes, by affecting interactions between DNA and the cell's protein-making machinery.
Zongli Xu, Ph.D., and Jack Taylor, M.D., Ph.D., researchers from the National Institute of Environmental Health Sciences (NIEHS), part of NIH, identified DNA methylation sites across the human genome that changed with age. They demonstrated that a subset of those sites - the ones that become increasingly methylated with advancing age - are also disproportionately methylated in a variety of human cancers. Their findings were published online in the journal Carcinogenesis.
"You can think of methylation as dust settling on an unused switch, which then prevents the cell from turning on certain genes," Taylor said. "If a cell can no longer turn on critical developmental programs, it might be easier for it to become a cancer cell."
Xu and Taylor made the discovery using blood samples from participants in the Sister Study, a nationwide research effort to find the environmental and genetic causes of breast cancer and other diseases. More than 50,000 sisters of women who have had breast cancer are participating in the study.
The researchers analyzed blood samples from 1,000 women, using a microarray that contained 27,000 specific methylation sites. Nearly one-third of the sites showed increased DNA methylation in association with age. They then looked at three additional data sets from smaller studies that used the same microarray and found 749 methylation sites that behaved consistently across all four data sets. As an additional check, they consulted methylation data from normal tissues and seven different types of cancerous tumors in The The Cancer Genome Atlas, a database funded by the National Cancer Institute and the National Human Genome Research Institute.
Taylor said that DNA methylation appears to be part of the normal aging process and occurs in genes involved in cell development. Cancer cells often have altered DNA methylation, but the researchers were surprised to find that 70-90 percent of the sites associated with age showed significantly increased methylation in all seven cancer types. Taylor suggests that age-related methylation may disable the expression of certain genes, making it easier for cells to transition to cancer.
The research also determined how fast these methylation events accumulate in cells. They occur at a rate of one per year, according to Xu.
"On your 50th birthday, you would have 50 of these sites [from the subset of 749] that have acquired methyl groups in each cell," Xu said. "The longer you live, the more methylation you will have."
For future work, Xu and Taylor want to examine more samples, using a newer microarray that will explore methylation at 450,000 genomic methylation sites. The additional samples and larger microarray, which will provide 16 times more genomic coverage, will allow them to address whether environmental exposures during adulthood or infancy affect methylation profiles. These additional studies will help scientists better understand why methylation happens as people march toward their retirement years.
DNA methylation is one of several epigenetic mechanisms that can control gene expression without changes in DNA sequence. This study is part of a broader research effort, funded by NIEHS, to understand how environmental and other factors affect epigenetic mechanisms in relation to health.

Continue to Read more ...

Paracetamol overdose and liver failure

University of Adelaide researchers have identified a key step for the future prevention of liver failure resulting from taking too much of the everyday painkiller paracetamol (also known as acetaminophen).
Published in the Proceedings of the National Academy of Sciences (PNAS), the study pinpoints a target for new treatments to prevent the potentially lethal consequences of paracetamol overdose.
"Paracetamol is the most frequently used over-the-counter pain medication," says Dr Grigori Rychkov, Senior Research Fellow in the University's School of Medical Sciences.
"Overdose of paracetamol is the most common cause of acute liver failure and the leading cause of liver damage requiring transplantation in developed countries. The precise mechanisms of liver toxicity due to paracetamol overdose, however, have remained unclear."
It has been known for a long time that paracetamol overdose is associated with toxic levels of calcium in liver cells but nobody has known how the calcium gets into the cells.
The University of Adelaide researchers have identified a channel transporting calcium across the cell membrane that is triggered by paracetamol overdose, known as Transient Receptor Potential Melanostatine2 (TRPM2). Once the channel is activated, the cells become overloaded with calcium, leading to cell death. If this continues and enough cells die, it can lead to liver failure.
The research, conducted by PhD student Ehsan Kheradpezhouh, showed in laboratory studies that when the TRPM2 channel was missing or blocked, liver cells were protected from paracetamol damage.
"We now have a potential drug target for treating paracetamol overdose and possibly some other liver-damaging poisonings," says Dr Rychkov.
Currently paracetamol overdose can be effectively treated - but only if caught within 18 hours.
"If we can block the TRPM2 channel we might be able to prevent the toxicity or extend this timeframe. If we can stop the calcium uptake and cell death, we'll be giving the liver a better chance for recovery and, hopefully, preventing complete liver failure," says Dr Rychkov.

Continue to Read more ...

Enjoy life more - your body will age better, study shows

A new study from the UK and published in the Canadian Medical Association Journal claims that people who enjoy life will have better physical function and faster walking speeds than their more pessimistic counterparts.
We already know there are health benefits associated with a positive outlook on life. A study from 2013 suggested people who have happy marriages also enjoy better physical health than couples in stressful marriages.
In 2012, Medical News Today reported on a study by researchers at University College London (UCL) in the UK, which found seniors who enjoy life more tend to live longer.
As part of a follow-up study testing the link between happiness and physical performance, the UCL researchers have assessed the enjoyment of life of 3,199 participants aged 60 years or older.

Enjoying life makes your body work better?

The participants in the study were asked to rate on a four-point scale how much they subscribed to the following statements: "I enjoy the things that I do," "I enjoy being in the company of others," "On balance, I look back on my life with a sense of happiness" and "I feel full of energy these days."

The study found that seniors who enjoy life had better physical function than unhappy people.

Interviewing the people in the study, the researchers then assessed to what extent they had difficulty performing daily activities, such as bathing or getting dressed. They also measured the walking speed of the participants.
The study found that people who had a low sense of well-being were more than three times as likely to experience problems in performing daily activities.
"Our results provide further evidence that enjoyment of life is relevant to the future disability and mobility of older people," says Dr. Steptoe, co-author of the study. "Efforts to enhance well-being at older ages may have benefits to society and health care systems."
Although the study recorded - perhaps unsurprisingly - that people suffering from chronic illness had lower levels of enjoyment of life, Dr. Steptoe says the link between happiness and physical health is not simply that happier people are healthier:

"This is not because the happier people are in better health, or younger, or richer, or have more healthy lifestyles at the outset, since even when we take these factors into account, the relationship persists. Our previous work has shown that older people with greater enjoyment of life are more likely to survive over the next 8 years; what this study shows is that they also keep up better physical function."

Enjoying life makes you live longer?

Dr. Steptoe's previous study found that nearly three times more people in the study group of over 50s who had low enjoyment of life had died, compared with participants who enjoyed life more.
That study considered social isolation in seniors - having few hobbies or social interactions - as being a factor in a loss of enjoyment in life. It found that 1 in 6 people aged 50 and over living in England were socially isolated. But there was also a socio-economic aspect - the wealthier seniors were half as likely to become socially isolated as the less wealthy people in the study.
In the new study, people with higher socio-economic status and education were also more likely to enjoy life. Married and working people also scored higher on the happiness scale than retired or single seniors. "The study shows that older people who are happier and enjoy life more show slower declines in physical function as they age," Dr. Steptoe concludes. "They are less likely to develop impairments in activities of daily living such as dressing or getting in or out of bed, and their walking speed declines at a slower rate than those who enjoy life less."

Continue to Read more ...

Brain training boosted older adults' mental skills

Researchers found that giving a group of older adults a brief course of mental or cognitive training helped to improve their reasoning ability and processing speed, and hold onto the gains for up to 10 years, compared with a group of untrained controls. Plus, those who received additional training for another 3 years improved even further.
Cognitive decline is not uncommon among older adults and can seriously affect their ability to lead a normal life and carry out everyday tasks.
Study leader George Rebok, a professor at Johns Hopkins University in Baltimore, MD, and an expert on aging and mental health, says:
"Showing that training gains are maintained for up to 10 years is a stunning result because it suggests that a fairly modest intervention in practicing mental skills can have relatively long-term effects beyond what we might reasonably expect."

He and his colleagues also found the seniors who received the brief cognitive training also reported experiencing less difficulty in carrying out everyday living tasks.
Prof. Rebok says even small delays in impairment of mental and functional ability can have a big effect on public health and help reduce the rising cost of caring for older adults.
They report their findings in a soon-to-be-published issue of the Journal of the American Geriatrics Society.

Seniors received training in memory, reasoning and processing speed skills

The results come from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study, which tested whether cognitive training sessions could help older adults maintain functional independence by improving basic mental skills.
This latest analysis is of 10 years of follow-up results from 2,832 participants whose average age was 73.6 years at the start of the study, when they were randomly assigned to one of three groups for memory, reasoning or speed-of-processing training, or to an untrained control group.
The participants who underwent cognitive training received 10 sessions, which lasted 60-75 minutes, over 5-6 weeks in small groups.
Those in the memory training group were taught how to remember word lists and sequences of items, texts, and themes and details of stories.
Those assigned to the reasoning group learned problem-solving skills that help with daily tasks, such as filling out order forms and reading bus timetables.
And the participants who received speed-of-processing training used computer programs to learn how to spot and find visual information quickly. This kind of training can boost scanning skills, such as noticing changes in traffic when driving or looking up phone numbers.

Cognitive training groups reported less difficulty with daily living

After 10 years of follow-up, the groups that received cognitive training reported experiencing less difficulty with carrying out daily living tasks, such as cooking, taking medications and managing finances.
After 10 years, 60% of the participants who had mental training were at the same level of functioning in carrying out daily living tasks, compared with only 50% of the untrained controls.
While memory performance showed improvement in the training group for up to 5 years after training, 10 years later there was no significant difference between the trained groups and the untrained controls.
However, reasoning and speed-of-processing training appeared to have a more lasting effect - trained participants still showed significant improvements in these skills, compared with controls at the 10-year follow-up.

'Booster' sessions resulted in even greater improvements

Some of the trained participants also had four "booster" sessions just before the end of the first year, and just before the end of the third year of follow-up. These resulted in additional improvements in reasoning and speed-of-processing.
Prof. Rebok says:

"Our findings provide support for the development of other interventions for senior adults, particularly those that target cognitive abilities showing the most rapid decline with age and that can affect their everyday functioning and independence. Such interventions have potential to delay the onset of difficulties in daily functioning."

The researchers say more studies are needed to find out how such brief training can translate to such lasting effects on everyday functioning.
The team now plans to test whether more training over a longer period leads to even greater improvements, and also whether cognitive training can help older adults maintain safe driving skills.

Funds from various institutions, including the National Institute on Aging and private sources, helped finance the study.
Meanwhile in another study reported in October 2013, researchers showed that sleeping longer is linked to faster cognitive decline in older adults. They found people in their 60s and 70s who slept on average more than 9 hours a night showed double the amount of cognitive function decline, compared with people who slept 6-8 hours a night.

Continue to Read more ...

New blood test 'could accurately predict heart attack risk'

According to The Heart Foundation, more than 920,000 Americans will suffer a heart attack this year, and many of these will occur without warning. But researchers from The Scripps Research Institute in California say they have created a blood test which may be able to predict whether patients are at high risk of heart attack.
The research team, led by Prof. Pete Kuhn, says that at present there is no test available that can predict the occurrence of a heart attack with good accuracy.
But they say their novel test, details of which have been recently published in the journal Physical Biology, has so far proved successful in identifying which patients are undergoing treatment for a recent heart attack and which patients are healthy.

Test identifies endothelial cells in blood

The new test uses a "fluid biopsy" technique. It works by identifying the presence of endothelial cells - which line the artery walls - in the bloodstream.
According to the researchers, endothelial cells that circulate in the bloodstream have been associated with ongoing heart attacks.

Researchers say the HD-CEC test can accurately detect circulating endothelial cells in patients, meaning the test could be used to predict heart attack risk.

They believe that endothelial cells enter the bloodstream as a result of diseased plaque building up, rupturing and ulcerating in the arteries, which triggers inflammation.
They add that this damage to the arteries can lead to the formation of blood clots. This stops the blood flowing through the arteries, which in turn can cause a heart attack.
Using a newly-created procedure called the High-Definition Circulating Endothelial Cell (HD-CEC) assay, the researchers were able to identify and differentiate endothelial cells in blood samples of 79 patients, all of whom had already suffered a heart attack when their samples were taken.
The researchers also used the HD-CEC assay on two groups of patients as a control measure. One group was made up of seven patients who were receiving treatment for cardiovascular disease, while the other group consisted of 25 healthy patients.

Blood test 'successfully identified heart attack patients'

The research team found that the HD-CEC assay was able to detect circulating endothelial cells in the blood of the patients through the cells' "morphological features and their reactions with specific antibodies."
Patients who suffered a heart attack had much higher levels of circulating endothelial cells in their blood, compared with healthy patients. And the researchers note that the cells were identified with "high sensitivity and high specificity."
To further confirm the accuracy of the HD-CEC assay, the researchers compared it with CellSearch - a test that has been approved by the US Food and Drug Administration (FDA) to identify circulating tumor cells in patients with cancer.
From this, the investigators found that the HD-CEC test was able to detect circulating endothelial cells more accurately than the CellSearch test.
The researchers say this is because the HD-CEC test "used a direct analysis method and was free of bias from an enrichment stage."
"Our assay effectively analyzes millions of cells, which is more work but guarantees that you are analyzing all of the potential cells," says Prof. Kuhn.
The investigators believe the technique is now ready to be tested on patients who show symptoms of increased risk of heart attack, but have not yet suffered one.
Prof. Kuhn adds:

"The goal of this paper was to establish evidence that these circulating endothelial cells can be detected reliably in patients following a heart attack and do not exist in healthy controls - which we have achieved.
Our results were so significant relative to the healthy controls that the obvious next step is to assess the usefulness of the test in identifying patients during the early stages of a heart attack."

This is not the only research to look at the possibility of predicting heart attack risk. In November last year, Medical News Today reported on a study from researchers at the University of Edinburgh in the UK, which detailed a new imaging technique that can light up dangerous fatty plaques in the arteries that are in danger of rupturing - therefore identifying heart attack risk.

Continue to Read more ...

Caffeine may boost long-term memory

Numerous studies have suggested that caffeine has many health benefits. Now, new research suggests that a dose of caffeine after a learning session may help to boost long-term memory. This is according to a study published in the journal Nature Neuroscience.
The research team, led by Daniel Borota of the Johns Hopkins University in Baltimore, notes that although previous research has analyzed the effects of caffeine as a cognitive enhancer, whether caffeine can impact long-term memory has not been studied in detail.
To find out, the investigators analyzed 160 participants aged between 18 and 30 years.
On the first day of the study, the participants were shown pictures of different objects and were asked to identify them as "indoor" or "outdoor" items.
Soon after this task, they were randomized to receive either 200 mg of caffeine in the form of a pill, or a placebo tablet.
The next day, the participants were shown the same pictures as well as some new ones. The researchers asked them to identify whether the pictures were "new," "old" or "similar to the original pictures."

200 mg of caffeine 'enhanced memory'

From this, the researchers found that subjects who took the caffeine were better at identifying pictures that were similar, compared with participants who took the placebo.
However, the researchers note that both groups were able to accurately distinguish whether pictures were old or new.

New research suggests that consuming 200 mg of caffeine a day may boost long-term memory.

The team conducted further experiments using 100 mg and 300 mg doses of caffeine. They found that performance was better after the 200 mg dose, compared with the 100 mg dose, but there was no improvement after the 300 mg of caffeine, compared with 200 mg.
"Thus, we conclude that a dose of at least 200 mg is required to observe the enhancing effect of caffeine on consolidation of memory," the study authors write.
The team also found that memory performance was not improved if subjects were given caffeine 1 hour before carrying out the picture identification test.
They investigators say there are many possibilities as to how caffeine may enhance long-term memory.
For example, they say it may block a molecule called adenosine, preventing it from stopping the function of norepinephrine - a hormone that has been shown to have positive effects on memory.
They note that further research should be conducted to better understand the mechanisms by which caffeine affects long-term memory.
They add:

"Given the widespread use of caffeine and the growing interest in its effects both as a cognitive enhancer and as a neuroprotectant, these questions are of critical importance."

Potential benefits and risks of caffeine consumption

According to the latest figures from the US Food and Drug Administration (FDA), the average American consumes 300 mg of caffeine a day. The main sources of the compound are coffee, tea and soft drinks.
Many studies have suggested that caffeine offers health benefits. Last year, Medical News Today reported on a study suggesting that caffeinated drinks may reduce the risk of liver disease, while another study says drinking 2-4 cups of coffee a day may reduce suicide risk.
But it is not all good news. One study suggests that the stimulant is able to disrupt sleep patterns hours after consuming it, while another proposes that caffeine from energy drinks may alter heart function.

Continue to Read more ...