Discrimination May Lead to Smoking in Boys

FRIDAY, Jan. 22 (HealthDay News) — Minority teen boys smoke more when they suffer discrimination, but that’s not the case for minority teen girls, a U.S. study finds.

Perceived discrimination had no effect on smoking rates among minority girls aged 12 to 15 and was associated with lower rates of smoking among minority teen girls aged 16 to 19.

“Our findings in girls, especially in the older girls, really surprised us,” study first author Dr. Sarah Wiehe, an assistant professor of pediatrics at the Indiana University School of Medicine, said in a news release from the school. “We do not know why older girls who perceived discrimination were less likely to smoke, but there may be a possibility that they perceived discrimination because they were pregnant and also that they did not smoke due to pregnancy.”

The study included 2,561 black and Hispanic teens, aged 12 to 19, living in low-income households in Baltimore, Boston, Chicago, Los Angeles and New York. About 25% of the teens reported discrimination within the previous six months, and 12% said they’d smoked within the previous 30 days.

Increased smoking by boys who suffer higher levels of discrimination may be caused by increased stress from male-specific targeting by police and business, the study concluded.

“Boys and girls may experience discrimination differently due to where they spend their time and that may account for the differences in whether discrimination was associated with smoking,” Wiehe said. “In other words, the context of discrimination matters. We need to be aware that discrimination is a public health problem for adolescents — one related to major health issues like smoking — and need to actively work to reduce these occurrences.”

The study appears online and in the March print issue of the American Journal of Public Health

Acupuncture stimulates brain metabolism in dementia patients

CM NEWS – Needling specific acupoints may help patients with dementia, a recently published study shows. The acupoint combo seems to increase cerebral glucose metabolism in the brain, as indicated by cerebral functional imaging.

The study has been published in the January 2007 issue of the Journal of Acupuncture and Tuina Science. Chinese researchers observed the effects of needling three acupoints – Baihui (百會, Hundred Convergences; GV 20), Shuigou (水溝, Water Trough; GV 26) and Shenmen (神門, Spirit Gate; HT 7) – and their effects on cerebral glucose metabolism in patients with vascular dementia.

25 patients with vascular dementia were divided into 5 groups (Group A, B, C, D and E) randomly. Patients in the Group A were treated by needling routine acupoints for hemiplegia (paralysis in the vertical half of a patient’s body), which are acupoints of the three “yang meridians” of the hand and foot.

In addition to the “routine acupoints”, Group B patients received acupuncture to Baihui (GV 20); Group C to Shuigou (GV 26), Group D to Shenmen (HT 7), and Group E to Baihui (GV 20), Shuigou (GV 26), and Shenmen (HT 7).

All the patients were examined by Positron Emission Tomography (PET) to detect cerebral glucose metabolism in the bilateral frontal lobes (orbital gyri), parietal lobes, temporal lobes (hippocampus and hippocampal gyrus), occipital lobes, thalamus, lentiform nucleus, caudate nuclei, cingulate gyms and cerebellum before treatments and after treatments.

Why checking on cerebral glucose metabolism? Studies have linked dementia with the slowing of glucose metabolism in certain parts of the brain. One study indicated that patients with frontotemporal dementia not only showed significant metabolic deficits primarily in frontal cortical areas, but also in the caudate nuclei and the thalami. These findings demonstrate that the clinical progression in patients with frontotemporal dementia is accompanied by a region-specific decline in cerebral glucose metabolism.

Another study found that patients with multi-infarct dementia (MID) had significantly lower glucose metabolism in all the grey matter regions measured and were also characterized by more individuality in metabolic pattern.

The present study shows that after needling the routine acupoints for hemiplegia, glucose metabolism increased in lentiform nucleus and temporal lobe; and:

* patients with Baihui (GV 20) needled showed increased glucose metabolism in the frontal lobe, temporal lobe and lentiform nucleus.
* patients with Shuigou (GV 26) needled showed increased glucose metabolism in the frontal lobe, thalamus and lentiform nucleus;
* patients with Shenmen (HT 7) needled got more glucose metabolism in the parietal lobe and lentiform nucleus;
* patients who recieved needling to all these three acupoints has higher glucose metabolism in the frontal lobe, temporal lobe, thalamus and lentiform nucleus.

The results suggest that needling Baihui (GV 20), Shuigou (GV 26) and Shenmen (HT 7) affect glucose metabolism in different functional regions of the brain. In other words, the three acupoints are closely correlated to different functional regions of the brain.

Placebo effect may be at play in acupuncture studies: analysis

Reuters Health – Acupuncture can bring some relief to people with knee arthritis, but the benefits may be at least partly from a placebo effect, a new research review suggests.

In an analysis of 9 clinical trials from the past 15 years, researchers found that acupuncture generally seemed to improve knee arthritis sufferers’ pain and stiffness in the short term. The patients had osteoarthritis, a degenerative joint disease associated with age, as opposed to arthritis associated with an autoimmune disorder.

However, a closer look showed that the benefits were limited to trials that compared acupuncture with doing nothing or with “usual care,” such as anti-inflammatory medication.

In trials that compared acupuncture with “sham” acupuncture, on the other hand, there was no clear evidence that the real therapy was more effective.

Sham acupuncture is accomplished by using non-penetrating needles, or inserting needles only into the superficial layer of skin, at random sites rather than the specific points used in real acupuncture. In studies that evaluated electro-acupuncture, the sham version involved phony electrodes and “mock” electrical stimulation of acupuncture points.

The point is to keep study participants from knowing whether they were receiving the real or the placebo treatment. This helps separate the specific effects of a therapy from any placebo effects — where people feel better simply because they believe they’ve been treated.

The new findings suggest that the benefits of acupuncture for knee arthritis are at least partly due to patients’ expectations, the study authors report in the Annals of Internal Medicine.

However, that doesn’t mean acupuncture is not worthwhile, according to the researchers, led by Eric Manheimer of the University of Maryland School of Medicine in Baltimore.

Research does suggest that acupuncture has a “genuine biological effect,” and there was evidence in some studies that the real therapy resulted in somewhat better short-term effects than sham acupuncture, the researchers note.

For their study, Manheimer and his colleagues combined the results of nine clinical trials conducted in Europe, the U.S. and Thailand. The trials included a total of more than 3,500 subjects.

Each trial included a patient group that received acupuncture for knee arthritis, as well as a “control” group. In some studies, control patients were placed on a waiting list for acupuncture, while in others they received some standard therapy that acupuncture patients did not. Control patients in other studies received sham acupuncture.

In general, the Manheimer’s team found, only studies that pitted acupuncture against doing nothing, or against standard care, showed clear benefits. The results of the sham-controlled trials were too mixed to show any benefits, according to the researchers.

The investigators do not, however, dismiss the potential benefits of acupuncture for knee arthritis. Indeed, they note, a possible explanation for the mixed results is that sham acupuncture had some actual biological effects.

Given the overall safety of acupuncture, the researchers conclude, patients can still consider it as one option in a “multidisciplinary approach” to treating knee arthritis.

World’s largest conference on acupuncture to convene in China

Xinhua – More than 1,500 acupuncturists from nearly 30 countries and regions will gather in Beijing this October, to discuss the future of traditional Chinese medicine.

From Oct. 20 to 22, the acupuncturists will attend an academic forum for the 20th anniversary of the World Association of Acupuncture. The forum, with the theme of “acupuncture: looking back and looking forward”, will have eight sub-forums on topics like education, the evolution of acupuncture and needle therapy practise and assessment.

An exhibition of new methods and technologies in the field will also be held.

Deng Liangyue, chairman of the World Association of Acupuncture, said the association had successfully held six forums on acupuncture in China, Japan, the United States, France and the Republic of Korea over the past 20 years. With efforts from acupuncturists worldwide, needle therapy has spread to the four corners of the earth.

So far, more than 140 countries and regions have adopted acupuncture treatment. Traditional Chinese medicine represented by needle therapy is accepted and welcomed by mainstream society in many countries.

Statistics from the World Association of Acupuncture show there are about 100,000 people engaged in acupuncture services in Japan. 29 percent of Tokyo’s residents have received acupuncture treatment at least once. More than five million European patients choose needle therapy every year.

Acupuncture, one of the oldest traditional Chinese therapies, can not only help people give up smoking, but also cure sterility and even drug addiction. For poor people, it is a low-cost and easily accessible medical resource.

Is swine flu (H1N1) a cause of an epidemic or pandemic in 2009?

An epidemic is defined as an outbreak of a contagious disease that is rapid and widespread, affecting many individuals at the same time. The swine flu outbreak in Mexico fit this definition. A pandemic is an epidemic that becomes so widespread that it affects a region, continent, or the world. As of April 2009, the H1N1 swine flu outbreak did not meet this definition. However, as of June 11, 2009, WHO officials determined that H1N1 2009 influenza A swine flu reached WHO level 6 criteria (person-to-person transmission in two separate WHO-determined world regions) and declared the first flu pandemic in 41 years. To date, the flu has reached over 74 different countries on every continent except Antarctica in about three month’s time; fortunately, the severity of the disease has not increased.

What is the history of swine flu (H1N1) in humans?

In 1976, there was an outbreak of swine flu at Fort Dix. This virus is not the same as the 2009 outbreak, but it was similar insofar as it was an influenza A virus that had similarities to the swine flu virus. There was one death at Fort Dix. The government decided to produce a vaccine against this virus, but the vaccine was associated with neurological complications (Guillain-Barré syndrome) and was discontinued. Some individuals speculate that formalin, used to inactivate the virus, may have played a role in the development of this complication in 1976. There is no evidence that anyone who obtained this vaccine would be protected against the 2009 swine flu. One of the reasons it takes a few months to develop a new vaccine is to test the vaccine for safety to avoid the complications seen in the 1976 vaccine. New vaccines against any flu virus type are usually made by growing virus particles in eggs. A serious side effect (allergic reaction such as swelling of the airway) to vaccines can occur in people who are allergic to eggs; these people should not get flu vaccines. Individuals with active infections or diseases of the nervous system are also not recommended to get flu vaccines.

Can novel H1N1 swine flu be prevented with a vaccine?

The best way to prevent novel H1N1 swine flu would be the same best way to prevent other influenza infections, and that is vaccination. The CDC has multiple recommendations for vaccination based on who should obtain the first doses when the vaccine becomes available (to protect the most susceptible populations) and according to age groups. The CDC based the recommendations on data obtained from vaccine trials and infection reports gathered over the last few months. The current (October 2009) vaccine recommendations from the CDC say the following groups should get the vaccine as soon as it is available:

* pregnant women,

* people who live with or provide care for children younger than 6 months of age,

* health-care and emergency medical services personnel,

* people between 6 months and 24 years of age, and

* people from the ages of 25 through 64 who are at higher risk because of chronic health disorders such as asthma, diabetes, or a weakened immune system.

Currently, the CDC is stating that people ages 10 and above are likely to need only one vaccine shot to provide protection against novel H1N1 swine flu and further suggest that these shots will be effective in about 76% of people who obtain the vaccine. New vaccine trial data showed that healthy adults produce protective antibodies in about 98% of people in 21 days. Unfortunately, the vaccine shot in children ages 6 months to 9 years of age is not as effective as it is in older children and adults. Consequently, the CDC currently recommends that for ages 6 months up to and including 9 years of age, the children obtain two shots of the novel H1N1 vaccine, the second shot 21 days after the first shot.

Pregnant women are strongly suggested to get vaccinated as stated above. Although some vaccine preparations (multidose vials) contain low levels of thimerosal preservative (a mercury-containing preservative), the CDC still considers the vaccine safe for the fetus and mother. However, some vaccine preparations that are in single-dose vials will not have thimerosal preservative, so those pregnant individuals who are concerned about thimerosal can get this vaccine preparation when it is available.

Another type of vaccine (currently named Influenza A [H1N1] 2009 Monovalent Vaccine Live, Intranasal) has been made available during the first week in October 2009. It is a live attenuated novel H1N1 flu vaccine that contains no thimerosal, is produced by MedImmune, LLC, and is sprayed into the nostrils. This vaccine is only for healthy people 2-49 years of age, and some data suggest that it is less effective in generating an immune response in adults than the vaccine injection. The dosing schedule is as follows:

* Children 2-9 years of age should receive two doses (0.1 ml in each nostril; total equals 0.2 ml per dose) — the second dose should be given the same way about one month after the first dose

* Children, adolescents and adults, 10-49 years of age should receive one dose — (0.1 ml in each nostril; total equals 0.2 ml per dose)

The CDC occasionally makes changes and updates its information on vaccines and other recommendations about the current flu pandemic. The CDC states, “for the most accurate health information, visit http://www.cdc.gov or call 1-800-CDC-INFO, 24/7.” Caregivers should check the vaccine package inserts for more detailed information on the vaccines when they become available. This article has an updated timeline for novel H1N1 swine flu attached (see below) and provides the reader with current details about the pandemic. The following is a list of the CDC-approved H1N1 vaccines and the companies that name and manufacture them as of 10/29/09:

* Influenza A (H1N1) 2009 Monovalent Vaccine by Sanofi Pasteur

* Influenza A (H1N1) 2009 Monovalent Vaccine by Novartis

* Influenza A (H1N1) 2009 Monovalent Vaccine Live, Intranasal by MedImmune, LLC

* Influenza A (H1N1) 2009 Monovalent Vaccine by CSL Limited

The CDC says that a good way to prevent any flu disease is to avoid exposure to the virus; this is done by frequent hand washing, not touching your hands to your face (especially the nose and mouth), and avoiding any close proximity to or touching any person who may have flu symptoms. Since the virus can remain viable and infectious for about 48 hours on many surfaces, good hygiene and cleaning with soap and water or alcohol-based hand disinfectants are also recommended. Some physicians say face masks may help prevent getting airborne flu viruses (for example, from a cough or sneeze), but others think the better use for masks would be on those people who have symptoms and sneeze or cough. The use of Tamiflu or Relenza may help prevent the flu if taken before symptoms develop or reduce symptoms if taken within about 48 hours after symptoms develop. Some investigators say that administration of these drugs is still useful after 48 hours, especially in high-risk patient populations .However, taking these drugs is not routinely recommended for prevention for the healthy population because investigators suggest that as occurs with most drugs, flu strains will develop resistance to these medications. Recently, the CDC made further suggestions about the use of these antiviral medications. Dr. Schuchat, a CDC official, indicated that three modifications were being suggested (Sept. 8, 2009) to the interim guidelines for use of Tamiflu and Relenza:

1. Patients with high-risk factors should discuss flu symptoms and when to use antiviral medications; doctors should provide a prescription for the antiviral drug for the patient to use if the patient is exposed to flu or develops flu-like symptoms without having to go in to see the doctor.

2. “Watchful waiting” was added as a response to taking antiviral medications, with the emphasis on the fact that those people who develop fever and have a preexisting health condition should then begin the antiviral medication.

3. The antiviral medications are the first-line medicines for treatment of novel H1N1 swine flu, and most current cases of flu are novel H1N1 and are, to date, susceptible to Tamiflu and Relenza.

Your doctor should be consulted before these drugs are prescribed.

In general, preventive measures to prevent the spread of flu are often undertaken by those people who have symptoms. Symptomatic people should stay at home, avoid crowds, and take off from work or school until the disease is no longer transmittable (about two to three weeks) or until medical help and advice is sought. Sneezing, coughing, and nasal secretions need to be kept away from other people; simply using tissues and disposing of them will help others. Quarantining patients is usually not warranted, but such measures depend on the severity of the disease. The CDC recommends that people who appear to have an influenza-like illness upon arrival at work or school or become ill during the day be promptly separated from other people and be advised to go home until at least 24 hours after they are free of fever (100 F [37.8 C] or greater), or signs of a fever, without the use of fever-reducing medications. The novel H1N1 swine flu disease takes about seven to 10 days before fevers stop, but new research data (Sept. 14, 2009) suggests waiting until the cough is gone since many people are still infectious about one week after fever is gone. The CDC has not yet extended their recommendations to stay home for that extra week.

Tai chi soothes pain in arthritis sufferers

CM NEWS – The results of a new analysis have provided good evidence to suggest that Tai Chi is beneficial for arthritis. Specifically, it was shown to decrease pain with trends towards improving overall physical health, level of tension and satisfaction with health status.

Musculoskeletal pain, such as that experienced by people with arthritis, places a severe burden on the patient and community and is recognized as an international health priority. Exercise therapy including such as strengthening, stretching and aerobic programs, have been shown to be effective for arthritic pain. Tai Chi, is a form of exercise that is regularly practiced in China to improve overall health and well-being. It is usually preformed in a group but is also practiced individually at one’s leisure, which differs from traditional exercise therapy approaches used in the clinic.

Recently, a new study examined the effectiveness of Tai Chi in decreasing pain and disability and improving physical function and quality of life in people with chronic musculoskeletal pain. The study is published in the June issue of Arthritis Care & Research. Led by Amanda Hall of The George Institute in Sydney, Australia, researchers conducted a systematic review and meta-analysis. They analyzed seven eligible randomized controlled trials that used Tai Chi as the main intervention for patients with musculoskeletal pain. The results demonstrate that Tai Chi improves pain and disability in patients suffering arthritis.

The authors state, “The fact that Tai Chi is inexpensive, convenient, and enjoyable and conveys other psychological and social benefits supports the use this type of intervention for pain conditions such as arthritis.”

“It is of importance to note that the results reported in this systematic review are indicative of the effect of Tai Chi versus minimal intervention (usual health care or health education) or wait list control,” the authors note. Establishing the specific effects of Tai Chi would require a placebo-controlled trial, which has not yet been undertaken.