Cancer Patients May Face Higher Bankruptcy Odds

By Barbara Bronson Gray
HealthDay Reporter

WEDNESDAY, May 15 (HealthDay News) -- People diagnosed with cancer are almost three times more likely to declare bankruptcy than are those without the disease, a large new study suggests.

And younger people with cancer have up to five times higher bankruptcy rates compared to older patients with the disease, the researchers found.

Of almost 200,000 people with cancer in the study based in Washington state, about 2 percent filed for bankruptcy protection after being diagnosed. Of those who were not diagnosed with cancer, 1 percent filed.

Although the risk of bankruptcy for those with cancer is still relatively low, researchers said it is significant.

"Bankruptcy is such an extreme measure of financial distress, and we didn't include the other forms of financial difficulties people encounter," said Catherine Fedorenko, a study co-author and technical project coordinator at the Fred Hutchinson Cancer Research Center, in Seattle.

Whether people suffer substantial debt or have to go so far as to declare bankruptcy, their financial problems are likely to be stressful, said Karma Kreizenbeck, a study co-author and project director at the Hutchinson Institute for Cancer Outcomes Research.

"This paper shows how medical debt associated with a cancer diagnosis could be more likely to lead to a bankruptcy," Kreizenbeck said. "But it could also mean people have to take second jobs, end up with lower credit scores or have to make other decisions."

Celeste Smith, 63, was diagnosed five years ago with breast cancer. A Seattle realtor who was just starting to do well in a new job, she found she had to stop working when she was faced with months of radiation and chemotherapy. Despite the fact that she had health insurance, her mortgage and car payment bills began to mount. "It's a horrible circle trying to get over cancer and deal with all the financial stress," she said. Smith ended up filing for bankruptcy and moving from her foreclosed house to affordable living for seniors.

Researchers have noted before that the financial burden on people with cancer can be substantial. Data from the Medical Expenditure Panel Survey in 2004 showed that 6.5 percent of the $20.1 billion spent on cancer care by those not yet on Medicare each year comes directly from the patients themselves, according to study background information.

A small study presented last year at an American Society of Clinical Oncology meeting showed that four of every five cancer patients and their spouses or caregivers said they had concerns about meeting medical costs and suffered associated financial and mental stress.

The new research, published online May 15 and in the June print issue of Health Affairs, is based on data taken from a registry of people 21 and older who lived in Washington and were diagnosed with cancer from 1995 through 2009. They were compared to a randomly sampled population of people without cancer, matched by age, gender and ZIP code. Cancer cases were identified using a cancer registry based at the Fred Hutchinson Cancer Research Center, part of a U.S. National Cancer Institute epidemiology database.

Key findings of the new study include the following:

Cancer patients were 2.65 times more likely than people without cancer to go bankrupt.Those cancer patients who filed for bankruptcy were more likely to be younger, female and nonwhite than were cancer patients who didn't file. The youngest age groups had up to 10 times the bankruptcy rate compared to the older age groups. The youngest groups in the study were diagnosed at a time when their debt was typically high and their income was not, the study noted. Bankruptcy filings went up as time went by. While the proportion of cancer patients who filed for bankruptcy within one year of diagnosis was 0.52 percent, it went up to 1.7 percent after five years. Bankruptcy rates were highest for people with the diagnosis of thyroid and lung cancer, and lowest for melanoma, breast and prostate cancer. The authors suggested that the higher rate of bankruptcy associated with thyroid cancer was likely due to the fact that it affects younger women more often than do other cancers.

The study, based on data from 1995 to 2009, did not take into account the potential impact of the implementation of the Affordable Care Act (ACA) in 2010, an expert pointed out.

"The problem of bankruptcy was one thing the ACA was designed to address," said Peter Cunningham, a senior fellow and director of quantitative research at the Center for Studying Health System Change, in Washington, D.C.

Cunningham expressed concern that the researchers didn't note whether the cancer patients or the control participants had health insurance. "So we don't know how much of a difference having health insurance makes in terms of avoiding bankruptcy," he said. "It would have been nice to see what the impact of health insurance coverage is in being able to prevent bankruptcy and how many people lost their health insurance coverage because of their cancer diagnosis."

What should people do to avoid the stress of money troubles when faced with a serious disease? "The study points to the value of having health insurance," Cunningham said.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Catherine Fedorenko, technical project coordinator, Fred Hutchinson Cancer Research Center, Seattle; Karma Kreizenbeck, project director, Hutchinson Institute for Cancer Outcomes Research, Seattle; Peter J. Cunningham, Ph.D., senior fellow and director of quantitative research, Center for Studying Health System Change, Washington, D.C.; Celeste Smith, Seattle; June 2013, Health Affairs

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Blacks May Face Higher Risk of MS Than Whites

Study finding contradicts common belief that the opposite is true

By Robert Preidt

HealthDay Reporter

MONDAY, May 6 (HealthDay News) -- Black Americans may be at higher risk for multiple sclerosis than whites, according to study findings that contradict a widely held belief that blacks are less likely to develop the neurological disease.

The theory that blacks are less likely to develop multiple sclerosis (MS) than whites was based on faulty evidence, the study authors said.

For the new study, the researchers examined three years of data from more than 3.5 million members of the Kaiser Permanente Southern California health plan and identified 496 people who were diagnosed with MS during that time.

The investigators found that blacks had a 47 percent increased risk of MS compared with whites, while Hispanics and Asians had a 58 percent and 80 percent lower risk than whites. The higher risk in blacks was seen only in women, while the lower risk for Hispanics and Asians was seen in both sexes. Black women had triple the risk of MS that black men did, the findings showed.

Blacks accounted for 21 percent of the patients diagnosed with MS, but made up only 10 percent of the total number of patients in the study. Among the other groups: whites made up 52 percent of those with MS and 38 percent of the study population; Hispanics made up 23 percent of those with MS, and 40 percent of the study population; Asians accounted for 3 percent of those with MS, and 9 percent of the study population, according to the study in the May 7 issue of the journal Neurology.

"One explanation for our findings is that people with darker skin tones have lower vitamin D levels and, ultimately, an increased risk, but this would not explain why Hispanics and Asians have a lower risk than [whites]," study author Dr. Annette Langer-Gould, of the Kaiser Permanente Southern California department of research & evaluation, said in a journal news release.

"About 19,000 people per year, or 250 people per week, will be diagnosed with MS in the U.S. alone. These numbers highlight the need for more minorities to be included in MS studies, so that we can fully understand how race may play a role in developing the disease," she added.

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Quicker Infant Growth Tied to Higher IQ Later

But difference in scores was fairly small in study of full-term babies

By Serena Gordon

HealthDay Reporter

FRIDAY, June 21 (HealthDay News) -- Babies who gained weight and head circumference more rapidly during the first month of life scored slightly higher on intelligence tests when they were 6 years old, according to a large new study.

But a baby's early rate of growth didn't influence the child's behavior later in life, according to the study.

"We found that faster growth in the first four weeks following birth was linked to a small increase in intelligence quotient scores at 6.5 years, but there were no clear effects on children's behavior," said the study's lead author, Lisa Smithers, a postdoctoral research fellow in early life nutrition at the University of Adelaide, in Australia.

She added that these findings suggest that "it is important that parents seek help for any concerns they might have about their baby's growth or feeding quite quickly so that any problems can be addressed early."

"[However], we cannot say that faster growth causes a higher IQ," Smithers said. "It is possible that a phenomenon called 'reverse causality' may be at play, for example, if children with lower IQs had poorer growth."

The study results appeared online June 17 and in the July print issue of the journal Pediatrics.

The study included about 17,000 mothers and their babies from Belarus. Only mothers who delivered a single, healthy baby were included in the study. In addition, the babies were all born at or after 37 weeks of gestation.

Researchers measured the babies' weights and head circumferences over the first four weeks of life. Intelligence was measured using several IQ scales that were combined to yield a full-scale IQ score at 6.5 years. The full-scale IQ scores can range from 50 to 150, Smithers said, and the average score is 100. To assess behavior, parents and teachers completed behavior questionnaires.

Babies with the highest growth in weight and head circumference scored 1.5 points higher on the IQ scale compared to babies with the lowest growth. The researchers found no statistically significant differences in children's later behavior based on early growth.

"Our study involved thousands of healthy babies, so our findings reflect a wide range of growth patterns that might be expected within a healthy population," Smithers said.

Researchers accounted for other important factors, such as family income and parental education, in their analysis.

"The size of the effect we found on children's IQ would not be noticeable to individuals," Smithers said.

But the results may be important in the bigger picture, a U.S. expert said.

"A 1.5-point difference would be meaningless in an individual child and that child's success in life, but on a population level, such a difference may matter," said Dr. Lisa Thornton, medical director of pediatric rehabilitation at LaRabida Children's Hospital in Chicago.

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Some Infertile Men Show Higher Cancer Risk, Study Suggests

Factors that contribute to lack of sperm may also raise odds for tumors, researchers say

By Amy Norton

HealthDay Reporter

FRIDAY, June 21 (HealthDay News) -- Men who are infertile because they produce no sperm may have a higher-than-average risk of developing cancer, a new study finds.

Researchers found that of more than 2,000 men with fertility problems, those with no sperm production had an increased risk of developing cancer over the next six years.

The men were young going into the study (about age 36, on average), so few did develop cancer. Among men with no sperm -- what doctors call azoospermia -- just over 2 percent were diagnosed with cancer.

Still, their risk was three times higher than that of the average man their age.

"They have the cancer risk of a man about 10 years older," said lead researcher Dr. Michael Eisenberg, an assistant professor of urology at Stanford University School of Medicine.

About 15 percent of infertile men are azoospermic, according to the study, which was published June 20 in the journal Fertility and Sterility.

This isn't the first work to connect male infertility to cancer risk, but it suggests the link may be concentrated among men with the most severe type of infertility.

"This suggests that it's not male infertility in general, but azoospermia in particular," Eisenberg said.

That's an important piece of information, said a male-infertility expert not involved in the study. If the link between male infertility and cancer is real, you would expect that more severe infertility would be tied to a greater cancer risk, said Dr. Thomas Walsh, of the University of Washington in Seattle.

"This reinforces the idea that this is a real relationship," Walsh said.

He said he doubts anyone would say that infertility is causing cancer. But he and Eisenberg said it's possible that some common genetic factors contribute to both azoospermia and a greater vulnerability to cancer.

"When we see a man with azoospermia, we usually assume there's a genetic cause," Eisenberg said. There are certain gene mutations already tied to the condition, but a minority of azoospermic men turn out to have one of them when they are tested. That means there are likely other, as yet unknown, gene defects involved in azoospermia, Eisenberg said.

And some of those genetic flaws might be involved in cancer susceptibility, he said.

Another infertility expert was cautious about interpreting the findings because of the small numbers: only 10 cases of cancer among the 451 men with azoospermia, and 19 cases among nearly 1,800 men with other types of infertility.

The idea that genetic abnormalities might underlie both azoospermia and cancer risk has merit, said Dr. Frederick Licciardi of NYU Langone Medical Center in New York City. But, he said, "while this is important reasoning and is based in basic science studies, I do not feel they have enough evidence in this paper to bolster this theory."

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Balding Men Could Face Higher Heart Risks, Study Finds

But not those with a receding hairline, say Japanese investigators who analyzed previous research

By Alan Mozes

HealthDay Reporter

WEDNESDAY, April 3 (HealthDay News) -- New research out of Japan shows a potential link between male baldness and an increased risk for coronary heart disease.

But it only affects men who are balding on top. Those with a receding hairline are not at risk, the researchers reported.

The findings stem from an analysis of six published studies on hair loss and heart health that involved approximately 37,000 men.

And although the researchers admitted the small study size was a limitation, they reported that men whose baldness affected the crown on their head faced a 32 percent to 84 percent increase in the risk of developing heart disease compared to men with a full head of hair or a receding hairline.

Study lead author Dr. Tomohide Yamada, of the department of diabetes and metabolic diseases at the University of Tokyo's Graduate School of Medicine, in Japan, reported his findings in the current issue of the journal BMJ Open and called for more research on the topic. Although the research review found an association between baldness and heart disease risk, it did not prove a cause-and-effect link.

Male pattern baldness (technically referred to as "androgenetic alopecia") affects up to 40 percent of adult men and is the most common type of hair loss, the researchers reported. By age 80, about four in five men will experience this form of baldness.

To explore the link to heart disease, the researchers analyzed databases covering the period 1950 through 2012. Out of 850 related investigations, they selected six studies, all published between 1993 and 2008 in the United States, Denmark or Croatia.

In the three studies that tracked patients for a minimum of 11 years, the research showed that, overall, balding men face a 33 percent greater risk for heart disease than other men, and those between 55 and 60 years old faced an even higher risk (44 percent).

The other three studies, comparing the cardiac health of balding men to non-balding men, showed a 70 percent bump in heart disease risk among the balding group, and an 84 percent risk for younger balding men.

What's more, a balding man's heart disease risk appeared to be dependent on the severity of his hair loss, with more severe loss translating into greater risk, the studies showed.

Yamada's team said the driving mechanism behind the connection is unknown, but they theorized that baldness could be a marker for insulin resistance, chronic inflammation or an increased sensitivity to testosterone, all of which are factors in the onset of heart disease.

Regardless, Yamada said, balding men should do what all men should do when it comes to controlling heart disease risk. "I recommend adapting a heart-healthy lifestyle that includes a low-fat diet, exercise and less stress [in order to mitigate against] classical coronary risk factors," such as age, high blood pressure, blood lipid disruption and a history of smoking, he said.

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Light Exercise & Higher Calories...

The past few days I've been eating 2100 calories, and exercising a lot less than before. I wanted to see if I could maintain with more food and less exercise.

I'm now losing weight on 2100. I'm 5'5" or 5'6"...I think. I keep getting taller lately. But on the teen calculators it says that for light activity I should eat around 1800. 

Do you think that I've sped up my metabolism? Or do you think this is just going to last for a couple of days, and I should keep at 2100? 

I'm going to see my doctor again soon , and I think it's going to cause a lot of problems if my doctor sees that I'm still losing. 

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Pregnant Women Under Stress May Be at Higher Risk for Stillbirth

Title: Pregnant Women Under Stress May Be at Higher Risk for Stillbirth
Category: Health News
Created: 3/29/2013 2:35:00 PM
Last Editorial Review: 4/1/2013 12:00:00 AM

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Men Face Higher Risk of Infections Related to Health Care

Extensive study found hospitalized men had 60 percent greater odds of bloodstream, surgical infections

By Mary Elizabeth Dallas

HealthDay Reporter

WEDNESDAY, June 5 (HealthDay News) -- Women are less likely to develop infections related to receiving health care than men, according to a large new study.

After examining thousands of cases involving hospitalized patients, researchers found that women were at much lower risk for bloodstream infection and surgical-site infection than men. The study authors suggested that their findings could help health care providers reduce men's risk of these infections.

"By understanding the factors that put patients at risk for infections, clinicians may be able to design targeted prevention and surveillance strategies to improve infection rates and outcomes," lead study author Bevin Cohen, program director at the Center for Interdisciplinary Research to Prevent Infections at Columbia University School of Nursing, said in a university news release.

The study, recently published online in the Journal of General Internal Medicine, revealed that the odds of developing a community-associated bloodstream infection were 30 percent higher among men. Meanwhile, the researchers found a 60 percent higher risk among men for health care-associated bloodstream infections as well as for surgical-site infections.

Biological differences between men and women's skin may play a role in men's increased risk for infection. Previous studies have shown there are more bacteria present at the insertion site of a central venous catheter on men than women.

These gender differences were less apparent in children younger than 12 and people older than 70, the study found.

"In addition to using enhanced infection risk profiles to improve infection rates, it may be sensible to conduct specialized preoperative skin decontamination procedures and postoperative wound care for men to further reduce the risk of infection," Cohen concluded.

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Women Abused in Childhood at Higher Odds of Having Child With Autism: Study

Title: Women Abused in Childhood at Higher Odds of Having Child With Autism: Study
Category: Health News
Created: 3/20/2013 4:36:00 PM
Last Editorial Review: 3/21/2013 12:00:00 AM

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Migraine, Chronic Back Pain Tied to Higher Suicide Risk

Hopelessness, disability may play a role in feelings of despair, study finds

By Dennis Thompson

HealthDay Reporter

WEDNESDAY, May 22 (HealthDay News) -- People who endure chronic migraines or back pain are more likely to attempt suicide, whether or not they also suffer from depression or another psychiatric condition, according to a new study.

"Clinicians who are seeing patients with certain pain conditions should be aware they are at increased risk of suicide," said study co-author Mark Ilgen, of the Veterans Affairs Serious Mental Illness Treatment Resource and Evaluation Center in Ann Arbor, Mich.

"Although undoubtedly psychiatric factors are important, there might be aspects of the pain that in and of themselves increase a person's risk," Ilgen said. "There might be something about someone with significant pain that puts them at increased risk."

The wide-ranging study, published online May 22 in the journal JAMA Psychiatry, involved more than 4.8 million people who received care from the U.S. Veterans Health Administration during fiscal year 2005. Researchers identified those suffering from chronic pain and tracked them for the next three years to see if any died from suicide.

The research team then looked for associations between suicide death -- the 10th most common cause of death in the United States -- and clinical diagnoses of chronic pain conditions, such as arthritis, back pain, migraines, neuropathy, headaches or tension headaches, fibromyalgia and psychogenic pain.

They found that all pain conditions except arthritis and neuropathy were associated with elevated suicide risk. But when they took into account the mental-health problems that chronic pain patients also had, the associations reduced for all but three types of chronic pain: back pain, migraines and psychogenic pain, which stems from psychological factors.

Dr. Elspeth Cameron Ritchie, a retired Army colonel and psychiatrist living in Washington, D.C., said the study clearly reinforces the anecdotal link between pain and suicide.

"It makes sense that pain is a risk factor for suicide," she said. "Often, suicide has several different things going on, but pain can be the straw that breaks the camel's back in terms of a person's decision not to go on."

Therapists performing a suicide-risk evaluation should consider adding a question regarding pain to the standard questions aimed at suicidal thoughts and planning, she said.

"It's not a standard question: 'Are you in pain?'" Ritchie said. "I would ask, 'Are you in pain?,' or 'Is pain an issue for you?'"

Psychogenic pain increased people's risk of suicide the most, followed by migraines and back pain. Psychogenic pain is chronic pain caused or exacerbated by mental or emotional problems, and Ilgen said it is a rare and not well understood condition.

"We think that's not so much about psychogenic pain per se, but the fact that the pain itself is poorly understood and may be poorly managed," Ilgen said. "There's not a clear treatment plan for that type of pain. It's likely that patients with this type of pain may be frustrated with their care and more hopeless and more at risk for suicide."

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Tooth Loss Associated With Higher Risk for Heart Disease

Reason for link between teeth, gums and heart health is still unclear, researcher says

By Robert Preidt

HealthDay Reporter

THURSDAY, March 7 (HealthDay News) -- For adults, losing teeth is bad enough, but tooth loss is also associated with several risk factors for heart disease, a large international study suggests.

These heart disease-related risk factors include diabetes, obesity, high blood pressure and smoking.

For the study, researchers analyzed data from nearly 16,000 people in 39 countries who provided information about their remaining number of teeth and the frequency of gum bleeds. About 40 percent of the participants had fewer than 15 teeth and 16 percent had no teeth, while 25 percent reported gum bleeds.

For every decrease in the number of teeth, there was an increase in the levels of a harmful enzyme that promotes inflammation and hardening of the arteries. The study authors also noted that along with fewer teeth came increases in other heart disease risk markers, including "bad" LDL cholesterol levels and higher blood sugar, blood pressure and waist size.

People with fewer teeth were also more likely to have diabetes, with the risk increasing 11 percent for every significant decrease in the number of teeth, the investigators found.

Being a current or former smoker was also linked to tooth loss, according to the study scheduled for presentation Saturday at the annual meeting of the American College of Cardiology (ACC), in San Francisco.

Gum bleeds were associated with higher levels of bad cholesterol and blood pressure.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

The researchers added that it is still unclear what is behind the association between tooth loss, gum health and heart health.

"Whether periodontal disease actually causes coronary heart disease remains to be shown. It could be that the two conditions share common risk factors independently," Dr. Ola Vedin, from the department of medical sciences at Uppsala University in Sweden, said in an ACC news release. "Those who believe that a causal relationship exists propose several theories, including systemic inflammation, the presence of bacteria in the blood from infected teeth and bacteria invading coronary plaques."

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Tooth Loss Associated With Higher Risk for Heart Disease

Title: Tooth Loss Associated With Higher Risk for Heart Disease
Category: Health News
Created: 3/7/2013 12:36:00 PM
Last Editorial Review: 3/8/2013 12:00:00 AM

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Higher Indoor Humidity Levels Might Slow Flu's Spread

By Alan Mozes

HealthDay Reporter

THURSDAY, Feb. 28 (HealthDay News) -- As the flu season continues to pack a punch for some Americans, new research suggests there might be a simple way to reduce the risk for infection in an indoor setting: hike up humidity levels.

By raising indoor relative humidity levels to 43 percent or above, investigators reported that they were able to quickly render 86 percent of airborne virus particles powerless.

The finding is reported in the February issue of the journal PLOS One by a team led by John Noti, a senior service fellow with the U.S. National Institute for Occupational Safety and Health's Health Effects Laboratory Division at the U.S. Centers for Disease Control and Prevention in Morgantown, W.V.

To assess the role of humidity in flu transmission, Noti and his colleagues relied on mechanized mannequins and tissue cultures rather than actual humans.

Placed in a tightly sealed and disinfected model of a hospital examination room, a coughing mannequin served as a flu patient and was outfitted with aerosolized viral solution. The viral solution was projected into the air via five mechanized "coughs," spread out over one-minute intervals.

At the same time, a breathing mannequin (serving as a caregiver) was set to face the coughing mannequin at a distance of a little less than 7 feet. The breathing model was programmed to inhale in sync with the coughing, and aerosol samples of inhaled air were collected at various points around the mouth of the caregiver for up to five hours post-coughing.

Throughout testing, humidity levels were adjusted from a low of 7 percent relative humidity to a high of 73 percent.

The result: the team found that when humidity levels were set to 43 percent, only 14 percent of the virus particles that were released were able to transmit the influenza virus, compared with a transmission rate of 70 percent to 77 percent in a relatively low-humidity environment (23 percent).

What's more, the protective impact of higher humidity levels appeared to be rapid, with the majority of viral inactivation taking place within 15 minutes of when viral particles were first "coughed" into a high-humidity environment.

The study authors cautioned that it remains to be seen whether humidity adjustments can undermine infection risk as effectively in a real-world setting.

If confirmed, however, the protective impact of humidity levels of 40 percent and above probably would be of the most practical benefit in hospital settings, where the ability to protect medical staff by strictly regulating humidity levels would be most feasible.

"I totally buy this," said Dr. Marc Siegel, a clinical associate professor of medicine at NYU Langone Medical Center in New York City. "It's very hard to prove that lower humidity increases the risk of transmissibility, but it's not surprising because the reasoning makes sense, which is that droplets fall to the ground in high humidity because water travels on dry air, not on water. If you combine airborne viral droplets with water droplets, they fall."

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Newest Diabetes Drugs Linked to Higher Pancreatitis Risk

Title: Newest Diabetes Drugs Linked to Higher Pancreatitis Risk
Category: Health News
Created: 2/25/2013 4:36:00 PM
Last Editorial Review: 2/26/2013 12:00:00 AM

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Dialysis Catheters Tied to Higher Risk for Infection, Death, Study Finds

By Mary Elizabeth Dallas

HealthDay Reporter

THURSDAY, Feb. 21 (HealthDay News) -- Dialysis patients using catheters have a higher risk for death, infection and heart problems than patients using other procedures to access the blood, according to a new analysis.

Researchers examined 67 studies involving nearly 600,000 dialysis patients to compare the risks associated with three procedures used to access the blood: arteriovenous fistula, arteriovenous graft and central venous catheter.

An arteriovenous fistula is formed when a patient's vein and artery are connected to form a site through which blood can be removed and returned. An arteriovenous graft is a plastic channel between an artery and a vein. A third option for dialysis patients is a catheter, which patients often use to avoid surgery or needles or because of declining health.

Because of kidney failure, more than 1.5 million people around the world are treated with hemodialysis. The procedure involves filtering the blood to remove wastes, extra salt and water.

In conducting the study, the researchers assessed the link between these three types of vascular access and death, infection and major heart problems, such as heart attack and stroke.

The study, published Feb. 21 in the Journal of the American Society of Nephrology , revealed that patients using catheters had a 38 percent greater risk for a major heart problem, a 53 percent higher risk of dying and more than double the risk of developing a fatal infection than patients with fistulas.

Grafts also had an 18 percent higher risk of death and a 36 percent greater risk of serious infections than fistulas. But the researchers noted that patients with grafts did not have a greater risk for a major heart problem than those with fistulas.

Assuming patients on dialysis were of similar health, the researchers concluded that catheters used for hemodialysis have the highest risks for death, infections and heart trouble, while fistulas are the least risky.

"Our findings are reflected in current clinical practice guidelines, which promote fistulas as the preferred form of bloodstream access in hemodialysis patients," Dr. Pietro Ravani, of the University of Calgary, in Canada, said in a journal news release.

The study's authors noted that patients involved in the study who were using catheters were probably sicker than those using fistulas. They concluded that more research is needed to determine individual patient risk and assess the safety of the various types of blood access used for hemodialysis.

More information

The U.S. National Kidney and Urologic Diseases Information Clearninghouse provides more information on hemodialysis.

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Obese Black Women at Higher Risk for Having Very Large Babies

Title: Obese Black Women at Higher Risk for Having Very Large Babies
Category: Health News
Created: 2/14/2013 2:36:00 PM
Last Editorial Review: 2/15/2013 12:00:00 AM

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Distress Tied to Higher Risk of Stroke

Dec. 13, 2012 -- Older adults with high levels of distress are more likely to have certain kinds of strokes than those who aren’t as troubled, a new study shows.

Distress is a combined measure of stress, depression, negativity, and dissatisfaction with life.

“It’s really trying to capture more than negative mood. A lot of studies have looked a depression and how it relates to heart disease or stroke risk, and in this case what we really wanted to get at was a general tendency to have a negative outlook on life,” says researcher Susan A. Everson-Rose, PhD, MPH, associate director of the Program in Health Disparities Research at the University of Minnesota in Minneapolis.

For the study, researchers surveyed more than 4,000 adults over age 65 in the three neighborhoods in Chicago. The majority of people who took part were women and African-American. Their average age was 77.

Each person in the study gave a detailed medical history. They also answered questions about their income, education, daily functioning, and mental outlook.

After an average of seven years, 452 people in the study were hospitalized for strokes, and at least 151 people died of one.

After researchers accounted for other known risk factors for stroke, like smoking, high blood pressure, chronic health conditions, weight, and age, they found that high levels of distress were associated with having an increased risk for having a hemorrhagic stroke, or a stroke caused by bleeding in the brain, rather than the more common stroke caused by a blood clot.

Researchers say they were surprised by that finding.  

“Everything I knew about how measures of distress or depression link to heart disease and stroke went through [clotting] mechanisms. I’m really curious about what the biological mechanisms might be, but that’s really a task for future studies,” Everson-Rose says.

People in the study with the highest levels of distress also had roughly twice the risk of dying of a stroke compared to those with little distress.

The study doesn’t prove that distress causes strokes. Instead, it shows relationships between distress and health that are probably more complicated than simple cause and effect.

Gabor Toth, MD, a vascular neurologist at the Cleveland Clinic in Ohio, says it would be nice to find out more about how distress and stroke are related.

“It may just be that you don’t take care of yourself when you’re under a lot of stress and don’t eat well,  you smoke more. But at the same time, there could be some kind of hormonal, metabolic changes in the body that are brought on by stress that put you at a higher risk for stroke,” says Toth, who wasn’t involved in the research. 

Whatever the connection may be, researchers say understanding that distress and poor health can go hand in hand is important.

“It’s really recognizing this general negativity, these emotions around distress, and realizing that they can have a physical impact,” Everson-Rose says. “It’s important to pay attention to them and find ways to alleviate the distress. Emotional states can have strong effects.”

The study was funded by the National Heart, Lung, and Blood Institute. It’s published in the journal Stroke.

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Distress Tied to Higher Risk of Stroke

ByBrenda Goodman, MA
WebMD Health News Reviewed byBrunilda Nazario, MD

Dec. 13, 2012 -- Older adults with high levels of distress are more likely to have certain kinds of strokes than those who aren’t as troubled, a new study shows.

Distress is a combined measure of stress, depression, negativity, and dissatisfaction with life.

“It’s really trying to capture more than negative mood. A lot of studies have looked a depression and how it relates to heart disease or stroke risk, and in this case what we really wanted to get at was a general tendency to have a negative outlook on life,” says researcher Susan A. Everson-Rose, PhD, MPH, associate director of the Program in Health Disparities Research at the University of Minnesota in Minneapolis.

A Visual Guide to Understanding Stroke

Tracking Distress in Older Adults

For the study, researchers surveyed more than 4,000 adults over age 65 in the three neighborhoods in Chicago. The majority of people who took part were women and African-American. Their average age was 77.

Each person in the study gave a detailed medical history. They also answered questions about their income, education, daily functioning, and mental outlook.

After an average of seven years, 452 people in the study were hospitalized for strokes, and at least 151 people died of one.

After researchers accounted for other known risk factors for stroke, like smoking, high blood pressure, chronic health conditions, weight, and age, they found that high levels of distress were associated with having an increased risk for having a hemorrhagic stroke, or a stroke caused by bleeding in the brain, rather than the more common stroke caused by a blood clot.

Researchers say they were surprised by that finding.  

“Everything I knew about how measures of distress or depression link to heart disease and stroke went through [clotting] mechanisms. I’m really curious about what the biological mechanisms might be, but that’s really a task for future studies,” Everson-Rose says.

People in the study with the highest levels of distress also had roughly twice the risk of dying of a stroke compared to those with little distress.

More Research Needed

The study doesn’t prove that distress causes strokes. Instead, it shows relationships between distress and health that are probably more complicated than simple cause and effect.

Gabor Toth, MD, a vascular neurologist at the Cleveland Clinic in Ohio, says it would be nice to find out more about how distress and stroke are related.

“It may just be that you don’t take care of yourself when you’re under a lot of stress and don’t eat well,  you smoke more. But at the same time, there could be some kind of hormonal, metabolic changes in the body that are brought on by stress that put you at a higher risk for stroke,” says Toth, who wasn’t involved in the research. 

Whatever the connection may be, researchers say understanding that distress and poor health can go hand in hand is important.

“It’s really recognizing this general negativity, these emotions around distress, and realizing that they can have a physical impact,” Everson-Rose says. “It’s important to pay attention to them and find ways to alleviate the distress. Emotional states can have strong effects.”

The study was funded by the National Heart, Lung, and Blood Institute. It’s published in the journal Stroke.

View Article Sources

SOURCES:

Henderson, K. Stroke, Dec. 13, 2012.

Susan A. Everson-Rose, PhD, MPH, associate director, Program in Health Disparities Research, University of Minnesota, Minneapolis.

Gabor Toth, MD, vascular neurologist, Cleveland Clinic, Cleveland, Ohio.

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