End-Of-Life Care at Home Can Improve Quality of Life for Patients and Families

Photo Courtesy - Getty Images(BOSTON) -- It's one of the most difficult conversations a doctor can have with a patient -- deciding how and where the terminally ill should best spend their final days.

"Physicians for a long time have believed these conversations would harm patients and they are difficult and upsetting," Dr. Alexi Wright, an oncologist at Boston's Dana-Farber Cancer Institute said. "Without any evidence that they improved care, I don't think there was a real push to have these conversations."

Wright, who has studied the impact of end-of-life discussions on patients' treatment, has found that patients who have those conversations with their physicians had better outcomes. Those patients and their families were not more likely to be distressed at the news.

For one of Wright's patients, 63-year-old Lois Riley, her end-of-life discussion was a conversation that ended with an agonizing decision -- should she battle her cancer with aggressive chemotherapy with no assurance of prolonging her life, or undergo less intensive chemo that would allow her to spend quality time with her family?

Riley was living the life she always imagined when she received the news her disease would ultimately take her life: a loving marriage, a fulfilling job and a family complete with three daughters and four grandchildren. She did not plan on the devastating diagnosis of terminal ovarian cancer.

"It made me angry, it made me sad," she said. "I didn't want to hear that, I wanted to hear that I was going to get strong and beat this."

Deciding to change her treatment so she could continue living at home, Riley said, has impacted every facet of her life.

"I've tried to spend quality time with everyone. We do a little bit more of private moments," she said.

The study determined that those who died in hospitals experienced more physical and psychological discomfort than those who died at home. According to a survey by the National Hospice and Palliatative Care Organization, 80 percent of terminally ill patients prefer to live out their last days at home as opposed to a hospital.

"Patients who died at home were less likely to die in pain. They had less psychological suffering and their loved ones saw that their overall quality of life was better," Wright said.

Copyright 2010 ABC News Radio


Salmonella Outbreak in 15 States Linked to Alfalfa Sprouts

Photo Courtesy - Getty Images(WASHINGTON) -- Health officials are investigating a salmonella outbreak linked to alfalfa sprouts that has sickened 89 people in 15 states and Washington, D.C., according to the U.S. Centers for Disease Control and Prevention. Most of the illnesses have occurred in Midwestern states, with 50 cases in Illinois, 14 in Missouri and nine in Indiana.

The Illinois Department of Public Health said many of the people who became ill said they'd eaten alfalfa sprouts at Jimmy John's restaurants in several counties. The department is trying to determine the source of the outbreak.

The CDC said the illnesses were reported between Nov. 1 and Dec. 21. So far, no one has died as a result of the outbreak, but about 18 people have been hospitalized.

According to the CDC, most people infected with salmonella experience diarrhea, fever and abdominal pain between 12 and 72 hours after exposure. Illnesses can last up to a week. If diarrhea is severe, it may require hospitalization, and if the bacteria enter the bloodstream and spread, it can be fatal if not treated with antibiotics.

Copyright 2010 ABC News Radio


Gallup: Religious Americans Lead Healthier Lives

Photo Courtesy -- Getty Images(PRINCETON, N.J.) – A new study found that the most religious Americans are more likely to lead healthy lives.
According to Gallup, Americans who were found to be very religious, meaning they attend their chosen religious gathering at least every week or almost every week, scored a 66.3 on the Gallup-Healthways Healthy Behavior Index. The index accounts for eating, exercise and smoking behaviors.

Americans who were classified as moderately religious scored a 60.6 on the index while those considered nonreligious scored a 58.3.

The study found that very religious Americans are likely to make healthier eating choices and exercise more often. The most significant difference in health among the groups was smoking, with nonreligious individuals being 85 percent more likely to smoke than the very religious.

Copyright 2010 ABC News Radio


Pfizer Calls for Expansion of Lipitor Recall

Photo Courtesy - Getty Images(WASHINGTON) -- Pharmaceutical manufacturer Pfizer, announced the expansion of an ongoing recall for Lipitor, a drug intended to lower cholesterol in patients.  The decision to expand followed the discovery of more bottles of the drug that give off a musty odor.

The latest recall will included an additional lot of 19,000 bottles of 40 mg Lipitor pills, which will bring the total number of bottles removed from shelves to 360,000.

Pfizer said in a statement that the musty odor is likely coming from a chemical called 2,4,6-tribromoanisole (TBA), which was previously identified in a bottle of Lipitor causing one of the original consumer complaints. The FDA says the health effects of TBA are "minimal," causing mainly gastrointestinal distress in consumers of the product.

The original Lipitor recall began in August, but was only announced in October after additional lots were included.  The supplier changed its methods to resolve the problem in August, but Pfizer said the lots involved in the newest recall may have been distributed before then.

"Product filled in bottles made by the supplier prior to those changes may still be on the market, so it is possible that additional recalls could be necessary," Pfizer said.

Copyright 2010 ABC News Radio 


HPV Vaccine Approved for Prevention of Anal Cancer

Photo Courtesy - Getty Images(WASHINGTON) -- The FDA has approved the human papillomavirus (HPV) vaccine Gardasil, which is already approved to prevent cervical and vaginal cancer in women and genital warts in both sexes, for the prevention of anal cancer in males and females ages nine to 26, MedPage Today reports.

A randomized trial including both men and women found that Gardasil was 78 percent effective in preventing anal cancer related to HPV. 

The FDA noted that the vaccination for HPV is not an effective method of anal cancer prevention for those who already have the virus.

"Treatment for anal cancer is challenging; the use of Gardasil as a method of prevention is important as it may result in fewer diagnoses and the subsequent surgery, radiation or chemotherapy that individuals need to endure," Dr. Karen Midthun, director of the FDA's Center for Biologics Evaluation and Research, said in a statement.

MedPage also reports that 90 percent of anal cancer cases stem from HPV.  Uncommon to the general population, about 5,300 people are diagnosed in the U.S. with anal cancer each year, with more cases occurring in women than men.

Copyright 2010 ABC News Radio 


Festive Partiers Beware: Holiday Heart Syndrome

Photo Courtesy - Getty Images(CLEVELAND) -- 'Tis the season for many of us of over-indulging in champagne, spiked eggnog and hors d'oeuvres. And although pounds gained in December can be shed next year, the more immediate effects of holiday excess can be serious.

Dr. Curtis Rimmerman, a cardiologist at the Cleveland Clinic, warns that binge drinking and overloading on sodium can trigger abnormal heart rhythms. The condition, known as "holiday heart syndrome," can require emergency medical care.

"Your heart is basically beating very erratically, chaotically, and extremely fast," Rimmerman said. His patients have described the feeling as "like having a Mexican jumping bean inside your chest."

The term "holiday heart syndrome" was coined in 1978 when researchers detected heart rhythm abnormalities in 24 study participants, none of whom had a history of heart disease. What they all did have was too much to drink, too fast.

Since then, several studies have confirmed alcohol's heart rhythm-disturbing effects. The most common abnormal heart rhythm, atrial fibrillation, occurs when the upper heart chambers quiver instead of contracting regularly. Although it's often asymptomatic, it can lead to congestive heart failure or stroke.

As the moniker suggests, holiday heart syndrome peaks on weekends and at holidays.

"Not only will I see more patients," Rimmerman said, "but talk to an emergency room physician and, boy, are the emergency rooms hopping!"

Although alcohol alone can derail normal heart rhythms, its effects are exaggerated when mixed with caffeine. Rimmerman warned against the popular practice of mixing alcohol with energy drinks, calling it a "very bad combination."

Salty foods, such as holiday ham and pre-packaged appetizers, can lead to fluid retention and exercerbate heart rhythm distrubances. So, despite the season's temptations, maintaining a relatively normal diet will lower the risk of holiday heart problems.

Similarly, when it comes to alcohol, moderation is key. If you don't drink much all year, avoid drinking a year's worth in one night. And if you do drink regularly, avoid drinking more than usual, Rimmerman said.

If your heart starts racing or beating irregularly, you should stop drinking and sit down, Rimmerman said. And if the feeling persists for five minutes, you should seek medical attention.

Copyright 2010 ABC News Radio


Genetic Mutation May Lead to Violent and Reckless Behavior

Photo Courtesy - Getty Images(NEW YORK) -- In a discovery that could help scientists further understand impulsivity in humans, researchers have announced they found a genetic variant that may contribute to spontaneous violent behavior.

In a new study released in the journal Nature, a multinational research team examined the genes of 96 violent criminal offenders in Finland with behavioral disorders and compared it with DNA from a control group of 96 people in the country who had no such psychiatric diagnoses.

Scientists found that the criminal offenders were three times more likely to have a genetic mutation, known as the HTR2B Q20* mutation, than the control group.

The offenders had been diagnosed with antisocial personality disorder, borderline personality disorder or intermittent explosive disorder -- all conditions with symptoms of impulsive aggression.

The mutation was found to affect the brain's levels of serotonin, a neurotransmitter that affects mood, appetite, sleep and impulsive behavior.

"Impulsivity is a normal dimension of behavior, but it also plays a role in many psychiatric disorders, including alcoholism and suicidalism," said Dr. David Goldman, chief of the Laboratory of Neurogenetics at the National Institute on Alcohol Abuse and Alcoholism, in Bethesda, Md., and senior author of the study. "These disorders are often difficult to disentangle at the causal level, but by studying traits, we can find genes that contribute to important aspects of them."

Researchers specifically conducted the study in Finland because of its unique population and medical genetics. Goldman said modern Finns descend from a relatively small number of original settlers, which increased the chance of finding specific genes that influence impulsive behavior.

"Finns have the same degree of genetic diversity as people from other cultures, but their genetic disease diversity is reduced," said Goldman. "Genetic heterogeneity tends to be reduced in Finland because of its unique population, which was founded by two major waves of migration." 

Copyright 2010 ABC News Radio


Lousy Mood? It Will Improve in a Couple of Decades

Photo Courtesy - Getty Images(BERKELEY, Calif.) -- Tired of hearing your brain is going to be mush by the time you're old and grey? Well, here's some good news. Your emotions, or how you deal with them, will get better. At least some of them.

Researchers at the University of California, Berkeley, have completed a series of studies showing that as we age, we become better at seeing the good things in life and managing our emotions to make the best of a bad scene.

But seniors tend to become sadder and more empathetic and compassionate, possibly because they have faced so many personal and irreversible losses.

"Lots of things about our lives develop early on, and then they decline with age, like our physical agility and our ability to think quickly," psychologist Robert Levenson, senior author of the studies, said in a telephone interview. "But we don't get bad at emotions. We actually start to develop refinements as we get older. Some emotions kind of stay the same, they were designed for the long run, but there are other things that we actually get better at."

The Berkeley work is in line with a hot button issue in the often fuzzy field of psychology and human behavior. It's called emotional intelligence, frequently defined as "the ability to perceive, regulate and communicate emotions -- to understand emotions in ourselves and others."

The Berkeley team produced several studies this year zeroing in on how our emotional intelligence evolves as we age. In two large studies, the psychologists tested 366 people in three age groups, from the 20s to the 40s and 60s. They were tested for how they responded emotionally to three film clips showing neutral, sad and disgusting scenes.

The scientists wanted to determine how good their subjects were at detaching themselves from the emotional nature of the clips, or whether they could see something good even in sad scenes, as well as suppress their disgust at a woman eating part of a horse not normally consumed in the human diet.

Copyright 2010 ABC News Radio


Patients Report Largest Hospital Drug Shortage in Decades

Photo Courtesy - Getty Images(ALEXANDRIA, Va.) -- Many hospital patients are being turned away for potentially life-saving injection treatments in what may be the largest U.S. hospital drug shortage in over two decades.

Most drugs in short supply are known as injectables and include sedation medication such as propofol, the popular blood thinner heparin, and hard-hitting chemotherapy drugs like doxorubicin.

"I've been in practice more than 30 years and this is the first time I've encountered shortages that may affect patient care," said Dr. Michael Link, president of the American Society of Clinical Oncology.

Limited manufacturing, lagging production time, and lack of profits from these drugs are contributing to the shortage, according to an August 2010 editorial published in the New England Journal of Medicine.  The production cost outweighs the profits for some companies.  Since many firms would rather produce cheaper generic drugs, manufacturers are shunning some costly brands.

Doctors at local hospitals are frustrated and many times they're not even informed of the shortage, according to survey results released in September by the Institute for Safe Medication Practices.  Of those surveyed, 85 percent said they were given little to no information on how long the shortages would last.

And since these medications are mainly housed in hospitals, most patients won't know it might not be available until they really need it.

Copyright 2010 ABC News Radio


Rate of Teenage Births at 70-Year Low

Photo Courtesy - Getty Images(WASHINGTON) -- Teenage girls in the U.S. gave birth to babies in 2009 at the lowest rate seen in seven decades.

The Centers for Disease Control and Prevention reported Tuesday that there were 39.1 births per 1,000 females ages 15 to 19 last year.  That figure represents a six percent drop from 2008.

CDC statistician Brady Hamilton, who co-authored the report, said the decline puts teen births at a record low.  One physician not affiliated with the study said that's due to a drop in vaginal intercourse and increased use of effective contraception.

In other developments, the number of overall births fell to around 4,130,000 in 2009, compared to 4,248,000 the year before.  Hamilton says possible factors for that drop include both the weak economy and women postponing having babies until their 30s or 40s.

Copyright 2010 ABC News Radio

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