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Defibrillators may not save women, study finds

June 30, 2012Uncategorizedabnormal heart rhythms, and, archives of internal medicine, be, beating, bf1, blister, blood, california san francisco, calories, Cancer, chronic condition, clinical trials, dangerous heart, Defibrillators, Defibrillators Asia, Defibrillators Gallery, Defibrillators Health, Defibrillators Health History, Defibrillators Health Information, Defibrillators Health Latest, Defibrillators Photo Gallery, Defibrillators Picture, Defibrillators Video, Defibrillators Web, DefibrillatorsHealth latest, DefibrillatorsHealth Photo, Defibrillatorsover Picture, diet, Drug, eating, Exercise, Exercising for Weight Gallery, Exercising for Weight Health Story, Exercising for Weight Health Photo, Exercising Weight, Exercising Weight Health, Flu, for, gallery, Gym, Health Health, Health Latest, health video, Healthy Minnesota, Healthy Minnesota Asia, Healthy Minnesota Health Story, Healthy Minnesota Photo Gallery, heart, heart failure, heart institute, heart quivers, heart rhythm, heartbeat, history, hundreds of thousands, implantable defibrillators, in, laparoscopy, Malaysia Health, may, medical, nine times, not, Nutrition, of, operation, organic, organs, photo, physical, protect, providence hospital, skin, spiritual, study, substantial evidence, sudden cardiac death, Surgery, symptoms, tips, to, training, university of california san francisco, use implantable, video, video photo, video surgery, virus, web, web Health, web Health picture, weightloss, womenazuan

Defibrillators may not save women, study finds

Despite their widespread use, implantable defibrillators to protect against deadly heart rhythms do not prevent deaths in women with advanced heart failure, U.S. researchers said on Monday.

They said implantable defibrillators — which detect abnormal heart rhythms and offer a life-saving shock to restore a regular heartbeat — do not appear to protect men and women equally.

“There seems to be much less significant benefit” in women, said Dr. Christian Machado of Providence Hospital Heart Institute and Medical Center in Michigan, whose study appears in the Archives of Internal Medicine.

“Implantable cardioverter-defibrillators are being implanted in hundreds of thousands of women without substantial evidence of benefit,” Dr. Rita Redberg of the University of California, San Francisco, wrote in a commentary in the journal.

Nearly 22 million people worldwide suffer from heart failure, a chronic condition in which the heart struggles to pump blood. Heart failure affects about 5.3 million Americans, and nearly half are women.

People with heart failure are six to nine times more likely than most people to suffer sudden cardiac death, a dangerous heart rhythm in which the heart quivers but does not pump blood to the organs. Implantable defibrillators can detect this rhythm and deliver a shock to restore a normal heart beat.

Many clinical trials have found implantable defibrillators save lives and are cost-effective; but too often, the studies are overpopulated with men, Machado said.

He and colleagues searched published clinical trials data on implantable defibrillators from 1950 to 2008.

“Our trials are biased toward males. Seventy to 80 percent are made up of male subjects,” Machado said.

His team analyzed five trials with a total of 934 women with advanced heart failure. None showed defibrillators significantly decreased the rate of death from any cause compared with drug therapy alone.

Among the 3,810 men in the studies, however, there was a significant reduction in the rate of death among those who had a defibrillator.

Machado said many women with heart failure are routinely offered defibrillators to safeguard against sudden cardiac arrest, even though the device may not help them live longer.

He said it would not be ethical to do a randomized clinical trial to prove women do not benefit, but said ongoing studies should be sure to focus on the effects in both men and women.

“We need to do a better job in trials recruiting at least the same amount of women as we do men. We have failed to do that,” he said.

Implantable defibrillators, which cost between $20,000 to $30,000 to implant, represent a $6 billion global market for companies such as Medtronic Inc, Boston Scientific Corp and St. Jude Medical Inc.

Dr. Mark Carlson of medical device maker St. Jude Medical said in a statement that women enrolled in clinical studies evaluating heart failure have tended to be sicker than men in the same studies, and they have tended to be undertreated in general.

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Is swimming pool chlorine fueling the allergy epidemic?

Is swimming pool chlorine fueling the allergy epidemic?

Swimming in a chlorinated pool may boost the odds that a child susceptible to asthma and allergies will develop these problems, a study released today indicates.

“These new data clearly show that by irritating the airways of swimmers chlorination products in water and air of swimming pools exert a strong additive effect on the development of asthma and respiratory allergies such as hay fever and allergic rhinitis,” Dr. Alfred Bernard, a toxicologist at the Catholic University of Louvain in Brussels, Belgium, noted in an email to Reuters Health.

“The impact of these chemicals on the respiratory health of children and adolescents appears to be much more important — at least by a factor of five — than that associated with secondhand smoke,” Bernard noted.

Taken together with his team’s prior studies, he added, “There is little doubt that pool chlorine is an important factor implicated in the epidemic of allergic diseases affecting the westernized world.”

In the current study, Bernard and colleagues compared the health of 733 adolescents, 13 to 18 years old, who swam in chlorinated outdoor and indoor pools for various amounts of time with that of 114 “control” adolescents who swam mostly in pools sanitized with a concentration of copper and silver.

In children with allergic sensitivities, swimming in chlorinated pools significantly increased the likelihood of asthma and respiratory allergies, the researchers report in the journal Pediatrics.

Among “sensitive” adolescents, the odds for hay fever were between 3.3- and 6.6-fold higher in those who swam in chlorinated pools for greater than 100 hours and the odds of allergic rhinitis were increased 2.2- to 3.5-fold among those who logged more than 1000 hours of chlorinated pool time.

For example, among children and teens who swam in chlorinated pools for 100-500 lifetime hours, 22 children out of 369 (6.0%) had current asthma, compared with those who had spent less than 100 hours (2 of 144, 1.8%). The proportions with asthma rose with longer exposure, to 14 out of 221 (6.4%) who had been swimming for 500-1000 hours, and 17 out of 143 (11.9%) who swam for more than 1000 hours.

The risk of asthma and allergy was not influenced by swimming in copper-silver sanitized pools and children without allergic tendencies were not at increased risk of developing allergies.

“The only plausible explanation” for these observations, the researchers argue, is that the chlorine-based toxic chemicals in the water or hovering in the air at the pool surface cause changes in the airway and promote the development of allergic diseases.

“It is probably not by chance,” Bernard told Reuters Health, “that countries with the highest prevalence of asthma and respiratory allergies are also those where swimming pools are the most popular.”

The current findings, he and colleagues conclude, “reinforce” the need for further study on the issue and to enforce regulations concerning the levels of these chemicals in water and air of swimming pools.

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Early daycare may not lower asthma risk

June 26, 2012Uncategorizedallergic conditions, american journal of respiratory and critical care, american journal of respiratory and critical care medicine, and, asthma, beating, bf1, blister, breathing difficulties, calories, Cancer, childhood allergies, children, critical care medicine, daycare, diet, Drug, Early, Early daycare, Early daycare Asia, Early daycare Gallery, Early daycare Health, Early daycare Health History, Early daycare Health Information, Early daycare Health Latest, Early daycare Photo Gallery, Early daycare Picture, Early daycare Video, Early daycare Web, Early daycare Health Photo, Early daycare over Picture, eating, erasmus university, Exercise, Exercising for Weight Gallery, Exercising for Weight Health Story, Exercising for Weight Health Photo, Flu, gallery, germ, Gym, Health Health, health video, Healthy Minnesota, Healthy Minnesota Asia, Healthy Minnesota Health Story, Healthy Minnesota Photo Gallery, history, hygiene hypothesis, immune system, in, investigators, johan, laparoscopy, life, lower, Malaysia Health, may, medical, not, Nutrition, of, operation, or, organic, peers, photo, physical, researcher, researchers, respiratory and critical care medicine, respiratory health, reuters health, risk, rotterdam, siblings, skin, spiritual, study, Surgery, symptoms, tips, to, training, video, video photo, video surgery, virus, web Health, web Health picture, weightlossazuan

Early daycare may not lower asthma risk

Contrary to what some previous studies have suggested, children who enter daycare at an early age may not have a reduced risk of allergies and asthma later on, researchers reported Tuesday.

In a study of more than 3,600 children followed from birth, the investigators found that children who entered daycare before the age of 2 were no less likely than their peers to suffer from allergies or asthma at the age of 8.

But early daycare did not appear to raise those risks either, senior researcher Dr. Johan C. de Jongste, of Erasmus University in Rotterdam, the Netherlands, told Reuters Health in an email.

Instead, the findings suggest that daycare has little long-term effect on children’s respiratory health — and that it should not be seen as a way to protect them from allergies and asthma down the road, the researchers report in the journal American Journal of Respiratory and Critical Care Medicine.

The study, de Jongste said, challenges what is known as the “hygiene hypothesis” — the theory that the increasingly germ-free surroundings of modern life are actually contributing to an increase in allergies and asthma.

Some researchers speculate that exposure to viruses and other bugs at daycare may help push a young child’s immune system toward infection-fighting mode, and away from a tendency to over-react to the normally benign substances — the basis of allergic conditions.

Along with daycare attendance, certain other factors that suggest greater early-life exposure to infections — like having older siblings — have also been linked to lower risks of childhood allergies and asthma.

But in the current study, neither daycare nor the presence of older siblings showed long-term effects.

Of the 3,643 children followed from birth to age 8, 30 percent started daycare before age 2. These children were twice as likely as the rest to suffer breathing difficulties in the first year of life.

But the pattern shifted with time, and by the age of 8, early-daycare children were no more — or no less — likely to have episodes of wheezing or other signs or symptoms of asthma. Nor did early daycare affect the risk of showing reactions to airborne allergens during allergy testing.

Children with older siblings were also more likely to have wheezing symptoms in the first year of life, but were no more or no less likely to have signs or symptoms of allergies or asthma at age 8.

The findings, de Jongste’s team writes, suggests that early daycare simply “shifts the burden” of respiratory symptoms to an earlier age, with no tradeoff of protective effects later on.

“Hence,” they conclude, “early daycare should not be promoted for reasons of preventing allergy and asthma.”

SOURCE: American Journal of Respiratory and Critical Care Medicine, September 15, 2009.

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