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Category Archives: health

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Cell Phone Bad for Kids ?

Gone are the days of kids stretching the cord of the one house phone into a quiet corner to have some privacy while chatting with friends. Now kids as young as 5 years old are using cell phones.

Aside from concerns that cell phones give kids more phone privacy than you might be comfortable with, some parents are worried that cell phone radiation could be causing them physical harm. Cell phones emit low levels of electromagnetic radiation, and some are concerned that this can increase the risk for cancer and other health problems — and that children may be more vulnerable than the adult population because their brains are still developing. Also, over the course of their lifetime, they could be exposed to radiation for many more years than adults who started using cell phones much later in life.

Although several studies have been done on adults (and only adults), the results have been mixed and none has yet given a definitive answer to the question of whether cell phone use increases cancer risk. Even the largest study done to date couldn’t conclude that cell phones increase the incidence of tumors, but more, wider research is already in the works. Also, one large study involving children is under way.

What is a parent to do in the meantime? First, consider the existing research, and then make a game plan.

Cell Phone Radiation: The Research

In a recent, large study, researchers interviewed 5,117 adults in 13 countries with two of the most common types of brain tumors about their cell phone use. They found no increase in risk for brain tumors among people who used cell phones. Although those who had the highest exposure to cell phones may have had a higher risk for one particular type of brain tumor, the study authors said study biases and errors could have contributed to the results and they found it to be inconclusive.

Other studies have taken different approaches. “The best evidence comes from a surprising type of study,” says Anatoly Belilovsky, MD, medical director of Belilovsky Pediatrics in Brooklyn, N.Y. Most people have a favorite side to hold their cell phone, and researchers have compared the incidents of tumors on the favorite vs. the other side, he says. Having a tumor on the favorite side was anywhere from 1.3 to 6 times higher, Dr. Belilovsky reports. While 1.3 times is a very small increase in risk, 6 times higher is substantial, he adds. The findings also seem to suggest that people who use cell phones the most have a slightly higher risk of cancer on the same side they use it, he says.

The problem with cell phone studies is that there are so many other factors that cell phone use may be linked to and that could cause an increased cancer risk, such as job stress or being a business frequent flyer, which also exposes you to radiation, Belilovsky says.

Protect Your Kids From Potential Cell Phone Dangers

With so many unknowns, how do you answer your tween or teen’s plea for a cell phone? Here are some guidelines for parents:

Wait for a good reason to give kids their own cell phones. The age at which you give your kids phones depends on a lot of factors — need, affordability, and, yes, even how many of their friends have one.

The most important reason may be for safety. Gary Baker, a communications director in New York City, gave his twin boys cell phones in seventh grade when they were 11 and started taking public buses to school.

If there’s not a pressing reason, waiting may be a good idea. “You don’t want to leave them completely outside of their social group,” Belilovsky says. But it’s also not a good thing for them to develop a callus on their outer ear, he adds.

Allow texting. Actually talking on a cell phone is old-school for many kids. They’ve switched to texting, and that’s a good thing, Belilovsky says, because it keeps the phone away from their head.

Get a hands-free device. A cell phone emits radiation from its antenna, which is on the handset. Using a hands-free device will ensure that your kids aren’t putting the antenna next to their head when they talk.

Limit their minutes. Unlimited minutes may not be the best cell phone plan to choose if you’re concerned about health risks. It’s like giving your kids an open invitation to permanently attach the phone to their ear.

Put the cell phone to bed every night. One way to cut down on the amount of time your kids spend on the cell phones (and to help them get more sleep) is to make a rule that the phones go on a charger at bedtime. And make sure the charger is outside of their rooms. That’s what Baker did for his twin boys (who are now 12) when late-night phoning and texting started to become a problem.

Keep a land line at home. It may be a good rule of thumb to hold long conversations on a land line and tell your kids the cell phone is only to be used when they’re on the go or making a quick call.

Although results have been inconclusive, there’s no doubt that researchers will continue to study the potential effects cell phone radiation may have on kids’ brains. In the meantime, enforcing judicious cell phone use may be the best protection.

Cell Phones Affect Brain Activity

Holding a cell phone to your ear for a long period of time increases activity in parts of the brain close to the antenna, researchers have found.

Glucose metabolism — that’s a measurement of how the brain uses energy — in these areas increased significantly when the phone was turned on and muted, compared with when it was off, Dr. Nora Volkow, director of the National Institute on Drug Abuse, and colleagues reported in the Journal of the American Medical Association.

“Although we cannot determine the clinical significance, our results give evidence that the human brain is sensitive to the effects of radiofrequency-electromagnetic fields from acute cell phone exposures,” co-author Dr. Gene-Jack Wang of Brookhaven National Laboratory in Long Island, where the study was conducted, told MedPage Today.

Although the study can’t draw conclusions about long-term implications, other researchers are calling the findings significant.

“Clearly there is an acute effect, and the important question is whether this acute effect is associated with events that may be damaging to the brain or predispose to the development of future problems such as cancer as suggested by recent epidemiological studies,” Dr. Santosh Kesari, director of neuro-oncology at the University of California San Diego, said in an e-mail to MedPage Today and ABC News.

There have been many population-based studies evaluating the potential links between brain cancer and cellphone use, and the results have often been inconsistent or inconclusive.

Most recently, the anticipated Interphone study was interpreted as “implausible” because some of its statistics revealed a significant protective effect for cell phone use. On the other hand, the most intense users had an increased risk of glioma — but the researchers called their level of use “unrealistic.”

But few researchers have looked at the actual physiological effects that radiofrequency and electromagnetic fields from the devices can have on brain tissue. Some have shown that blood flow can be increased in specific brain regions during cell phone use, but there’s been little work on effects at the level of the brain’s neurons.

So Dr. Volkow and colleagues conducted a crossover study at Brookhaven National Laboratory, enrolling 47 patients who had one cell phone placed on each ear while they lay in a PET scanner for 50 minutes.

The researchers scanned patients’ brain glucose metabolism twice — once with the right cell phone turned on but muted, and once with both phones turned off.

There was no difference in whole-brain metabolism whether the phone was on or off.

But glucose metabolism in the regions closest to the antenna — the orbitofrontal cortex and the temporal pole — was significantly higher when the phone was turned on.

Further analyses confirmed that the regions expected to have the greatest absorption of radiofrequency and electromagnetic fields from cell phone use were indeed the ones that showed the larger increases in glucose metabolism.

“Even though the radio frequencies that are emitted from current cell phone technologies are very weak, they are able to activate the human brain to have an effect,” Dr. Volkow said in a JAMA video report.

The effects on neuronal activity could be due to changes in neurotransmitter release, cell membrane permeability, cell excitability, or calcium efflux.

It’s also been theorized that heat from cell phones can contribute to functional brain changes, but that is probably less likely to be the case, the researchers said.

Dr. Wang noted that the implications remain unclear — “further studies are needed to assess if the effects we observed could have potential long-term consequences,” he said — but the researchers have not yet devised a follow-up study.

“The take-home message,” Dr. Kesair said, “is that we still don’t know, more studies are needed, and in the meantime users should try to use headsets and reduce cell phone use if at all possible. Restricting cell phone use in young children certainly is not unreasonable.”

Medical Leech Linked to Infection

A resistant Aeromonas infection transmitted by a medicinal leech developed in a man undergoing reconstructive surgery of the jaw, leading to total failure of the graft, investigators reported.

“Leech therapy is the most effective nonsurgical management of soft-tissue venous congestion,” explained Dr. Brian Nussenbaum, of Washington University School of Medicine in St. Louis, and colleagues.

However, because a bug — Aeromonas hydrophila — lives in the gut of leeches where this bacteria aids in the digestion of blood, infections can occur in as many as 20 percent of patients treated with medical leeches, according to a report in the February Archives of Otolaryngology-Head and Neck Surgery.

So to prevent infection, researchers are recommending that when medical leeches are used, patients should be given antibiotics, preferably Cipro (ciprofloxacin) or Septra (trimethoprim-sulfamethoxazole).

The patient was a 56-year-old man undergoing a reconstructive procedure for a large benign tumor in his jaw. He was given ampicillin-sulbactam as prophylaxis.

Approximately 24 hours after the surgery, he developed a condition called acute venous congestion, meaning a lack of blood supply that turns skin and tissue blue, in the area of the surgery.

In preparation for revision of the surgery, which revealed widespread clot formation, the patient was given 400 mg of intravenous ciprofloxacin and three leeches were applied to the area.

The surgery appeared to have been successful, but despite maintenance therapy with ciprofloxacin, 48 hours later purulent secretions appeared, and cultures with sensitivity testing identified a strain of A. hydrophila that was resistant to both trimethoprim-sulfamethoxazole and ciprofloxacin.

Ciprofloxacin was withdrawn and the fourth-generation cephalosporin, cefepime, was prescribed.

The wound did not heal completely and eight months later the patient required a second reconstruction eight months later.

To determine the source of this resistant infection, Nussenbaum’s group conducted a two-part investigation.

First, to see if the infection was acquired within their hospital, they performed cultures on samples of water from their leech tank — and found that all samples were susceptible to multiple antimicrobials, including ciprofloxacin and trimethoprim-sulfamethoxazole.

They also noted that no other resistant Aeromonas infections had been seen at their institution.

“This practice-based investigation suggests that this strain was not acquired within our hospital,” they stated.

They then conducted a broader investigation, contacting various organizations including the Centers for Disease Control and Prevention and the Emerging Infections Network, finding that no other cases of similar resistant infections associated with medical leeches had been reported.

The leech supplier also reported careful maintenance of holding tanks, although antibiotic resistance tests were not routinely done.

The investigators found, however, that ciprofloxacin-resistant strains of Aeromonashad been identified from environmental sources such as drinking water in Turkey, a lake in Switzerland, and the Seine River.

These isolates contained a plasmid encoding fluoroquinolone resistance, which had previously only been found in Enterobacteriaceae.

“These findings suggest the possibility of emerging ciprofloxacin resistance in environmental water supplies, which is concerning,” observed Nussenbaum and colleagues.

Limitations of the study included the investigators’ inability to culture the gut contents of other leeches from the same batch, and the lack of specimens that could be tested for the presence of the resistance-conferring plasmid.

The study suggests that, although resistance to trimethoprim-sulfamethoxazole and ciprofloxacin is rare in A. hydrophila, it can occur and should be considered when antibiotic prophylaxis is undertaken, according to the investigators.

“Surgeons using leech therapy should be aware of this possibility and collaborate with infectious disease specialists in their hospital to determine appropriate antibiotic prophylaxis on local resistance patterns,” they cautioned.

Why You Need a Health Emergency Fund

Even with good health insurance, a health emergency or a prolonged illness can be a financial disaster. Health insurance deductibles, co-payments, emergency room costs, and other costs of illness can add up in a hurry.

A health savings account (HSA) is one way you can put aside tax-free money for a health emergency. HSAs were established in 2003. If you are covered by a type of insurance known as a high-deductible insurance plan, you can make tax-deductible contributions to an HSA. Your employer may also make tax-deductible contributions.

“An HSA account is very different from having a general emergency fund account,” says Joseph J. Porco, managing member of the Financial Security Group, LLC, in Newtown, Conn. “An emergency fund is about more than just out-of-pocket medical expenses. If possible, it’s a good idea to have both.”

How Much of an Emergency Fund Do You Need?

For an older adult, a health emergency might result in the need for long-term care, possibly for the rest of the senior’s life. For a young adult supporting a family, a medical emergency might be much more than just the cost of illness. Your health emergency could cause a disability that results in loss of income over an extended period. That means you should save enough to cover all your expenses.

“Most advisers would say you should have enough emergency funds saved to cover your family expenses for three to six months. I would recommend trying to put enough aside to cover all your expenses, not just health expenses, for 6 to 12 months,” says Porco.

How much you need for a health emergency and how much you can actually put into an emergency fund will depend on your family size, your income, your health status, and your age. But your first step is to understand your health insurance situation.

“The best way to start is to sit down with a financial adviser and figure out what your insurance actually covers and what it doesn’t cover. What are your insurance limits? What kind of medical bills might arise that you would be responsible for? Get some expert advice on how best to cover your actual needs,” advises Porco.

What Insurance May Not Cover

How much insurance companies actually pay for accidents, cancer treatment, or surgery depends on what kind of insurance you have, but there are usually limits. Here are some facts to consider:

  • Cost of illness. Most insurance companies have a cap on how much they will pay for a long-term illness. A recent survey found that 10 percent of people with cancer have hit their lifetime cap and are no longer covered by insurance. Looking forward, however, the new health care reform law will eliminate caps on lifetime insurance by 2014.
  • Emergency room cost. If you have an accident that requires emergency treatment and you end up in an emergency room outside your insurance network, you may not be covered. One study found that HMOs in California denied one out of every six claims for emergency room costs.
  • Surgical coverage. You may be surprised at what your insurance company considers non-covered surgery. There can be a big gray area between covered “reconstructive” surgery and uncovered “cosmetic” surgery. Even when surgery is covered, your deductible may be $500 or more, and you may still be responsible for up to 25 percent or more of surgical costs, depending on the specifics of your plan.

How to Save for a Health Emergency

Once you know what your insurance actually covers and how much you need to put away for an emergency, the next question is where to put it. “Money that you put aside for a health emergency needs to be liquid and secure,” says Porco. “That means you need to be able to get it when you need it.”

And your money needs to remain liquid. “Those who fail to set up an emergency fund may find themselves running up credit card debts to cover their expenses. The last thing you need is to be paying interest on your emergency,” warns Porco.

Examples of places to put your emergency fund include an interest-bearing checking or savings account, money market fund, or bond fund. Don’t tie your money up in anything that would penalize you for early withdrawals or any investment or account that has the potential for loss.

Practical Ways to Save

There are many different ways to approach starting — and adding to — your health emergency savings. “You can take advantage of a health savings account if this is offered at your job, but start a general emergency fund also,” suggests Porco.

Here are more health savings tips:

  • Put any money you get from a tax refund or earned income credit into your health savings fund.
  • Ask your bank or credit union to automatically transfer funds into your emergency account.
  • Explain the importance of an emergency fund to your family and get everyone involved in cutting back on unnecessary expenditures.

Remember, while HSA accounts are useful, a general emergency fund is equally important. Whether it is a health emergency that involves an uncovered emergency room cost or a prolonged illness like cancer, the actual cost of illness may end up being much more than your out-of-pocket health costs if you’re unable to work. Sit down with a financial adviser and find out what you can do to better insulate yourself from a health emergency.

Chemical Found in Blood Holds Clues to Survival

Even within the normal range, higher bilirubin levels appear to be associated with reduced risks of lung cancer, chronic obstructive pulmonary disease (COPD), and death, a longitudinal, prospective analysis of a large database showed.

For every 0.1-mg/dL increase in bilirubin level, the rate of lung cancer dropped by 8 percent in men and 11 percent in women, according to Laura Horsfall, MSc, of University College London, and colleagues.

In addition, the same incremental increase in bilirubin was associated with a 6 percent decline in the rate of COPD and a 3 percent decline in mortality for both sexes, the researchers reported in the Feb. 16 issue of the Journal of the American Medical Association.

“Based on our findings, bilirubin levels within the normal range appear to capture information about patients that may reflect a combination of environmental and genetically determined susceptibility to respiratory diseases,” they wrote.

Most people are familiar with bilirubin because of its role in jaundice — the yellowing of the skin that is sometimes seen in newborns but is also associated with liver disease.

Bilirubin is actually a byproduct of the turn over of red blood cells — the cells that carry oxygen throughout the body. Healthy individuals constantly replace old red blood cells with new ones. As the old cells are broken down they produce bilirubin, a chemical characterized by a distinctive yellow color.

The spleen and the liver taking in bilirubin and use it to break down or metabolize other substances into bile, which is used to aid digestion.

Although the study cannot establish causality for any of the relationships, there is some experimental evidence that bilirubin has benefits for respiratory health because of its cytoprotective properties, including antioxidant, anti-inflammatory, and antiproliferative effects, according to the researchers.

They noted that a better understanding of the possible mechanisms linking bilirubin levels to lung cancer, COPD, and death may lead to potential therapies that target the activity of UGT1A1, a liver enzyme responsible for converting insoluble bilirubin to an excretable form.

Horsfall and her colleagues examined data from the Health Improvement Network, a U.K. primary care research database.

Their analysis included 504,206 patients ages 20 and older from 371 practices. All of the patients had recorded serum bilirubin levels but no evidence of hepatobiliary or hemolytic disease.

Median bilirubin levels were 0.64 mg/dL in men and 0.53 mg/dL in women.

Through a median follow-up of eight years, there were 1,341 incident cases of lung cancer, 5,863 incident cases of COPD, and 23,103 all-cause deaths. The corresponding rates per 10,000 person-years were 2.5, 11.9, and 42.5.

For men, the rate of lung cancer per 10,000 person-years dropped from 5.0 in the lowest decile of bilirubin levels to 3.0 in the fifth decile. Similar declines were seen for COPD (19.5 to 14.4) and death (51.3 to 38.1).

The findings were similar for all outcomes in women, and the declines in both sexes remained significant after adjustment for age, body mass index, systolic blood pressure, smoking, alcohol intake, and a measure of social deprivation.

The authors acknowledged some limitations of the study, including possible residual confounding by unmeasured environmental exposures or race/ethnicity and the inability to establish causality for the observed relationships.

Marijuana Users at Risk for Early Psychosis

Data on more than 22,000 patients with psychosis showed an onset of symptoms almost three years earlier among users of cannabis compared with patients who had no history of substance use.

The age of onset also was earlier in cannabis users compared with patients in the more broadly characterized category of substance use, investigators reported online in Archives of General Psychiatry.

“The results of this study provide strong evidence that reducing cannabis use could delay or even prevent some cases of psychosis,” Dr. Matthew Large, of the University of New South Wales in Sydney, Australia, and co-authors wrote in conclusion.

“Reducing the use of cannabis could be one of the few ways of altering the outcome of the illness because earlier onset of schizophrenia is associated with a worse prognosis and because other factors associated with age at onset, such as family history and sex, cannot be changed.”

Psychosis has a strong association with substance use. Patients of mental health facilities have a high prevalence of substance use, which also is more common in patients with schizophrenia compared with the general population, the authors wrote.

Several birth cohort and population studies have suggested a potentially causal association between cannabis use and psychosis, and cannabis use has been linked to earlier onset of schizophrenia. However, researchers in the field remain divided over the issue of a causal association, the authors continued.

Attempts to confirm an earlier onset of psychosis among cannabis users have been complicated by individual studies’ variation in methods used to examine the association. The authors sought to resolve some of the uncertainty by means of meta-analysis.

A systematic search of multiple electronic databases yielded 443 potentially relevant publications. The authors whittled the list down to 83 that met their inclusion criteria: All the studies reported age at onset of psychosis among substance users and nonusers.

The studies comprised 8,167 substance-using patients and 14,352 patients who had no history of substance use. Although the studies had a wide range of definitions of substance use, the use was considered “clinically significant” in all 83 studies. None of the studies included tobacco in the definition of substance use.

The studies included a total of 131 patient samples.

Substance use included alcohol in 22 samples, cannabis in 41, and was simply defined as “substance use” in 68 samples.

Alcohol use was not significantly associated with earlier age at onset of psychosis.

On average, substance users were about 2 years younger than nonusers were. The effect of substance use on age at onset was greater in women than in men, but not significantly so. Heavy use was associated with earlier age at onset compared with light use and former use, but also not significantly different, the authors reported.

Substance users were two years younger at the onset of psychosis compared with nonusers. Age at onset was 2.7 years earlier among cannabis users compared with nonusers.

Acknowledging limitations of the study, the authors cited the lack of information on tobacco use and its association with earlier age at onset of psychosis, and the lack of data on individual patients inherent in all meta-analyses.

Despite the limitations, the authors said the findings have potentially major clinical and policy implications.

“This finding is an important breakthrough in our understanding of the relationship between cannabis use and psychosis,” they wrote in conclusion. “It raises the question of whether those substance users would still have gone on to develop psychosis a few years later.”

“The results of this study confirm the need for a renewed public health warning about the potential for cannabis use to bring on psychotic illness,” they added.

Painkiller Use Common Among NFL Players

Retired National Football League players who abused opioid painkillers while active were most likely to use and abuse the same drugs after leaving the sport, the results of a telephone survey and analysis found.

The survey found more than half of the retired NFL players interviewed used opioidpainkillers during their career. Of those, 71 percent reported misusing the drugs while playing, and 15 percent said they still abuse the prescription medication, Dr. Linda B. Cottler, of Washington University School of Medicine, and colleagues reported online in Drug and Alcohol Dependence.

The former broadcaster and NY Giants great, Frank Gifford, said, “pro football is like nuclear warfare. There are no winners, only survivors.”

The findings from Cottler’s survey support Gifford’s assessment.

An analysis of survey data showed the rate of opioid misuse while the retired players were active in the NFL was roughly three times greater than the lifetime rate of nonmedical use of opioids in the general population of approximately the same age.

Misuse in the past 30 days in retired players was seven percent, versus less than two percent in adults 26 and older in the general population. Looking only at men in the general population, the abuse rate is about two and half percent.

The final sample included 644 former players listed in the 2009 Retired NFL Football Players Association Directory who had retired from 1979 to 2006 and had at least one phone number listed.

They completed a phone interview that discussed general demographic data, health status, pain, impairment, alcohol use, prescription opioid use, and illicit drug use. Prescription opioid use was measured for while a player was active as well as over the past 30 days. Participants were categorized into users and nonusers. Users were subcategorized as having used the drugs as prescribed, or having misused them.

Misuse was defined as taking more of the drug than prescribed, using it in a way other than prescribed, using it after a prescription ended, using it for a different reason, or using it without a prescription.

When compared against players prescribed opioids while in the NFL and with those who were non-users during their NFL careers, 17 percent of those who misused while playing used as prescribed in the past 30 days, 15 percent misused in the past 30 days, and 68 percent reported no use.

In a multivariate analysis, moderate to severe pain, undiagnosed concussions, and drinking 20 or more alcoholic drinks a week were the strongest predictors of misuse. Undiagnosed concussions were reported by 81 percent of misusers.

“This association might have been due to the fact that those who choose not to report concussions are the same players who choose not to reveal their pain to a physician, thus managing their pain on their own,” the researchers wrote. “They may believe that if they report a concussion, they will be pulled from active play.”

The researchers noted the study may have been limited by lack of detailed pain information from while a player was active, a small sample size, a more inclusive definition of misuse that included abuse of opioids a player was prescribed, and a sample that included potentially more-healthy-than-average retired footballers — the researchers noted interviews with former players not in the Retired Players Association uncovered “multiple examples of serious and heavy opioid abuse.”

They added that future research could measure number of alcoholic drinks and level of pain while active in the NFL against opioid use and abuse.

Head Injuries Carry Long Term Death Risk

The risk of death after head injury remained significantly increased for as long as 13 years, irrespective of the severity of the injury, results of a case-control study showed.

Overall, patients with a history of head injury had more than a twofold greater risk of death than did two control groups of individuals without head injury.

Among young adults, the risk disparity ballooned to more than a fivefold difference, Scottish investigators reported online in the Journal of Neurology, Neurosurgery and Psychiatry.

“More than 40% of young people and adults admitted to hospital in Glasgow after a head injury were dead 13 years later,” Dr. Thomas M. McMillan, of the University of Glasgow, and coauthors wrote in the discussion of their findings. “This stark finding is not explained by age, gender, or deprivation characteristics.”

“As might be expected following an injury, the highest rate of death occurred in the first year after head injury,” they continued. “However, risk of death remained high for at least a further 12 years when, for example, death was 2.8 times more likely after head injury than for community controls.”

Previous studies of mortality after head injury have focused primarily on early death, either during hospitalization or in the first year after the injury. Whether the excess mortality risk persists over time has remained unclear, the authors noted.

Few studies have compared mortality after head injury with expected mortality in the community. To provide that missing context, McMillan and coauthors conducted a case-control study involving 757 patients who incurred head injuries of varying severity from February 1995 to February 1996 and were admitted to a Glasgow-area hospital.

For comparison, the investigators assembled two control groups, both matched with the cases for age, sex, and socioeconomic status and one matched for duration of hospitalization after injury not involving the head.

One control group was comprised of persons hospitalized for other injured and other comparison group included healthy non-hospitalized adults.

The cases comprised 602 men and 155 women who had a mean age of 43, and almost 70 percent were in the lowest socioeconomic quintile.

At the end of follow-up, 305 of the head-injured patients had died, compared with 215 of the hospitalized control group, and 135 of healthy, non-hospitalized adults.

Mortality after one year remained significantly higher in the head-injury group—34 percent versus 24 percent among the hospitalized comparison group and 16 percent for the healthy non-hospitalized adults.

Overall, the head-injury group had a death rate of 30.99/1,000/ year versus 13.72/1,000/year in the community controls and 21.85/1,000/year in the hospitalized-other injury control group.

The disparity was greater among younger adults (15 to 54), who had a rate of 17.36/1,000/year versus 2.21/1,000/year in the community controls. Older adults in the head injury group had a death rate of 61.47/1,000/year compared with 39.45/1,000/year in the community controls.

“Demographic factors do not explain the risk of death late after head injury, and there is a need to further consider factors that might lead to health vulnerability after head injury and in this way explain the range of causes of death,” the authors wrote in conclusion. “The elevated risk of mortality after mild head injury and in younger adults makes further study in this area a priority.”

Walking Can Helps Your Heart and Brain

Regular aerobic exercise such as walking may protect the memory center in the brain, while stretching exercise may cause the center — called the hippocampus — to shrink, researchers reported.

In a randomized study involving men and women in their mid-60s, walking three times a week for a year led to increases in the volume of the hippocampus, which plays an important role in memory, according to Dr. Arthur Kramer, of the University of Illinois Urbana-Champaign in Urbana, Ill., and colleagues.

On the other hand, control participants who took stretching classes saw drops in the volume of the hippocampus, Kramer and colleagues reported online in theProceedings of the National Academy of Sciences.

The findings suggest that it’s possible to overcome the age-related decline in hippocampal volume with only moderate exercise, Kramer told MedPage Today, leading to better fitness and perhaps to better spatial memory. “I don’t see a down side to it,” he said.

The volume of the hippocampus is known to fall with age by between 1 percent and 2 percent a year, the researchers noted, leading to impaired memory and increased risk for dementia.

But animal research suggests that exercise reduces the loss of volume and preserves memory, they added.

To test the effect on humans, they enrolled 120 men and women in their mid-sixties and randomly assigned 60 of them to a program of aerobic walking three times a week for a year. The remaining 60 were given stretch classes three times a week and served as a control group.

Their fitness and memory were tested before the intervention, again after six months, and for a last time after a year. Magnetic resonance images of their brains were taken at the same times in order to measure the effect on the hippocampal volume.

The study showed that overall the walkers had a 2 percent increase in the volume of the hippocampus, compared with an average loss of about 1.4% in the control participants.

The researchers also found, improvements in fitness, measured by exercise testing on a treadmill, were significantly associated with increases in the volume of the hippocampus.

On the other hand, the study fell short of demonstrating a group effect on memory – both groups showed significant improvements both in accuracy and speed on a standard test. The apparent lack of effect, Kramer told MedPage Today, is probably a statistical artifact that results from large individual differences within the groups.

Analyses showed that that higher aerobic fitness levels at baseline and after the one-year intervention were associated with better spatial memory performance, the researchers reported.

But change in aerobic fitness was not related to improvements in memory for either the entire sample or either group separately, they found.

On the other hand, larger hippocampi at baseline and after the intervention were associated with better memory performance, they reported.

The results “clearly indicate that aerobic exercise is neuroprotective and that starting an exercise regimen later in life is not futile for either enhancing cognition or augmenting brain volume,” the researchers argued.

The study was supported by the National Institute on Aging, the Pittsburgh Claude D. Pepper Older Americans Independence Center, and the University of Pittsburgh Alzheimer’s Disease Research Center. The authors said they had no conflicts.