June 8th, 2010
04:00 PM ET

Youth hockey players: Too young to body check?

By Stephanie Smith
CNN Medical Producer

Youth hockey does not look so different than adult hockey, besides the obvious differences in stature among the players. The essential elements of the game are there: The skates' clatter on the ice; the smoothly sliding puck; and, oh yes, that tousling and hitting they call body checking.

The question: Are 11 and 12-year-olds - still engaged in that complex dance called brain development - ready for body checking?

A new study in the Journal of the American Medical Association does not attempt to answer that question, but it does provide some fodder for discussion. As it turns out, in youth hockey leagues where body checking is allowed, there is a three-fold increase in severe injuries, including mild-to-severe concussions.

The study examined youths in Canadian hockey leagues, but the implications of the study spread well beyond hockey, to other contact sports, says one brain injury expert.

"The simple fact is, the more risky the behavior, the more you increase the chance of concussion," said David Hovda, director of the UCLA Brain Injury Research Center, who was not involved with the study. "The brain is not like a muscle so that when you pull it, it swells up and (the injury) goes away. When the brain gets hurt, it's a very bad thing. The problem is you can't see it."

At issue when it comes to children, those invisible injuries - even when they are mild - may have dangerous implications for their still-developing brains. Last year, two studies published by the American Psychological Association found that children who sustained severe brain injuries had more problems academically, with learning and memory, and with behavior over the long-term.

"Let's say a child is playing hockey and had repeated head injuries," said Hovda. "That kid grows up and becomes a first class car repairman, but maybe he was supposed to be a first class doctor. The problem is, we don’t know how much those repeated blows to the head could have compromised that child's brain to reach its full capacity."

Hovda calls concussion an epidemic in the United States - it results in 435,000 emergency department visits per year among children, according to the National Center for Brain Injury and Control - but confesses that he, like many, is a sports fan.

"We don't necessarily need to change the nature of sports," said Hovda. "But since we don't know how devastating this can be for a child, it's better to restrict activities in sports where children may be exposed to repeat concussions."

Where many brain injury experts seem to agree is that children should be protected from concussion - by adults. That includes having experienced trainers and medical staff on hand at all games and coercing children, in situations where there is even a suggestion of a concussion (even if the child doth protest), to stay on the sidelines to heal.

The question that lingers is, is all of that enough? Is there some credence to the argument that there should be an age limit on body checking (or tackling, or any major contact in youth sports)? These are questions that may take years - even decades - to sort out.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

June 8th, 2010
03:57 PM ET

Secondhand smoke linked to depression, other psychological distress

By Caitlin Hagan
CNN Medical Associate Producer

Researchers say exposure to secondhand smoke, even at low levels, is associated with depression and other types of psychological distress. Their study and findings are published in the Journal of the American Medical Association Archives of Psychiatry.

The university researchers from London and Edinburgh, Scotland took saliva samples from more than 8,000 participants in the Scottish General Health survey and tested them for cotinine, a metabolite of nicotine. Using those objective measurements, the study authors found a strong association between exposure to secondhand smoke psychological health issues, including depression, delirium, mood swings, and even schizophrenia. The association became stronger as the participants' cotinine levels increased.

"You need to think of secondhand smoke as a toxic stew," says Thomas J. Glynn, the Director of Cancer Science and Trends at the American Cancer Society. "There are more than 4,000 compounds in both mainstream smoke and secondhand smoke. And the list of chemicals is frightening."

The study only found an association between the two, not a cause and effect relationship. Still, the study authors hypothesized that the negative psychological effects were caused by the smoke interrupting the body's immune system or weakening various pathways in the brain, including the dopaminergic pathway responsible for transmitting dopamine.

According to the American Cancer Society, 50 to 60 percent of Americans are still exposed to secondhand smoke. The Environmental Protection Agency has classified secondhand smoke as a "known human carcinogen", meaning it's been proven to cause cancer in humans. It's responsible for various illnesses and conditions, from lung infections and asthma attacks to nearly 750,000 middle ear infections in children every year.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

June 8th, 2010
03:45 PM ET

FDA's food safety programs sometimes puts public health at risk

By Saundra Young
CNN Medical Senior Producer

The Food and Drug Administration is not properly protecting the nation's food supply and must change it's approach to food safety in order protect public health, according to a report released today by the Institute of Medicine (IOM), part of the National Academies of Science (NAS).

The report, 18 months in the making, found that outbreaks of foodborne illness will continue unless the FDA changes its management style and adopts a risk-based approach to food safety, moving from a "reactive" system where they address issues on a case by case basis. The IOM suggested a new system would include strategic planning, the ranking of hazard risks, targeted surveillance and designing an intervention plan. It would allow the FDA to better identify potential weak links in the chain where  contamination can start and catch problems before an outbreak occurs.

In the United States there are about 76 million cases of foodborne illness  every year. More than 300,000 people are hospitalized and 5,000 die.  "As recent illnesses traced to produce underscore, foodborne diseases cause significant suffering so it's imperative that our food safety system functions efficiently at all levels," said IOM committee chair Robert Wallace, professor, College of Public Health , University of Iowa, Iowa City.  "FDA uses some risk assessment and management tactics, but the agency's approach is too often reactive and lacks a systematic focus on prevention."

Part of the problem: Food safety is regulated by several agencies and the systems currently in place are not very well integrated. The FDA oversees about 80 percent of the food supply with responsibility for all produce, seafood and dairy products. The U.S. Department of Agriculture is responsible for meat, poultry and egg products. Mostly state and local agencies handle inspections of food production facilities. They also provide surveillance and investigate illness outbreaks. On top of that, the FDA also is responsible for more than 1 million restaurants and food establishments, more than 150,000 food facilities, more than 2 million farms, and millions of tons of imported foods–leaving it without the resources it needs to adequately monitor everything, according to the IOM committee doing the review.

"Food safety is an important issue for the entire administration. Through the President's Food Safety Working Group, which includes all agencies involved in food safety," said FDA Commissioner Margaret Hamburg.  "We already are making significant progress to ensure government agencies are working seamlessly to protect the American public. At FDA, we are engaged in the long-term, strategic transformation of our Foods Program, including appointing a Deputy Commissioner for Foods to oversee the newly created Office of Foods."  That office is tasked with overseeing all food policy, but IOM says what is still needed is direct authority over inspectors in the field which is often handled at the state and local level.

The IOM committee called on the FDA to establish review standards and also recommended federal officials create a separate food safety data agency that would collect information and quickly assess risks to determine appropriate action. The commitee also called on the FDA to consider turning over facility inspections to  state governments– something for which the Center for Science in the Public Interest (CSPI), public advocates for nutrition, health, and food safety expressed "serious reservations."

"Tasking these overburdened, understaffed and underfunded state agencies with additional responsibilities will produce only frustration and not safer food." Sarah Klein, CSPI staff attorney said.

It was Congress who asked IOM to look at the problems in the system and work with the FDA to improve food safety. Now IOM is calling on Congress to step up and give the agency the authority it needs to protect public health by amending the Federal Food, Drug, and Cosmetic Act. That legislation is pending in the Senate. "The report clearly highlights the need for enactment of pending legislation that provides much needed authorities and resources to assist in our efforts to ensure the safety of our nation's food supply." Hamburg said.

On that CSPI agrees. "The NAS report offers several strong recommendations for improving food safety under the FDA, many of which are echoed in the legislation pending in the Senate. It's gratifying and yet not surprising to have this chorus of experts reach the conclusion that our food safety system is in desperate need of help, and we hope the Senate will heed their call to provide many of the authorities that would be needed to make these important improvements."

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

June 8th, 2010
01:34 PM ET

CDC answers health questions about the oil spill

By Ann J. Curley
CNN Medical News Assignment Manager

The Centers for Disease Control and Prevention and the U.S. Department of Health and Human Services are monitoring the Gulf of Mexico oil disaster for any public health hazards.

The CDC web site says they are  in constant contact with state officials and preparing to support and respond to any developing health threats.

In the meantime, the CDC has posted answers to FAQs, including whether the oil will hurt people who touch it or those who breathe by products of the oil spill. Read more here.

June 8th, 2010
01:13 PM ET

New tool to evaluate stem cell clinic claims

By Miriam Falco
CNN Medical Managing Editor

Concern over the aggressive marketing of stem cell treatments without solid evidence that the procedures actually work and are safe has led the International Society for Stem Cell Research (ISSCR) to launch a website called “A Closer Look at Stem Cell Treatments”.

According to ISSCR, the website is meant to “arm patients, their families, and doctors with information they need to make decisions about stem cell treatments.”

ISSCR President and stem cell expert Dr. Irving Weissman began developing the idea for this website more than a year ago because of a growing concern that many clinics and websites offer stem cell treatments, without providing evidence that the treatments work and/or are safe.

“We want to clarify what would and would not be a safe stem cell therapy,” says Weissman.

Dr. Lawrence Goldstein, another prominent stem cell researcher and ISSCR board member says this is the first organized attempt by an international body to help patients with questions about what these clinics are offering.

For the past decade, the promise and controversy over stem cells has fueled a passionate debate among politicians, researchers and patients.

Questions over funding and the type of research has made a lot of headlines over the years. What the various types of stem cells can do now or in the future often is up for debate. But actual stem cell treatment advances that have reached patients (with the exception of bone marrow transplants, which have been done for 40 years now), are still few. Yet if you Google ‘stem cell treatments,’ you’ll get nearly half a million hits.

Clinics are often located in Asia or the Caribbean. Patients are often asked to pay tens of thousands of dollars to have stem cells injected into their bodies. Many clinics claim the injections of their stem cells have cured many different illnesses from autism to cancer to multiple sclerosis and spinal cord injuries. Testimonials on the web seem to confirm some of the claims of recovery. However, research that can be reproduced by others (the gold standard for confirming medical discoveries) is often lacking. Companies will claim their techniques are patented and they can’t reveal specifics due for proprietary reasons.

For a Canadian study published in 2008 in the peer-reviewed journal “Cell Stem Cell” researchers took a snapshot of the many websites by specifically looking at 19 sites advertising stem cell treatments to consumers. The study concluded “the portrayal of stem cell medicine on provider websites is optimistic and unsubstantiated by peer-reviewed literature.”

This newly launched website offers a variety of tools for patients and patients’ families, including the top 10 things to know about stem cell research and what questions to ask the clinics. The ISSCR also is asking people to submit names of clinics for the ISSCR to review. ISSCR plans to investigate the claims of these clinics and whether there’s a medical ethics committee involved to protect the rights of patients and if the clinics are under the supervision of a regulatory body like the U.S. Food and Drug Administration or the European Medicines Agency.

The ISSCR website will list whether the stem cell clinics do or do not provide the requested information. Weissman says "we're trying to let people know what's unapproved in those treatment clinics."

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

June 8th, 2010
11:49 AM ET

Did WHO overstate H1N1 threat?

By Elizabeth Landau
CNN.com Health Writer/Producer

Last week the British Medical Journal published an article accusing the World Health Organization (WHO) of conflicts of interest with regard to H1N1. The authors accused the organization of exaggerating the severity of the virus, and of taking advice from experts with ties to vaccine- and antiviral-producing pharmaceutical companies.

There has been a lack of transparency over conflicts of interests, the article stated, based on research from the British Medical Journal and the Bureau of Investigative Journalism in London, England. It also claimed the WHO also changed the definition of a pandemic, removing the phrase "enormous numbers of deaths and illness" from the criteria.

Dr. Margaret Chan, director of the WHO, said in a statement Tuesday that WHO needs to have stricter rules regarding engaging industry, but that "At no time, not for one second, did commercial interests enter my decision-making." 

Chan said that when she announced the start of the pandemic on June 11, 2009, she highlighted that the number of deaths worldwide was small, and that there would not be an expected jump in the number of severe or fatal infections. "In every assessment of the pandemic, WHO consistently reminded the public that the overwhelming majority of patients experienced mild symptoms and made a rapid and full recovery, even without medical treatment," she said.

She also denies that the WHO changed the criteria for a pandemic because of H1N1. The current plan with its definitions came into being in February 2009, long before H1N1, she said.

Chan wants the WHO's work on H1N1 examined.  She asked for an independent review of how the WHO handled H1N1 in January.

The names of the members of the Emergency Committee that advised WHO on the pandemic will be released when the Committee finishes its work, as the WHO had intended previously, she said.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

June 8th, 2010
10:00 AM ET

Less stress helps breast cancer patients

By Val Willingham
CNN Medical Producer

It's tough enough for a woman to go through one diagnosis of breast cancer, but when the cancer recurs it can be devastating. Not only does the stress of wondering whether the cancer will come back again, take a toll on the patient's quality of life, it can also take a toll on her health.

So how can the medical community help these patients?
According to a new study in the publication Clinical Cancer Research, a journal of the American Association for Cancer Research, stress-reducing psychological intervention seems to help increase the quality of life and the survival rate among women with recurrent breast cancer over the long term.

In a previous study called The Stress and Immunity Breast Cancer Project, data showed that after an average of 11 years of follow-up, women who received psychological intervention had a 45 percent reduced risk of breast cancer recurrence. In this most recent study researchers tested the same hypothesis looking at mortality from breast cancer.

Participants in the current study included 227 women with newly diagnosed Stage II or III breast cancer. The women were randomized to receive a psychological intervention or assessment only. The psychological intervention treatment helped patients understand the nature of cancer and stress, taught them tangible ways to reduce stress and improve quality of life; helped patients follow-up on their cancer care and showed them how better to communicate with their medical care providers. Those who were given an assessment were only told their diagnosis and their options.

During follow-up, 62 women were found to have recurrent breast cancer. After recurrence, women who had earlier received the psychological intervention had a 59 percent reduction in the risk of dying of breast cancer.

According to lead investigator, Barbara Anderson, professor in the department of psychology at the Ohio State University, Columbus, and a researcher at the Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute, these results "show enduring benefits from the psychological intervention that were never previously considered or observed," and suggest that the interventions affected patients' risks for recurrence and for breast cancer death.

June 8th, 2010
09:52 AM ET

Mixing energy drinks and alcohol may lead to riskier behavior

By Trisha Henry
CNN Medical Producer

A new study finds that college athletes are significantly more likely to engage in energy-binge drinking when consuming alcohol than non-athletes. Athletes who combined alcohol and energy drinks, 150 of the 401 surveyed, also consumed more than double the amount of alcohol when compared to athletes who consumed alcohol-only. The survey by Oklahoma State and University of Missouri researchers also found that when people drink "energy cocktails" there were significant increases in risk-taking. This was especially true in men.

Researchers found by mixing caffeine with alcohol the college athletes became more intoxicated and therefore engaged in riskier behavior, than with alcohol alone. In addition, the researchers noted, drinking a stimulant and a depressant at the same time can be dangerous because it sends mixed signals to the body and the body doesn't know how to respond. The researchers also found those who drink "energy cocktails" are more likely to be hurt or injured and more likely to ride with an intoxicated driver.

Besides increased overall alcohol consumption and risk-taking, the study also found links to health problems and negative consequences associated with the "energy cocktails". Researchers found the combination of caffeine with alcohol, along with the other substances influenced brain functioning. According to the study, overindulging in these cocktails could affect motivation, concentration, mood and can create or exacerbate mental problems.

With so many of these stimulants in the body, study author, Dr. Conrad Woolsey from Oklahoma State University says, "this can cause a sort of manic depressive state afterwards and over time can lead to anxiety disorders, especially in young people."

According to the National Institute of Health, the brain is still developing until the age of twenty-five. College athletes who expose themselves to these stimulants in increased amounts are putting themselves at a greater risk of depression and anxiety disorders in the future. Woolsey says the danger isn't specifically in the caffeine; it's in the combination of drinks with the other stimulants potentially being more dangerous because people haven't built up tolerances to them. Woolsey says many of these so called energy drinks contain unregulated herbal stimulants.

The energy drink market has ballooned from $200 million in sales in 2002 to $3.5 billion in 2006, according to figures included in the study.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

June 8th, 2010
06:10 AM ET

What’s affecting your sleep in 2010: Shift work to ‘sexsomnia’

By Caitlin Hagan
CNN Medical Associate Producer

SLEEP 2010 the 24th annual meeting of the American Academy of Sleep Medicine and the Sleep Research Society, is happening now in San Antonio, Texas. The findings ranged from how shift work affects sleep patterns to having sex while you’re asleep. Read on for more details.

Tired? Can't sleep? It might be your job.

How tired you are and how much sleep you get may depend on what time of the day you work. A new study being presented at SLEEP 2010 predicts that day shifts allow workers to get more sleep than night shifts, and a night shift that begins after midnight may be better than a shift that starts at 11 p.m. Specifically, people who started work between 9 a.m. and 2 p.m. slept the longest, while those who started their shift after 8 p.m. but before midnight, slept the least. The number of hours varied from 4.5 to eight hours.

By creating 24 separate six-day work schedules with varying shift start times by one-hour increments , researchers found late-night workers had less sleep and poorer performances at work. When it came to early early shifts, meaning those after midnight, studies found those workers were actually better rested because most of them slept right before their duty periods. In contrast, shifts that started just before midnight did not allow for pre-shift sleep because the timing conflicted with the body's early evening circadian process, better known as the body's inner clock.

"Shifts of equal duration differ in how fatiguing they are depending on the time of day when they are scheduled," said lead author Angela Bowen, research assistant at the Sleep and Performance Research Center at Washington State University Spokane.

"The same limitation on the number of duty hours may be either overly restrictive if during the day or too liberal if during the night."

Because of these statistics, experts at the conference believe labor regulations should also provide guidance to employers on shift start times, so companines may maximize their workers' sleep opportunity and minimize their risk of on-the-job fatigue.

Sex while you sleep?

Sexsomnia, defined by the American Academy of Sleep Medicine as the act of initiating or engaging in sexual activity with a bed partner while asleep, seems to be a common sleep disorder among patients being treated at sleep centers. Researchers conducted a retrospective chart review of more than 800 patients who were evaluated at one sleep center for possible sleep disorders. While answering questionnaires, 8 percent of patients admitted to acts of sexsomnia and male patients were three times more likely to report sexsomniac activity. Yet only four patients of the entire pool actually raised the issue with their doctor or specialist.

Study investigator Sharon A. Chung, Ph.D., Sleep Research Laboratory staff scientist at the University Health Network in Toronto , Canada, said in a press release, "while our finding of eight percent of people reporting sexsomnia seems really a high number, it should be stressed that we only studied patients referred to a sleep clinic. So, we would expect the numbers to be much lower in the general population."

Sexsomnia is classified by the American Academy of Sleep Medicine as a parasomnia, or an undesirable behavior that occurs while a person is falling asleep, sleeping, or waking up. According to the researchers, the study was the first of its kind to measure how frequently sexsomnia occurs.

Too much sleep may be bad for your health

It's a unique headline: For adults over the age of 50, sleeping longer than eight hours a night may actually have negative health implications. Study participants who slept more than eight hours, including naps, had a 15 percent higher chance of developing metabolic syndrome, a group of risk factors that increase a person's risk for heart disease. The study could not determine the cause of this assocation.

"The most surprising aspect of our study was that long sleep – and not short sleep – was related to the presence of the metabolic syndrome," lead author Teresa Arora said in a press release. Arora is a research scientist at the University of Birmingham School of Medicine in Birmingham , U.K.

The study involved more than 29,000 adults. The association remained true even after researchers accounted for lifestyle factors and other metabolic markers.

Regular, early bedtimes linked to smarter preschoolers

Preschool-aged children with established, regular bedtimes scored higher on a range of developmental assessments than children without. Researchers used a nationally representative sample of approximately 8,000 children to determine that children 4 years of age who had regular bedtimes and got ample sleep had higher math, literacy, and expressive language abilities.

"Getting parents to set bedtime routines can be an important way to make a significant impact on children's emergent literacy and language skills," lead author Erika Gaylor, Ph.D., early childhood policy researcher for SRI International, an independent, nonprofit research institute in Menlo Park, California, said in a press release.

"Pediatricians can easily promote regular bedtimes with parents and children, behaviors which in turn lead to healthy sleep."

CNN Producer Val Willingham contributed to this blog.

About this blog

Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.