Health Tip: Triggers of Acne

(HealthDay News) - While acne is commonly attributed to poor diet and skin care, this and other types of problem skin are often triggered by factors beyond a person's control.

The U.S. National Women's Health Information Center offers this list of potential risk factors for acne:

• Hormonal changes caused by puberty.
• Hormonal changes caused by menopause, menstrual cycles or pregnancy.
• Some medications, including some used for epilepsy and depression.
• Wearing makeup.
• Irritation to the skin caused by friction from hats, helmets or backpacks.
• A family history of acne.

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Post-Holiday Letdown Can Be Avoided

(HealthDay News) -- Eating a balanced diet and staying active are key to beating the blues this holiday season, say mental health experts.

"I see more cases of depression in January than any other time of year," Dr. Gary L. Malone, medical director and chief of behavioral health at Baylor All Saints Medical Center at Fort Worth, Texas, said in a prepared statement.

Once the party is over, and the wrapping paper has been picked up, many otherwise festive people may feel unusually down.

According to Baylor health system experts, the holiday season is fraught with triggers for depression. Eating, drinking and spending too much are among the causes of holiday blues. Add family tension or grief over lost loved ones, and the mix can become potent.

According to Malone, there are a few things people can do to avoid post-holiday letdown:

• Eat a balanced diet, which results in more energy and an improved sense of wellbeing.
• Cut back on caffeine if you are having trouble sleeping and cut back on the festive cocktails.
• Go for a walk. Physical activity helps you lose weight and improves your mood. If the winter weather looks foreboding, work out inside. Take advantage of New Year's specials to join a gym or your fellow post-holiday shoppers walking the outer edge of the mall.
• Talk about it. According to Malone, sharing your troubles with someone else can be a relief, and they may be able to offer another perspective that could help you.
  If these steps don't help ease the blues away, consider talking to a physician.

The symptoms of depression include a persistent sad or "empty" mood; sleeping too little or too much; weight loss or weight gain; loss of interest in once-enjoyed activities; restlessness; difficulty concentrating; tiredness; and thoughts of death or suicide.

More information
To learn more about coping with the holiday blues, visit the American Psychological Association.

Shorter Legs Might Boost Liver Risks

(HealthDay News) -- People with short legs may have an increased risk of liver disease, suggests a study that adds to growing evidence of a link between leg length and health.

Researchers at the University of Bristol analyzed leg and torso measurements, as well as blood samples, from 4,300 women, ages 60 to 79, in 23 British towns.

The blood samples were checked for levels of four liver enzymes -- ALT, GGT, AST and ALP -- that indicate how well the liver is working and whether it's been damaged.

ALP is also an indicator of bone disease, such as osteoporosis.

The women were also asked about their medical history, lifestyle and social class -- all of which can influence health and body stature.

The researchers found that longer leg length was associated with lower levels of ALT, GGT, and ALP. ALT levels were lowest among women with the longest legs, while ALT and ALP levels were highest among women with the shortest torso length.

These findings held true after the researchers adjusted for important factors such as age, alcohol consumption, smoking, exercise, and childhood social class, and after the researchers excluded women who already had liver cancer, diabetes, cardiovascular disease, or osteoporosis.

"Our interpretation of the results is that childhood exposures, such as good nutrition, that influence growth patterns, also influence liver development and therefore levels of liver enzymes in adulthood and/or the propensity for liver damage," the study authors wrote.

The study was published in the Journal of Epidemiology and Community Health.

More information
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about liver disease.

Lack of Strong Thirst Signals Leads Elderly to Drink Too Little

(HealthDay News) -- Older adults don't drink enough water and become dehydrated during heat waves because their brains and bodies don't coordinate sensory signals about thirst, a new Australian study suggests.

The researchers aren't sure whether thirst signals from the body or the interpretation of these signals by the brain cause the problem, said study author Gary Egan, an associate professor at the University of Melbourne.

Knowledge of this lack of coordination may make it easier to motivate older people "to make sure they are actively re-hydrating because there is a clear reason why they are not necessarily aware of their own need to drink," Egan said.

Deaths of elderly people from dehydration is a well-known public health problem, Egan said. During a French heat wave in 2003, the deaths of 14,000 mostly older people were attributed largely to not drinking enough water, he said. "This issue becomes of paramount public health significance," he added.

For the study, Egan and his colleagues recruited a group of 10 younger men (mean age 23.7) and a group of 12 healthy older men (mean age 68.1). The researchers injected saline solution into the volunteers to make them thirsty. Then they were permitted to drink as much water as they liked, Egan said.

The older men drank less water to quench their thirst. PET scans of areas of their brains activated by thirst showed reactions -- particularly in the cingulate cortex.

"In the elderly, drinking a much smaller volume of water is needed to cause that area of brain activation to subside," said Egan, who is an expert on neuro-imaging. "For some reason, elderly people's attention of awareness of the need to drink to re-hydrate rapidly dissipates after a small amount of ingested water."

One cause of this could be the result of weaker signals from the body, Egan explained. For example, as people age their stomach muscles weaken. So, when they consume water or food their stomach expands more in comparison to volume, he said.

"When muscles are weaker, there is less sensory input telling you have eaten or drunk as much as you have," Egan said. Signals come from other areas of the body, such as the back of the throat, and that is also less sensitive with age, the study noted.

The study concluded that "scheduled drinking may be a strategy to reduce the risk of dehydration in older people, although care should be exercised to avoid excessive water intake and the associated risks of cerebral swelling."

The findings are published in this week's edition of Proceedings of the National Academy of Sciences.

The work of Egan and his team of scientists from Melbourne and San Antonio, Texas, is one of many studies of thirst in the elderly, said Neil E. Rowland, a professor of psychology at the University of Florida and a thirst researcher. "These studies have had two different results: That elderly people experience less thirst and consequently drink less fluid, or that elderly people experience just as much thirst but still drink less," he said.

"This paper is important because it's really the first study that looks inside the brain to try to find out what might be different" about the thirst mechanism in older people, Rowland said.
The study is also interesting because it looked at the cingulate cortex, a region of the brain that hasn't been studied widely by thirst researchers, he added.

While the findings are important to basic science, they don't have immediate practical consequences, Rowland said. "The authors suggest controlled drinking programs so that [older people] take more drinks across the day. That doesn't follow from this particular research. Those sorts of programs have been around for a long time."

Scheduled drinking isn't always successful with the elderly, added Barb Troy, a clinical assistant professor of dietetics at Marquette University. Anyone who works with the elderly will say that if you prod them to drink beyond their limit, that can be counterproductive, she said.

"They don't ambulate as well. In the middle of the night they don't want to be running to the bathroom, and that catches up with them."

More information
For more on the need to stay hydrated during hot weather, visit Ball State University.

High-Dose Chemo Provides Little Benefit to Breast Cancer Patients

(HealthDay News) -- High-dose chemotherapy has only a minimal effect on survival in breast cancer patients with node-positive disease, new research shows.

"It's pretty clearly established that [high-dose chemotherapy] is a false hope," said study author Donald Berry, head of the Division of Quantitative Sciences at the University of Texas M.D. Anderson Cancer Center in Houston. "There's a disease-free survival benefit but not much of a survival benefit. There may be a subset which would benefit, but we looked and couldn't find it."
The study, done in collaboration with the European Blood and Marrow Transplant Group, essentially sounds the death knell for this type of therapy.

"When you're doing a meta-analysis and combining large numbers of studies with different populations, and you're not able to get a really significant survival advantage, I think that the benefits of high-dose chemo are not there," added Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La. "Outside of a clinical research trial, I do not recommend high-dose chemotherapy."

The findings are expected to be presented Thursday at the San Antonio Breast Cancer Symposium.

High-dose chemotherapy for breast cancer has a somewhat controversial history. The treatment is delivered in conjunction with an autologous (from the same person) bone marrow transplant, which rebuilds bone marrow damaged by the chemotherapy. The regimen was at one time favored for high-risk patients (those whose cancer has spread to at least four lymph nodes).

The rationale for the treatment came from successes in the 1960s and 1970s in treating certain leukemia patients with radiation and high-dose chemotherapy, along with bone marrow transplants.

By the late 1980s, the regimen was all the rage. An estimated 20,000 to 30,000 U.S. women have undergone high-dose chemotherapy with bone marrow transplants.

"Ten years ago, if a woman didn't get a bone marrow transplant, people were suing HMOS, because they said they were denying care," Brooks said. "The cases won."

Although progressively easier to tolerate, the therapy often caused nausea, vomiting, extreme weakness and infection. Some patients even died from the treatment.

Some small studies found that the treatment was beneficial for women with very high-risk cancer (at least 10 positive lymph nodes), but the trials were not randomized.

Later, randomized trials did not confirm the same benefit, and the treatment has largely fallen out of favor.

"But there were still some nagging questions," Berry said. "One was that maybe there was a subset who benefited."

Berry and his colleagues reviewed 15 randomized studies of high-dose chemotherapy conducted around the world between 1988 and 2002. Together, the trials involved more than 6,000 patients with a median follow-up of seven years.

There was a 13 percent decrease in the rate of breast cancer relapse in patients receiving high-dose chemotherapy. But that benefit did not extend survival. The decrease in mortality was only 6 percent, which was not statistically significant.

Increasing doses of chemotherapy do have some benefit for breast cancer patients, but it does reach a point of diminishing returns.

"Increasing the dose is good, but it reaches a plateau," confirmed Berry.

More information
The American Cancer Society has more on chemotherapy for breast cancer.

Health Tip: When Your Child Has a Fever

(HealthDay News) - When your child has a fever, it means her body is fighting an infection.

Nonetheless, there are things you can do to help her feel better.

Here are some suggestions, courtesy of the American Academy of Family Physicians:

• Never give your child aspirin. In rare cases, it can trigger a life-threatening illness.
• Instead, give her acetaminophen to relieve pain and reduce fever.
• Make sure she drinks plenty of fluids to stay hydrated and cool.
• Let your child rest and stay quiet while she is not feeling well.
• Keep the room temperature at between 70 and 74 degrees Fahrenheit.
• Dress her in comfortable, lightweight, loose-fitting cotton pajamas.
• Cover your child with a blanket when she is cold, but remove it when she warms up.

Baclofen Aids Abstinence in Alcoholics With Cirrhosis

(HealthDay News) -- The drug baclofen promotes alcohol abstinence in alcoholics with cirrhosis of the liver, says an Italian study in this week's issue of The Lancet.

The study included 84 alcohol-dependent patients with liver cirrhosis who received either oral baclofen (42 patients) or a placebo (42 patients). Total alcohol abstinence and duration of this abstinence were assessed during outpatient visits. Relapse was defined as alcohol intake of more than four standard drinks per day (a standard drink defined as equal to 12 grams of absolute alcohol) or overall consumption of 14 or more standard drinks per week over a period of at least four weeks.

Among those taking baclofen, 71 percent (30 of 42 patients) achieved and maintained alcohol abstinence, compared to 29 percent (12 of 42) of those who took the placebo. The study also found that patients taking baclofen abstained from alcohol for more than twice as long as those taking the placebo -- 62.8 days vs. 30.8 days.

"Our results show that oral administration of baclofen is significantly more effective than placebo at achieving and maintaining alcohol abstinence and at increasing cumulative abstinence duration in alcohol-dependent patients with liver cirrhosis. This reduction in self-reported alcohol use was associated with significant reductions in clinical markers of liver injury, findings that confirm self-reported data and suggest that the reduction in alcohol consumption was sufficient to lessen liver injury," Dr. Giovanni Addolorato, of the Institute of Internal Medicine at the Catholic University of Rome, said in a prepared statement.

"Our results suggest that bacolfen, because of its anti-craving action and safety, could have an important role for treatment of alcohol-dependent patients with advanced liver disease," the researchers concluded.

Alcohol is the most common cause of liver cirrhosis in developed nations, according to background information in the study.

More information
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about liver cirrhosis.

Night Shift Work May Heighten Risk for Cancer

(HealthDay News) -- Workers on the night shifts at bars, convenience stores, hospitals and other venues may be putting themselves at heightened risk for cancer.

That's the conclusion of an international group of experts who plan to add night shift work to the official list of "probable" carcinogens.

A team of scientists at the International Agency for Research on Cancer (IARC) pored over human epidemiological data, animal study results, and studies looking at possible mechanisms linking night work to tumor formation.

"All three of those things suggested that, yes, this might be something that could contribute to human cancer," said Aaron Blair, scientist emeritus at the U.S. National Cancer Institute and chairman of the IARC Working Group that evaluated the shift work-cancer link.

The IARC -- a branch of the World Health Organization -- was expected to publish its findings in the December issue of The Lancet Oncology.

Although numerous studies have suggested a link between night shift work and cancer, this is the first time it has been evaluated by the IARC, Blair said.

On the epidemiological side, "there's human data -- nurses, airplane flight attendants, different groups that engage in shift work -- that have an elevated risk of breast cancer, and that's the strongest finding," Blair said. "There's lesser evidence, but some positive evidence, for [increased risk of] prostate cancer, and a little less, but still positive, evidence, for colon cancer," he noted.

In animal studies, rats exposed to light during their nocturnal, active phase, also displayed spikes in cancer incidence, Blair said.

Then there are investigations into possible biological mechanisms linking working through the wee hours to heightened odds for malignancy. The strongest theory involves melatonin, a hormone produced by the brain's pineal gland.

"Melatonin gets made during the dark period," Blair explained. "If you get light exposure during the normal dark period, it severely reduces the amount of melatonin that is made."

The hormone affects many different physiological systems, Blair added. "It is also an antioxidant -- a sink for chemicals that are normally dangerous to life," he noted.

Melatonin can affect the immune system, as well, including cancer-suppressing genes, Blair said.
Night shift workers may also have to deal with disrupted sleep patterns, another expert pointed out. "Night shift people tend to be day shift people who are trying to stay awake at night," Mark Rea, director of the Light Research Center at Rensselaer Polytechnic Institute in New York, told the Associated Press.

Altered sleep patterns and sleep deprivation weaken the immune system, he said, and upset natural rhythms the body uses to maintain healthy cells.

Blair stressed that the IARC has only defined night shift work as a "probable" cancer risk -- there's not enough proof to place it in the "definite" category alongside such villains as asbestos and smoking.

So, is there anything night shift workers can do to reduce their potential risk? Besides switching to a day job, maybe not a lot -- experts don't recommend long-term melatonin supplementation, because it may undermine the body's ability to produce the hormone naturally.

"It appears that the impact of shift work is greatest if you keep changing the shift that you are on," Blair said. If you find yourself working at night, then "it's better that you are always a night shift worker," he said. Switching back between day and night shifts is really tough on the body's circadian clock, and "there was the sense that this might be the most hazardous type of shift work that you could be engaged in," Blair said.

The American Cancer Society said it was reserving judgment on the new listing, noting that it had not yet reviewed the literature in depth.

"We understand that the epidemiologic literature is complex, the study results have not been entirely consistent, and that exposure itself is not easy to classify or measure," Elizabeth Ward, director of surveillance research at the ACS, said in a statement. She stressed that the society does not itself create a list of carcinogens but instead relies on IARC and the U.S. National Toxicology Program to do so.

More information
There's more on melatonin at the U.S. National Institutes of Health.

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More Young Americans Are Contracting HIV

(HealthDay News) -- In the 26 years since scientists first spotted AIDS in America, millions of dollars have been poured into outreach efforts aimed at keeping young people clear of HIV, the virus that causes the disease.

But on the eve of World AIDS Day, a disturbing statistical fact has emerged in this country: The number of newly infected teens and young adults is suddenly on the rise.

And the question is, why?

According to data from the U.S. Centers for Disease Control and Prevention for 2001 to 2005 (the latest years available), the number of new cases of HIV infection diagnosed among 15-to-19-year-olds in the United States rose from 1,010 in 2001, held steady for the next three years, then jumped 20 percent in 2005, to 1,213 cases.

For young people aged 20 to 24, cases of new infection have climbed steadily, from 3,184 in 2001 to 3,876 in 2005.

Experts say a number of factors may be at play, including the fact that many HIV-infected patients are now being kept healthy with powerful drugs -- making AIDS seem like less of a threat to young people than it did in the past.

"Certainly the 'scare factor' isn't there anymore," said Rowena Johnston, vice president of research at the Foundation for AIDS Research (amfAR) in New York City.

In the 1980s and early 1990s, the ravages of AIDS were apparent to most Americans -- either on their TV screens as high-profile celebrities succumbed to the disease, or as individuals lost friends or family members to HIV.

"To see people looking gaunt, skinny and skeletal, and to know that they were going to be dead soon," Johnston said. "It had a sobering effect."

The advent of antiretroviral drugs in the mid-1990s changed all that, however. "These days, for the most part, you can look at a person and not know that they even have AIDS," Johnston said.
That's making HIV seem like less of a threat to young people, said Martha Chono-Helsley. She's executive director of REACH LA, a Los Angeles-based nonprofit that helps disadvantaged youth understand and defend against threats like poverty, drug abuse and HIV.

"They're in this age group that feels they are invincible -- that it's never going to happen to them," she said. "Yes, they're getting all these messages from public schools on HIV and AIDS, but they've never actually seen what HIV has done, up close and personal."

Chris Blades, one of REACH LA's young, black "peer educators," said he's seen a kind of nonchalance towards HIV among the gay or bisexual men of color that he counsels.

"On a daily basis, they don't see their friends suffering from it, so it's not a major threat to them," said Blades, 21. "They're in that whole mindset of 'Oh, it can't happen to me, it will never happen to me.'"

But there has been a recent, troubling spike in new infections among gay men, young and old alike. According to the CDC, the rate of new cases of HIV infection linked to male-male sex held steady at around 16,000 cases between 2001-2004, then suddenly jumped to 18,296 in 2005.
Johnston and Chono-Helsley both point to advertisements for HIV-suppressing medicines as one possible contributing factor.

"In gay magazines, you now see [ads with] buff, handsome men climbing mountains, with some kind of quote about how 'I'm not letting HIV get in my way,'" Johnston said. "It sends the message that you, too, can be hot, buff and handsome, even with HIV."

Chono-Helsley agreed. "It's always these bright, healthy vibrant young men in these ads," she said. That could spur young gay men to relax their guard and take more risks, thinking that if they do contract HIV, "I only have to take a pill," she said.

The reality of living with HIV in America is much different, however, even when medication is working. According to Johnston, the side effects of powerful HIV-suppressing drug cocktails include fat redistribution (including unsightly "humps"), insulin resistance, higher cholesterol, increased risks for heart disease, and dangerous liver toxicities.

There's also the fear that, someday, HIV will develop mutations that render these drugs useless, triggering the re-emergence of AIDS, she said.

HIV continues to cut a wide swath through young men and women in the black community, too. According to the CDC, the number of new infections actually dipped slightly for black Americans between 2001 (20,868 cases) and 2005 (18,121 cases). However, black men are still six times more likely than white men to contract HIV, and black women are 20 times more likely to acquire the virus compared to white women.

The answers to that disparity lie mainly in economics, experts say.

"The young men that we work with are predominantly African-American, and HIV is not their No. 1 priority," said Chono-Helsley. "Often survival is their main priority -- where they are going to sleep tonight. They're kicked out of the house; they have substance abuse issues, they're in recovery."

Young black women can easily get caught up in similar problems, or are coerced into unsafe sex by their partners, she added.

Another trend -- soaring rates of methamphetamine use over the past five years -- may also be fueling HIV infection rates for both blacks and young gay men, the experts noted.

Too often, marginalized young people develop "a 'whatever' attitude -- whatever happens, happens," Chono-Helsey said.

Outreach aimed at HIV prevention remains important, of course. But one expert believes too much state and federal money is being funneled away from community outreach programs and toward "HIV Stops With Me" campaigns that focus on individuals already living with the virus.

"The message there is that, if I don't have HIV right now, then all I have got to do is avoid those people who have got it," said Carrie Davis, director of adult services at the Lesbian, Gay, Bisexual and Transgendered Community Center in New York City.

She believes those types of messages allow uninfected people to shift the burden of responsibility from themselves to the HIV-positive, or to people they deem at high risk, such as gay men or drug abusers.

"I think it affects straight people, too, in that they absorb this 'magical thinking' -- that this is someone else's problem," Davis said.

So what doeswork to change attitudes and behaviors? That's a tough question, Chono-Helsley said, and the answer usually depends on particular contexts and communities.

"You really have to evaluate what methods you're using and think about the person as a whole, not just the infection," she said. "Because they've all heard 'use a condom, use a condom.'"

The right approach is key, Blades added. "If you deliver the message to them in a way that's not preachy or looking down on them, I think that's more effective," he said. "That's what we try to do - deliver HIV information in a way that will click in with them, so that they'll take home something that they didn't know the night before."

"One thing is for sure, we can't just shake our finger at young people and say, 'You're bad,'" Chono-Helsley said. "We have to be supportive. They're young, we've all been there, remember. You can save some, but you can't save them all."

More information
There's more on HIV and AIDS at amfAR.


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