Indian Medicine

NEW YORK (Reuters Health) - Elite swimmers appear to experience higher rates of lower back disk degeneration than recreational swimmers, study findings suggest.

A screening study of 56 male and female competitive swimmers identified lower back disk degeneration in 68 percent, report Dr. Koji Kaneoka, University of Tsukuba, and colleagues at the Japan Institute of Sports Sciences.

By comparison, among 38 male and female recreational swim club members, lower back disk degeneration was evident in 29 percent -- a rate similar to that of the general population, the researchers note in the American Journal of Sports Medicine.

Kaneoka and colleagues suggest that "excessive competitive swimming activities" may account for higher rates of disk degeneration among the elite swimmers, who had been swimming, on average, more than 49,000 meters weekly for over 9 years. The recreational swimmers, on the other hand, reported swimming about 8,400 meters weekly for 5.4 years, on average.

Using magnetic resonance imaging, the investigators spotted disk degeneration in the lumbar spine in the both groups of swimmers, particularly between the fourth lumbar (L4) and the first sacral (S1) vertebrae - the area where the lower back joins the pelvis.

The competitive swimmers had significantly higher rates of degeneration, 27 and 43 percent in the L4-L5 and L5-S1 disks, respectively, compared with rates of 13 and 21 percent in the recreational swimmers.

There was no relationship between disk degeneration and the swimmers' most frequently used strokes.

Kaneoka's team undertook the study after three of 39 members of the Japanese national swim team were impeded by lumbar disk herniation in an international competition. Despite the findings from the current study, however, the researchers say further investigation is needed to confirm any association between swimming frequency and duration and disk degeneration in the lower back.

SOURCE: American Journal of Sports Medicine, August 2007

Copyright © 2007 Reuters Limited.

NEW YORK (Reuters Health) - A subtle difference in responses on a newborn hearing screening test may identify babies who are at risk for sudden infant death syndrome (SIDS), according to a new study.

A disruption of the function of the inner ear may interfere with not only hearing but also with a baby's control of breathing during sleep, the researchers explain in the medical journal Early Human Development. This defect in the inner ear of newborns can be detected with a particular hearing test, called "transient evoked otoacoustic emission" or TEOAE.

Dr. Daniel D. Rubens from Children's Hospital & Regional Medical Center, Seattle, and associates compared the TEOAE screening results of 31 infants who subsequently died of SIDS with those of 31 matched healthy babies.

The hearing responses tended to be higher on the right side than on the left among the normal babies, but tended to be higher on the left side in the infants who succumbed to SIDS.

"The direction of the asymmetry among the SIDS infants was reversed and it further supports the potential application of newborn hearing tests for identifying at-risk infants," the investigators write.

They have planned several animal studies to investigate the possible association between inner ear damage and breathing control, and to shed light on the mystery of sudden infant death syndrome.

"The animal study findings will hopefully turn things around to substantiate the understanding of the mechanism of death," Rubens said. "I expect results from the animal study within 3 to 6 months."

SOURCE: Early Human Development, online July 3, 2007.

Copyright © 2007 Reuters Limited.

NEW YORK (Reuters Health) - For some people with chronic tinnitus -- a persistent, inescapable sensation of ringing in the ears -- repeated magnetic stimulation through the cranium appears to provide temporary relief, Italian researchers report.

However, enthusiasm for repetitive transcranial magnetic stimulation, or rTMS, for tinnitus "should be tempered," Dr. Simone Rossi told Reuters Health. "The beneficial effects of rTMS are short-lived, and only about a half of tinnitus sufferers may benefit from it."

Tinnitus affects millions of people, and in some it can lead to psychiatric distress, sleep disturbances, and work impairment, Dr. Rossi of the University of Sienna and colleagues point out in the Journal of Neurology, Neurosurgery, and Psychiatry.

The team tested the effects of rTMS in 16 patients with tinnitus. They underwent active treatment and sham treatment in random order, without knowing which was which.

During sessions on 5 days, the coil generating the magnetic field was positioned close to the skull over the left temporal region for active treatment; in the sham set up, the coil was positioned at 90 degrees to the head so that the magnetic field pointed away from the brain.

Two patients actually dropped out because of worsening symptoms, the researchers report, but eight patients responded.

Among the responders, subjective tinnitus scores improved by an average of 35 percent, but the condition returned to original levels after 2 weeks.

This good, albeit transient, response, said Rossi "might indicate that the brain reacts somewhat positively to stimulation."

These data "could help in the selection of tinnitus patient candidates for more invasive, chronic, neuromodulatory strategies such as epidural implants on the auditory cortex," Rossi added.

He was referring to what he described as a "sort of pacemaker for brain stimulation." Work on such a device "is in progress in this sense in many labs."

SOURCE: Journal of Neurology, Neurosurgery, and Psychiatry, August 2007.

Copyright © 2007 Reuters Limited.

NEW YORK (Reuters Health) - Infrared thermometers that take a person's temperature with a sweep of the forehead may not be as accurate as old-fashioned measures, a study suggests.

The devices, known as temporal thermometers or temporal scanners, have become popular with doctors, parents and athletic trainers alike because they are quick and easy to use. The thermometers use an infrared scanner to gauge the heat radiating from blood vessels in the forehead, and use this to calculate the core body temperature.

However, Texas researchers found that the thermometers' readings were generally lower than volunteers' actual core body temperatures when they were under heat stress. The researchers measured actual core temperature with an ingested pill that gauges the temperature in the intestines.

The findings, reported in the journal Medicine & Science in Sports & Exercise, cast doubt on the ability of temporal scanners to diagnose fevers or heat-related illness.

"In my opinion, (people) should not use these thermometers," said study co-author Dr. Craig G. Crandall of the Institute for Exercise and Environmental Medicine at the Presbyterian Hospital of Dallas.

"The data simply don't support their accuracy," he told Reuters Health.

For their study, Crandall and his colleagues had 16 healthy adults wear special wetsuits that were gradually heated to raise their core body temperature. Their temperatures were repeatedly measured with a temporal scanner and with the ingested pill.

Before the suits were heated up, readings from the temporal scanner and pill generally matched up. But after 30 minutes of heat, readings from the scanner actually fell, despite the fact that volunteers' core temperature was climbing.

One concern, Crandall said, is that temporal scanners, used in the hospital or home, could miss many cases of fever.

Another is that athletes suffering from heat exhaustion will be misdiagnosed. Temporal scanners have been used in major sporting events, including the Boston Marathon, Crandall and his colleagues point out.

Some past studies have similarly raised doubts about the accuracy of infrared ear thermometers. Crandall said that he lacks confidence in both the ear and forehead measurements.

For the general public, the best way to gauge core temperature is through the old-fashioned rectal approach, according to Crandall -- though he acknowledged that most people old enough to refuse this method probably will.

Measurements taken under the tongue or in the armpit are "suitable" alternatives, he said.

SOURCE: Medicine & Science in Sports & Exercise, July 2007.

Copyright © 2007 Reuters Limited.

WASHINGTON (Reuters) - Influenza killed at least 68 children in America during the latest flu season and a third of them had a worrying new complication, U.S. health officials said on Thursday.

The 2006-2007 annual flu season never reached epidemic stage, but doctors should keep a lookout for such dangerous cases in children, the Centers for Disease Control and Prevention said.

The CDC issued an alert in May for deaths of children who were infected with both flu and a bacterium called Staphylococcus aureus, or staph. It said 21 of the children who died also had such infections, some of them resistant to antibiotics.

"Only one pediatric death with influenza and S. aureus coinfection had been reported during 2004-05, and three had been reported during the 2005-06 season," the CDC report said.

Staph and other bacterial infections can complicate flu and make the disease more likely to kill, and the number of antibiotic-resistant staph infections is on the rise.

More than 90 percent of the children who died in the latest season had not been vaccinated against flu, the CDC said. Flu vaccination is recommended for children aged 6 months to 5 years old, for anyone with chronic conditions such as asthma, and for people aged over 64.

Seasonal flu kills an estimated 36,000 people a year in the United States, most of them elderly. Last year 41 children who died from flu were reported to the CDC, although the agency stresses that reporting is not routine yet and it is misleading to compare deaths from one season to another.

The CDC is still trying to build an accurate picture of an average flu season in the United States but it is difficult because doctors do not often even test patients for respiratory diseases, much less report them to the federal government.

But because health experts suspect a pandemic -- a serious global epidemic -- of influenza is potentially imminent, the CDC is struggling to gather as much information as possible about flu now.

Copyright © 2007 Reuters Limited.