Indian Medicine

NEW YORK (Reuters Health) - People who drink heavily in their youth may have a higher risk of developing a collection of risk factors for heart disease and stroke, new research suggests.

In a study that examined the lifetime drinking habits of more than 2,800 adults, researchers found that those who drank heavily in their teens and young adulthood were more likely to have metabolic syndrome than those who drank more moderately throughout adulthood.

Metabolic syndrome refers to a grouping of risk factors for heart disease, stroke and diabetes -- including abdominal obesity, high blood pressure, low levels of "good" HDL cholesterol, high blood sugar and high triglycerides, a type of blood fat. People who have three or more of these problems are considered to have metabolic syndrome.

While moderate drinking can be heart-healthy -- helping to boost HDL levels, for example -- excessive drinking is not. The new findings suggest that drinking heavily early in life might contribute to metabolic syndrome later on.

"There are already many reasons for encouraging young people to avoid heavy drinking," Dr. Marcia Russell, one of the researchers on the study, told Reuters Health.

"Long-term health consequences, such as an increased risk of cardiovascular disease, may be another," added Russell, a researcher at the Pacific Institute for Research and Evaluation in Berkeley, California.

She and her colleagues report their findings in the Journal of Clinical Endocrinology & Metabolism.

The study included 2,818 adults ages 35 to 80 who were questioned about their lifetime drinking habits and other lifestyle factors, like whether they exercised regularly or smoked.

All of the study participants had consumed alcohol regularly at some point in their lives, but Russell and her colleagues were able to identify two major lifetime "trajectories" of drinking: in one, people started drinking early in life and tended to drink heavily in their teens and young adulthood, then tapered off by middle-age; in the second, "stable" trajectory, people generally drank moderately over the years.

Compared with the stable group, the early drinkers were almost one-third more likely to have metabolic syndrome. In addition, their risk of being abdominally obese was 48 percent higher, while their odds of having low HDL cholesterol were 62 percent higher.

Russell said that to her knowledge, this is the first study to take the "lifetime approach" to understanding the relationship between alcohol and health, and more research is needed to confirm the findings.

However, it is plausible that early, heavy drinking contributes to metabolic syndrome later on. Russell noted that excessive drinking causes oxidative stress in the body -- a state that damages body cells over time and is thought to contribute to cardiovascular disease and other ills.

She also pointed out that alcohol contains 7 calories per gram, versus only 4 calories per gram of carbohydrate or protein. Those calories, coupled with the appetite-stimulating effect of alcohol, may help explain the link between early drinking and excess weight.

SOURCE: Journal of Clinical Endocrinology & Metabolism, January 2008.

Copyright © 2008 Reuters Limited.

NEW YORK (Reuters Health) - Insufficient sleep during the months after childbirth may play a role in the retention of weight gained during pregnancy, research suggests.

"Even relatively short periods of sleep deprivation (6 months after delivery) may influence weight," Dr. Erica P. Gunderson told Reuters Health.

Gunderson, an epidemiologist with Kaiser Permanente, in Oakland, California, and colleagues found that women who got less than an average of 5 hours of sleep daily during the first 6 months after childbirth were likely to weigh at least 5 kilograms (about 11 pounds) more than their pre-pregnancy weight at one year after childbirth.

The researchers assessed pre- and post-pregnancy weight among 940 women in eastern Massachusetts and determined sleep patterns through self-reported questionnaires and in-person interviews, they explain in the American Journal of Epidemiology.

Overall, 12 percent of the women reported 5 hours or less sleep per day while 30, 34, and 24 percent, respectively, received 6, 7, and 8 or more hours a day.

The women who slept 5 hours or less, on average, during the first 6 months after childbirth were 2.3 times more likely than those who got 7 hours of sleep to retain at least 5 kilograms of weight at one year.

This likelihood rose to three-fold after the investigators adjusted for factors such as the mother's pre-pregnancy body mass index, diet, breastfeeding pattern, physical activity level, number of children, race, age, and education level.

"Getting enough sleep may be as important as a healthy diet and regular physical activity in preventing excess weight retention after childbirth," Gunderson said.

Further research should investigate specific characteristics of women who get less sleep, and whether sleeping during the day makes up for the lack of nighttime sleep, the researchers note.

SOURCE: American Journal of Epidemiology, January 15, 2008

Copyright © 2008 Reuters Limited.

NEW YORK (Reuters Health) - Workers at one U.S. nuclear facility have suffered higher-than-average rates of certain cancers, a study shows -- suggesting that on-the-job exposures are to blame.

The study looked at nearly 19,000 employees of the Savannah River Site, a South Carolina facility that has processed nuclear materials since the 1950s.

Researchers found that while death rates from many causes were lower than national rates, workers had higher-than-expected rates of death from certain cancers.

Among men, leukemia and cancer of the pleura, the tissue covering the lungs and lining the chest cavity, caused an abnormally high number of deaths, while female workers had elevated rates of kidney and skin cancers.

Pleural cancer is strongly related to long-term exposure to asbestos. Some workers at the Savannah River Site were apparently overexposed to asbestos, based on "industrial hygiene" reports from the early 1970s, according to the researchers.

Dr. David B. Richardson and colleagues at the University of North Carolina at Chapel Hill report the findings in the American Journal of Industrial Medicine.

The study included 18,883 employees of the Savannah River Site who were hired prior to 1987 and worked there for at least three months.

When the researchers looked at deaths from all causes and deaths from all cancers as a whole, the workers had rates that were below the U.S. norm. However, as mentioned, there was an excess of certain cancers.

"It is plausible," Richardson and his colleagues write, "that occupational hazards, including asbestos and ionizing radiation, contribute to these excesses."

The findings highlight the importance of ongoing government research into former nuclear workers' health, according to the researchers. This, they write, will be key to understanding "the range of potential occupational health effects," especially diseases that typically take years to become apparent.

SOURCE: American Journal of Industrial Medicine, December 2007.

Copyright © 2008 Reuters Limited.

NEW YORK (Reuters Health) - Guidelines for determining brain death differ substantially between major U.S. hospitals, a national survey shows, and few stick to parameters established by the American Academy of Neurology.

"There are substantial differences in practice that may have consequences for the determination of death and initiation of transplant procedures," Dr. David M. Greer, at Massachusetts General Hospital in Boston, and colleagues report in the medical journal Neurology.

Greer's team requested guidelines from hospitals named as having the top 50 neurology programs in the nation in 2006 by US News and World Report.

Only 42 percent of the hospitals required that a neurologist or neurosurgeon perform the examination for brain death, results showed. Among the 71 percent that stipulated multiple examinations, the time required between examinations varied from 1 to 24 hours.

Furthermore, the authors point out, "It was surprising to find that the cause of brain death was not stipulated in a large number (37 percent) of guidelines."

They observed overall good compliance (82 percent to 100 percent) with most of the tests required for the clinical examination, although fewer than half of the hospitals mandated testing for pain in the cranium, jaw jerk, and absence of spontaneous respirations.

Commenting on this "disturbing pattern of non-uniformity," Dr. James L. Berna from Dartmouth Medical School in Hannover, New Hampshire, writes in an editorial that current guidelines also need to be updated.

SOURCE: Neurology, January 22, 2008.

Copyright © 2008 Reuters Limited.

NEW YORK (Reuters Health) - Children recovering from having their tonsils and adenoids removed can be given painkillers like ibuprofen without increasing the risk of postop bleeding, according to a new study.

"After surgery, such as tonsillectomy, almost all children have considerable pain for longer than 7 days ... and the need for effective pain management is obvious," Dr. Anita Jeyakumar from Washington University School of Medicine, St. Louis, and colleagues note in the Archives of Otolaryngology--Head and Neck Surgery.

However, there is conflicting information about whether painkillers called nonsteroidal antiinflammatory drugs or NSAIDs (ibuprofen is one of several in the class) increase postoperative bleeding, and "many otolaryngologists are very hesitant about using NSAIDs."

Against this backdrop, Jeyakumar's group evaluated the rate of bleeding associated with NSAIDs in 1160 children undergoing adenotonsillectomy or tonsillectomy.

Of the total group, 487 were given weight-appropriate doses of ibuprofen before and after surgery, whereas 673 were not.

There was no immediate postop bleeding (within 24 hours of surgery) in either group and there was no statistical difference in bleeding rates between the two groups during the 1-month follow up period, the team found.

"This was my expected result," Jeyakumar noted in comments to Reuters Health.

Ibuprofen "should be used in the control of postoperative pain if it is indicated in the patient," the investigators conclude.

"Our patients would benefit from improved pain control following any surgical procedure," Jeyakumar added.

SOURCE: Archives of Otolaryngology--Head and Neck Surgery, January 2008.

Copyright © 2008 Reuters Limited.