INTELIHEALTH - People infected with HIV have an increased risk of gum disease, a new study finds. 

To read more of the Intelihealth article, click here. 

Millions of people will make a resolution to quit smoking around Jan. 1, but a new study suggests an even more powerful motivator than New Year’s resolutions: celebrity cancer diagnoses.

In a study published this week in Preventive Medicine, researchers from San Diego State University, the Santa Fe Institute, the University of North Carolina and the Johns Hopkins Bloomberg School of Public Health found that when celebrities publicly discuss their struggles with cancer diagnoses, the resulting media coverage prompts more smokers to search for  information on quitting than events like New Year’s Day or World No Tobacco Day.

Public health experts have long known these discussions spur others to get screened for cancer or consider the same treatments, but it was unclear whether these discussions also promoted cancer prevention behaviors, like quitting smoking. This question has evaded study because the method most commonly used to assess cancer-related behaviors—annual telephone surveys—isn’t fine-grained enough to tell researchers which events are influencing respondents’ answers.

The researchers, led by San Diego State University research professor John W. Ayers, investigated whether a different method might yield new insights. Using the case of former Brazilian President Lula da Silva, who was diagnosed with laryngeal cancer in October 2011 and attributed his cancer to his long-held smoking habit, the researchers analyzed both media coverage of smoking cessation and the public’s online search activity surrounding the event.

By mining Google News archives, the team found Brazilian news coverage of quitting increased as much as 500 percent immediately after the diagnosis—and remained 163 percent higher for one week—before returning to typical levels. At the same time, Brazilian Google searches related to quitting smoking increased by 67 percent.

However, long after the media stopped covering Lula’s diagnosis, the public had not forgotten. Two weeks after the diagnosis, quitting-related Google searches remained 153 percent higher than expected, and remained 130 percent and 71 percent higher three and four weeks respectively after Lula’s announcement.

“Lula’s announced cancer diagnosis, though tragic, was potentially the greatest smoking cessation-promoting event in Brazilian history,” Ayers said. “Interest in quitting smoking, as indicated by Google searches, reached its highest recorded level after Lula’s diagnosis, even when compared to traditional cessation awareness events such as New Year’s Day or World No Tobacco Day.”

Benjamin Althouse, the study’s coauthor and Santa Fe Institute epidemiologist added, “In practical terms, we estimated there were about 1.1 million more quit-smoking queries in Brazil the month after Lula’s diagnosis than expected. Not only will quitting prevent throat cancer, but it can prevent nearly all cancers, including lung, stomach, breast, etc.”

The benefits don’t end there. Following Lula’s diagnosis, Brazilian legislators passed a number of new laws strengthening anti-tobacco measures in the country, making Brazil the largest smoke-free nation in the world, said Joanna E. Cohen, another coauthor and director of the Johns Hopkins Institute for Global Tobacco Control.

“This study is the first to demonstrate that celebrity diagnoses can prompt the public to engage in behaviors that prevent cancer,” said Seth M. Noar, coauthor and health communication professor at the University of North Carolina at Chapel Hill. “Harnessing this finding will save far more lives than screening alone.”

The study has a compelling lesson for tobacco control advocates, concluded Ayers: “These kinds of events act as teachable moments when the public is more receptive to messages about cancer than is ordinarily the case. When these events take place, tobacco control and cancer prevention advocates should better leverage these opportunities to promote behaviors that will prevent all future cancers.”

The study was funded by the Bloomberg Initiative to Reduce Tobacco Use via the Institute for Global Tobacco Control at the Johns Hopkins Bloomberg School of Public Health.

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Three major types of smoking cessation therapies don't increase the risk of heart attack, stroke or heart-related death, according to research published in the American Heart Association journal Circulation.

In recent years, there has been concern that some smoking cessation products may have serious cardiovascular risks. But in the largest analysis of side effects (63 clinical trials and 30,508 people), serious heart events didn't increase with nicotine replacement gums and patches or the nicotine addiction treatment varenicline (Chantix), and the antidepressant bupropion (Wellbutrin) protected against serious heart events.

"Undoubtedly, the benefits of quitting smoking outweigh any potential risks from smoking cessation therapies," said Edward J. Mills, Ph.D., M.Sc., study co-author and associate professor of medicine at Stanford University and Canada Research Chair at the University of Ottawa.

Smoking cessation is associated with improved cardiovascular health, increased life expectancy, improved quality of life and reduced healthcare costs for smoking-associated conditions.

Nicotine replacement therapy via patch or gum increased the risk of minor heart symptoms such as a rapid or irregular heartbeat, researchers said.

"These more minor risks are well known to clinicians and usually pass with time," Mills said. "They occur most often when people are taking nicotine replacement therapy and smoking at the same time, which is a bad idea."

Previously, the researchers found that combination nicotine replacement therapy — wearing a patch and using nicotine gum when there is the urge to smoke — may be more effective but lead to more side effects than the gum or patch alone.

Most patients in the analysis were relatively healthy, so the results may not be true for everyone.

"It's possible that the risk factors might be different in people with multiple diseases," Mills said. "Patients should discuss with their healthcare provider any potential risk factors that they may have developed from their smoking history. For patients who have chronic lung disease or other associated cardiovascular risks, clinicians should determine which smoking cessation aid to use by their risk profiles."

The study identifies five healthy behaviours as being integral to having the best chance of leading a disease-free lifestyle: taking regular exercise, non-smoking, a low bodyweight, a healthy diet and a low alcohol intake.

The people who consistently followed four or five of these behaviours experienced a 60% decline in dementia and cognitive decline - with exercise being the strongest mitigating factor – as well as 70% fewer instances of diabetes, heart disease and stroke, compared with people who followed none.

"The size of reduction in the instance of disease owing to these simple healthy steps has really amazed us and is of enormous importance in an aging population," said Principle Investigator Professor Peter Elwood from Cardiff University's School of Medicine. "What the research shows is that following a healthy lifestyle confers surprisingly large benefits to health – healthy behaviours have a far more beneficial effect than any medical treatment or preventative procedure.

"Taking up and following a healthy lifestyle is however the responsibility of the individual him or herself. Sadly, the evidence from this study shows that very few people follow a fully healthy lifestyle. Furthermore, our findings reveal that while the number of people who smoke has gone down since the study started, the number of people leading a fully healthy lifestyle has not changed," he added.

Recent surveys indicate that less than one per cent of people in Wales follow a completely healthy lifestyle, based on the five recommended behaviours, and that five per cent of the population follow none of the healthy behaviours; roughly equating to a city with a population the size of Swansea (240,000).

Professor Elwood continued: "If the men had been urged to adopt just one additional healthy behaviour at the start of the study 35 years ago, and if only half of them complied, then during the ensuing 35 years there would have been a 13% reduction in dementia, a 12% drop in diabetes, six per cent less vascular disease and a five per cent reduction in deaths."

The Caerphilly Cohort Study recorded the healthy behaviours of 2,235 men aged 45-59 in Caerphilly, South Wales. The study had multiple aims and has been the basis for over 400 research papers in the medical press. One of the most important aims was to examine the relationship between healthy lifestyles, chronic disease and cognitive decline over a 35-year period; and to monitor changes in the take-up of healthy behaviours.

Dr Doug Brown, Director of Research and Development at the Alzheimer's Society, said: "We have known for some time that what is good for your heart is also good for your head, and this study provides more evidence to show that healthy living could significantly reduce the chances of developing dementia. These large, longitudinal studies are expensive and complicated to run, but are essential to understand how dementia can be prevented. We are calling on the G8 Summit next week to commit to greater funding of important studies such as this one which give us hope for reducing the impact of dementia in the future."

Christopher Allen, Senior Cardiac Nurse at the British Heart Foundation, which part-funded the study, said: "The results of this study overwhelmingly support the notion that adopting a healthy lifestyle reduces your risk of cardiovascular disease and dementia. These findings will hopefully go a long way in encouraging people to carefully consider their lifestyle and how it will impact on their health in later years."

Unhealthy living has accounted for around 10% of the costs of the NHS in Wales since the study first started, while the annual expenditure on prevention and public health services in Wales is estimated to have been £280M.

The study was funded by the Medical Research Council, Alzheimer's Society and the British Heart Foundation.

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Fifty years after the approval of an extremely effective vaccine against measles, one of the world’s most contagious diseases, the virus still poses a threat to domestic and global health security.

On an average day, 430 children – 18 every hour – die of measles worldwide. In 2011, there were an estimated 158,000 measles deaths.

In an article published on December 5 by JAMA Pediatrics, CDC’s Mark J. Papania, M.D., M.P.H., and colleagues report that United States measles elimination, announced in 2000, has been sustained through 2011. Elimination is defined as absence of continuous disease transmission for greater than 12 months. Dr. Papania and colleagues warn, however, that international importation continues, and that American doctors should suspect measles in children with high fever and rash, “especially when associated with international travel or international visitors,” and should report suspected cases to the local health department. Before the U.S. vaccination program started in 1963, measles was a year-round threat in this country. Nearly every child became infected; each year 450 to 500 people died each year, 48,000 were hospitalized, 7,000 had seizures, and about 1,000 suffered permanent brain damage or deafness.

People infected abroad continue to spark outbreaks among pockets of unvaccinated people, including infants and young children. It is still a serious illness: 1 in 5 children with measles is hospitalized. Usually there are about 60 cases per year, but 2013 saw a spike in American communities – some 175 cases and counting – virtually all linked to people who brought the infection home after foreign travel.

“A measles outbreak anywhere is a risk everywhere,” said CDC Director Tom Frieden, M.D., M.P.H. “The steady arrival of measles in the United States is a constant reminder that deadly diseases are testing our health security every day. Someday, it won’t be only measles at the international arrival gate; so, detecting diseases before they arrive is a wise investment in U.S. health security.

Eliminating measles worldwide has benefits beyond the lives saved each year. Actions taken to stop measles can also help us stop other diseases in their tracks. CDC and its partners are building a global health security infrastructure that can be scaled up to deal with multiple emerging health threats.

Currently, only 1 in 5 countries can rapidly detect, respond to, or prevent global health threats caused by emerging infections. Improvements overseas, such as strengthening surveillance and lab systems, training disease detectives, and building facilities to investigate disease outbreaks make the world -- and the United States -- more secure.

“There may be a misconception that infectious diseases are over in the industrialized world. But in fact, infectious diseases continue to be, and will always be, with us. Global health and protecting our country go hand in hand,” Dr. Frieden said.

Today’s health security threats come from at least five sources:

• The emergence and spread of new microbes

• The globalization of travel and food supply

• The rise of drug-resistant pathogens

• The acceleration of biological science capabilities and the risk that these capabilities may cause the inadvertent or intentional release of pathogens

• Continued concerns about terrorist acquisition, development, and use of biological agents.

“With patterns of global travel and trade, disease can spread nearly anywhere within 24 hours,” Dr. Frieden said. “That’s why the ability to detect, fight, and prevent these diseases must be developed and strengthened overseas, and not just here in the United States.”

The threat from measles would be far greater were it not for the vaccine and the man who played a major role in creating it, Samuel L. Katz, M.D., emeritus professor of medicine at Duke University. CDC is honoring Dr. Katz 50 years after his historic achievement. During the ceremony, global leaders in public health are highlighting the domestic importance of global health security, how far we have come in reducing the burden of measles, and the prospects for eliminating the disease worldwide.

Measles, like smallpox, can be eliminated. However, measles is so contagious that the vast majority of a population must be vaccinated to prevent sustained outbreaks. Major strides already have been made. Since 2001, a global partnership that includes the CDC has vaccinated 1.1 billion children. Over the last decade, these vaccinations averted 10 million deaths – one fifth of all deaths prevented by modern medicine.

“The challenge is not whether we shall see a world without measles, but when,” Dr. Katz said.

“No vaccine is the work of a single person, but no single person had more to do with the creation of the measles vaccine than Dr. Katz,” said Alan Hinman, M.D., M.P.H., Director for Programs, Center for Vaccine Equity, Task Force for Global Health. “Although the measles virus had been isolated by others, it was Dr. Katz’s painstaking work passing the virus from one culture to another that finally resulted in a safe form of the virus that could be used as a vaccine.”

Only three in 10 adults 40 and older who have modifiable risk factors for diabetes think they have “a great deal” or “some” risk for diabetes, according to recent American Diabetes Association studies. In fact, four in 10 at-risk adults believe they have no risk for diabetes or prediabetes. Provider perceptions support this; only one in four believes at-risk patients are “extremely” or ”very” knowledgeable about their elevated risk for type 2 diabetes or heart disease. The surveys were conducted with 1,426 consumers aged 40 and older and 601 health care providers.

Cardiometabolic risk is a group of factors that are good indicators of a patient’s overall risk for type 2 diabetes and heart disease. While some risk factors cannot be controlled (age, race/ethnicity, gender, family history), patients do have control over other risk factors (weight, unhealthy cholesterol levels, high blood pressure, smoking, sedentary lifestyle, unhealthy diet and high blood glucose [sugar] level.)

Not surprisingly, since most at-risk patients don’t recognize or acknowledge their elevated risk, most are not at goal for key risk factors. Weight and physical activity were the risk factors with the lowest at-goal rates. “This points to a serious disconnect since weight and physical activity are two risk factors that more than half of at-risk patients discuss with their providers regularly,” said Virginia Peragallo-Dittko, RN, BC-ADM, CDE, FAADE, Incoming Chair of the Association’s Prevention Committee.

Less than half of at-risk patients report discussing “internal” metrics (such as blood glucose, blood pressure and cholesterol) regularly with their providers, and don’t recall them being tested as often as providers report actually measuring them. On the other hand, providers report discussing diabetes and heart disease risk reduction with most of their at-risk patients, and reveal that some patients actually ask about particular risk factors, like blood pressure and weight.

The surveys suggest risk factor reduction discussions may not register with patients because patients are not connecting the risk factors to disease development. On one hand, patients do know what helps lower diabetes and heart disease risks, citing “healthier diet” and “more exercise.” On the other hand, many of the at-risk are overweight or obese (69.6 percent) and/or sedentary (37.2 percent).

Providers report high BMI and sedentary lifestyle are the risk factors most likely to lead to diabetes and heart disease. In fact, the top three cardiometabolic risk factors providers treat are high blood pressure, elevated blood glucose and overweight/obesity.

“These findings suggest it is critical for providers to connect the dots with patients between risk factors and disease development,” said Peragallo-Dittko. “Providers think their at-risk patients are making the link between risk factors and heart attack, diabetes and death, but a quarter of these patients report they don’t even have any health problems. We have to close the gap if we want to prevent future development of type 2 diabetes and heart disease.”

Providers say the greatest barrier to treating their at-risk patients is noncompliance with lifestyle modification recommendations, because patients “don’t take their risk seriously,” or “are in denial.” Nearly 80 percent of at-risk patients think they are in “excellent” or “good health,” even though they don’t regularly implement good health habits and don’t believe they are at risk, or have control over lowering their cardiometabolic risk. Peragallo-Dittko emphasized that “providers have an opportunity when reviewing test levels to tell patients exactly what these numbers mean and how they contribute to disease development.”

In an effort to educate and empower people to take action for their health, the American Diabetes Association implements CheckUp America, a national prevention initiative aimed at helping Americans learn how to lower their risk for type 2 diabetes and heart disease. CheckUp America works to help people manage these factors and thereby reduce disease risk through public and physician education campaigns, in addition to online, interactive resources.

The American Diabetes Association’s CheckUp America initiative is supported in part by Bristol Myers-Squibb Company and Janssen Pharmaceuticals Inc.

For more information, visit CheckUpAmerica.org.

Survey Methodology

These studies were conducted through the Association’s CheckUp America initiative. The consumer survey was conducted through a telephone omnibus survey with 1,426 adults aged 40 and older (half male, half female) in April 2013.  The health care provider survey was taken online by 601 primary care physicians, nurse practitioners and physician assistants in June 2013.

(BOSTON) -- One in 10 high school youth in the U.S. reports having been hit or physically hurt by a dating partner in the past year, according to a new study led by a Boston University School of Public Health researcher.

In a study published in the Journal of School Violence, Emily Rothman and Ziming Xuan, faculty at Boston University, analyzed data from 100,901 students who participated in the national Youth Risk Behavior Surveillance System survey (YRBSS) for the years 1999-2011. They found that 9.3 percent of U.S. high school students have been "hit, slapped, or physically hurt on purpose" by a boyfriend or girlfriend in the past year – an annual prevalence rate that has not changed significantly in the past 12 years.

The experience of being hit, slapped or otherwise physically hurt was reported at nearly equivalent rates by males and females who participated in the survey. There was a statistically significant increased rate of dating-violence victimization among black (12.9 percent) and multiracial (12.2 percent) youth, as compared to whites and Asians (8 percent) or Hispanic youth (10.5 percent). The rate of dating violence victimization remained stable over the 1999-2011 period for both males and females, and for each racial subgroup, despite a number of efforts to curb dating violence in the last decade.

That 9 percent of the nation's youth are hurt by dating partners every year is a serious public health concern, given that consequences of such violence can include depression, eating disorders, injury, and in the most severe cases, death, said Rothman, an associate professor of community health sciences at BUSPH.

"While 9 percent may sound low, this figure puts dating violence on par with many of the other public health issues that we tend to view as serious problems, such as obesity, frequent cigarette smoking, or driving after drinking," Rothman said. "The real concern here is that the rate has not gone down at all in the past 12 years, while the rate of physical fighting with peers has decreased significantly.

That means that whatever headway we have made in reducing youth violence does not extend to people in dating or sexual relationships."

Malcolm Astley, father of Lauren Astley, who was murdered in Wayland, MA, by her boyfriend in July of 2011, said that the new study should serve as a wake-up call to parents and teachers around the nation.

"Parents, teachers, counselors and legislators need to do everything they can to prevent dating abuse," said Astley. "No other family or community should have to go through what we, and thousands of other families, have gone through.

"I hope that 10 years from now, dating violence will be a much smaller issue. People facing break-ups should get the direction and education they need to handle their feelings." Rothman said that several programs specifically geared to dating-violence prevention have been tested through randomized controlled trials and shown to be effective.

"Our data support the idea that states and communities should invest in these types of prevention programs in order to try to address this problem," she said.