(HealthDay News) -- Breast reduction surgery can alleviate painful symptoms in women who have unusually large breasts. These symptoms may include back or neck pain, and painful indentations in the shoulders caused by pressure on bra straps.
If you're considering breast reduction surgery, here are possible complications to keep in mind, courtesy of the American Society of Plastic Surgeons:
Reduced feeling in the nipples.
Small sores around the nipples.
Permanent scarring.
Breasts of slightly uneven size.
Nipples that are slightly unevenly placed.
Inability to breast feed.
As with any surgery, infection, bleeding and reaction to anesthesia are possible.
Kamis, 30 Agustus 2007
Minggu, 26 Agustus 2007
Sleepless Kids Are Troubled Kids
(HealthDay News) -- The nightly trip to dreamland is a frustrating one for millions of American children suffering from insomnia, night awakenings and even sleep apnea, experts say.
"Across every study, 20 to 25 percent of children have some kind of sleep problem," said Jodi Mindell, associate director of the Sleep Center at Children's Hospital of Philadelphia. "That spans everything from kids who are waking during the night, to resisting bedtime, to sleepwalking, disordered breathing -- the gamut," she said.
One 2004 National Sleep Foundation poll found that, among children under 11, 60 percent experienced some kind of sleep trouble at least a few nights a week, Mindell said. "And 74 percent of parents said they wanted to change something about their child's sleep," she added.
So, parents awakened in the night by a sleepless child have lots of company nationwide. One big culprit: sleep apnea, which occurs when blockages in the airway trigger snoring and frequent nighttime awakenings.
"About 2 to 3 percent of children will have sleep apnea," said Mindell, co-author of Take Charge of Your Child's Sleep. "About 10 to 12 percent of kids snore on a regular basis, but not all children who snore have sleep apnea. In children, the primary cause of obstructive sleep apnea is enlarged tonsils or adenoids."
In most cases, tonsillectomy or adenoidectomy offers a quick fix for pediatric sleep apnea, Mindell said. But there's another contributing factor that's rising in prevalence -- obesity. "In obese kids, what you're getting is the tonsils and adenoids being big, and then the weight on the neck closing the airways," she explained.
The daytime drowsiness that comes with sleep apnea can greatly affect a child's mood, daytime alertness and academics. One 2006 study in the journal Public Library of Science Medicine found that youngsters with sleep apnea scored lower on standard IQ tests compared with unaffected kids -- an average of 85 points vs. 100, respectively.
Left untreated, sleep apnea might even permanently damage cognitive function, the researchers said. "We can only assume that it could turn an otherwise smart kid into a mediocre kid," lead investigator Dr. Ann Halbower, of the John Hopkins University Children Center, told HealthDay.
But there are other sleep woes affecting children, including insomnia, night terrors, and frequent awakenings and sleepwalking.
Many can be fixed with simple behavioral changes at home, Mindell said. Those steps include:
Setting firm schedules. "Get them to bed the same time every night and wake them up the same time every morning," Mindell said. "This sets a child's internal clock and makes it so they'll get sleepy easier and fall asleep easier."
Create a bedtime routine. Implementing a "wind-down" time before bed, perhaps 20 to 30 minutes each night, helps kids of all ages settle down and ready their minds and bodies for sleep, Mindell said.
Ban electronics from the bedroom. According to polls, 97 percent of U.S. kids have some kind of electronic distraction -- TV, cell phone, computer, Gameboy -- in their rooms. "That has a major impact on sleep," Mindell said. "We want to get kid's bedrooms unplugged."
Limit caffeine. This doesn't mean only coffee -- it's ice tea, plus dark- and light-colored sodas. "For some kids it takes much longer to metabolize caffeine," Mindell said. "So, that ice tea at 3 o'clock in the afternoon can still be keeping them up at 10 p.m."
Make sleep-time a solo affair. Kids who get used to a parent being with them as they drift off will need that parent every time they seek slumber. "So, if you're lying down with your 5-year-old at bedtime, be prepared to be lying down with him at 1 a.m.," Mindell warned. Allowing a child to fall asleep on his or her own eliminates that problem.
School boards have an important role to play, too, Mindell said.
"Many high schools are starting now at 7:15 in the morning, and that's completely against what is happening with teenagers' internal clocks," she explained. "Their clocks actually shift later [than adults] -- that's just a simple biological function."
So, later school start times can make a big difference. According to Mindell, school districts that have made such a change "have seen huge, positive responses in their kids' grades."
More information
There's more on helping children get their shut-eye at the National Sleep Foundation.
"Across every study, 20 to 25 percent of children have some kind of sleep problem," said Jodi Mindell, associate director of the Sleep Center at Children's Hospital of Philadelphia. "That spans everything from kids who are waking during the night, to resisting bedtime, to sleepwalking, disordered breathing -- the gamut," she said.
One 2004 National Sleep Foundation poll found that, among children under 11, 60 percent experienced some kind of sleep trouble at least a few nights a week, Mindell said. "And 74 percent of parents said they wanted to change something about their child's sleep," she added.
So, parents awakened in the night by a sleepless child have lots of company nationwide. One big culprit: sleep apnea, which occurs when blockages in the airway trigger snoring and frequent nighttime awakenings.
"About 2 to 3 percent of children will have sleep apnea," said Mindell, co-author of Take Charge of Your Child's Sleep. "About 10 to 12 percent of kids snore on a regular basis, but not all children who snore have sleep apnea. In children, the primary cause of obstructive sleep apnea is enlarged tonsils or adenoids."
In most cases, tonsillectomy or adenoidectomy offers a quick fix for pediatric sleep apnea, Mindell said. But there's another contributing factor that's rising in prevalence -- obesity. "In obese kids, what you're getting is the tonsils and adenoids being big, and then the weight on the neck closing the airways," she explained.
The daytime drowsiness that comes with sleep apnea can greatly affect a child's mood, daytime alertness and academics. One 2006 study in the journal Public Library of Science Medicine found that youngsters with sleep apnea scored lower on standard IQ tests compared with unaffected kids -- an average of 85 points vs. 100, respectively.
Left untreated, sleep apnea might even permanently damage cognitive function, the researchers said. "We can only assume that it could turn an otherwise smart kid into a mediocre kid," lead investigator Dr. Ann Halbower, of the John Hopkins University Children Center, told HealthDay.
But there are other sleep woes affecting children, including insomnia, night terrors, and frequent awakenings and sleepwalking.
Many can be fixed with simple behavioral changes at home, Mindell said. Those steps include:
Setting firm schedules. "Get them to bed the same time every night and wake them up the same time every morning," Mindell said. "This sets a child's internal clock and makes it so they'll get sleepy easier and fall asleep easier."
Create a bedtime routine. Implementing a "wind-down" time before bed, perhaps 20 to 30 minutes each night, helps kids of all ages settle down and ready their minds and bodies for sleep, Mindell said.
Ban electronics from the bedroom. According to polls, 97 percent of U.S. kids have some kind of electronic distraction -- TV, cell phone, computer, Gameboy -- in their rooms. "That has a major impact on sleep," Mindell said. "We want to get kid's bedrooms unplugged."
Limit caffeine. This doesn't mean only coffee -- it's ice tea, plus dark- and light-colored sodas. "For some kids it takes much longer to metabolize caffeine," Mindell said. "So, that ice tea at 3 o'clock in the afternoon can still be keeping them up at 10 p.m."
Make sleep-time a solo affair. Kids who get used to a parent being with them as they drift off will need that parent every time they seek slumber. "So, if you're lying down with your 5-year-old at bedtime, be prepared to be lying down with him at 1 a.m.," Mindell warned. Allowing a child to fall asleep on his or her own eliminates that problem.
School boards have an important role to play, too, Mindell said.
"Many high schools are starting now at 7:15 in the morning, and that's completely against what is happening with teenagers' internal clocks," she explained. "Their clocks actually shift later [than adults] -- that's just a simple biological function."
So, later school start times can make a big difference. According to Mindell, school districts that have made such a change "have seen huge, positive responses in their kids' grades."
More information
There's more on helping children get their shut-eye at the National Sleep Foundation.
Senin, 20 Agustus 2007
Work-Family Conflict Dogs Air Force Women After Deployment
(HealthDay News) -- At least one major symptom of post-traumatic stress disorder (PTSD) was reported by about 20 percent of 1,114 women in the U.S. Air Force deployed during the Iraq War, says a University of Michigan study that found a link between PTSD and work-family conflict.
The women in the survey (74.2 percent enlisted, 25.8 percent officers) were deployed at least once since March 19, 2003. About 62 percent of them were deployed in a theater of war.
The study authors found that women who experienced higher levels of family-work conflict were more likely to have symptoms of anxiety and depression. They were also less likely to feel they could cope with daily demands and responsibilities.
"We were surprised to find that work-family conflict is an independent and significant predictor of PTSD, above and beyond combat exposure. This finding is important, because there are many things we can do to help minimize work-family stress and the toll it is taking on women in the military," study author Penny Pierce, an associate professor in the U-M School of Nursing, said in a prepared statement.
"Since the Gulf War, the role of women in combat has been a subject of heated debate. This study is the latest attempt to assess the impact of deployment-related stressors, including family separation, on military women, who now comprise 13 percent of our nation's armed forces," said Pierce, who is a colonel in the Air Force Reserve Program.
She presented preliminary findings from the study on Sunday at the American Psychological Association annual meeting in San Francisco.
"We cannot hope to take away the stress of combat, but the additional stress caused by family-work conflicts can be modified," Pierce said. "Steps can be taken to reduce the anxiety and depression of servicewomen who are worried about what is happening on the home front. In the near future, we hope to identify some areas where we can intervene to help reduce this source of stress."
Another study presented at the meeting found that almost half -- 42 percent -- of veterans returning from Iraq and Afghanistan said they now felt like a "guest in their own home," and one in five felt their children did not respond warmly to them, or were even afraid of them. In many of these cases, depression or PTSD played a major role, the researchers reported.
More information
The American Academy of Family Physicians has more about PTSD.
The women in the survey (74.2 percent enlisted, 25.8 percent officers) were deployed at least once since March 19, 2003. About 62 percent of them were deployed in a theater of war.
The study authors found that women who experienced higher levels of family-work conflict were more likely to have symptoms of anxiety and depression. They were also less likely to feel they could cope with daily demands and responsibilities.
"We were surprised to find that work-family conflict is an independent and significant predictor of PTSD, above and beyond combat exposure. This finding is important, because there are many things we can do to help minimize work-family stress and the toll it is taking on women in the military," study author Penny Pierce, an associate professor in the U-M School of Nursing, said in a prepared statement.
"Since the Gulf War, the role of women in combat has been a subject of heated debate. This study is the latest attempt to assess the impact of deployment-related stressors, including family separation, on military women, who now comprise 13 percent of our nation's armed forces," said Pierce, who is a colonel in the Air Force Reserve Program.
She presented preliminary findings from the study on Sunday at the American Psychological Association annual meeting in San Francisco.
"We cannot hope to take away the stress of combat, but the additional stress caused by family-work conflicts can be modified," Pierce said. "Steps can be taken to reduce the anxiety and depression of servicewomen who are worried about what is happening on the home front. In the near future, we hope to identify some areas where we can intervene to help reduce this source of stress."
Another study presented at the meeting found that almost half -- 42 percent -- of veterans returning from Iraq and Afghanistan said they now felt like a "guest in their own home," and one in five felt their children did not respond warmly to them, or were even afraid of them. In many of these cases, depression or PTSD played a major role, the researchers reported.
More information
The American Academy of Family Physicians has more about PTSD.
Rabu, 15 Agustus 2007
FDA to Take Another Look at Cold Remedies for Kids
(HealthDay News) -- U.S. health officials said Wednesday they will meet in October to review the safety and effectiveness of cough and cold drug products used by children.
The U.S. Food and Drug Administration said "questions have been raised about the safety of these products" and whether the risks outweigh the benefits, particularly for children younger than 2 years old.
To prepare for the meeting, the FDA said its Nonprescription Drugs Advisory Committee will review safety data for the ingredients of these products.
The FDA, in a prepared statement, said reports of serious adverse events appeared to be the result of giving too much of these medicines to children. Over-the-counter cough and cold medicines can be harmful if more than the recommended amount is used, if it is given too often, or if more than one cough and cold medicine containing the same active ingredient is being used, the statement said.
To avoid giving a child too much medicine, the FDA recommends that parents carefully follow the directions for use of the product in the "Drug Facts" box on the product label.
The FDA also offered several other suggestions, including:
Do not use cough and cold products in children under 2 years of age unless given specific directions to do so by a health-care provider.
Do not give children medicine that is packaged and made for adults. Use only products marked for use in babies, infants or children (sometimes called "pediatric" use).
Cough and cold medicines come in many different strengths. If you are unsure about the right product for your child, ask a healthcare provider.
If other medicines -- over-the-counter or prescription -- are being given to a child, the child's health-care provider should review and approve their combined use.
In March, the FDA said it was reviewing the safety of children's over-the-counter cold and cough remedies.
Dr. Charles Ganley, the FDA's director of the Office of Nonprescription Products, said at the time that the agency has been "looking into the issue of safety of children's cough medicine since the middle of last year." He noted that when these medicines were originally approved, in some cases several decades ago, there was no mandate that the effectiveness, safety or dose be determined for children; rather, the guidelines were extrapolated from studies done with adults.
"We have not established a dose that is safe for children 2 and under," Ganley said during a teleconference. "We hope to have our review done in several months and then make recommendations."
When these drugs are taken in higher-than-normal doses, they can affect the heart's electrical system, leading to arrhythmias, which are irregular heartbeats. Some medicines affect the blood vessels and, in high doses, have been associated with high blood pressure and stroke. In rare cases, children have been injured even when given recommended doses, The New York Times reported.
A group of prominent pediatricians and public health officials petitioned the FDA in March to stop drug makers from marketing cold and cough medicines for children under 6. The petition said the medicines do not work and, in rare cases, can cause serious injury.
When the FDA initially approved the drugs for pediatric use, it had determined they were safe and effective for children ages 6 to 12, Ganley said. The agency is looking at data from newer studies to see if the drugs are effective, he said.
In the Jan. 12 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report, researchers noted that cough and cold medicines can be harmful and should be used with caution in children under 2 years of age.
The CDC had identified three infants who died from the toxic effects of cough and cold medicines in 2005. In addition, in 2004 and 2005, more than 1,500 children younger than 2 years old were treated in emergency rooms for adverse events from cough and cold medicines, the report said.
The report also noted that although these drugs are effective in older children and adults, there's little evidence the medications help in children under 2 years old. "Parents should always consult a health-care provider before giving cough or cold medicine to kids under 2 years old. Health-care providers should use caution when giving cough and cold medicines to children under 2 years old," the report concluded.
The Consumer Healthcare Products Association, which represents the non-prescription over-the-counter drug industry, believes these medicines are safe and effective.
"These medicines have been found safe and effective by the FDA and are the same medicines that families have safely relied upon for decades to help relieve cough and cold symptoms and make their children feel better," Linda A. Suydam, president of the Consumer Healthcare Products Association, said in a prepared statement released in March.
More information
For more about colds and cold medications for young children, visit the American Academy of Pediatrics.
The U.S. Food and Drug Administration said "questions have been raised about the safety of these products" and whether the risks outweigh the benefits, particularly for children younger than 2 years old.
To prepare for the meeting, the FDA said its Nonprescription Drugs Advisory Committee will review safety data for the ingredients of these products.
The FDA, in a prepared statement, said reports of serious adverse events appeared to be the result of giving too much of these medicines to children. Over-the-counter cough and cold medicines can be harmful if more than the recommended amount is used, if it is given too often, or if more than one cough and cold medicine containing the same active ingredient is being used, the statement said.
To avoid giving a child too much medicine, the FDA recommends that parents carefully follow the directions for use of the product in the "Drug Facts" box on the product label.
The FDA also offered several other suggestions, including:
Do not use cough and cold products in children under 2 years of age unless given specific directions to do so by a health-care provider.
Do not give children medicine that is packaged and made for adults. Use only products marked for use in babies, infants or children (sometimes called "pediatric" use).
Cough and cold medicines come in many different strengths. If you are unsure about the right product for your child, ask a healthcare provider.
If other medicines -- over-the-counter or prescription -- are being given to a child, the child's health-care provider should review and approve their combined use.
In March, the FDA said it was reviewing the safety of children's over-the-counter cold and cough remedies.
Dr. Charles Ganley, the FDA's director of the Office of Nonprescription Products, said at the time that the agency has been "looking into the issue of safety of children's cough medicine since the middle of last year." He noted that when these medicines were originally approved, in some cases several decades ago, there was no mandate that the effectiveness, safety or dose be determined for children; rather, the guidelines were extrapolated from studies done with adults.
"We have not established a dose that is safe for children 2 and under," Ganley said during a teleconference. "We hope to have our review done in several months and then make recommendations."
When these drugs are taken in higher-than-normal doses, they can affect the heart's electrical system, leading to arrhythmias, which are irregular heartbeats. Some medicines affect the blood vessels and, in high doses, have been associated with high blood pressure and stroke. In rare cases, children have been injured even when given recommended doses, The New York Times reported.
A group of prominent pediatricians and public health officials petitioned the FDA in March to stop drug makers from marketing cold and cough medicines for children under 6. The petition said the medicines do not work and, in rare cases, can cause serious injury.
When the FDA initially approved the drugs for pediatric use, it had determined they were safe and effective for children ages 6 to 12, Ganley said. The agency is looking at data from newer studies to see if the drugs are effective, he said.
In the Jan. 12 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report, researchers noted that cough and cold medicines can be harmful and should be used with caution in children under 2 years of age.
The CDC had identified three infants who died from the toxic effects of cough and cold medicines in 2005. In addition, in 2004 and 2005, more than 1,500 children younger than 2 years old were treated in emergency rooms for adverse events from cough and cold medicines, the report said.
The report also noted that although these drugs are effective in older children and adults, there's little evidence the medications help in children under 2 years old. "Parents should always consult a health-care provider before giving cough or cold medicine to kids under 2 years old. Health-care providers should use caution when giving cough and cold medicines to children under 2 years old," the report concluded.
The Consumer Healthcare Products Association, which represents the non-prescription over-the-counter drug industry, believes these medicines are safe and effective.
"These medicines have been found safe and effective by the FDA and are the same medicines that families have safely relied upon for decades to help relieve cough and cold symptoms and make their children feel better," Linda A. Suydam, president of the Consumer Healthcare Products Association, said in a prepared statement released in March.
More information
For more about colds and cold medications for young children, visit the American Academy of Pediatrics.
Jumat, 10 Agustus 2007
Stem Cell Trouble Slows Healing of Aging Muscle
(HealthDay News) -- Poor stem cell communication causes the slow, incomplete muscle healing associated with aging, a new study suggests.
Publishing in the Aug. 10 issue of the journal Science, researchers from Stanford University School of Medicine found an age-related decline in the lines of communication to the stem cells of muscles. The stem cells receive garbled messages about muscle repair, which leads to slower and poorer quality healing.
The Stanford team also identified a key player in this process, a protein called Wnt. It's believed to help in the maintenance and proliferation of stem cells in many tissues, but, in this case, Wnt appears to block proper communication to muscle stem cells.
"This was a total surprise. We had no idea that the Wnt signaling pathway would have a negative effect on stem cell function," senior author Dr. Thomas Rando, associate professor of neurology and neurological sciences, said in a prepared statement.
The finding could lead to new treatments for injuries in muscles and other tissues.
"Theoretically, given the number of ways to block Wnt and Wnt signaling, one could envision this becoming a therapeutic. You could potentially enhance the healing of aged tissues by reducing this effect of Wnt signaling on the resident stem cells," Rando said.
More information
The MedlinePlus Medical Encyclopedia has more about age-related changes in muscle, bones and joints.
Publishing in the Aug. 10 issue of the journal Science, researchers from Stanford University School of Medicine found an age-related decline in the lines of communication to the stem cells of muscles. The stem cells receive garbled messages about muscle repair, which leads to slower and poorer quality healing.
The Stanford team also identified a key player in this process, a protein called Wnt. It's believed to help in the maintenance and proliferation of stem cells in many tissues, but, in this case, Wnt appears to block proper communication to muscle stem cells.
"This was a total surprise. We had no idea that the Wnt signaling pathway would have a negative effect on stem cell function," senior author Dr. Thomas Rando, associate professor of neurology and neurological sciences, said in a prepared statement.
The finding could lead to new treatments for injuries in muscles and other tissues.
"Theoretically, given the number of ways to block Wnt and Wnt signaling, one could envision this becoming a therapeutic. You could potentially enhance the healing of aged tissues by reducing this effect of Wnt signaling on the resident stem cells," Rando said.
More information
The MedlinePlus Medical Encyclopedia has more about age-related changes in muscle, bones and joints.
Senin, 06 Agustus 2007
Many New Moms Feel 'Unready' at Hospital Discharge
(HealthDay News) -- About one in six new moms may not be ready to fully take care of their newborns at the time they're discharged from U.S. hospitals, new research suggests.
Reporting in the August issue of Pediatrics, researchers found that 17 percent of new mothers and infants were "unready" for the transition at the time of discharge. Eleven percent of mothers felt unready, while 5 percent of pediatricians felt mother-infant pairs were unready.
Just 1 percent of obstetricians felt the mother-infant pairs were unready.
"We wanted to address the lack of information regarding the postpartum decision-making process for healthy term newborns and its consequences during the neonatal period, after federal legislation that went in effect in 1998 established a minimum postpartum length of stay of 48 hours after vaginal deliveries and 96 hours after Caesarean deliveries, unless a mother and physician decide otherwise," explained the study's lead author, Dr. Henry Bernstein. He is chief of general academic pediatrics at Children's Hospital at Dartmouth, in Lebanon, N.H.
To do this, Bernstein and his colleagues got more than 450 practitioners from 112 sites around the country to recruit 4,300 mother-infant pairs. Mothers, obstetricians and pediatricians are considered key partners in decisions on when to leave the hospital after delivery.
The researchers found that, at the time of discharge, almost one in six mother-infant pairs was deemed unready. In most cases, it was the mother, rather than her doctors, who felt she and/or her infant was not yet prepared to go home.
The researchers identified eight factors that seemed to correlate with feeling unready, including a maternal history of chronic disease, first-time parenthood, inadequate prenatal care, delivering during non-routine hours, neonatal problems in the hospital, a limited number of in-hospital education classes, plans to breast-feed, and the mother's race -- black women were almost 40 percent more likely to feel unready to be discharged than whites, the study found.
"The data suggests that mothers and clinicians must make the decision jointly," said Bernstein. He added that, "To increase readiness, it's critical to emphasize personalized discharge plans for that infant and his or her family."
Additionally, Bernstein said the researchers found that the length of a hospital stay was not a determinant of readiness.
"This study shows that the time in the hospital is not the issue; education is a more important issue," said Dr. Robert Welch, chairman and program director of obstetrics and gynecology at St. John Health's Providence Hospital in Southfield, Mich.
Welch pointed out that changes in society may have created this issue. In the past, when women came home from the hospital, a grandmother was often there to help out and teach newborn care.
"A lot of times now, moms are going home, and they're alone with the baby, and she may not have an appropriate support system in place, or day care if she's planning on going back to work," said Welch.
"From the time that they have the first inkling that they want to have a baby, women should start building a support system," he suggested.
Welch also believes that it might be a good idea for hospitals to provide more standardized postpartum education. Right now, individual centers design their own programs, and he said that what's included in those after-birth education programs can vary greatly from hospital to hospital.
Bernstein said his team is continuing its work to see if postpartum unreadiness had any effect on the newborns. Their next study will look at the health outcomes of these newborns at four weeks after hospital discharge.
And, he added, "We're hoping to come up with a score to be used at discharge, similar to the Apgar score just after birth, that can help clinicians predict who is ready and who is not ready, so appropriate postpartum supports or services can be put in place."
More information
The Nemours Foundation has more information on bringing baby home.
Reporting in the August issue of Pediatrics, researchers found that 17 percent of new mothers and infants were "unready" for the transition at the time of discharge. Eleven percent of mothers felt unready, while 5 percent of pediatricians felt mother-infant pairs were unready.
Just 1 percent of obstetricians felt the mother-infant pairs were unready.
"We wanted to address the lack of information regarding the postpartum decision-making process for healthy term newborns and its consequences during the neonatal period, after federal legislation that went in effect in 1998 established a minimum postpartum length of stay of 48 hours after vaginal deliveries and 96 hours after Caesarean deliveries, unless a mother and physician decide otherwise," explained the study's lead author, Dr. Henry Bernstein. He is chief of general academic pediatrics at Children's Hospital at Dartmouth, in Lebanon, N.H.
To do this, Bernstein and his colleagues got more than 450 practitioners from 112 sites around the country to recruit 4,300 mother-infant pairs. Mothers, obstetricians and pediatricians are considered key partners in decisions on when to leave the hospital after delivery.
The researchers found that, at the time of discharge, almost one in six mother-infant pairs was deemed unready. In most cases, it was the mother, rather than her doctors, who felt she and/or her infant was not yet prepared to go home.
The researchers identified eight factors that seemed to correlate with feeling unready, including a maternal history of chronic disease, first-time parenthood, inadequate prenatal care, delivering during non-routine hours, neonatal problems in the hospital, a limited number of in-hospital education classes, plans to breast-feed, and the mother's race -- black women were almost 40 percent more likely to feel unready to be discharged than whites, the study found.
"The data suggests that mothers and clinicians must make the decision jointly," said Bernstein. He added that, "To increase readiness, it's critical to emphasize personalized discharge plans for that infant and his or her family."
Additionally, Bernstein said the researchers found that the length of a hospital stay was not a determinant of readiness.
"This study shows that the time in the hospital is not the issue; education is a more important issue," said Dr. Robert Welch, chairman and program director of obstetrics and gynecology at St. John Health's Providence Hospital in Southfield, Mich.
Welch pointed out that changes in society may have created this issue. In the past, when women came home from the hospital, a grandmother was often there to help out and teach newborn care.
"A lot of times now, moms are going home, and they're alone with the baby, and she may not have an appropriate support system in place, or day care if she's planning on going back to work," said Welch.
"From the time that they have the first inkling that they want to have a baby, women should start building a support system," he suggested.
Welch also believes that it might be a good idea for hospitals to provide more standardized postpartum education. Right now, individual centers design their own programs, and he said that what's included in those after-birth education programs can vary greatly from hospital to hospital.
Bernstein said his team is continuing its work to see if postpartum unreadiness had any effect on the newborns. Their next study will look at the health outcomes of these newborns at four weeks after hospital discharge.
And, he added, "We're hoping to come up with a score to be used at discharge, similar to the Apgar score just after birth, that can help clinicians predict who is ready and who is not ready, so appropriate postpartum supports or services can be put in place."
More information
The Nemours Foundation has more information on bringing baby home.
Jumat, 03 Agustus 2007
Hostility Puts Men's Hearts at Risk
(HealthDay News) -- Ten years of frequent hostility and depression may harm men's immune systems and put them at risk for heart disease, a U.S. study found.These negative emotional states may also hike men's risks for related disorders such as type 2 diabetes and high blood pressure, according to research in the August issue of Brain, Behavior, and Immunity.
Angry men are more likely to have increased levels of C3, an immune system protein associated with chronic inflammation, say the researchers from Duke University.
"Hostile, depressed and angry people see the world around them in a different way, and sometimes they see it as them against the world," study co-author Edward Suarez said in a prepared statement. "That kind of lifestyle often leads to greater stress and possibly changes in the way the body functions that could lead to disease."
Other research has shown a relationship between elevated levels of C3 and chronic diseases such as heart disease and diabetes.
The Duke team studied 313 male Vietnam veterans over a 10-year period. The men were part of a larger study on the effects of the wartime defoliant Agent Orange. All of the men underwent standard psychological testing to assess hostility, depression and anger. The researchers also tested the men's blood on three occasions between 1992 and 2002.
The researchers looked for changes in levels of C3 and C4, immune system proteins that are markers of inflammation, the body's response to injury or infection.
Men whose psychological screening showed the highest level of hostility, depressive symptoms and anger had a 7.1 percent increase in C3 levels, the investigators found, while men with low scores on the test showed no change in C3 or C4 over the decade. Levels of C4 did not change for either group.
The relationship between the psychological scores and C3 levels remained true even when the researchers looked for the possible effects of other risk factors. Smoking, age, race, alcohol use, body mass index and Agent Orange exposure had no influence on C3 levels.
The researchers noted that while the study does not point to psychological therapy as a means of preventing inflammation, finding ways to reduce anger and hostility couldn't hurt.
More information
To learn more about anger management, visit the American Psychological Association.
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