Researchers found that hearing problems were more common in men than in women and in whites than in blacks. As expected, they also increased with age.

The prevalence of hearing loss “was pretty shocking,” said Dr. Frank Lin, from the Johns Hopkins School of Medicine in Baltimore, who worked on the study.

“There’s a common perception that hearing loss is a more inconsequential part of the aging process,” he added. But, “It’s not just inconsequential. Hearing loss actually does have a significant health impact on people’s lives.”

Lin’s own recent research has suggested that bad hearing may be tied to declines in thinking and memory as people age, for example (see Reuters Health story of February 14, 2011).

The new nationwide estimates are based on hearing exams that were given to about 7,500 people age 12 and up between 2001 and 2008.

Participants’ hearing was tested at a range of different noise levels in a sound-proof booth. The definition of hearing loss was not being able to hear sounds softer than 25 decibels. (According to the National Institutes of Health, a whisper is about 20 decibels.)

“This is the level of hearing loss at which you’re going to begin noticing you have trouble communicating in situations with background noise,” Lin explained.

While less than one percent of people age 29 and younger had hearing loss in both ears, close to 80 percent of the oldest group, age 80 and above, had significant hearing problems.

The number of participants with hearing loss in at least one ear ranged from two percent of teenagers to 89 percent of the most elderly, according to findings published in the Archives of Internal Medicine.

In middle-aged and older adults, rates of hearing loss tended to be highest in white and Hispanic study participants and in men.

Based on the findings, the researchers calculated that 30 million Americans age 12 and older, or about one in eight, are hard of hearing in both ears.

“We’ve known that (hearing loss) is a big problem, and I think this highlights just how big a problem it is,” said Dr. Josef Shargorodsky, an ear, nose and throat doctor and researcher with Harvard Medical School in Boston who wasn’t involved in the new study.

“It’s a little bit startling just how many people have hearing loss in this country,” he told Reuters Health.

Researchers said that genetics, poor nutrition, exposure to loud noises and certain medications have all been tied to an increased risk of hearing loss. But the biggest cause, Lin and Shargorodsky agreed, is simply old-age.

“Very much like you develop white hair over time… you develop damage to your ears over time,” Lin told Reuters Health.

Many people with hearing problems might not even know it, he said, because it often comes on so slowly. And partly because of that, most hearing problems are untreated, even though there are treatments — such as hearing aids — that have very little risk of side effects, Lin added.

Still, the idea of screening everyone for hearing loss is controversial, Shargorodsky said, partly because almost all older adults would test positive — and then, “where do you go from there?” he said.

But Lin is not in doubt.

“Anybody who thinks they may have hearing loss… it’s definitely worth getting evaluated, and you should definitely consider treating it.”

SOURCE: http://bit.ly/tJ6PWU Archives of Internal Medicine, online November 14, 2011.

In cases of myelofibrosis, healthy bone marrow is replaced by scar tissue, causing blood cells to be made in the liver, spleen and other organs. Symptoms often include an enlarged spleen, anemia, a decrease in white blood cells and platelets, fatigue, abdominal discomfort, pain under the ribs, muscle and bone pain, itching and night sweats, the FDA said in a news release.

Jakafi inhibits the actions of two enzymes that are involved in regulating blood, the agency said. The drug was evaluated in clinical studies involving 528 people, all of whom had an enlarged spleen.

Observed side effects included low blood platelet levels, anemia, fatigue, diarrhea, shortness of breath, headache, dizziness, nausea and confusion.

Jakafi was approved as an orphan drug, since myelofibrosis affects fewer than 200,000 people in the United States, the FDA said.

The drug is produced by Incyte Corp., based in Wilmington, Del.

More information

The FDA has more about this approval.

Copyright © 2011HealthDay. All rights reserved.

While researchers couldn’t tell if those extra costly procedures were really called for, they said the findings suggest that doctors may detect small changes in the arteries on CT scans that lead them to do more invasive, potentially unnecessary, surgeries.

So-called CT angiography was developed as an alternative to coronary angiography, which requires doctors to thread a catheter through the blood vessels to check for blockages in patients with signs of heart disease.

“It’s a promising technology that allows one to avoid the invasiveness of (coronary angiography),” said Colonel Patrick O’Malley, of the Uniformed Services University in Bethesda, Maryland, who wasn’t involved in the new study.

“The trouble with that, though, is because it’s noninvasive, it tends to get utilized inappropriately,” he added.

“The proper utility of this test is in somebody who is symptomatic that you think needs a coronary angiography, but you want to avoid the risk of it, so you want to rule out any clinically significant (artery blockage). All too often they’re happening in even asymptomatic folks,” O’Malley, who has studied heart imaging, told Reuters Health.

For the current study, researchers from Stanford University in California looked back at records of Medicare beneficiaries who had non-invasive tests for coronary artery disease in 2005 through 2008, including more than 280,000 older adults. Those included CT angiographies and stress tests done with echocardiography (ECG).

Over the six months after patients had those tests to check heart function, the researchers tracked any other heart-related procedures they underwent, as well as the total cost of their medical care.

Only about three percent of patients — or close to 9,000 — had a CT test to begin with. But those patients were more likely than people getting any other type of stress test to later have a number of more invasive tests and procedures, including cardiac catheterization, stenting and bypass graft surgery.

For example, close to eight percent of patients had a stent inserted in their arteries after a CT angiography, compared to between two and three percent after stress tests.

A similar number of patients getting each type of test — around one percent — died over the six months after the test.

Total medical spending related to heart care over those six months was almost twice as high in patients who’d had CT scans, at about $15,000, than in those who’d been given stress tests (about $8,000).

“The thing that worries me… is that it’s associated with a higher incidence of percutaneous coronary intervention, and it’s also associated with a higher (incidence of) bypass surgery — that’s really disturbing,” O’Malley said, noting that there’s evidence that both of those heart procedures are also done too frequently in the U.S.

When doctors see build-up in the arteries on a CT scan, even if it might not lead to any heart problems, “the reflex is to stent it,” he added.

CT angiography “is a very sensitive test, meaning that you’ll see an abnormality if it’s there… but sometimes you’ll see something and it will turn out on an angiography that it’s not really a clinically important problem,” said Dr. Mark Hlatky, who worked on the study.

Especially with older Medicare patients, he told Reuters Health, “It’s pretty unlikely that somebody at that age has totally normal arteries.”

Hlatky said he suspects that at least some of the extra tests and procedures were ordered by doctors to “sort out” those small abnormalities.

Still, he added, “our study was too short to really know whether that’s really good for patients in the long run or not.” He and his colleagues couldn’t tell, for instance, if use of CT scans — and subsequent heart procedures — led to better health or quality of life for patients years later.

Current guidelines, his team wrote in the Journal of the American Medical Association, call for a stress test for most patients, with angiography reserved for those whose stress test indicates problems or who have signs of higher heart risks.

The findings were also presented this week at the American Heart Association Scientific Sessions in Orlando, Florida.

Patients, O’Malley said, need to be aware that CT angiography, even though it’s non-invasive, isn’t a risk-free procedure. “Indeed, it’s not harmless,” he said. People “need to be mindful that there’s radiation associated with it. Now it seems like there’s unappreciated risk that it may lead to unnecessary interventions down the road.”

SOURCE: http://bit.ly/w3jKd5 Journal of the American Medical Association, online November 15, 2011.

Those who did suffered fewer heart-related problems and saved $500 on average for health care over roughly a year. And it didn’t cost the insurer more; in fact, costs were trending lower because of fewer hospitalizations.

“People don’t get as sick, and it’s people getting sick that costs the most money,” said Dr. Lonny Reisman, an author on the study and chief medical officer for Aetna, one of its sponsors.

Aetna plans to start offering some of these drugs for free or with a reduced copayment to some heart attack survivors and is researching whether to do so for other chronic conditions such as diabetes and chronic lung disease, Reisman told The Associated Press.

This study may persuade other insurers to do the same, heart specialists said.

“A drug only works if it’s taken,” said Dr. Eric Peterson of Duke University. “Adherence in America is miserable,” and only 10 percent of patients in this study were taking all medicines they should one year after a heart attack, said Peterson, who had no role in the work.

It was proposed and led by Dr. Niteesh Choudhry of Brigham and Women’s Hospital in Boston, who presented results Monday at an American Heart Association conference in Florida. They also were published online by the New England Journal of Medicine. The Commonwealth Fund helped pay for the work and some authors consult for insurance companies.

Several types of drugs — cholesterol-lowering statins and medicines that slow the heart rate and help the heart pump more effectively — can prevent future problems after a heart attack, and they’re supposed to be used for the rest of a patient’s life. But many people don’t take them. In one survey, a third of Americans said they didn’t fill a prescription or used less medicine than they should because of cost.

Researchers wanted to see if use would improve if they took the “medicine or milk” choice off the table, said Dr. Elliott Antman of Brigham and Women’s, one of the authors and chief of the heart association conference.

The study enrolled 5,855 Aetna plan members who had a drug plan as part of their benefits and were going home from the hospital after a heart attack. They were 53 years old on average, and three-fourths were men. Preventive medicines were offered free to 2,845 patients and prescribed with the usual copays for the rest.

Copays for these drugs run around $50 a month.

Roughly one year later, compliance with taking medicines, measured by how many filled prescriptions, ranged from 36 percent to 49 percent, depending on the drug, and improved only 4 percent to 6 percent in the group that had no copays.

“My God, we gave these people the medicines for free and only half took it,” Antman said.

Why don’t people take their meds after a life-threatening heart attack?

Some forget. Most of these preventive drugs mean three pills a day, sometimes more frequent doses.

Some suffer side effects; some of these medicines can cause fatigue, lightheadedness, muscle pains, cough — even sexual difficulties for men. That may seem like a high price to pay when you’re suffering one of these versus a less tangible prevention benefit.

Even former President Bill Clinton confessed he had stopped taking his cholesterol medicine after leaving office in 2001. He later developed severely clogged arteries that required heart bypass surgery in 2004.

In the study, the main outcome being tracked — the first major heart problem or need for an artery-unclogging procedure — was no different between the groups.

However, the total number of heart attacks, strokes, cases of chest pain or heart failure and other such problems was significantly lower in the group offered free medicines. It meant that an additional 2 of every 100 people were spared such problems because of being offered free medicines, and doctors suspect the difference between the groups would have been greater if more people had filled their prescriptions.

Costs dropped 26 percent for patients in the free drug group compared to the others — about $500 on average — partly because of fewer doctor visits, lab tests and hospitalizations.

Costs for the insurer averaged $69,997 over the next year for those with usual coverage and $64,726 for those offered free medicines. That wasn’t considered a big difference statistically, but from an actuarial standpoint, could matter to an insurer, Aetna’s Reisman said.

Providing such important medicines for free had a “distressingly modest” impact on patients’ willingness to take them, Dr. Lee Goldman of Columbia University and Dr. Arnold Epstein of the Harvard School of Public Health write in an editorial in the medical journal.

They note that common generic medicines cost less than the average copays faced by patients in the study, and speculate that the results should spur interest by other insurers “even if the business case does not yet indisputably confirm lower costs for them.”

___

Online:

Heart Association: http://www.americanheart.org

New England Journal: http://www.nejm.org

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

Green or yellow “sputum,” as clinicians call it, more often than not reflects a bacterial infection, whereas clear, white or rust colored phlegm most likely does not, according to the new study.

The results could help doctors determine whether or not a patient would benefit from antibiotics.

“When someone comes in and complains of sputum production and it’s clear or white, there’s no reason to spend money on antibiotics,” said Dr. Neil Hampson, a professor emeritus at Virginia Mason Medical Center in Seattle, who was not involved in this study.

That’s because the researchers found that the great majority of the time, clear phlegm did not harbor disease-causing bacteria.

Antibiotics treat bacterial infections, but don’t work on virus-caused illnesses like the common cold.

The team analyzed sputum from more than 4,000 people with chronic bronchitis.

Just 18 out of every 100 samples of clear phlegm tested positive for disease-causing bacteria.

The study, published in the European Respiratory Journal, did not show that green or yellow phlegm warrants an antibiotic prescription every time, however.

Green sputum had bacteria in it 59 out of every 100 times, and yellow sputum had bacteria in it 46 out of every 100 times.

Dr. Marc Miravitlles, the lead author of the study and a researcher at the Hospital Clinic in Barcelona, Spain, said sputum color is not as good an indicator of bacterial infections as testing the sample in a laboratory.

“But sputum culture is not readily available in most clinical practices,” Miravitlles wrote in an email to Reuters Health. “Therefore, the simple inspection of the sputum may be a surrogate marker of infection: cheap and quick.”

Many parents and physicians have long considered colored snot to be a marker of a bacterial infection.

The olive or pea-like hue comes from a green-colored enzyme called myeloperoxidase, which is involved in fighting infections.

Some researchers have called into question the practice of prescribing antibiotics based on phlegm color.

A recent study found that people with green or yellow phlegm who received antibiotics didn’t recover any faster from their sickness than people without mucous and who didn’t get the medications.

Miravitlles said his results do not apply to people with the occasional respiratory illness, because his study looked only at people with long term bronchitis.

A study by Hampson from three years ago, however, found similar results among patients who coughed up mucus, but didn’t necessarily have chronic bronchitis.

While it’s not clear whether people with colored phlegm would benefit from antibiotics, “my advice to the person at home or to the parent of a child is that if the sputum is clear or white, they shouldn’t be as concerned,” Hampson said.

SOURCE: http://bit.ly/soHxaX European Respiratory Journal, online October 27, 2011.

That strain of flu was once the most common cause of bacterial meningitis. The Hib vaccine was introduced in the mid-1980s.

But the researchers also found that other strains of H. influenzae continue to threatren the youngest and oldest people in the United States, according to the study published online Nov. 11 in the journal Clinical Infectious Diseases.

The analysis of national data showed that the highest rates of disease from non-b type strains occur in adults 65 and older and infants less than 1 year old. Among infants, most cases occur during the first month of life, with premature and low-birthweight babies the most vulnerable, according to a journal news release.

Among adults 65 and older who become ill because of H. influenzae, nearly 25 percent die, the release noted.

A disproportionately large number of both Hib and non-b type infections continue to occur among Native American and native Alaskan children, the study found. The reasons are not fully understood and should be the focus of future studies, a researcher said. Possible factors include poverty, crowded households and poor air quality.

More information

The MedlinePlus Medical Encyclopedia has more about the Hib vaccine.

Copyright © 2011HealthDay. All rights reserved.

The results are reassuring for a country that, by law, allows children to track down the sperm donors who contributed to their conception.

The personality characteristics of the Swedish sperm donors “show that they will be able to handle it if in the future somebody comes to them and says, ‘I am your donor child,’” said Dr. Robert Oates, president of the Society for Male Reproduction and Urology, who was not involved in the study.

Sweden was the first country to pass a so-called “non-anonymous” law, which entitles children to contact the sperm donor if they choose.

Britain, Australia and other countries also require that donors consent to being contacted, though donors typically have no rights to reach out to the child.

The United States allows for donors to remain anonymous and for them to get paid, unlike Sweden where men can only volunteer.

The non-anonymous laws “might be a problem, and for both parties since no one can prepare themselves for their reactions” if a child decides to contact the biological father, said Dr. Gunilla Sydsjö, a professor at Linköping University in Sweden and lead author of the study.

“A decision made at the age of 25 might be crystal clear for the individual at that time but might take on other dimensions 20 years later,” she wrote in an email to Reuters Health.

She and her colleagues surveyed 115 men who donated sperm at clinics in Sweden between 2005 and 2008, and compared them to other men of similar age who did not attempt to donate sperm.

Donors go through a screening process that weeds out men with psychological or health problems.

The questionnaire asked about behaviors, emotions and social skills.

The donors scored lower on one measure, called harm avoidance. “This indicates that the sperm donors described themselves as being less worried, uncertain, shy and less subject to fatigue,” the researchers wrote in their study, published in the British obstetrics and gynecology journal BJOG.

On two measures — self-directedness and cooperativeness — the donors scored higher than the comparison group of men, showing that they pursue goals, stick to their values and take responsibility.

All other personality traits, including persistence and novelty seeking behaviors, were similar between the two groups.

“We have in this study shown that the men who are accepted for the program were all in the normal range of character and also demonstrated a mature personality and a stable character,” said Sydsjö.

Oates said he thinks the Swedish system works well in recruiting men who donate for altruistic reasons.

“I think the majority are just nice people who want to help people out,” Oates told Reuters Health. “That may be a different personality than the 21 year old college student who wants to make a lot of money.”

He pointed out that, while the United States allows for anonymous donation, there are well-publicized instances of children ultimately tracking down their sperm-donor fathers.

“My worry has always been that young kids who have not had their own children and are (donating sperm) just for the money would really have a difficult life in the future if someone came looking for them,” said Oates, who is also a professor at Boston University School of Medicine.

Two recent studies have shown that uniting kids with donor dads is usually a positive experience (see Reuters Health story of January 6, 2011).

The researchers write in their study that they are not aware of any children in Sweden taking advantage of the transparency law to contact their biological fathers.

SOURCE: http://bit.ly/vvRuq6 BJOG, online October 18, 2011.

The American Academy of Family Physicians says these people should not get the nasal spray version of the flu vaccine:

Children under age 2, or adults aged 50 and older. Anyone with a chronic health condition or a weak immune system. Anyone taking aspirin therapy. Women who are pregnant. Anyone with Guillain-Barre syndrome, diabetes, or heart, lung or kidney disease. Anyone with an egg allergy or a previous allergic reaction to the flu vaccine.

Copyright © 2011HealthDay. All rights reserved.

“We are worried about the absence of coordination between the (German) federal and local veterinary services,” Alexei Alexeyenko, a spokesman for the watchdog said, explaining the ban.

“As a result we do not have sufficient guarantees that pigs are not tainted with dioxin, or they haven’t been fed antibiotics.”

The spokesman could not provide volumes of live pigs imports from Germany, although they are small in relation to Russia’s imports of pork meat.

Live pigs except for pedigree animals are liable to a high import tariff of 40 percent of customs value but no less than 0.5 euros ($0.69) per kilo.

Germany’s Agriculture and Consumer Protection Ministry said the Russian move was not justified.

“The context as presented here is not known to us and is not understandable,” a ministry spokeswoman said. “We are in discussions with our Russian partners to remove any possible misunderstandings.”

On Monday, German authorities said they saw no danger to the public after sugar producer Pfeifer & Langen reported it has produced the feed ingredient sugar beet pulp with dioxin levels of 1.0-1.6 nanograms, per kilo, “slightly above” permitted levels of 0.75 nanograms.

In January, an EU-wide health alert started when German officials said animal feed tainted with highly-poisonous dioxin had been fed to hens and pigs, contaminating eggs, poultry meat and pork at the affected farms.

Germany’s agriculture minister on Wednesday said the country will review use of antibiotics in farm animals.

(Reporting by Aleksandras Budrys, additional reporting by Michael Hogan in Hamburg)

“The definition of fair skin is it doesn’t tan very well, so stop trying!” said Dr. Virginia Moyer, head of the Preventive Services Task Force (USPSTF). “All you are doing is damaging your skin.”

The new proposal, posted in draft form on the USPSTF’s website, is the latest attempt to shield Americans against the cancer-promoting effects of ultraviolet, or UV, radiation.

Earlier this year, the American Academy of Pediatrics joined the World Health Organization, the American Academy of Dermatology and other groups pushing for a ban of indoor tanning.

According to Moyer, research has shown a strong link between UV radiation and skin cancer.

More than two million Americans get skin cancer every year, but most cases aren’t very dangerous and can usually be cured.

“It’s not going to kill them, but it’s no fun either,” said Moyer, whose mother has skin cancer and is currently getting injections with chemicals to destroy the tumor cells.

About one in 50 white Americans born today will get a deadlier type of skin cancer called melanoma at some point. The American Cancer Society estimates that melanoma causes just under three-quarters of the nearly 11,800 skin cancer deaths every year.

The USPSTF recommendation spans children and young adults 10 to 24 years old and updates a 2003 statement that said the evidence was insufficient to give advice.

According to the panel, there is now sufficient evidence that counseling people in this age group — for instance by showing them pictures of wrinkled, sun-damaged skin — will make them more careful about sunbathing and indoor tanning.

“The approach that you take is not, ‘Stay out of the sun and prevent cancer.’ It is, ‘Stay out of the sun and prevent ugly skin,’” Moyer told Reuters Health. “There is nothing more important to a teenager than how they look.”

For kids under 10 and adults over 24, the panel said there is not enough evidence that counseling changes behavior. And for older adults, Moyer added, chances are that a sunburn won’t have time to cause tumors.

“Sun damage takes a long time to evolve into something,” she said.

The American Academy of Dermatology (AAD) welcomed the new recommendations but said the USPSTF hadn’t gone far enough.

“The Academy believes sun protection counseling is important for everyone, including the adult population,” AAD President Dr. Ronald L. Moy told Reuters Health by email.

“More than 3.5 million skin cancers in more than 2 million people are diagnosed annually, and excessive exposure to ultraviolet radiation from the sun and tanning beds is the most preventable cause of all skin cancers.”

The American Cancer Society promotes sun protection with the slogan “Slip! Slop! Slap! and Wrap” — that is, Slip on a shirt, Slop on sunscreen, Slap on a hat, and Wrap on sunglasses.

Moyer said there are no signs that following such advice would have downsides, like kids not playing outside or lacking vitamin D, which is made by the skin when it’s exposed to sunlight.

“There is absolutely no evidence that fair-skinned people who avoid sun exposure have vitamin D deficiency,” she said.

Although the USPSTF doesn’t consider cost, Moyer acknowledged that advising young people about sun protection requires valuable time from busy doctors.