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There is good news for people who have never had chickenpox or received the vaccine but are exposed to the virus: vaccination within five days of exposure can significantly reduce the risk of illness, or at least make it less severe, Spanish researchers say.

The study, published in the January issue of the Pediatric Infectious Disease Journal, found that out of 67 people who received the varicella zoster vaccine within five days of exposure to chickenpox, only 22 got sick. That’s about 62 percent fewer than would be expected to become ill with the disease. Based on past studies, 58 out of the 67 would be estimated to develop chickenpox.

The patients who did get chickenpox developed mild to moderate cases, suggesting that the vaccine is 79 percent effective in preventing moderate to severe disease. It didn’t matter if those vaccinated were children or adults: the vaccine appeared to have the same effectiveness, the study authors noted in a news release from the journal’s publisher.

“Available varicella vaccines administered within five days after exposure to chickenpox are effective in preventing chickenpox and highly effective in attenuating the disease,” Dr. Maria Brotons and colleagues of Hospital Universitario Vall d’Hebron, Barcelona, stated in the news release.

Chickenpox often causes mild illness, but the virus can cause complications and scarring. Young children and teens are especially at risk of developing rare complications that can be serious.

SOURCE: Lippincott Williams & Wilkins, news release

Eating fruits and vegetables, and drinking tea and red wine may offer overweight men and normal weight women some protection from colon and rectal cancers, hint study findings from the Netherlands.

Plant-based foods contain flavonoids, compounds thought to interfere with cancer-causing processes, the study team notes in the International Journal of Cancer.

Colinda C.J.M. Simons, a PhD student at Maastricht University, and her co-investigators estimated the intake of specific flavonoids in 120,852 men and women, 55 to 69 years old, who filled out dietary surveys as part of a large designed to assess ties between diet and cancer.

Over about 13 years, 1,444 men and 1,041 women developed colon or rectal cancer.

Specific flavonoid intake did not seem to influence the risk for colorectal cancer when the investigators allowed for multiple factors potentially tied to the development of colorectal cancer, including age, family history, smoking, drinking alcohol, physical activity, and eating habits overall, plus estrogen use among women.

But when they allowed for weight, it seems “there may be protective effects of some of these compounds in subgroups of overweight men and normal weight women,” Simons noted in an email to Reuters Health.

Compared with the least intake, the greatest intake of catechins — common in berries, grapes, black chocolate, tea, red wine, and some beans — seemed to be associated with lower colorectal cancer risk among both overweight men and normal weight women.

The researchers observed a similar trend for flavonols — found in onions, kale, apples, pears, tea, wine, and fruit juices — in normal weight women.

“The fact that the inverse trend was observed for most of the specific catechins and flavonols argues against the associations being spurious,” Simons said.

She and colleagues, therefore, call for further investigations to shed more light on the how these compounds alter colon and rectal cancer risk and how weight modifies this impact.

Most smokers around the world support workplace smoking bans, according to a new study.

Researchers surveyed more than 3,500 employees who smoke and more than 1,400 employers (smokers and nonsmokers) in the United States and 13 other countries. They found that 74 percent of employees who smoke and 87 percent of employers said the workplace should be smoke-free.

“Although there was widespread variation among countries, overall the results demonstrate global support for workplace smoking bans,” lead author Michael Halpern, a senior fellow at RTI International, said in a news release. “This study shows support for additional programs and policies to increase those bans and assist employees with smoking cessation.”

Support for workplace smoking bans was greatest in India (85 percent) and Japan (75 percent), and much lower in Germany (33 percent) and Poland (37 percent).

Even though they smoked an average of one hour a day at work, nearly 70 percent of workers didn’t think their smoking had a negative financial impact on their employer, compared with about half of employers.

“Several previous studies indicate that despite the beliefs of smoking employees and some employers in our study, smoking does have a substantial negative impact on a business’ finances,” Halpern said. “More research needs to be done to quantify the economic impacts of workplace smoking and educate both employers and employees on those effects.”

Regular exercise may help keep teenagers’

blood pressure in check, regardless of their body weight, a new study suggests.

Researchers found that among nearly 1,300 Canadian teenagers they followed for five years, declining exercise levels over time were linked to small increases in blood pressure.

Gains in body fat were also linked to blood pressure increases, but excess weight did not fully account for the relationship between exercise and blood pressure changes –especially in girls.

The implication, the researchers report in the American Journal of Epidemiology, is that both weight and exercise habits independently affect teenagers’ blood pressure.

And that means that getting teens off the couch might help keep their blood pressure under better control, write Katerina Maximova and colleagues of McGill University in Montreal.

The findings are based on 1,293 boys and girls who were 12 to 13 years old at the start of the study. The teens reported on their typical physical activity levels and had their body fat and blood pressure measured at the outset, and then periodically over five years.

For each exercise assessment, the teenagers reported the number of times in the past week they had engaged in moderate to vigorous activities — like biking, walking or jogging — for at least 5 minutes.

Overall, the researchers found, the teens’ blood pressure inched upward for each session of exercise they lost over time. The increase amounted to less than one point in systolic blood pressure — the top number in a blood pressure reading — but the findings do suggest that sedentary lifestyles directly affect teenagers’ blood pressure, according to Maximova’s team.

And that, they write, could have “important public health implications.”

High blood pressure and other heart disease risk factors like type 2 diabetes and high cholesterol were once uncommon, or unheard of, in children and teenagers. But rates of these conditions in teenagers have risen since the 1990s, in tandem with escalating obesity rates.

A study of Canadian teenagers published last month found that between 2002 and 2008, the percentage with at least one heart disease risk factor — such as high blood pressure or high cholesterol — rose from 17 percent to 21 percent.

Those researchers also noted that more than half of Canadian children between the ages of 5 and 17 are not getting enough exercise.

And while young people may not see immediate health effects, studies show that teens who are overweight, inactive and carrying heart disease risk factors tend to become adults with those same problems.

The American Heart Association recommends that all children ages 3 and older have their blood pressure checked yearly. Diet changes and exercise are usually the first-line treatment for high blood pressure in teenagers, though some may also need medication.

When it comes to exercise, experts generally recommend that kids strive for 30 minutes of moderate activity, like brisk walking, on most days of the week, as well as 20 minutes of vigorous exercise, like running or bicycling, at least three days per week.

Morticians who use formaldehyde to embalm bodies have a higher risk of leukemia, researchers reported on Friday.

They found deaths from one particular kind of leukemia, myeloid leukemia, increased the longer the workers were involved with embalming.

Their study of more than 400 funeral workers is the first to look carefully at the association, they reported in the Journal of the National Cancer Institute.

“Previous studies have shown excess mortality from lymphohematopoietic malignancies and brain cancer in anatomists, pathologists, and funeral industry workers, all of whom may have worked with formaldehyde,” Laura Freeman of the U.S. National Cancer Institute and colleagues wrote.

They studied 168 professionals who died of various forms of leukemia, 48 who died of brain tumors and compared them to 265 funeral workers who died of something else.

The people who spent more years embalming bodies or were otherwise exposed to embalming fluid were more likely to have died from a myeloid leukemia, the researchers found.

“In recent decades, more than 2 million U.S. workers are exposed to formaldehyde, including anatomists, pathologists, and professionals who are employed in the funeral industry and who handle bodies or biological specimens preserved with formaldehyde,” they wrote.

Their study could help explain a known higher risk of death among these professionals, they said.

Diet and exercise can keep diabetes at bay for a decade, cutting the risk for the disease by more than a third in the most susceptible people, a new study finds.

About 11 percent of U.S. adults (24 million) have diabetes, mostly type 2, which is linked to poor diet and sedentary lifestyle. In addition, 57 million overweight adults have higher-than-normal blood sugar levels, which raise the risk of a heart attack or stroke and the likelihood of developing type 2 diabetes, researchers say.

But new research, published in the Oct. 29 online edition of The Lancet, shows that losing weight and exercising can delay or prevent the onset of diabetes more effectively than the prescription drug metformin or a placebo.

“Interventions that result in weight loss lower the risk of diabetes, and that lower risk appears to persist for a long period of time,” said study author Dr. William C. Knowler of the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

For people who are at high risk of getting diabetes, losing weight “is clearly to be recommended,” he said. In addition, using a drug like metformin may also benefit people unable to lose weight through exercise and diet alone, he said.

For the diabetes prevention study, 3,234 overweight or obese adults with elevated blood sugar levels were randomly assigned to either lifestyle changes or metformin to control their blood sugar, or a placebo.

After 10 years, 2,766 remained in the trial, and those taking metformin saw an 18 percent reduction in their rate of developing diabetes, compared with those on placebo.

But those who had made lifestyle changes — reducing caloric and fat intake and exercising at least 150 minutes a week — reduced their risk of getting diabetes by 34 percent compared with those on placebo, the researchers found.

In the first year of the trial, people in the lifestyle group lost an average of 15 pounds, regaining all but about five pounds over 10 years. People on metformin maintained a five-pound weight loss, and those on placebo lost less than two pounds over 10 years, the researchers note.

Over 10 years, after all the participants made lifestyle changes, the yearly diabetes incidence rates for the drug and placebo groups had dropped to about 5 to 6 percent, the same rate as the lifestyle group.

“Lifestyle intervention, even when provided later, also seemed to lower diabetes incidence rate,” Knowler said.

But losing weight is difficult, and simply telling someone to slim down won’t work, he acknowledges.

“To make things like this happen on a large scale, we have to do more than simply tell people to lose weight,” he said. People need access to weight loss clinics that can teach them about diet and exercise, he added.

Dr. Anoop Misra, director of the department of diabetes and metabolic diseases at Fortis Hospitals in India, and author of an accompanying journal editorial, said that “prevention of diabetes is important to curb epidemic of diabetes globally. Diet and exercise remain the most important modalities to prevent diabetes, and any drugs are less important.”

At-risk groups of diabetes need to be identified, especially certain ethnic groups, and taught proper lifestyle management strategies, Misra said. “Young adults with family history of diabetes should be carefully managed along the same lines,” he said.

Diabetes prevention makes economic sense as well, by decreasing costly, lifelong expenditures on management of the disease and its complications, Misra said.

All nations, particularly developing countries, seeing a rapid rise in diabetes should devise or strengthen a national diabetes-control program to help curb the epidemic, he said.

“In particular, regulations should apply for advertisement and sale of energy-dense junk food to children, and regular physical activity should be encouraged starting at a young age. Spreading awareness about proper lifestyle and adverse consequences of obesity and diabetes should be at the top of health agenda of all nations,” Misra said.

Regarding the study findings, other experts are optimistic. Dr. Ronald Goldberg, a professor of medicine at the Diabetes Research Institute of the University of Miami Miller School of Medicine, whose institution participated in the study, said that “seeing quite significant effects lasting this long really bodes well for the utility of these interventions for diabetes prevention.”

Cutting calories and increasing physical activity clearly slow the progression to diabetes, Goldberg said. “Lifestyle works, and every effort needs to be made to begin and maintain a lifestyle program in the long-term.”

If you’ve had a heart attack, you may be at risk for another one unless you make some major lifestyle changes.

The American Academy of Family Physicians says the following risk factors increase your risk of having a subsequent heart attack:
Lack of exercise
Excessive alcohol consumption
Being overweight
Having high cholesterol or high blood pressure
Uncontrolled diabetes
Smoking
Too much stress

People with systemic lupus erythematosus (SLE) have a more than twofold increased risk of cardiovascular disease, according to a new study.

Lupus is a chronic “autoimmune” disease in which the immune system confuses its own healthy tissues with foreign tissues and sometimes attacks both. The condition can manifest as a skin rash or arthritis and may lead to damage to the kidneys, heart, lungs and brain to varying degrees. The disorder disproportionately affects women.

“Despite improved life expectancy in the past few decades,” increased heart-related illness and death among people with lupus has been documented in several studies, Dr. A. Elisabeth Hak, from Erasmus MC University Medical Center, Rotterdam, the Netherlands, and colleagues note in the journal Arthritis Care and Research.

Hak’s team examined ties between lupus and cardiovascular disease among women participating in the Nurses’ Health Study. A total of 119,332 women who were free of cardiovascular disease and lupus in 1976 were included in the study and were followed until 2004.

Over 28 years of follow-up, there were 8,169 cardiovascular “events,” such as heart attack, stroke. Lupus was confirmed in 148 women and 20 of these women experienced a cardiovascular event.

After allowing for multiple factors, having lupus was associated with a 2.26-fold increased risk of suffering a cardiovascular event.

The investigators point out that the increased risk of cardiovascular disease in lupus patients is probably caused by a combination of factors. While traditional cardiovascular disease risk factors are more prevalent in people with lupus, this does not fully explain the risk. It is unclear whether lupus itself or its treatment increases the risk.

The way to reduce the chances of developing dementia such as Alzheimer’s disease after a stroke is to prevent a second stroke by concentrating on all the known stroke risk factors, a new British study suggests.

Two major findings emerged from an analysis of 30 previous studies that involved more than 7,500 people who had suffered a stroke, said Dr. Sarah Pendlebury, a senior clinical fellow at the Stroke Prevention Research Unit of John Radcliffe Hospital in Oxford and lead author of a report published online Sept. 23 in The Lancet Neurology.

“First, there is a clear relationship between having multiple strokes and the risk of dementia,” Pendlebury said. “If someone has multiple strokes at the same time, that person has a strong risk of becoming demented in the first month.”

“Second, the data suggest that the presence of complications after stroke — such as hypertension [high blood pressure], low oxygen saturation, cardiac events and seizures — also increases the risk of developing dementia.”

Because of this, Pendlebury said, the focus of stroke treatment units should be on all the risk factors for stroke. “So, to prevent worsening of damage to the brain, the patient must be maintained in as stable a condition as is possible,” she said. “We must prevent either high or low blood pressure and maximize all other secondary prevention measures.”

The study found that dementia rates in the first year after a stroke vary widely, ranging from 7.4 percent in population-based studies of stroke victims who did not previously have dementia to 41.3 percent in hospital-based studies that included people who had signs of dementia before a stroke.

But the study’s conclusion that the risk of dementia was associated with the risk and number of strokes, rather than underlying risk factors for cardiovascular diseases, was contested in an accompanying editorial by Dr. Michael G. Hennerici, chairman of neurology at the University of Heidelberg in Germany.

“This study lumps together several studies that have been performed in the last 30 years,” Hennerici said. “These studies are of very different quality. From these data, they draw the conclusion that stroke per se has a risk of post-stroke dementia. I question this finding because, according to the data, it is not stroke itself but rather an additional neurodegeneration that is ongoing, or additional changes in the brain in combination with stroke, that produces post-stroke dementia.”

Hennerici’s interpretation is that treatment of one major risk factor, hypertension, is essential to prevent both stroke and the underlying deterioration of brain function that leads to dementia.

“Hypertension is the best treatable risk factor for dementia and stroke,” he said. “It should be addressed even in those patients who are not hypertensive but who have other risk factors, such as diabetes and advanced age. The aging population should be carefully treated with hypertensive agents and also should be advised about methods of dealing with other hypertension risk factors, such as reduced salt intake, exercise and lifestyle changes.”

That recommendation drew no argument from Pendlebury. “Yet more aggressive treatment of high blood pressure can help prevent dementia, and also stroke,” she said.