By Robert Preidt

FRIDAY, Sept. 20 (HealthDay News) -- Heart failure patients' mental health history and their thinking abilities may influence whether they're readmitted to the hospital within a month of discharge, a new study says.

Depression, a history of substance abuse and a history of coronary artery disease were linked with patients' hospital admissions during the previous year, the researchers found. Factors associated with readmission within 30 days of discharge included memory problems, a history of mental health treatment and/or the use of an antidepressant.

The severity of congestive heart failure was not a factor in either admission or readmission rates, according to the study, which was published online recently in the journal Psychosomatics.

"Our results agree with several recent studies in finding an adverse impact of depression on admission and readmission rates," lead author Mark Ketterer, a psychologist at Henry Ford Health System in Detroit, said in a system news release. "In addition, substance abuse and chronic kidney disease may also adversely impact these rates in congestive heart failure patients."

The study involved 84 patients, average age 66, admitted to Henry Ford Hospital in Detroit for treatment of acute congestive heart failure.

"Even severe heart disease, except in the extreme, appears to be manageable after release from the hospital unless it's complicated by one or more of the behavioral factors," Ketterer added.

Perhaps the most important finding is the link between emotional stress and/or cognitive impairment and early readmission to the hospital, said Ketterer.

"Both suggest a possible way to predict readmission and avoid it," he said.

Educating patients about their mental illness, and getting live-in family members to help patients follow their medication regimen and keep medical appointments may also help reduce hospital readmissions, the researchers concluded.

"Given both the exorbitant fiscal costs and known health risks of hospitalization, including exposure to drug-resistant infections and medical errors, it could be well worth further study to test our findings," Ketterer said.

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By Robert Preidt

HealthDay Reporter

FRIDAY, Sept. 20 (HealthDay News) -- Pregnant women with a body-mass index (BMI) that is too low or too high are at increased risk for complications and additional hospitalization, according to a new Scottish study.

BMI is a measurement of body fat based on height and weight.

The findings -- published Sept. 18 in BJOG: An International Journal of Obstetrics and Gynaecology -- highlight the need for strategies to reduce obesity rates, said study co-author Dr. Fiona Denison of Queens's Medical Research Institute in Edinburgh.

"Longer-term benefits of reducing maternal obesity will show improvements, not only in the health outcomes of mothers and their babies, but the workload and cost to current maternity services," she said in a journal news release.

For the study, researchers examined data from nearly 110,000 pregnant women in Scotland who were divided into five groups based on BMI: underweight, BMI of less than 18.5; normal weight, BMI of 18.5 to 24.9; overweight, BMI of 25 to 29.9; obese, BMI of 30 to 35; and severely obese, BMI of more than 35.

The risk of pregnancy complications among women increased with BMI, according to the study.

Severely obese women were three times more likely than normal-weight women to have high blood pressure (7.8 percent vs. 2.6 percent) and gestational diabetes (3 percent vs. 0.1 percent).

Compared to normal-weight women, those in all other weight categories had more and longer hospitalizations after birth. The risk of hospitalization was 8 percent higher for underweight women, 16 percent higher for overweight women, 45 percent higher for obese women and 88 percent higher for severely obese women.

The study also found that women with high or low BMI had higher medical costs than normal-weight women.

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In a new study sure to raise hackles and controversy, an international team of researchers is reporting that pregnant women who drink alcohol during the first trimester of pregnancy and possibly beyond aren’t putting their babies at risk for premature birth or low birth weight, or themselves at risk for high blood pressure complications during pregnancy.

Dr. Fergus McCarthy and colleagues from Ireland, England, New Zealand, and Australia compared birth outcomes among 5,628 women who were pregnant for the first time between 2004 and 2011. More than half of them reported drinking alcohol during the first three months of pregnancy. Some (19%) reported occasionally drinking alcohol. Twenty-five percent reported low alcohol consumption, or three to seven drinks per week (“a drink” defined as a glass of wine or a little less than a 12-ounce bottle of beer). Another 15% reported having more than seven drinks per week.

Rates of premature birth, babies with low birth weight or small size, and preeclampsia—a potentially life-threatening condition in which a pregnant woman develops high blood pressure—were similar across the alcohol consumption categories

The study did not measure the effect of drinking alcohol during pregnancy on development after birth. The results were published online ahead of print in the October issue of the journal Obstetrics & Gynecology.

For the past few decades, women have been urged to avoid alcohol during pregnancy. Respected medical societies like the American College of Obstetricians and Gynecologists and the United Kingdom’s Royal College of Obstetricians and Gynaecologists Women both say women shouldn’t drink any alcohol during pregnancy. The main reason for this is that heavy use of alcohol during pregnancy has been linked to a long-term and irreversible condition known as fetal alcohol syndrome (FAS).

Babies with FAS may be born early. They are often underweight and don’t grow well. Some have characteristic facial features like a thin upper lip and small eye openings, or the small vertical groove between the upper lip and the nose may be flattened. Other physical signs that go along with fetal alcohol syndrome include a small head, short nose, and problems with the way the heart or the joints are formed.

Children with FAS are slower to learn language skills than other kids. When they reach school age they often have learning disabilities and difficulty with attention, memory and hyperactivity. They are more likely to have poor coordination and a hard time with problem-solving. And some have trouble making friends and relating to other kids. All of which can make school a really difficult time.

Despite this clear advice, up to half of women drink alcohol during pregnancy.

How clear is the medical evidence supporting strict abstinence from alcohol during pregnancy? Not very strong. And recent studies suggest pregnant women who have an occasional drink don’t harm themselves or their baby. A 2012 Danish study, for example, found that low to moderate alcohol consumption during pregnancy did not affect executive functioning among 5-year-olds. Executive functioning is a catchall term that describes the ability to perform activities such as planning, organizing, strategizing, remembering details, and managing time.

Keep in mind that moderate drinking means no more than one drink per day.

Since it’s not clear how much alcohol it takes to cause problems, the best advice remains the same: women should avoid alcohol if they are pregnant or might become pregnant.

Many women are pregnant for a while before they know it. Does their alcohol consumption during the time they were pregnant but didn’t realize it doom their child? No. They almost surely did no harm to their unborn children.

Not everyone agrees that you should avoid all alcohol if you are trying to get pregnant. Some respected health agencies, like the United Kingdom’s Department of Health, indicate that having one alcoholic beverage a couple times per week during pregnancy is okay.

Looking at the evidence, a strict recommendation to have zero alcohol during pregnancy seems extreme. Will there be consensus about whether it’s safe for a pregnant woman to have a glass of wine or a beer once or twice a week? I don’t think we will see that any time soon.

By Steven Reinberg

HealthDay Reporter

THURSDAY, Sept. 19 (HealthDay News) -- The statin medications that millions of adults take to lower their cholesterol levels may also raise their risk of developing cataracts, a new study suggests.

This is the latest of several studies looking for a link between statins such as Lipitor and Zocor and cataracts, a clouding of the lens of the eye. The results to date have been conflicting and inconclusive, the researchers note.

"Cataracts are a main cause of poor vision and blindness, specifically for the elderly," said lead investigator Dr. Ishak Mansi, of the VA North Texas Health System in Dallas.

"This study cannot identify that statins cause cataracts; rather, it identifies statin use as associated with a higher risk of being diagnosed with cataract," he added.

The report, published Sept. 19 in the online edition of JAMA Ophthalmology, involved almost 14,000 men and women, 6,972 pairs of statin users and nonusers, who were seen by the military health care system from October 2001 to March 2010.

Those taking statins had a 27 percent increased risk of developing cataracts compared with nonusers, the researchers found.

"We tried to slice the data in different directions and look at our findings from different angles and approaches of analyses to ensure its consistency," Mansi said. "Consistently, statin use was associated with higher risk of cataract."

The findings should encourage patients to talk with their doctor about the risks and benefits of these drugs, but they shouldn't discontinue them based on this study, Mansi added.

"These medications have been a main tool in treatment of heart disease and should not be stopped because of a small higher risk of association with other diseases," he said.

The best way to prevent heart disease, however, is to modify your lifestyle, Mansi added.

"Effective medications are expected to have side effects; it is much better to do your best to lower your own risk of cardiovascular disease by stopping smoking and keeping physically active than to take a pill to lower your risk of heart disease," he said.

One expert doesn't think this study adds to the evidence of an association between statins and cataracts.

"The fact that many such observational studies gave conflicting results -- some suggest statin use prevents cataract, while others, like this one, suggest that it might increase cataract development -- means we have no idea," said Dr. Alfred Sommer, a professor of ophthalmology at the Johns Hopkins Bloomberg School of Public Health in Baltimore.

The only definitive way to answer the question is to randomize patients to use statins and not use statins, and then see what their risk of cataract becomes, he said.

"But this would be unethical, because statins save lives," Sommer added.

Even if there is an increased risk of cataracts from statin use, which remains uncertain, people should still take statins if they are indicated, Sommer said.

"Statins reduce the risk of heart attacks, something that is frequently lethal," he said. Cataract surgery, on the other hand, is highly effective, and has only rare complications, he noted.

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By Robert Preidt

TUESDAY, Sept. 17 (HealthDay News) -- A gene mutation explains why some people develop cold sores while others do not, according to a new study.

Cold sores -- blisters that appear on and around the lips -- are caused by the herpes simplex virus type 1 (HSV-1). Between 80 percent and 90 percent of people are infected with the virus, but only about one-quarter of them get frequent cold sores.

Scottish researchers analyzed blood samples from people affected by cold sores and found that they have a mutation in a gene called IL28b. This mutation means the body can't mount an adequate immune response to HSV-1.

"Most people carry the cold sore strain of the herpes simplex virus, but until now we never knew why only some of them develop cold sores," Professor Juergen Haas, of the University of Edinburgh, said in a university news release.

"Knowing that susceptibility to the virus involved relates to people's genes reinforces the need to research not only the evolution of viruses themselves, but also the susceptibility of hosts to infection," Haas said.

The study was published in the journal PLoS Pathogens.

The IL28b gene also is linked to treatment responses for hepatitis C patients. If this gene is mutated, patients are less likely to respond as well to treatment. The research provides further evidence that a single genetic mutation can be linked to different viruses, Haas said.

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