Health Tip: Packing for a Camping Trip

(HealthDay News) -- As you're jotting down what to bring on that upcoming camping trip, don't forget to bring the essentials.

The Nemours Foundation suggests this checklist:

• A map of the camping site and a compass.
• A flashlight and additional batteries.
• Plenty of food.
• An additional set of clothing, and protective rain gear.
• Sunscreen and a pair of sunglasses.
• A pocket knife and folding saw.
• Matches in a waterproof case, and a candle or fire starter.
• Plenty of clean water to drink.
• Insect repellent.

Newer Drugs Beat Gleevec in Head-to-Head Trials

SATURDAY, June 5 (HealthDay News) -- Two new drugs, dasatinib (Sprycel) and nilotinib (Tasigna), appear better than imatinib (Gleevec) in treating patients with newly diagnosed chronic myeloid leukemia and should be considered as first-line treatments, two new studies show.

The findings, which should change clinical practice, are to be presented Saturday at the American Society of Clinical Oncology annual meeting in Chicago and were simultaneously published online June 5 in the New England Journal of Medicine.

"Both next-generation inhibitors of BCR-ABL [dasatinib and nilotinib] are superior to Gleevec in treating chronic myeloid leukemia when compared head-to-head after one year of follow-up," said Dr. Charles L. Sawyers, chair of the Human Oncology and Pathogenesis Program at the Howard Hughes Medical Institute at Memorial Sloan-Kettering Cancer Center in New York City and author of an accompanying journal editorial.

"This magnitude of success -- beating a drug like imatinib [Gleevec] that was already pretty great -- is possible because we have a very precise understanding of the drug target BCR-ABL and of the mechanisms of resistance to imatinib," Sawyers added.

Newly diagnosed chronic myeloid leukemia patients should probably now be treated with one of the new drugs instead of imatinib, he noted.

In the first study, a team led by Dr. Hagop Kantarjian, chairman of the leukemia department at the University of Texas M.D. Anderson Cancer Center in Houston, randomly assigned 519 patients to Sprycel or Gleevec.

After a year, 77 percent of the patients receiving Sprycel had a complete cytogenetic response, compared with 66 percent of the patients receiving Gleevec, the researchers found.

Complete cytogenetic response is the disappearance of all the cancer cells from the bone marrow, Kantarjian explained.

In addition, the rate of major molecular response was higher among those taking Sprycel (46 percent) than those taking Gleevec (28 percent). Moreover, patients responded faster to Sprycel than to Gleevec, the researchers noted. A major molecular response is a 99.9 percent reduction of the disease, Kantarjian noted.

"The data we have suggests that perhaps dasatinib [Sprycel] therapy could be first-line treatment for chronic myeloid leukemia," Kantarjian said.

The safety of both drugs was similar, however, with five patients receiving Sprycel and nine patients receiving Gleevec seeing their disease progress.

The patients in the study continue to receive treatment and are being followed to see if there is a relapse, Kantarjian said.

Currently, Sprycel is approved for use only in patients who have failed Gleevec treatment. Sprycel is made by Bristol-Myers Squibb and Gleevec is made by Novartis Pharmaceuticals.

"We have new treatments that are better than Gleevec," Kantarjian said. "These new treatments could become front-line therapy for chronic myeloid leukemia soon."

In the second report, Italian researchers randomly assigned 846 patients to Tasigna or Gleevec.

After one year, more patients -- about 80 percent of those receiving Tasigna -- had a complete cytogenetic response, compared with 65 percent of the patients receiving Gleevec, the researchers found.

"Nilotinib [Tasigna] has been tried as first-line therapy for patients and has, indeed, produced more responses and better outcomes for patients," said lead researcher Dr. Giuseppe Saglio, a professor of internal medicine and hematology at the University of Turin and San Luigi Gonzaga Hospital in Italy.

Tasigna is also made by Novartis Pharmaceuticals.

"In less than 10 years, we have come up with nearly ideal drugs for treating chronic myeloid leukemia," Sawyers noted. "Many other cancers -- lung, melanoma, sarcoma -- are caused by mutations in similar genes and are being treated with drugs similar to imatinib [Gleevec]. The success in chronic myeloid leukemia predicts for similar success in these other diseases."

Another expert, Dr. Marshall A. Lichtman, a professor of medicine, biochemistry and biophysics at the University of Rochester Medical Center in Rochester, N.Y., said that "there have been good reasons to consider nilotinib [Tasigna] or dasatinib [Sprycel] as upgrades to imatinib [Gleevec] in the treatment of BCR-ABL-positive chronic myeloid leukemia."

Since their availability, they have been shown to be able to rescue patients who did not respond or lost their response to Gleevec, he said.

"We now have formal evidence through phase 3 clinical trials that either dasatinib [Sprycel] or nilotinib [Tasigna] increase the rate of complete cytogenetic remission and of a major molecular remission, the later a more sensitive measure of residual leukemic cells during therapy," Lichtman said.

"The one remaining question is will the 12-month results translate into 12-year results?" he said. "The experienced observer would predict yes, but the experienced observer also knows that seeing is believing. We should have a pretty good idea in a few more years about the long-term response in comparison to imatinib [Gleevec]."

The evidence from these studies, along with many prior observations of their effectiveness, should lead the U.S. Food and Drug Administration to consider approving them for newly diagnosed patients, Lichtman said.

More information

For more information on chronic myeloid leukemia, visit the U.S. National Institutes of Health.

Novel Drug Combats Advanced Melanoma

SATURDAY, June 5 (HealthDay News) -- Scientists say that a new drug to treat melanoma, the first in its class, improved survival by 68 percent in patients whose disease had spread from the skin to other parts of the body.

This is big news in the field of melanoma research, where survival rates have refused to budge, despite numerous efforts to come up with an effective treatment for the increasingly common and fatal skin cancer over the past three decades.

"The last time a drug was approved for metastatic melanoma was 12 years ago, and 85 percent of people who take that drug have no benefit, so finding another drug that is going to have an impact, and even a bigger impact than what's out there now, is a major improvement for patients," said Timothy Turnham, executive director of the Melanoma Research Foundation in Washington, D.C.

The findings on the drug, called ipilimumab, were reported simultaneously Saturday at the annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago and in the June 5 online issue of the New England Journal of Medicine.

Ipilimumab is the first in a new class of targeted T-cell antibodies, with potential applications for other cancers as well.

Both the incidence of metastatic melanoma and the death rate have risen during the past 30 years, and patients with advanced disease typically have limited treatment options.

"Ipilimumab is a human monoclonal antibody directed against CTLA-4, which is on the surface of T-cells [which fight infection]," explained lead study author Dr. Steven O'Day, director of the melanoma program at the Angeles Clinic and Research Institute in Los Angeles. "CTL is a very important break to the immune system, so by blocking this break with ipilimumab, it accelerates and potentiates the T-cells. And by doing that they become activated and can go out and kill the cancer. This drug is targeting not the tumor directly, but turning the T-cells on by blocking their brakes and allowing the T-cells to do their work, which is very different from chemotherapy and other targeted therapies directed at cancer cells."

The drug was developed and the study funded by Bristol-Myers Squibb and Medarex.

For this study, 676 patients at 125 centers around the world were randomly assigned to one of three treatment groups: ipilimumab plus gp100, a peptide vaccine which has shown some benefit in melanoma cases; ipilimumab on its own; or gp100 alone. All participants had stage 3 or 4 melanoma, and had been previously treated.

Those in both the combination arm and the ipilumumab-alone arm lived a median of 10 months vs. 6.4 months in the gp100-alone arm, a 68 percent increase in survival time.

"This is important because this is a disease where the average survival is six to nine months, so an increase on average by an additional four months is a very large difference in this population," O'Day said. "Even more importantly than the median survival are the one- and two- year landmark survivals, which were nearly doubled in the two ipilimumab arms, going from 25 to 46 percent at one year and 14 to 24 percent at two years."

Fourteen of the patients (2.1 percent) died because of reactions to the treatment, seven of those from immune system problems.

It's not entirely clear at this point which patients will benefit most but, Turnham pointed out, a large proportion of patients benefited from this therapy, whereas other therapies help only 5 percent to 15 percent of patients with metastatic melanoma.

The drug has not yet received approval from the U.S. Food and Drug Administration, but it is available at many medical centers and some patients may be able to get access to it, O'Day said.

More information

The Skin Cancer Foundation has more on melanoma.

Studies Suggest New Treatment Paradigms for Ovarian, Prostate Cancers

SUNDAY, June 6 (HealthDay News) -- New research points toward novel ways to treat ovarian and prostate cancer, while producing a disappointment for those with a certain form of colon cancer.

Both the ovarian and prostate cancer trials could change clinical practice, with more women taking the drug bevacizumab (Avastin) to combat the disease in its advanced stages and more men getting radiation therapy for locally advanced prostate cancer, according to researchers who presented the findings Sunday at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago.

A third trial, looking at the effectiveness of cetuximab (Erbitux) in treating certain colon cancer patients, found the drug made little difference to their survival.

The first study found that adding Avastin to standard chemotherapy (carboplatin and paclitaxel) and continuing with "maintenance" Avastin after chemo actually slowed the time-to-disease recurrence in women with advanced ovarian cancer.

Avastin is an anti-angiogenic drug, meaning it interferes with a tumor's blood supply.

"This is the first molecular-targeted and first anti-angiogenesis therapy to demonstrate benefit in this population and, combined with chemotherapy followed by [Avastin] maintenance, should be considered as one standard option for women with this disease," said lead researcher Dr. Robert A. Burger, director of the Women's Cancer Center at Fox Chase Cancer Center in Philadelphia.

"This is a new potential treatment paradigm for stage 3 and 4 ovarian cancer," added Dr. Jennifer Obel, an attending physician at Northshore University Health System and moderator of a Sunday news conference at which these results were presented.

The phase 3 study involved almost 1,900 women with stage 3 and stage 4 ovarian cancer.

Those who received standard chemotherapy plus Avastin, and then maintenance Avastin, for up to 10 months lived just over 14 months without their disease progressing compared with about 10 months for those receiving standard chemotherapy alone.

Those who received chemo plus Avastin but no maintenance drug lived without a recurrence for 11.2 months, a difference not considered statistically significant.

"I'm cautiously optimistic about this data. It clearly shows that those who had maintenance [Avastin] had improved profession-free survival," said Dr. Robert Morgan, co-director of the gynecologic oncology program at City of Hope Cancer Center in Duarte, Calif. "I think we have to wait for longer term outcomes before we make definite conclusions. It's too early for overall survival benefit data."

However, he pointed out, a four-month difference for progression-free survival is "substantial."

Doctors are already using Avastin off-label widely to treat ovarian cancer, he said, although it is not yet approved for this use. It has been shown to be more active in this cancer than in many cancers for which it is approved, Morgan noted.

"Clinicians will need to make decisions based upon the specific subsets of patients with advanced ovarian cancer, including the stage of the cancer," added Dr. Ursula Matulonis, director of medical gynecologic oncology at Dana-Farber Cancer Institute and an associate professor of medicine at Harvard Medical School in Boston.

"Also, Avastin has a lot of side effects," she pointed out. "The physician has to balance the benefit vs. the risk."

A second phase 3 study presented Sunday found that adding radiation to hormone therapy, also known as androgen-deprivation therapy (ADT) in patients with locally advanced or high-risk prostate cancer reduced the seven-year risk of dying by 43 percent compared to treating with hormone therapy alone.

"We know that radiation is better if added to ADT, but we didn't know if we could treat patients with ADT alone," said Obel. "The message here is that radiation is an indispensable element in the treatment of high-risk prostate cancer patients."

In the Canadian study, more than 1,200 men were randomized to receive either hormone therapy alone or hormone therapy with radiation.

Over the next seven years, those in the combination group had a 43 percent lower risk of dying from prostate cancer, the team found.

"After seven years, 74 percent of patients with the combined treatment were alive as compared to 66 percent in the ADT group alone," noted study author Dr. Padraig Warde, deputy head of the radiation medicine program at the University of Toronto's Princess Margaret Hospital. "At seven years, only 10 percent of patients who received radiation and ADT had died of prostate cancer vs. 21 percent in the ADT-alone group."

"Patients treated with the combined treatment -- radiation and hormones -- live longer and are less likely to die of prostate cancer," he said. "Radiation treatments should be part of the treatment package for this group of patients."

Also, radiation doses are higher today and may be even more potent, he added.

Finally, yet another phase 3 study -- albeit one with less encouraging results -- found that the monoclonal antibody drug cetuximab (Erbitux) did not aid people with (potentially curable) early-stage colon cancer if they carried the normal form of the KRAS gene.

The finding was a blow, given that Erbitux has helped patients with more advanced cancers.

Patients in this study had the normal form of the KRAS gene, for which the drug works in more advanced cancer.

The more than 1,600 patients in the study were followed for almost 16 months and were also treated with conventional chemotherapy.

"Much to our surprise, the trial showed that patients receiving standard therapy compared to those receiving cetuximab with standard therapy had no difference in outcomes," said study author Dr. Steven Alberts, a professor of oncology at the Mayo Clinic College of Medicine in Rochester, Minn. "It also indicates that disease in earlier stages may be different than diseases in later stages."

The trial, which was supported by the U.S. National Institutes of Health, Bristol-Myers Squibb, ImClone, Sanofi-Aventis and Pfizer, was halted after researchers realized there was no added benefit.

More information

Visit the U.S. National Cancer Institute for these and other types of cancers.

'Sleep Sex' Might Be Nightmare for Some

MONDAY, June 7 (HealthDay News) -- Sexsomnia -- having sex while asleep -- is a common complaint of patients seeking treatment for sleep disorders, new research shows.

Nearly 8 percent of patients referred to a sleep disorders clinic reported they had initiated or taken part in sexual behavior while sleeping. Men accounted for three-quarters of the self-reported sexsomniacs.

"We were surprised at how common it was," said study author Sharon A. Chung, a staff scientist in the Sleep Research Laboratory at the University Health Network in Toronto. "We thought we'd get just a handful of people, yet it was almost one in twelve."

The research was to be presented Monday at SLEEP 2010, the annual meeting of the Associated Professional Sleep Societies, in San Antonio.

In the study, researchers asked 832 patients about sexual behavior while sleeping, which can range from masturbation to intercourse. About 11 percent of men and 4 percent of women said they had engaged in "sleep sex."

Researchers said the prevalence is probably lower in the general population.

Sexsomnia is a form of a sleep disorder called parasomnia, or unwanted behavior that occurs during sleep. "An act of parasomnia can be as small as opening your eyes while fast asleep or grinding your teeth, to getting up and vacuuming, speaking, eating or having sex," Chung said.

Generally, people have no awareness of what they are doing and no recollection of it, Chung said.

Sexsomnia is more than a medical curiosity. It has been used as a criminal defense in sexual assault cases. In 2008, a Toronto man was found not guilty of sexually assaulting a woman after the court heard evidence that the man had engaged in "sleep sex" with several former girlfriends, according to news reports.

Colin Shapiro, the senior author of the paper, was an expert witness in that case, Chung noted, which got the team wondering just how common sexsomnia really was.

What brings on sexsomnia isn't really understood, but about twice as many patients who reported sexsomnia had used illegal drugs (15.9 percent vs. 7.7 percent) and were more likely to have consumed alcohol (41 percent vs. 27 percent). People who had experienced sexsomnia reported problems with insomnia (falling or staying asleep), fatigue and depression, although no more so than other patients at the sleep clinic. Rates of caffeine consumption and smoking were also similar, according to the study.

People experiencing a parasomnia are not often violent; they usually pose more of a threat to themselves, said Dr. Lisa Shives, medical director of Northshore Sleep Medicine in Evanston, Ill. But there are rare cases in which people have killed someone and claimed they were sleeping and unaware of their actions.

The good news is that parasomnia, sexsomnia included, is treatable with medications including benzodiazepines, such as clonazepam, which is also used to treat epilepsy and anxiety disorders, Shives said.

Yet few patients bring the issue up with the doctors. In the study, only four said they had previously told a medical professional about sexsomnia.

"Of the thousands of patients I've seen, I've never had someone come in complaining of sexsomnia, but I have always believed it's a bona fide disorder," Shives said. "It's a form of sleep walking. When people are sleep walking, they may do any rote or instinctual behavior. That can include walking, eating, driving and sexual activity."

The reason patients don't bring it up could be embarrassment, the fact that doctors rarely ask about it, or that patients aren't particularly bothered by it, Chung said.

"Is it a problem? As long as you don't get into legal problems and as long as your partner doesn't mind, it's not a problem," Chung said. "Although it can leave you tired the next day."

More information

The American Academy of Sleep Medicine has more on parasomnia.

Teen Headaches Tied to Alcohol, Coffee

MONDAY, June 7 (HealthDay News) -- A new German study links alcohol, smoking and coffee drinking to higher rates of migraine and tension headaches among teens and young adults.

An estimated 5 to 15 percent of high school students surveyed reported suffering from migraines, and 15 to 25 percent said they have tension headaches. Migraines were more common among those who drank coffee and didn't get much exercise. Smoking and alcohol also upped the risk.

Astrid Milde-Busch, a researcher at Ludwig-Maximilians-University in Munich, Germany, and colleagues surveyed 1,260 students aged 14 to 20 about headaches and their activities.

Of the students, 83 percent said they'd had a headache within the previous six months.

"Our study confirms that adolescents with any type of headache might benefit from regular physical activity and low consumption of alcoholic drinks," Milde-Busch said. "In teens suffering from migraine, a low coffee consumption should also be suggested."

Young adults who skipped meals weren't at higher risk of headache, the researchers found.

The study was published online June 7 in the journal Headache.

More information

For more about headaches, see the U.S. National Library of Medicine.

Clinical Trials Update: June 7, 2010

(HealthDay News) -- Here are the latest clinical trials, courtesy of ClinicalConnection.com:

Osteoarthritis of the Hip or Knee

This study will evaluate a non-narcotic investigational drug for arthritis pain. Participants must be at least 18 to qualify.

The research site is in Phoenix, Ariz.

More information

Please see http://www.clinicalconnection.com/clinical_trials/condition/osteoarthritis.aspx.

-----

Treatment Resistant Depression

This study will evaluate an investigational drug for people with major depressive disorder who have not responded to two antidepressants.

The research site is in Florence, Ky.

More information

Please see http://www.clinicalconnection.com/clinical_trials/condition/depression.aspx.

-----

COPD (Chronic Obstructive Pulmonary Disease)

This study will evaluate the safety and effectiveness of an investigational drug. Candidates must be 40 or older and diagnosed with COPD.

The research site is in Henderson, Nev.

More information

Please see http://www.clinicalconnection.com/clinical_trials/condition/COPD.aspx.

-----

Copyright 2010 ClinicalConnection.com. All rights reserved.

Military Deployment May Affect Kids' Health Care

MONDAY, June 7 (HealthDay News) -- The young children of a single parent deployed for military service are less likely to get medical care than the children of married service men and women, a new study has found.

"The bottom line is that military deployment of parents does affect the health care of their kids," said study co-author Dr. Gregory Gorman, a military-based commander and assistant professor of pediatrics at the Uniformed Services University of the Health Sciences in Bethesda, Md.

"Because there are so many demands on military personnel in this particularly high military tempo we have -- with two wars going on -- that routine care for their children very well might get deferred until when really needed," he added.

Gorman's research also uncovered a second interesting finding.

"Older couples in which one parent was deployed were actually bringing in their children for care more often than young, single-parent families. So the younger, single group should be one that we target to make sure that kids get the health care they need," he said.

Military personnel and their families experience unique sets of stressors, especially during wartime deployments, according to background information in the report, which was released online June 7 in advance of publication in the July print issue of the journal Pediatrics.

For the study, Gorman and his colleagues examined medical care patterns for nearly 170,000 children, one-third of whom had a parent that had been deployed at least once since 2007. All the children were younger than the age of 2 when the parent was deployed, and all were from families enrolled in the U.S. military's health-care system.

The researchers found that slightly more than one-quarter of all child-care visits were for issues other than an illness -- so called "well-child" visits. But, children from single-parent families experienced a drop-off in both outpatient visits for illness and well-child visits after the deployment of the parent. Conversely, children from married homes experienced an increase in both types of visits.

Gorman and his colleagues theorized that older parents may have more established support networks and better resources to carry out more frequent health-care visits for their children than younger parents.

But, he added, more research is needed before definitive conclusions can be reached.

Alyssa Mansfield, a research epidemiologist with the non-profit group RTI International in Research Triangle Park, N.C., said she'd also be hesitant to draw firm conclusions from the study findings.

"I would not be so quick to point to deployment as accounting for the differences they observed," she said. "I'm not disputing the results, but I would qualify the conclusions more than they did."

Mansfield noted, for example, that it would be premature to explain care-seeking frequency patterns by highlighting either the stress placed on non-deployed parents or caretakers, or the problems experienced by the children themselves.

"The researchers did not measure the parents' stress levels, so they just don't know what the case is with that," she said. "And because you're talking about extremely young children here -- including some babies under 1 year of age -- diagnosing behavioral problems in that group is very, very difficult. I would have also have wanted to see some sort of comparison of the military family experience with a civilian population."

Keith Armstrong, a professor of clinical psychiatry at the University of California, San Francisco, said the study findings "make intuitive sense," but agreed that "there should be follow-up studies to help us to refine our questions and our answers."

More information

For more on well-child visits, visit the U.S. National Library of Medicine.

Muscle Tone May Play a Role in GERD

MONDAY, June 7 (HealthDay News) -- Reduced muscle tone in the esophagus may be the cause of acid reflux disease, new research suggests.

Using molecular imaging, researchers examined the function of esophageal muscles in 49 people with suspected or confirmed gastro-esophageal reflux disease (GERD), and found what they described as strong evidence that poor esophageal muscle tone plays a role in the condition, whether people have mild, moderate or severe cases.

The findings were to be presented during the annual meeting of the Society of Nuclear Medicine, being held June 5-9 in Salt Lake City.

GERD is thought to affect from 15 percent to 35 percent of the U.S. population. In people with the condition, the circular muscle that seals off the stomach from the esophagus does not close properly. This enables the acidic stomach contents to rise up, or reflux, into the esophagus, resulting in inflammation and acid indigestion, or heartburn. Chronic reflux -- occurring more than twice a week -- is considered GERD, according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases. Long-term exposure to stomach acid can lead to serious damage of esophageal tissue and, possibly, cancer.

"If the findings of this study are confirmed by similar larger studies, it may lead to the use of medications to correct the abnormal muscular movements in the esophageal wall," Alok Pawaskar, a consultant in the nuclear medicine department at Apollo Hospitals, based in Chennai, India, said in a news release from the society. "These medications, when used in combination with common antacids that reduce the acidity of the stomach's contents, could provide patients with long-term relief from reflux disease."

More information

The American College of Gastroenterology has more about GERD.

Poor Asthma Outcomes in Black Kids Despite Access to Care

MONDAY, June 7 (HealthDay News) -- Even with equal access to health care, black and Hispanic children are more likely than white children to have asthma and their outcomes are often worse, a U.S. study has found.

Researchers analyzed data from 822,900 children, aged 2 to 17, continuously enrolled throughout 2007 in TRICARE Prime, a Department of Defense health maintenance organization-type plan. Asthma prevalence, treatment and outcomes were assessed among children in three age groups: 2 to 4, 5 to 10, and 11 to 17.

The study found a number of racial and ethnic differences. Compared to whites, black and Hispanic children were more likely to be diagnosed with asthma at all ages, and black children of all ages and Hispanic children aged 5 to 10 were more likely to have potentially avoidable asthma-related hospitalizations or emergency department visits.

"Our findings with regard to treatment patterns were mixed," wrote Kate A. Stewart, of Mathematica Policy Research in Chicago, and colleagues. "Black children, who at all ages were more likely to have a diagnosis of asthma and to have poorer outcomes than white children, were also more likely to receive recommended asthma medications, especially inhaled corticosteroids."

But this finding could be linked to the higher rates of emergency department and hospital visits among black children. Medication prescriptions may have been written and filled during or after these visits, the study authors noted.

The researchers also found that black children were less likely to be treated by an asthma specialist, who would be more likely to follow treatment guidelines, including proper use of asthma control medications.

"Thus, even though black children filled more prescriptions for asthma medications, they may have been less likely than white children who visited specialists to control their asthma and use the medications properly," the researchers wrote.

"Our findings suggest that eliminating racial and ethnic disparities in health care likely requires a multifaceted approach beyond universal health insurance coverage," the authors concluded.

The study was released online June 7 in advance of publication in the August print issue of the journal Archives of Pediatrics & Adolescent Medicine.

More information

The American Lung Association has more about childhood asthma.

Post-Combat Stress Disrupting Daily Lives of Returning Vets

MONDAY, June 7 (HealthDay News) -- Up to 14 percent of soldiers returning from Iraq suffer post-traumatic stress disorder (PTSD) or depression that is severe enough to disrupt their daily lives, new research shows.

Overall, between 8.5 percent and 14 percent of soldiers reported mental health issues that caused difficulties in work or private life, said Major Jeffrey L. Thomas, chief of the department of military psychiatry at the Walter Reed Army Institute of Research and lead author of a report in the June issue of the Archives of General Psychiatry.

Interestingly, surveys of self-reported depression and PTSD among 18,305 Iraq veterans in four regular army units and two National Guard infantry brigade combat teams found a significant difference between National Guardsmen and those on active duty, Thomas noted.

A first survey, taken three months after returning from Iraq, found almost equal rates of mental health problems among Guardsmen and regular Army soldiers. A second survey, done at 12 months, found unchanged rates among the regulars but a sharp increase among the Guardsmen.

"That's the one that surprised our team the most," Thomas said. "We don't know why, but we have some speculations."

When they come home, the Guardsmen have the stress of going back to whatever job they left, Thomas explained. "They have less contact with the peers they were activated with," he said. "Also, they don't have continual medical care. They have benefits for six months, then can buy into a government care program or get care on their own."

And in a sense, the regular Army soldiers didn't have the time to succumb to PTSD and depression, Thomas said. They knew they would be rotated back into Iraq within 12 months, which probably led to suppression of symptoms, he said.

PTSD is a set of psychological symptoms that can include nightmares, flashbacks to scenes of combat, surges in heart rate and periods of heavy sweating, alcohol misuse and aggressive behavior as minor as punching a wall or as great as a threat of committing physical violence.

The study graded the degree of psychological problems reported by individual soldiers. The least stringent definition, which included minor upsets, produced an incidence rate of PTSD ranging from 20.7 percent to 30.5 percent, and depression rates between 11.5 percent and 16 percent.

The strictest definition, with high incidence rates and serious impairment of normal functioning, found a PTSD rate of between 5.6 percent and 11.3 percent, with depression ranging from 5 to 8.5 percent.

That rating scale will help doctors determine when intervention is necessary, Thomas said. "It is a risk stratification system that clinicians can use," he said.

About 50 percent of those with strictly defined depression or PTSD also admitted to alcohol misuse or physical aggression.

The findings suggests a need for improved post-deployment screening, the researchers said.

Another study reported in the same issue of the journal found a higher incidence of dementia, such as Alzheimer's disease, in older veterans with PTSD.

Using a Veterans Affairs data base, the study of 181,000 veterans aged 55 and older found that 10.6 percent of those with PTSD developed dementia during a seven-year follow-up period, compared to 6.6 percent of those without PTSD.

That increased incidence was found even after adjusting for the presence of other problems, such as drug abuse, said Dr. Kristine Yaffe, a professor of psychiatry, neurology and epidemiology at the University of California, San Francisco, and chief of geriatric psychiatry at the San Francisco Veterans Affairs Medical Center.

"I can't say with 100 percent certainty that PTSD leads to a greater likelihood of dementia, but in our study it was not possible to explain away the relationship after fairly rigorous analysis," Yaffe said.

She offered two possible mechanisms for the relationship: PTSD could affect the brain's stress hormone pathways, possibly causing damage to the hippocampus, a brain area important for learning and memory; or genetic factors might increase the risk of developing both PTSD and dementia.

More information

To learn about PTSD and its treatment, visit the U.S. National Institute of Mental Health.

Secondhand Smoke a Mental Health Hazard?

MONDAY, June 7 (HealthDay News) -- Long linked to physical ailments such as asthma, heart disease and lung cancer, secondhand smoke may now be tied to an increase in mental woes, new research suggests.

Prolonged exposure to another's noxious tobacco fumes could up the odds for psychological distress, depression, schizophrenia and delirium, British researchers say.

"In the U.S., an estimated 60 percent of non-smokers have biological evidence of exposure to passive smoke. Thus, in order to improve mental and physical health, people should be made aware of these harmful effects," said lead researcher, Mark Hamer, from the Department of Epidemiology and Public Health at University College London.

"Exposure to passive smoke was associated with higher levels of psychological distress and greater risk of future psychiatric illness," he said.

The report is published in the June 7 online edition of the Archives of General Psychiatry.

For the study, Hamer's team collected data on over 5,500 non-smokers and nearly 2,600 smokers. None of these people had any history of mental illness at the start of the study, the researchers noted. In addition, the researchers measured levels of cotinine in saliva, which indicates an individual's level of exposure to tobacco smoke.

Over six years of follow-up, 14.5 percent of the individuals were found to be suffering from psychological distress. People who did not smoke, but who were exposed to high levels of secondhand smoke, were almost 50 percent more likely to suffer from psychological distress than those not exposed, the researchers found.

In addition, during the six-year follow-up period, 41 of the participants were admitted to psychiatric hospitals for problems such as depression, schizophrenia, delirium or other psychiatric problems. Those with high exposure to secondhand smoke were nearly three times as likely to be admitted versus people unexposed to the fumes, the study authors found.

Stanton A. Glantz, a professor of medicine and director of the Center for Tobacco Control Research and Education at the University of California, San Francisco, commented that "this is an important and well-done study that shows that secondhand smoke is even more dangerous than we previous thought."

Dr. Norman H. Edelman, a scientific consultant for the American Lung Association, agreed that "this is a very well done, potentially important study."

Edelman said, "It's not just that people with psychiatric symptoms tend to smoke more or be around those who smoke more, it may be that the exposure to smoke adds to their symptoms."

However, another expert questions the validity of the findings. While smoke may make one more susceptible to mental problems, people predisposed to mental health woes may find themselves in smoky environments more often.

Dr. Ted Schettler, the science director of the Science and Environmental Health Network, reasoned that, perhaps "nicotine is associated with an increased likelihood of psychological problems."

But, he added, "On the other hand, you can easily imagine that people who are in stressful life circumstances are also finding themselves in more smoke-filled environments. I don't know that you can separate it out."

More information

For more information on secondhand smoke, visit the U.S. National Library of Medicine.

Health Highlights: June 7, 2010

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Brain Influences Cholesterol Levels: Study

The brain plays a role in regulating the amount of cholesterol circulating in the blood, says a study that challenges the belief that cholesterol levels are influenced only by what you eat and by cholesterol production in the liver.

University of Cincinnati researchers concluded that the hunger hormone called ghrelin acts as a "remote control" for cholesterol. Their tests in mice found that higher levels of ghrelin were associated with higher levels of cholesterol circulating in the bloodstream, BBC News reported.

Cholesterol levels in the blood increased when signals from the brain told the liver to store less cholesterol, the researchers said. The study appears in the journal Nature Neuroscience.

"We have long thought that cholesterol is exclusively regulated through dietary absorption or synthesis and secretion by the liver," said study leader Professor Matthias Tschoep. "Our study shows for the first time that cholesterol is also under direct 'remote control' by specific neurocircuitry in the central nervous system."

While the findings need to be replicated in humans, this research "could potentially open up new forms of treatment to control cholesterol levels, which would be great news for people with heart and circulation problems," Fotini Rozakeas, a cardiac nurse with the British Heart Foundation, told BBC News.

-----

Stroke Prevention Trial Halted for Kids With Sickle Cell Disease

A study to determine whether the drug hydroxyurea prevents stroke in children with sickle cell anemia and iron overload has been halted early because the drug was unlikely to prove more effective than the current standard treatment of blood transfusions, the U.S. National Heart, Lung, and Blood Institute said Friday.

Hydroxyurea is known to prevent complications of sickle cell disease in adults. This 26-site clinical trial included 133 children, ages 5 to 18, who had already suffered a stroke and had received blood transfusions for at least 18 months and had high levels of iron.

"Protecting our participants is an important factor in determining whether to stop a trial," Dr. Susan B. Shurin, acting director of the NHLBI, said in an agency news release. "When an experimental treatment fails to meet its predetermined goals, it is best to return participants to standard treatment as soon as possible."

About 10 percent of children with sickle cell disease suffer a stroke, which puts them at high risk for subsequent stroke unless they receive preventive treatment, the agency said.

-----

McDonald's Recalls Shrek Glasses

About 12 million "Shrek"-themed drinking glasses sold nationwide at McDonald's are being recalled because the painted designs contain cadmium, a known carcinogen that can also cause bone softening and severe kidney problems.

Consumers should immediately stop using the 16-ounce glasses, warned the U.S. Consumer Product Safety Commission, the Associated Press reported.

The U.S.-made glasses, which cost about $2 each, are part of a promotional campaign for the movie "Shrek Forever After," and depict characters from the movie. McDonald's plans to post instructions on its Web site regarding refunds.

A pigment in paint on the glasses contained cadmium, said McDonald's USA spokesman Bill Whitman. CPSC spokesman Scott Wolfson did not specify the amounts of cadmium that leached from the paint in tests, but said the amounts were "slightly above the protective level currently being developed by the agency," the AP reported.

-----

WHO Flu Advisers Had Ties to Drug Makers: Report

A trio of experts who created the World Health Organization guidelines advising governments to stockpile drugs to prepare for a possible flu pandemic had close links to the drug companies that make the antiviral drugs, a new report contends.

The scientists who wrote the guidelines, issued by the WHO in 2004, had previously been paid for other work from Roche, which makes Tamiflu, and GlaxoSmithKline, which makes Relenza, according to an investigation by the British Medical Journal and the Bureau of Investigative Journalism, the Guardian newspaper in England reported.

The companies made more than $7 billion when governments around the world stockpiled the drugs, according to analysts.

Even though the trio of experts had previously publicly declared their ties to the drug companies, the WHO itself did not publicly disclose any of these connections in its 2004 guidance about the need to stockpile the antiviral drugs, the newspaper reported.