May 18, 2012 — Sprains, strains, and worse injuries are unavoidable in sports, and playing through the pain comes with the territory for most athletes.

So how do they continue to excel with pain that would leave others sidelined?

New research confirms that athletes have a higher tolerance for pain than couch potatoes or even weekend warriors, and the finding could help investigators discover better ways to manage pain.

No Pain, No Gain?

Researchers in Germany reviewed findings from 15 studies comparing pain threshold and pain tolerance among athletes and non-athletes.

“Pain threshold” refers to the point at which pain begins to be felt in response to stimulation (heat, pressure, etc.), while “pain tolerance” is the maximum amount of pain a person can stand.

Athletes and non-athletes in the studies had similar pain threshold levels, but athletes consistently reported higher pain tolerance than normally active adults.

And the amount of pain athletes were able to tolerate varied by their sport, with those involved in game sports like football or soccer generally more tolerant of pain than those who participated in endurance sports.

But this was not always the case. One study found that cross-country skiers were among the most pain tolerant, along with football players.

Endorphins May Blunt Pain

The findings, which appear in the June issue of the journal Pain, strongly suggest that athletes have a higher tolerance for pain than others, but the studies did not explore the reasons for this.

Researcher Jonas Tesarz, MD, of the University of Heidelberg, tells WebMD that more research is needed to determine if increased physical activity helps control pain.

If the association is confirmed, the finding could have major implications for pain management.

Physical activity boosts levels of chemicals that mimic the effects of “feel good” and pain-relieving opioids, known as endorphins.

In runners, this chemical rush is known as a “runner’s high.”

Pain researcher Allan Basbaum, PhD, of the University of California, San Francisco, says he was highly skeptical of the theory that endorphins blunt pain until about four years ago.

That is when a group of German researchers proved that running and other strenuous exercise really does increase endorphin levels in the brain as well as the blood.

Basbaum chairs the anatomy department at UCSF and is the editor-in-chief of the journal Pain.

“Previous studies had looked at endorphins in the blood, but blood levels are irrelevant to what is going on in the brain,” Basbaum says.

Playing Through the Pain

He adds that because athletes are highly motivated to keep doing what they do, they may also be far more likely than others to ignore pain signals and play through the pain.

“Most athletes don’t ask themselves, ‘Does it hurt?’” he says. “They ask themselves, ‘How much pain can I put up with?’”

And people who can put up with the most pain may be most likely to become athletes.

“There may be a ‘chicken and egg’ component,” Basbaum says. “Do they have a high pain tolerance because they are athletes, or are they athletes because they have a high pain tolerance?”

Surprising Reasons You’re in Pain

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May 18, 2012 — One in 30 baby boomers may be infected with the hepatitis C virus, but few know it until it’s too late for their livers.

In the wake of new statistics showing more than 2 million baby boomers in the U.S. are infected with hepatitis C, the CDC is proposing new guidelines calling for all adults of that generation to be tested for the virus.

Officials say baby boomers, the generation born from 1945 through 1965, now account for more than 75% of all Americans living with the virus. But recent studies show few are aware they are infected or at risk for infection.

“Identifying these hidden infections early will allow more baby boomers to receive care and treatment, before they develop life-threatening liver disease,” says Kevin Fenton, MD, PhD, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention, in a news release.

Current hepatitis C testing guidelines call for only those with certain risk factors to be tested for the virus.

The announcement of the proposed change coincides with the first-ever National Hepatitis Testing Day on May 19. After a public comment period, the new guidelines are expected to be finalized later this year.

Hepatitis C: Hidden Killer

The hepatitis C virus is spread through exposure to infected blood. The most common means of infection is through sharing of needles or other equipment used to inject drugs.

Researchers say most baby boomers were likely infected with hepatitis C when they were in their teens or 20s.

Some may have been infected when they experimented with injection drugs, even just once. Others may have been exposed to the virus through blood transfusions before modern blood-screening procedures came into effect in 1992.

Once infected, the hepatitis C virus causes progressive damage to the liver and can go undetected for many years without symptoms. Some people may have symptoms — like fever, fatigue, dark urine, and abdominal pain — six to seven weeks after getting infected.

Hepatitis C can lead to serious liver disease and liver cancer, which is the fastest-growing cause of cancer-related deaths. It is also the leading cause of liver transplants in the U.S.

The CDC says one-time testing of all baby boomers for the hepatitis C virus could identify more than 800,000 people infected with the virus, allow for early treatment to prevent liver disease, and save more than 120,000 lives.

Researchers say therapies can cure up to 75% of hepatitis C infections.

“With increasingly effective treatments now available, we can prevent tens of thousands of deaths from hepatitis C,” says CDC Director Thomas R. Frieden, MD, MPH, in the release.

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May 18, 2012 — The FDA has approved several generic versions of the popular blood thinner Plavix (clopidogrel).

Officials say the approval will make more affordable options available for people who take Plavix to reduce their risk of heart attack and stroke.

“For people who must manage chronic health conditions, having effective and affordable treatment options is important,” says Keith Webber, PhD, of the FDA’s Center for Drug Evaluation and Research, in a news release. “The generic products approved today will expand those options for patients.”

Major pharmacy chains say they expect to have the generic versions of clopidogrel in stock within days of the approval.

Generic Plavix Approved

Plavix was approved by the FDA in 1997 and is marketed in the U.S. by Bristol-Myers Squibb. The U.S. patent on the drug expired on May 17, paving the way for the FDA’s approval of generic versions.

Generic drugs approved by the FDA must be of the same quality and strength as the brand-name versions.

Clopidogrel is approved to treat people who have had a recent heart attack or stroke or who have plaque buildup in arteries known as peripheral artery disease.

The drug works by making the platelets in the blood less likely to clump and form clots that could lead to a heart attack or stroke.

The FDA approved three 300-milligram (mg) generic versions of clopidogrel and seven generic 75-mg versions.

Risks Same as With Plavix

Generic clopidogrel, like Plavix, may not work in people with certain genetic risk factors that affect how the drug is metabolized in the body. A genetic test can check for these factors.

Some drugs, including proton pump inhibitors used for heartburn and acid reflux like Nexium and Prilosec, may also reduce the effectiveness of clopidogrel.

Possible side effects of clopidogrel include bruising and excessive bleeding, which can be life-threatening in some cases.

A Visual Guide to Understanding Stroke

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May 17, 2012 — An extract from the Chinese herb kudzu may help drinkers cut down on drinking, according to a new pilot study.

“It didn’t stop the drinking,” says researcher David M. Penetar, PhD, assistant professor of psychology at McLean Hospital and Harvard Medical School. “They still drank, but they drank less.”

He studied the extract puerarin. It is one of the substances known as isoflavones found in kudzu.

The study is published in Drug and Alcohol Dependence.

12 Myths About Your Hangover

Drinking Problems

More remedies are needed to help drinkers who overdo it cut down, Penetar says. The medications approved for treating alcohol abuse and dependence don’t work for everyone, he says.

About 1 in 6 U.S. adults binge drinks, according to a CDC report. Experts disagree on the definition of binge drinking. According to the CDC, binge drinking is having four or more drinks on one occasion for a woman and five or more for a man.

Kudzu: A Brief History

In Chinese pharmacy books, kudzu is listed as a possible treatment for alcohol-related hangovers and cravings, Penetar tells WebMD.

“Some of the references go back to 600 A.D.,” he says.

Today, it’s used in China and other countries to treat coronary problems and blood-flow problems, Penetar says. “It has a good safety record already.”

It’s touted as a hangover remedy. However, studies looking at the effects of kudzu extracts have produced mixed findings, Penetar says.?

Herb to Cut Drinking: Study Details

Penetar’s team studied 10 men and women, average age 26. They typically drank about 18 alcoholic beverages a week.

“We set up a lab room to make it look like an apartment,” Penetar says.

The lab-turned-apartment had a reclining chair, TV, DVD player, and a refrigerator stocked with each person’s favorite beer. Non-alcoholic beverages were also available.

The researchers conducted four different sessions:

The first session was to make the participants familiar with the surroundings. They drank but took no herbs.Before the second, they took either 1,200 milligrams of puerarin or identical-looking placebo pills for a week. They came to the lab and could drink as much as they wanted, up to six beers.Two weeks later, they came back for a drinking session, without taking the herb or the placebo.For a final session, they took whichever pill they didn’t take the first time. They took it for a week, then went to the lab again for a drinking session.

The participants provided urine samples so the researchers could confirm they were compliant.

They were given dinner after the sessions and sent home in a taxi once their blood alcohol level declined.

Results of Puerarin Treatment

“When they were treated with puerarin they drank about a beer less than when they were treated with placebo,” he says.

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May 17, 2012 — With summer nearly upon us, our sunglass habits could use improvement, according to a new report issued today by The Vision Council, an industry group.

While 73% of adults do wear sunglasses, only 58% of them make their children wear shades, too, the report found.

More than half of us lose or break our sunglasses every year. More than a quarter of us never bother to wear them, despite benefits to eye health.

“A substantial proportion of people still do not understand that UV exposure is harmful to the eyes as well as the skin,” says Paul Michelson, MD, an ophthalmologist in La Jolla, Calif., and chairman of the Better Vision Institute, the medical advisory arm to The Vision Council.

“Even those who do understand, few understand it is the cumulative exposure that can be damaging,” says Michelson, the former section chief of ophthalmology at Scripps Memorial Hospital in La Jolla.

“The good news is, some people wear sunglasses some of the time,” Michelson says. “The bad news is, not enough people wear them enough of the time.”

It’s never too early, Michelson tells WebMD, to put sunglasses on kids. And it’s never too late to begin wearing them, he adds.

The report is titled “Finding Your Shades, Protecting Your Vision.” Besides tracking sunglass-wearing habits, it lists the long- and short-term effects of UV exposure and lists U.S. cities by UV exposure levels.

Your Eyewear Guide for Vision, Sport and Fashion

Sunglass Habits: The Survey

For the survey, The Vision Council polled 10,000 adults from across the country. Barely 1 in 6 said eye health was the reason for wearing sunglasses. Many more, two-thirds, said the purpose was to prevent glare.

The researchers found a variety of reasons why people do not wear sunglasses. Among them:

Nearly half simply forget.About 14% lose or break sunglasses often.About 20% don’t believe their eyes are at risk from sun exposure.UV Eye Exposure & Health Problems

UV exposure can cause short-term and long-term effects on eye health. People with blue eyes are more at risk for UV damage than those with brown eyes, experts say.

After a long day at the beach, eyes may seem bloodshot, swollen, and light-sensitive.

Sunburn of the eye, or photokeratitis, is one effect. It’s also known as ”snow blindness,” as it happens to skiers, too.

In severe cases, it can cause loss of vision for up to 48 hours, according to the report.

Long-term, excess UV exposure can cause a variety of eye problems, including:

“Surfer’s eye,” also known as pterygium: This abnormal but usually benign growth on the eye’s surface can itch, swell, and become irritated. Surgery can be done to remove it, but it can come back.Cataracts: The progressive clouding of the lens of the eye.Age-related macular degeneration: The macula is at the back of the eye, in the middle of the retina. Damage to the nerve cell in the macula can dull colors and blur fine detail in your vision.Cancer of the eye, eyelid, or nearby skin.

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May 16, 2012 — Sudden heart death?may be a new risk from the commonly prescribed antibiotic azithromycin — better known as Zithromax or the Z-Pak.

The finding comes from a study of Medicaid patients who received some 348,000 Z-Pak prescriptions from 1992 to 2006.

Compared to patients who took no antibiotics, those taking the five-day course of azithromycin treatment had about a threefold higher risk of heart death. Compared to patients with infections treated with amoxicillin, another antibiotic, those taking azithromycin had twice the risk of heart death.

Even so, it’s a small risk. For every million courses of azithromycin treatment there were an estimated 47 extra heart deaths. Among people at highest risk of heart disease, there were 245 extra heart deaths per million courses of azithromycin.

“It’s a small risk. And if you look carefully, you’ll see that all antibiotics have serious risks,” study leader Wayne A. Ray, PhD, professor of preventive medicine at Vanderbilt University, tells WebMD. “For most patients, this is a relatively small risk.”

Ray says the study probably will make doctors think hard about prescribing azithromycin for patients at high risk of heart death.

“When an equally effective alternative is available, it should be used for patients at high cardiac risk,” Ray says.

Infectious disease specialist Jay Varkey, MD, director of the antibiotic management program at Emory University, says the study is well done but far from conclusive.

“In and of itself, this study does not warrant a dramatic amount of alarm,” Varkey tells WebMD. “It calls for more studies to see whether the increased death rate was truly due to azithromycin or to the underlying disease being treated.”

Ray and colleagues tried to do this by comparing patients on azithromycin to those on amoxicillin. Both drugs are often used to treat ear, nose, and throat infections.

But Varkey notes that azithromycin is more likely to be used in patients with pneumonia, which might mean that those taking the drug were already at higher risk of death.

While the findings certainly will make Varkey pause before prescribing a Z-Pak to a patient with heart disease, he says the biggest risk to patients is from taking unnecessary antibiotics in the first place.

“At least half of antibiotic prescriptions are unnecessary and inappropriate,” he says. “The first question to all doctors is, ‘Does this person really need an antibiotic?’”

The study appears in the May 17 issue of The New England Journal of Medicine.

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May 16, 2012 — It is widely believed that raising “good” cholesterol levels lowers heart attack risk, but surprising new research finds evidence that this may not be the case.

Genetic studies failed to show a link between higher concentrations of high-density lipoprotein (HDL) cholesterol and lower heart attack risk.

Millions of people take statin drugs like Crestor, Lipitor, Pravachol, and Zocor to lower their low-density lipoprotein (LDL), or “bad” cholesterol. Studies have shown that high LDL levels are linked to an increase in heart attack risk.

But the benefits of increasing HDL are less clear, and studies of HDL-raising drugs have been largely disappointing.

Cholesterol 101: What Your Levels Mean

Higher HDL Not Protective

In the newly reported study, investigators from Harvard Medical School used a relatively new research technique that tests connections between genes and disease to examine whether HDL has a direct impact on heart attack risk.

In earlier studies, the researchers identified a gene variant found in about 2.6% of the population associated with elevated HDL levels.

People with the gene variant have levels that are, on average, about six points higher than people without it.

When the researchers looked for the variant in about 21,000 people who had experienced heart attacks and 95,000 people with no heart attack history, they found that carriers did, indeed, have higher HDL levels.

But they saw no evidence that these people also had a lower susceptibility to heart attacks.

“The expectation was that the people who carried this genetic variant would have a lower heart attack risk, but that is not what we found,” says researcher Sekar Kathiresan, MD, of Harvard Medical School and Massachusetts General Hospital.

In a second study, which involved 14 more common gene variants also associated with HDL, the researchers once again found no evidence that the variants had a direct, protective role in heart attack risk.

Kathiresan tells WebMD that HDL remains an important tool for assessing heart disease risk, but he says the new research raises even more questions about the benefits of taking drugs to raise HDL levels.

HDL Drug Trials Disappointing

Many clinicians still prescribe the vitamin niacin to help raise HDL levels, even though a government-funded trial proved disappointing.

The trial was halted early a year ago when it was determined that people with heart disease who had low HDL levels did not benefit from the treatment.

There was even a suggestion that taking high doses of niacin raised stroke risk.

The drug company Pfizer abandoned its experimental HDL-boosting drug torcetrapib in 2006 when trials showed an increase in heart attack and stroke risk among users.

And earlier this month, Roche Pharmaceuticals abruptly stopped late-phase trials of its similar drug, dalcetrapib, finding no evidence of a lower heart attack risk in users.

American Heart Association past president Robert Eckel, MD, says the new research casts even more doubt on the strategy of raising HDL to lower heart and stroke risk.

Eckel is a professor of medicine at the University of Colorado School of Medicine in Aurora.

“HDL levels are related to risk, but that doesn’t mean that raising HDL is beneficial,” he says. “What we do know is that lowering LDL has a big impact on risk, so the take-home message remains, ‘Get those LDL numbers down,’” he says.

Kathiresan says his research team will continue to search for genes that alter HDL and lower heart attack risk.

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May 16, 2012 — Whatever you call it — joe, java, mud — it is likely a key way to jump-start your day, and now new research suggests it may also help you live longer.

The study, described as the largest of its kind, found that coffee drinkers had a lower risk of death from heart disease, respiratory disease, stroke, accidents and injuries, diabetes, and infections, but not from cancer. Researchers observed these results after accounting for the effects of other risk factors for dying, such as smoking and drinking alcohol.

The scientists examined the connection between drinking coffee and death among more than 400,000 men and women in the National Institutes of Health-AARP Diet and Health Study. Participants lived in six scattered states and the Atlanta and Detroit metropolitan areas. At the beginning of the study, they were 50 to 71 years old and had not had cancer, heart disease, or stroke.

Between 1995 and 1996, the men and women completed a comprehensive questionnaire assessing their diet and lifestyle. Nine out of 10 study participants drank coffee, and few of the coffee drinkers said they also drank tea, the focus of a future analysis, says researcher Neal Freedman, PhD, of the Division of Cancer Epidemiology and Genetics at the National Cancer Institute.

Freedman and his collaborators then followed the people in the study until the date they died or Dec. 31, 2008, whichever came first.

Compared to people who drank no coffee, coffee drinkers who downed three or more cups a day had about a 10% lower risk of death overall and a lower risk of dying from each of a variety of leading killers. Cancer was the only exception.

Among women, coffee drinkers and non-drinkers were equally likely to die of cancer. Among men, there was only a slight connection between heavier coffee drinking and increased risk of dying from cancer.

Reassuring Findings

The study findings should be reassuring to people who drink coffee, one of the most popular beverages in the United States and worldwide, Freedman says. “There’s been a concern for a long time that coffee drinking might increase the risk of death.”

But he’s not advising anyone to start drinking coffee on the basis of his results.

“Coffee is a complicated beverage,” Freedman says, noting that it contains 1,000 different compounds, most of them little-studied.

Besides, because study participants weren’t assigned to drink coffee or not drink it, the researchers can’t be sure what caused the lower death rate — the beverage itself or some unmeasured characteristic of the people who chose to drink it. This type of study can show the association, but it can’t say that coffee caused people to live longer.

If you are thinking about starting to drink coffee, talk to your doctor about whether you might have any reason not to, Freedman says, adding that “there are some data that show coffee might cause a short-term increase in blood pressure.”

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March 16, 2012 — The CDC today released its annual state of the union’s health, and there’s good news and bad. We’re living longer. But we’re also gaining more weight. Teen pregnancies are at a record low. But fewer people can afford necessary prescription drugs and medical care.?

The 583-page federally mandated report, titled “Health, United States 2011,” also compares how well — or how poorly — we fare today with how we were doing over the past decade or so.

This year’s report features a special section on how our socioeconomic status and health are related. Here are some highlights:

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The Health Gap: Income- and Education-Related DisparitiesChildhood obesity rates go down as parent education goes up: Nearly a quarter of children whose parents have less than a high school education were obese, which is two to three times more than kids whose parents (or heads of household) had finished college.Seventy-five percent of college-educated mothers breastfed their babies for at least three months, compared to less than half of women who did not finish college.45- to 64-year-old adults living below the poverty line were as much as five times as likely to be depressed as those living well above it.Nearly a third of adults who only finished high school still smoke, compared to less than 10% among those with a college degree.The number of uninsured children decreased, particularly among those closest to the poverty line: from 22% down to 11-13% in families below 200% of the poverty level.Low-income adults were as much as six times more likely to be uninsured than those who have a family income at 400% or more of the poverty level. They were also much less likely to seek timely medical care.

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Life Expectancy, Disease, and Risk FactorsWe are living longer. Since 1980, men’s life expectancy rose from 70 to 76, while women’s increased from 77 to 81.Heart disease remains the most common killer for both men and women. It causes about one-quarter of all deaths each year. But over the past 10 years, the number of heart disease deaths has dropped by 32%.Deaths caused by stroke dropped by about a third for both men and women. Cancer deaths are also down — by 15% for men and 11% for women.Nearly half of all adults with high blood pressure don’t have it under control, though this percentage has gone down significantly since the early 1990s. The number of adults with high cholesterol also dropped during this period.Since 1994, obesity has gone up among all age groups. Nearly 20% of school-age children are now obese, while one-fifth of adults over 20 now have a BMI greater than 30 (which is considered obese).In 2010, only half of adults over 18 met the federal recommendations for physical activity.The number of 40-and-older women who had a mammogram over the past two years has held steady for a decade, while many more adults ages 50 to 75 are now being screened for colorectal cancer than 10 years ago.Drug poisoning deaths doubled between 2000 and 2008. Opioid painkillers accounted for 40% of those deaths in 2008.

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May 14, 2012 — Does high blood pressure run in your family? Keeping physically fit may lower your odds of developing high blood pressure by a third.

A new study shows that physically fit people with a family history of high blood pressure were up to 34% less likely to develop high blood pressure than people who rarely exercised.

And it didn’t take hours of working out at the gym every day to get that benefit.

“The results of this study send a very practical message, which is that even a very realistic, moderate amount of exercise — which we define as brisk walking for 150 minutes per week — can provide a huge health benefit, particularly to people predisposed to hypertension because of their family history,” researcher Robin P. Shook, a doctoral graduate student in the Arnold School of Public Health at the University of South Carolina in Columbia, says in a news release.

Having a parent with high blood pressure is one of the biggest risk factors for developing the condition yourself. Previous research suggests that having a parent with high blood pressure may account for about 35% to 65% of the variability of blood pressure levels.

Lowering Blood Pressure Slideshow: Exercise Tips for Getting

The Physical Fitness Factor

The new study, published in Hypertension, included more than 6,000 healthy adults. About a third of them had a parent with high blood pressure.

Their physical fitness levels were followed for nearly five years.

The results confirmed that people who had a parent with high blood pressure were more likely to develop high blood pressure — about 20% more likely, after considering other risk factors, including age, smoking, high cholesterol, and being overweight.

But the researchers found some good news for people with and without a family history of the disease, and physical fitness was the key.

People with a high level of physical fitness were 42% less likely to have high blood pressure and those with a moderate level of fitness were 26% less likely, compared to people with a low level of physical fitness.

Among people with a parent with high blood pressure, those who were most physically fit had only a 16% higher risk of developing high blood pressure than those who were fit and had no family history of the disease.

The reverse was also true. People with a parent with high blood pressure and a low level of physical fitness were 70% more likely to develop hypertension compared to highly fit people with no family history of the disease.

“The correlation between fitness levels, parental history, and risk are impossible to ignore,” Shook says.

Because most of the people in this study were relatively fit, well-educated, middle- to upper-class white men, the researchers note that the results of the study may not represent all groups of people in the U.S.

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