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In the study, 1,037 people born in New Zealand between April 1972 and March 1973 were assessed for socioeconomic disadvantage, abuse and social isolation during the first 10 years of life. The study authors followed up with the participants at age 32, and checked them for three risk factors for age-related diseases: depression, high inflammation levels (measured by the blood marker C-reactive protein), and the presence of multiple metabolic issues (such as high blood pressure, abnormal cholesterol levels and overweight).

Adult participants who’d experienced adversity in childhood were more likely to have the three risk factors for age-related diseases, the researchers found. Adverse childhood events contributed to an estimated 31 percent of the cases of depression, 13 percent of the cases of elevated inflammation, and 32 percent of the cases of clustered metabolic risk factors, the study authors reported.

“The effects of adverse childhood experiences on age-related disease risks in adulthood were non-redundant, cumulative and independent of the influence of established developmental and concurrent risk factors,” such as low birth weight, family history or childhood body-mass index, wrote Dr. Andrea Danese, of King’s College London, and colleagues.

“It has long been known that pathophysiological processes leading to age-related diseases may already be under way in childhood. The promotion of healthy psychosocial experiences for children is a necessary and potentially cost-effective target for the prevention of age-related disease,” the authors concluded.

People who got text messages each morning with a brief local weather report followed by a prompt like “slap on some sunscreen today” were twice as likely to use sunscreen as people who didn’t get the texts, Dr. April W. Armstrong of the University of California-Davis Health System in Sacramento and her colleagues found.

Study participants who received the reminders still went without sunscreen a lot of the time — about 4 in 10 days, on average, the researchers report in the Archives of Dermatology.

Nevertheless, Armstrong noted in an interview, the findings show that “we can use simple low cost technologies such as text message reminders to improve healthy habits.”

Getting people to take their pills or run on medicated cream as prescribed is a perennial problem for doctors, she added, and sunscreen is no exception. Overall, just one in five Americans report using sunscreen regularly, Armstrong and her team note in their report.

The researchers recruited 70 text-savvy adults to enroll in their study, and then randomly assigned them to receive the text message reminders or a control group who didn’t get the reminders. The text reminders were worded differently every day, to avoid “message fatigue.”

All of the study participants also were given sunscreen dispensers with embedded electronic sensors that sent the date and time back to a central server every time the container was opened. “We could actually track in real time when people are using their sunscreen,” Armstrong explained.

Over the course of the 42-day study, people in the text-message group used sunscreen on about 24 days, on average, for an adherence rate of 56 percent, compared to about 13 days for the group who didn’t receive reminders, or a 30 percent adherence rate.

Sixty-nine percent of the people who got the reminders said they would want to keep using them, while 89 percent said they’d recommend the system to other people.

The study shows that “even people who know they are being monitored do not use their sunscreen well,” Bridget V. Nolan and Dr. Steven R. Feldman of the Wake Forest University School of Medicine in Winston-Salem, North Carolina and colleagues point out in an accompanying editorial.

But the findings also hint, they say, that “new technologies may provide additional means by which we can help our patients use recommended treatments better.”

Modern-day imaging techniques have unearthed hardening of the arteries — or atherosclerosis, which causes heart attacks and stroke — in mummies up to 3,500 years old.

Experts have long believed that atherosclerosis is a scourge of modern society, caused by meals snatched at fast-food restaurants and eaten in front of high-definition TVs.

“Perhaps atherosclerosis has been around a lot longer than we think. It might have been a malady affecting man long-term,” said Dr. Clyde Yancy, president of the American Heart Association. “It doesn’t necessarily change anything we know or do now, but perhaps some of the accoutrements of civilization are not only unhealthy now, they were also unhealthy then.”

The unusual findings were presented Tuesday at the American Heart Association’s annual meeting in Orlando, Fla., and published simultaneously in the Nov. 18 issue of the Journal of the American Medical Association.

“We can’t say that atherosclerosis was the cause of death, but the simple fact that they had it was a great surprise to us,” said study co-author Dr. Samuel Wann, chairman of the department of cardiovascular medicine at the Wisconsin Heart Hospital in Wauwatosa. “We thought it was a disease of McDonald’s. We had this vision of people 3,000 and 4,000 years ago being more pure, free-living and not subject to the evils of modern civilization, but this has been going on for a long time.”

The research started when two physicians, one American and one Egyptian, saw a sign on a mummy at the Museum of Egyptian Antiquities in Cairo, saying that the pharaoh on display had atherosclerosis.

“How did they know?” the doctors wondered. Before getting a grant to carry out the research, none of the scientific team members thought the mummies would have atherosclerosis.

Twenty-two mummies were selected for CT (computed tomography) imaging scans on a machine kept in a truck behind the museum but seldom used. Those chosen had withstood the ravages of time better than most.

“The state of preservation of some of the bodies was superb,” said Dr. Randall C. Thompson, second author of the study, who’s with the Mid-America Heart Institute in Kansas City, Mo. “There were parts of the cardiovascular system that were intact amazingly well, and on the CT scan we could tell these were arteries, heart, cardiovascular tissue — even on mummies 3,000 or 3,500 years old. Atherosclerosis looked just like it does in modern patients.”

Definite or probable atherosclerosis was found in nine of the 22 mummies, and was more common (present in seven of eight) in older mummies — that is, mummies thought to have been 45 years or older when they died, the researchers said.

Fourteen of the mummies were members of the aristocracy or the royal household, including Lady Rai, nursemaid to Queen Nefertari, along with priests or priestesses and one soldier, the researchers said.

“We have every reason to believe the others were wealthy individuals as well because of the cost of mummification,” Thompson said. “In upper-class older and middle-age Egyptians, atherosclerosis was not uncommon.”

The disease process affected men and women.

Ancient Egyptians didn’t smoke tobacco, eat processed foods or skimp on exercise as far as anyone knows, but they did farm and eat protein.

“They did eat animals. Drawings on the tomb showed they ate ducks and sheep and particularly salted fish,” Wann explained. Hieroglyphics have also depicted what might be chest pain from a heart attack, the authors said.

The salt component of the diet may have resulted in high blood pressure, but that is only speculative, Thompson said.

One mummy had calcification at the base of the heart that some researchers thought might be indicative of a heart attack.

The investigators weren’t able to tell if the mummies were obese or had diabetes.

“This gives us insights into the relative importance of risk factors versus genetics,” Thompson said. “I use this information to give my patients hope. A lot of my patients have a certain denial. Why did this happen to me? Others have a sense of guilt or blaming family members, but this disease has been around since before the time of Moses. It’s older than the pyramids, and I think this knowledge helps patients get past the guilt and denial so they begin the healing process.”

In the so-called Bypassing the Blues trial, 50 percent of patients who were depressed after having coronary artery bypass surgery saw improvements of at least 50 percent in their negative mood after participating in the intervention, compared with 29 percent of control patients who received usual care.

Depressed men benefited most and were far less likely to be re-hospitalized for heart-related causes than men who got usual care, said study presenter Dr. Bruce L. Rollman, from the University of Pittsburgh, Pennsylvania.

Depression after heart surgery “is often unrecognized,” Rollman noted. When a patient still has symptoms, such as pain, the physician will order another stress test or other heart test “and they overlook the obvious sometimes. We just want people to be aware of the impact of depression and that there are safe and effective treatments available.”

In the trial, researchers screened heart bypass patients for depression before they were discharged from the hospital. Screen-positive patients were contacted again two weeks later when they were at home to see if their depression was persisting. If so, they were randomly allocated to receive an 8-month course of telephone-delivered collaborative care or usual care.

Patients in the collaborative care group received a workbook, mailed to them at home, which contained basic “talk therapy” approaches as well as recommendations for exercising, getting plenty of quality sleep, and staying connected socially.

Antidepressants were provided if patients felt it necessary. Patients who were already taking antidepressants could have their dose changed or could switch to another medication, and suggestions were made for consults with local mental health specialists if patients were not improving, Rollman said.

Trained nurse practitioners phoned the patients every other week at the start of the intervention and then once a month as the study progressed.

This simple intervention proved effective in relieving depression after heart bypass surgery, Rollman reported.

Patients should be screened for depression after heart bypass surgery, he said, because it occurs in roughly 25 percent of cases, and, as this study shows, treating depression speeds recovery.

“Many practices have care managers for helping people with their diabetes and other chronic conditions and a similar program could be used to help patients who are depressed cope after their bypass surgery,” Rollman said.

In the Fontan operation, doctors direct venous blood directly to the pulmonary arteries, bypassing the heart. The procedure is the third surgery in staged reconstruction for children with single-ventricle defects, explained the researchers from the Children’s Hospital of Philadelphia in a news release from the American Heart Association.

The study included 27 children and young adults who’d undergone the Fontan operation an average of 11 years earlier. The patients, average age 15, were given either a placebo or 20 milligrams of sildenafil three times daily for six weeks. That was followed by six weeks of no drug or placebo, and then the participants were switched to the opposite arm of the study for another six weeks.

Before and after each phase of the study, researchers assessed the participants’ heart function and found significant improvements in the myocardial performance index during the sildenafil phase compared to the placebo phase. They also found that taking sildenafil improved diastolic performance and increased heart output, but the differences didn’t reach statistical significance.

There was no difference in the average myocardial performance index improvement between the right ventricular dominant subgroup and the non-right ventricular dominant subgroup, indicating a benefit regardless of ventricular structure.

The findings suggest that improved ventricular performance associated with taking sildenafil may improve patients’ exercise performance and quality of life, the researchers concluded.

The study was scheduled to be presented Tuesday at the American Heart Association’s annual meeting in Orlando, Fla.

Among the new findings, presented this week at the annual meeting of the American Society for Reproductive Medicine in Atlanta:
More than half (58 percent) of couples diagnosed as infertile who opted not to pursue treatment said cost was the primary reason;
About 7 percent of couples who had leftover embryos in cold storage discarded the embryos from October 2008 to March 2009, a number that was almost three times higher than six months prior;
About 57 percent of young women who donated eggs to infertile couples in 2008 now say they planned to use the money to pay for school, up from 28 percent in 2002-2004.

Given the high cost of fertility treatments, which are often not covered by insurance, experts said they weren’t surprised by the findings. A single cycle of in vitro fertilization (IVF) costs about $12,000, and several cycles may be needed, according to the ASRM.

Yet some fertility experts said they were hesitant to blame the recession on the new numbers. Dr. Peter McGovern, director of the division of reproductive endocrinology and infertility at Hackensack University Medical Center, said his practice is as busy as ever.

“We’re not seeing much of a difference, quite honestly, compared to better times,” McGovern said. “It could be that the drive to reproduce is so important people are somehow making it happen.”

In one study, researchers followed 448 infertile couples from eight fertility clinics for 18 months. Of those, about 27 percent decided not to pursue treatments including in vitro fertilization, in which the egg and sperm are joined outside the womb and then the embryo is placed back into the mother.

About 58 percent of these couples said the primary reason to discontinue treatments was money, 38 percent cited life conflicts such as moving or a death in the family, and 26 percent cited medical futility.

Depression and increasing age also made it less likely a couple would pursue treatment, while those with a college education and higher incomes were more likely to go through with it.

“It’s financially challenging for some patients to pursue fertility treatments,” said Andrew La Barbera, scientific director of the American Society for Reproductive Medicine. “In most states insurance coverage for assisted reproductive technology [ART] is not mandated. Most patients have to pay for ART procedures themselves and it’s not easy.”

Financial stress linked to a worsening economy may be prompting more couples to dispose of leftover embryos being kept in cold storage, a second study found.

Researchers found that between October 2008 and March 2009, about 7 percent of couples discarded frozen embryos, compared to rates between 4.3 percent and 2.3 percent in the two years prior.

Fees to store embryos at minus 310 degrees Fahrenheit can cost several hundred dollars a year. For many couples, deciding what to do with unused embryos is a difficult ethical and emotional decision. The researchers concluded that “extreme economic conditions have forced patients to address an issue they have historically chosen to postpone when financially viable.”

The economic downturn may even be affecting the decisions of egg donors, who are paid between $4,000 to $10,000 to donate eggs to infertile women undergoing IVF.

In another study presented at the ASRM meeting, researchers found little change over the past few years in prospective egg donors’ average age, education level and marital status. However, they did find a change in what donors planned on doing with the money.

Researchers at Reproductive Medicine Associates of New York and Mount Sinai School of Medicine in New York City compared the screening interview records of 54 women who sought to donate eggs between 2002 and 2004 against the records of 46 women who sought to donate eggs in 2008.

About 57 percent of the women said they planned to use the money for schooling in 2008, compared to 28 percent in 2002-2004. Yet fewer said they planned to pay down debt or save the money in 2008 than in the earlier period.

Despite a difficult economic climate, many women who donate eggs do it for reasons beyond the money, McGovern reasoned. Donating eggs requires substantial time, effort and discomfort, including physical and psychological screenings, daily injections of fertility drugs that can cause side-effects including headache, cramping and bloating, multiple trips to the clinic, ultrasounds and blood tests.

“Egg donors don’t tend to be very mercenary,” McGovern said. “I find them to be a very generous group. It’s a lot of work, not like being a sperm donor.”

Sharing the womb with a female produces better results, in terms of birth weight and other factors, than sharing it with a male, whether the other twin is male or female, according to researchers from the Helen Schneider Hospital for Women and the Sackler School of Medicine at Tel Aviv University in Israel.

“A male fetus affects his co-twin negatively, probably due to the interfetal transport of substances, mainly hormones,” said Dr. Marek Glezerman, a university professor and chairman of the hospital’s obstetrics and gynecology department and a co-author of the study.

But a U.S.-based expert who reviewed the study calls it interesting but no cause to change the way pregnant women are followed during their pregnancies, regardless of whether they are carrying two girls, two boys or one of each.

“I don’t think it translates to changes in clinical practice,” said Dr. Steven Ory, a past president of the American Society for Reproductive Medicine and a fertility specialist in Margate, Fla.

The study is published in the November issue of Obstetrics & Gynecology.

The researchers evaluated 2,704 twin pregnancies, looking only at twins within separate placentas born from 1995 through 2006. Previous studies had not differentiated between twins with common or separate placentas, Glezerman said, and this could have blurred the effect of the fetus’s sex on the outcome of the pregnancies.

About 16 percent of the pregnancies involved female-female twins, 70 percent were male-female and 14 percent were male-male.

Preterm deliveries were most common among women carrying male-male twins, the study found. Of the male-male twins, 9.2 percent were delivered at less than 31 weeks, compared with 7.5 percent of the male-female twins and 5.5 percent of the female-female twins. Earlier studies have found a higher risk for premature delivery for a male fetus compared with a female.

In the new study, birth weight was higher, on average, for boys than girls: 4.95 pounds, compared with 4.75. But boys in the boy-boy pairs had lower average birth weights than boys in the boy-girl pairs: 4.85 pounds versus 4.99. Boys in the boy-boy pairs also had lower growth rates than boys in boy-girl pairs.

Girls in the girl-girl pairs had fewer respiratory and neurological problems than those in the girl-boy pairs.

The researchers attribute the findings to what they call a “male offending factor,” which means that the presence of a male fetus negatively affects the prospects of the co-twin in the womb, whether that co-twin is a sister or a brother.

However, the reasons for this aren’t clear. The researchers speculate that one possibility is that male fetuses who share the womb with females could be more successful in competing for nutrients because females tend to grow more slowly. As a result, a boy in a boy-girl pair might end up weighing more than one in a boy-boy pair. Hormonal influences might help explain the differences, too.

None of this should worry expectant mothers, says another U.S. expert.

“Look at this study with a grain of salt and move on,” said Dr. Abdulla Al-Khan, director of perinatal diagnostics and therapeutics in the maternal-fetal medicine division at Hackensack University Medical Center in New Jersey. The study’s findings have not been noticeable, he said, at his hospital. They deliver more than 6,000 babies a year, including twins, he said, and women carrying twins are already followed closely to monitor the babies’ progress.

Both Al-Khan and Ory also pointed out some of the study’s limitations. It is retrospective, looking back, which they said makes it subject to bias. And, Al-Khan said, it’s not clear whether the twins were conceived spontaneously or through fertility treatments, which might have affected the results.

Rotavirus is the leading cause worldwide of severe acute diarrhea in children younger than 5. Before 2006, rotavirus caused 20 to 60 deaths each year in the United States, along with 55,000 to 70,000 hospitalizations, 205,000 to 272,000 emergency department visits, and 410,000 outpatient visits among children younger than 5.

An analysis of data from a national network of sentinel laboratories showed that the 2007-2008 and 2008-2009 rotavirus seasons were both shorter and began later than pre-vaccine seasons (2000 to 2006), wrote researchers from the U.S. Centers for Disease Control and Prevention. Specifically, onset of the rotavirus season in 2007-2008 was 11 weeks later than the median for 2000 to 2006, and the number of positive test results was 64 percent lower than in the pre-vaccine seasons.

There were 15 percent more positive rotavirus test results in the 2008-2009 season than in the 2007-2008 seasons, but the number of positive test results for both seasons were substantially lower than during the 2000 to 2006 seasons, the study found.

While cases of rotavirus disease have decreased since the introduction of rotavirus vaccination, continued surveillance is needed to better understand the impact of the rotavirus vaccine, the researchers said.

Hysterectomy (removal of the uterus) is one of the most frequently performed surgical procedures in the US. Approximately 600,000 hysterectomies are performed each year. The most common reason for hysterectomy is fibroids (40.7%), followed by endometriosis (17.7%), and uterine prolapse (14.5%). Hysterectomy can be performed by several methods: via an open incision in the abdomen; through small incisions in the abdomen with the aid of a laparoscope; or through a small incision in the vagina. The standard procedure to remove the uterus has been through an open incision in the abdomen, but it is more invasive and requires the longest recovery time when compared to newer techniques which generally have shorter hospital stays and a faster return to normal activity for women. However, current national data show that the standard abdominal hysterectomy method is performed in 66% of cases. Vaginal hysterectomy is performed in 22% of cases and laparoscopic hysterectomy in 12% of cases.

“Vaginal hysterectomy is better for women in terms of fewer complications and quicker recoveries compared with abdominal or laparoscopic surgery,” says Cheryl B. Iglesia, MD, of Washington Hospital Center in Washington, DC, and chair of ACOG’s Committee on Gynecologic Practice. “Vaginal hysterectomy also is the most cost-effective method.”

Although vaginal hysterectomy is the approach of choice, it’s not always feasible in every situation. “The paramount concern is that we provide the safest procedure for our patients. That being said, based on the national data, it’s pretty clear that more hysterectomies in the US could be performed using the less invasive vaginal approach than are currently being done,” says Dr. Iglesia.

Physicians should consider which surgical procedure is safest and the most cost-effective to meet the needs of each patient undergoing hysterectomy, according to ACOG. A number of factors may influence the route of hysterectomy, including the size and shape of the vagina and uterus; accessibility to the uterus; surgeon training and experience; extent of disease; available hospital technology, devices, and support; and the preference of the informed patient.