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4A Daily News – Tuesday, July 23, 2013 Vitality health & fitness Decongestant use linked to birth defects By Kathryn Doyles Reuters Health NEW YORK - A woman's use of decongestant medications in the first trimester of pregnancy may raise her child's risk of certain rare birth defects, according to a small study. Some types of overthe-counter decongestants, including the popular phenylephrine and pseudoephedrine, were individually linked to rare, specific birth defects of the digestive tract, ear and heart. "Major birth defects of any kind affect about 2 to 3 percent of liveborn infants, so they are rare," study author Dr. Allen Mitchell said. "The associations we identified involved defects that generally affect less than 1 per 1,000 infants. Some of them may require surgery, but not all are life-threatening." Decongestants are some of the most commonly used drugs, however, so fully understanding the consequences of taking them during pregnancy is important, said Mitchell, director of the Slone Epidemiology Center at Boston University. His team worked with a large collection of data on babies born with birth defects between 1993 and 2010. Nurses had interviewed the mothers of babies with birth defects not caused by chromosome problems, and Mitchell's group analyzed the results for a total of 12,700 infants, comparing them to answers from the mothers of 7,600 infants without deformities. Mothers were asked about medications they took while pregnant and in the two months before becoming pregnant. First-trimester use of phenylephrine, which is Want to lose weight? Ditch calorierich rewards after exercise By Dorene Internicola Reuters found in Sudafed among other products, was tied to an eight-fold higher risk of a heart defect called endocardial cushion defect. And phenylpropanolamine (Acutrim) was also linked to an eight-fold risk of defects of the ear and stomach. All were associations that had been suggested by earlier studies. But for the first time, the authors found links between first-trimester use of pseudoephedrine (also in Sudafed) and a 3-fold higher risk of so-called limb reduction defects. Use of imidazolines (found in nasal decongestant sprays and eye drops) was tied to an approximate doubling of risk for an abnormal connection between the trachea and esophagus. "The risks we identified should be kept in perspective," Mitchell cautioned. "The risk of an endocardial cushion defect among babies whose mothers did not take decongestants is about 3 per 10,000 live births." Even the eight-fold increase in risk indicated by the study results, while it sounds large, would translate to a 2.7 in 1,000 chance the baby would have the defect, he said. Assuming the findings are correct, he added, the researchers could not speculate about why these drugs might be linked to this handful of defects. They found no link between the medications and several other deformities that had been suggested by previous studies, such as clubfoot or defects of the eye or face, according to the report published in the American Journal of Epidemiology. "This should offer some reassurance to women who have taken these medications in pregnancy," Mitchell said. "Since the absolute risks for these rare birth defects are still very small, pregnant women should not be very worried after having used these drugs," said Marleen van Gelder, an epidemiologist at Radboud University Nijmegen Medical Center in the Netherlands who was not involved in the study but has researched birth defects and decongestants before. "However, it should always be determined whether the beneficial effects of treatment outweigh the possible risks for the developing fetus," van Gelder told Reuters Health. Mitchell believes there's enough evidence indicating a possible connection to birth defects that doctors should not be recommending that pregnant women take decongestants, but should evaluate each woman's need for the drugs on a case-bycase basis. "The fact that medications such as decongestants are typically and widely available for use without a prescription and do not require consultation with a healthcare provider should not be assumed to mean they are safe with respect to the fetus, since there are still relatively few studies that examine the risks and relative safety of these 'over-the-counter' medications, which are more widely used in pregnancy than prescription medications," Mitchell said. If you're spending more time running, walking or pumping iron in the gym and still not losing weight, fitness experts say it could be due to too big a reward for still too little exercise. Although fitness has indisputable health benefits, it takes a lot of walking or running to burn off the calories in a donut. "There's a war between exercise and nutrition in our heads," said American Council on Exercise spokesperson Jonathan Ross. "People tend to overestimate the amount of physical activity they get. They work out a little bit and treat themselves a lot." A report by the University of Washington's Institute for Health Metrics and Evaluation showed that although Americans say they are more active, it has not made much of a dent in the obesity epidemic that affects more than one-third of U.S. adults. Ross, a personal trainer based outside Washington, D.C., said exercise can play a role in weight reduction, but without broader lifestyle and nutritional changes, that role is limited. "We put exercise in a box and once that exercise box is filled in we don't do much the rest of the day," he explained, adding that a post-workout calorie-dense treat doesn't help. "Some (weight-loss) programs stress nutrition, some stress exercise," he said. "But the two together are greater than the parts." The National Weight Control Registry, which gathers information from people who have successfully lost at least 30 pounds and kept it off for a least one year, reports that 90 percent of its members exercise, on average, about one hour per day. U.S. health officials recommend that healthy adults get at least 150 minutes of moderate-intensity physical activity a week, or around 20 minutes a day. Dr. Joseph E. Donnelly, an exercise physiologist with the American College of Sports Medicine said the U.S. government guidelines are for cardio vascular fitness, not weight loss. "It was never intended for weight management," said Donnelly, a researcher who focuses on obesity at the University of Kansas. "People have misused it." He added that studies suggest 250 to 300 minutes of exercise per week may be the minimum to lose weight. "At 150 (minutes) the best you can hope for is weight maintenance." Donnelly said if there's a success story for the role of exercise in weight control, it's in maintenance. "Even among the naysayers who feel you can't lose much weight through exercise, most people agree it seems important to maintain weight," he said. Dr. Michele Olson, professor of exercise physiology at Auburn University Montgomery, in Alabama, said it is difficult to shed pounds through exercise alone. "One pound of fat has 3,500 calories," she explained. "If you ran a 26-mile marathon, where you burn about 100 calories per mile, you would burn 2600 calories, falling 900 calories short of burning one pound of fat." She added that people must be physically active regardless of their size or whether they are losing weight. Child injuries from falling TVs rise in US By Andrew M. Seaman Reuters A child is rushed to a U.S. emergency department every 45 minutes with an injury that's related to a falling television, according to a new study. "These are occurring primarily to younger children… When (the TVs) start coming toward them, they don't realize the danger," said Dr. Gary Smith, the study's senior author and president of the Child Injury Prevention Alliance. Previous research has found that TVs are involved in child injuries, and that the frequency may be increasing. But according to the report published on Monday in Pediatrics, those studies were mostly small case studies, and the information was becoming out of date as the style and average number of TVs in U.S. homes has been changing in recent years. For a more recent look at TV-related injuries in U.S. children from 1990 through 2011, Smith and his colleagues used a database of emergency department visits at a nationally representative sample of hospitals The researchers found that about 381,000 children and teenagers were treated in U.S. emergency departments for TV- related injuries during that time. More than half of the injuries were caused by falling TVs, another 38 percent were caused by children running into the units and about 9 percent were caused by other situations, including televisions being moved from one location to another. The majority of the injuries were to boys and about 64 percent of the injuries were to children less than five years old. Two-year olds were the age group most likely to be hurt. There were six deaths. The head and neck area was the most common site of injury, and cuts, bruises and concussions the most common types of injury. The overall rate of TV-related injuries held steady at about 17,000 per year over the 22year period. The percentage of injuries related to "striking" TVs fell dramatically over time, however, while the rate of injuries caused by falling TVs doubled from about 1 per 10,000 children in 1990 to about 2 per 10,000 children in 2011. Although homes have more TVs now than years ago, Smith said that doesn't explain why injuries related to falling TVs were increasing but not injuries www.redbluff.mercy.org redbluff.mercy.org from running into the units. "What we're finding is when those second and third TVs are being brought into these homes, the (older and bulkier units) are being moved and put in other parts of the home that are unsafe," said Smith, who is also director of the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio. For example, as more people buy flat-screen TVs, their older and bulkier units are being put in bedrooms or playrooms on top of dressers, bureaus, draw- ers and armoires, which may tip over because they were never designed to support TVs. "TVs need to be strapped or anchored to the wall. I think that's our biggest problem right now. Many parents are unaware that TVs can be so life threatening if it topples over and falls on top of your child," Smith said. Dr. Marvin Platt, who has researched TV-related injuries but wasn't involved in the new research, said he hopes pediatricians take an active stance on this issue. A Retirement Community for the Active Senior Citizens EQUAL HOUSING OPPORTUNITY Tehama Estates provides the best living environment available to active seniors in Red Bluff, CA. We will show you ways to stay involved in the care of loved ones, and work with you to maintain the highest quality of life. 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Secondly, I think there needs to be legislation or regulation to have TVs secured to surfaces," said Platt, a retired forensic pathologist and pediatrician in Akron, Ohio. "Unless they take measures to bolt these things down, they're going to fall," he said. Smith said the new study may underestimate the number of TV-related injuries, because it only captured injuries seen in emergency departments. There may be some injuries that were treated at home or in doctors' offices. The ER data used by the researchers also wouldn't record most deaths related to falling TVs, though Smith's team does note in its report that according to the U.S. Consumer Product Safety Commission, 215 children died of injuries caused by a falling TV between 2000 and 2011. "If you have a TV at home it doesn't matter if it's a flat screen or (cathode ray tube model) - that TV must be anchored to a wall," Smith said, adding that people can find additional information on his organization's website preventchildinjury.org.