CDC: Measles Outbreaks on the Rise
Measles outbreaks are at their highest since 2001, according to a report released recently by the Centers for Disease Control and Prevention (CDC). Sixty-four cases of measles in nine states were reported in a 4-month period beginning on January 1 and ending on April 25. Many of the cases may have been imported into the United States, and many other cases may be linked to the imported cases, according to the CDC.

Only one of the patients who contracted measles had a record of prior vaccination for measles. The CDC is urging both adults and parents of children to consider the importance of vaccination against measles, which is highly contagious when airborne via coughing or sneezing. According to the CDC, symptoms of measles infection include rash, high fever, coughing, and runny nose. Serious complications of measles include ear infection, pneumonia, encephalitis, and death.

Although measles transmission in the United States was declared eliminated in 2000, there are 20 million cases per year globally. The CDC reported that, in 2005 alone, 300,000 children younger than 5 years of age died from measles, which is preventable through the MMR (measles, mumps, and rubella) vaccine.

Women Losing Edge in Life Expectancy
Smoking, obesity, and high blood pressure are key factors in decreasing the life expectancy for women in some areas of the United States, according to researchers. The purpose of the study, published online by the Public Library of Science, was to obtain long-term information on life expectancies across counties to determine the effect of demographics such as social factors and access to health care.

The time period for the analysis was 1961 to 1999. The general trend since 1961 was an increase in life expectancies; however, during the past 25 years, longevity has plateaued or dropped in 4% of men and 19% of women, according to the study. The study reports that life expectancy dropped by 1.3 years for women in 180 counties since 1983, and for men in 11 counties.

Demographics and economics appear to influence the rise in mortality from chronic diseases, according to researchers. Additionally, the study showed no significant differences in income for people whose life expectancies were either longer or shorter than the average numbers during the period from 1961 to 1983, but that after 1983, the wealthier had longer life-spans.

US Medical System Not Ready For Aging Baby Boomers
Bold measures are required to ready fix an unprepared health care system so that it is able to meet the needs of the impending surge of patients requiring geriatric care, according to a report sponsored by the Institute of Medicine. The report was commissioned to address the challenges posed to those who work in health care by a doubling of the population of elderly patients in the next 25 years. All health care workers, family members, and informal care-givers were included in the definition of those responsible for geriatric care.

The report calls upon public and private health care plans to spearhead efforts to provide better geriatric care training and incentives for providers and families. Additionally, Medicare was cited as hindering the quality of care for older adults through low reimbursement rates, a focus on short-term illnesses rather than chronic care, and lack of support for preventive care programs.

The target date for reforms to be under way is 2030, when baby boomers will all have reached the age of 65 years.

Regular Exercise May Protect Against Breast Cancer
Young women who exercise may benefit from a lower risk of premenopausal breast cancer, according to a study recently published in the Journal of the National Cancer Institute. The study followed almost 65,000 women ranging in age from 24 to 42 years who were enrolled in the Nurses' Health Study. The researchers used records of self-reported exercise habits from the time responders were 12 to 35 years of age to determine levels of physical activity. During the 6-year follow-up period, 550 women enrolled in the study developed premenopausal breast cancer.

The researchers found that women who were more physically active as teens and young women were 23% less likely to develop premenopausal breast cancer and that women who were active between the ages of 12 and 22 had the lowest risk. Additionally, 3.25 hours per week of vigorous exercise, such as running, or 13 hours per week of moderate exercise, such as walking, seemed to provide the maximum benefit.

NSAID Study Finds No Benefit for Alzheimer's Dementia
Nonsteroidal antiinflammatory drugs (NSAIDs) showed no protective effect against dementia in study results reported in the Archives of Neurology. This study contradicts earlier reports suggesting the long-term use of NSAIDs may prevent the progression of memory loss and other degenerative effects associated with Alzheimer's.

The three-arm study enrolled 2,117 patients and assigned them to take one of the following twice daily for close to 4 years: naproxen (Aleve, Bayer), celecoxib (Celebrex, Pfizer, Inc.), or placebo. No positive effect was seen on halting memory loss, although a slightly negative effect was found with naproxen.

An earlier study published in Neurology had found that dosing with the NSAID ibuprofen for 5 years lowered the risk for developing Alzheimer's by as much as 40%.

Folic Acid/Vitamin B Not Protective for Women at High Risk for Heart Disease
A combination of folic acid with vitamins B6 and B12 failed to reduce the risk for cardiovascular disease (CVD) in women who were either at high risk for the disease or who had a history of CVD, according to a study published in the Journal of the American Medical Association. The randomized, double-blind placebo-controlled study of more than 5,400 women 42 years of age or older followed those taking the supplement combination for more than 7 years. The outcomes measures for the study were combined rates of myocardial infarction, stroke, coronary revascularization, or CVD mortality. The risks for CVD events were similar among the groups.

The supplement combination consisted of 2.5 mg of folic acid, 50 mg of vitamin B6 and 1 mg of vitamin B12. The number of women who reported a CVD event was 406 in the group taking the supplement combination vs 390 in the group taking placebo, leading the researchers to conclude that the supplement combination had no lowering effect on the risk of CVD for the women in the study.

AHA: Chest Compressions Can Save Lives
Use hard, rapid chest compressions on adults in whom you have witnessed a heart attack until trained emergency medical personnel arrive, the American Heart Association (AHA) advises. The recommendations, published in Circulation, are updates to cardiopulmonary resuscitation (CPR) bulletins previously issued by the AHA in 1997 and 2005. The update is based on several studies that have shown that hands-only CPR can be just as effective as CPR using hands and mouth-to-mouth resuscitation. The studies also showed that training was not essential to the success of the technique used.

The authors of the report, however, stressed that it is important that this intervention not be used for cardiac arrest in children or in drowning or drug-related incidents, in which rescue breathing may be required.

Link Between Genetics and Tobacco Use and Risk Found
Three different studies have pinpointed two genetic variants to chromosome 15 that can both increase lung cancer risk for smokers and raise the likelihood of tobacco addiction in some individuals. The studies were published in Nature and Nature Genetics.

Individuals who have two copies of both variants and who either smoke or have smoked in the past can have an increased risk of lung cancer of 70% to 80% according to researchers. The same individuals, should they have only one copy could raise their risk of lung cancer 28%.

A separate study identified a link between these two variants and an increased intensity of addiction to tobacco following it use.

David S. Boyer, MD, is a Clinical Associate Professor of Ophthalmology at the University of Southern California Keck School of Medicine, Department of Ophthalmology in Los Angeles. He is a member of the Retina Today Editorial Board. Dr. Boyer may be reached at VITDOC@aol.com; phone: +1 310 854 6201; fax: +1 310 652 7250.