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The U.S. Food and Drug Administration today cautioned users of personal emergency response buttons worn around the neck of a potential choking hazard associated with this product.

The FDA is aware of at least six reports between 1998 and 2009 of serious injury or death, including three deaths in the United States and one in Canada, from choking after the cord on the Philips Lifeline Personal Help Button became entangled on other objects worn around the neck.

There are more than 750,000 users of these devices in the United States and Canada. By pushing the “help” button on the device when in distress, users can call for emergency assistance to their home. According to Philips Lifeline, the device is used primarily by seniors living independently, who feel they are at risk for falls or other medical emergencies.

The Lifeline pendant button is intentionally designed to not break away when tugged, which prevents the button from accidentally falling off. However, because it does not break away, there is a risk of choking, including the possibility of serious injury or death. Risks are greater for those with mobility limitations or for those who use wheelchairs, walkers, beds with guard rails, or other objects that could entangle with a neck cord.

Philips Lifeline is currently sending letters to its 750,000 customers and has changed the labeling of this product to include a warning against the potential choking hazard.

The FDA recommends that users consult their health care providers to determine which style of emergency button, including those that are worn on the wrist, is most beneficial for them.

These widely used devices provide critical and immediate access to emergency care for those at risk of falls or who may be more likely to need outside assistance. While the number of adverse events reported is small compared to the number of people who use this device, the severity of these events is of concern. It remains important that users, along with their health care providers, assess the options provided by each style of button, and choose the option that best fits their condition.

Health care professionals and users may report serious adverse events or product quality problems with the use of this product to the FDA’s MedWatch Adverse Event Reporting program either online, by regular mail, fax or phone.

Many U.S. medical schools have had cases of medical students posting unprofessional content online, including incidents where patient confidentiality was violated, according to a new study. It also found that few schools have policies to deal with such transgressions.

Researchers sent an anonymous survey to 130 medical schools in the Association of American Medical Colleges and received 78 responses. Of the schools that responded, 47 (60 percent) reported incidents involving students posting unprofessional content.

In the past year, six of those schools had no incidents, 36 had fewer than five incidents, three had five to 15 incidents, and one was aware of incidents but did not know how many, according to Dr. Katherine C. Chretien, of the Washington, D.C., VA Medical Center, and colleagues.

“Incidents involving violation of patient confidentiality in the past year were reported by 13 percent (6/46). Student use of profanity, frankly discriminatory language, depiction of intoxication, and sexually suggestive material were more commonly reported,” Chretien wrote in a news release.

“Of 45 schools that reported an incident and responded to the question about disciplinary actions, 30 gave informal warning (67 percent) and 3 reported student dismissal (7 percent). Policies that cover student-posted online content were reported by 38 percent (28/73) of deans. Of schools without such policies, 11 percent (5/46) were actively developing new policies to cover online content. Deans reporting incidents were significantly more likely to report having such a policy (51 percent vs. 18 percent), believing these issues could be effectively addressed (91 percent vs. 63 percent;), and having higher levels of concern,” she added.

The researchers recommended a number of ways to address the concerns identified in the study.

“The formal professional curriculum should include a digital media component, which could include instruction on managing the ‘digital footprint,’ such as electing privacy settings on social networking sites and performing periodic Web searches of oneself. This is important given that residency program directors, future employers, and patients may access this information,” they said.

Also, “discussions among students, residents, and faculty should occur to help define medical professionalism in the era of Web 2.0,” the researchers concluded.

The study appears in the Sept. 23-30 issue of the Journal of the American Medical Association, a theme issue on medical education.

Socioeconomic status seems to make no difference in mental decline after the age of 70, according to new research.

The study, published in the Aug. 1 issue of the American Journal of Epidemiology, challenges claims that economic status and background have an impact on cognitive functioning among the elderly. Rather, the University of California, Los Angeles study found that rates of cognitive decline among people aged 70 and older depended on other factors and were similar across socioeconomic and racial/ethnic groups.

“It has been known that cognitive performance at any given age appears to depend on demographic characteristics; the more educated, for instance, perform better,” said lead investigator Dr. Arun Karlamangla, associate professor of medicine at UCLA’s David Geffen School of Medicine, in a university news release. “But though there are differences in the level of performance you start with in your late 60s, this study’s surprise is that the rate of decline in your 70s is the same for every group.”

The study authors looked at data collected from 6,476 people born before 1924 who took part in the study of Assets and Health Dynamics Among the Oldest Old. Participants were tested five times between 1993 and 2002 on various memory and cognition tasks, including word recall, subtraction, attention, language and knowledge of current affairs.

The researchers found that cognitive decline depended on how active people were earlier in life, whether or not they were widowed or ever married, and how old they were. Other social factors appeared to have little impact.

“The most consistent predictors of faster declines in cognitive functioning were being old and being single,” the study authors wrote.

Most generally healthy adults starting an exercise program do not need to see their doctor first, researchers say.

Routine medical screening before starting a regular exercise regimen with the goal of reducing the risk of sudden exercise-induced death is not recommended, the researchers wrote in a report published this month.

“Sudden death is a rare adverse effect of exercise,” Dr. Mayer Brezis, of Hadassah Hebrew University Medical Center, Jerusalem, Israel, told Reuters Health in an interview.

“Medical screening before initiating regular exercise is often advised but without scientific basis,” Brezis noted.

An exercise electrocardiogram — a test that detects and records the heart’s electrical activity — is thought to help identify people at risk but the test yields “many” falsely positive and falsely negative test results, the researcher warned.

In a “simulation study,” Brezis and colleagues found that routine screening decreases deaths in intermediate to high-risk people but not in those who are at low risk.

“Actually, medical screening may cause damage,” Brezis said, “for instance because of labeling healthy people as sick or because of the side effects” of tests to check for heart disease.

“Medical screening may actually prevent the known benefit from exercise by diverting attention from the main goal: i.e., to have people exercise,” Brezis said.

“Sedentary people should be encouraged to initiate exercise gradually and go to a physician if they feel chest discomfort or dizziness during exercise,” Brezis said.

“Gyms should post boards explaining these warning signs. Exercise coaches should understand and explain these warning signs to customers,” he added.

Still, Brezis emphasized that this advice does not apply to individuals with known heart disease. “These people should be referred to cardiac rehabilitation centers where they can resume physical activity under supervision.”

A study published last year suggested that bipolar disorder may be over diagnosed in people seeking mental health care. Now new findings shed light on which disorders many of these patients actually have.

Bipolar disorder, also known as manic depression, involves dramatic swings in mood — ranging from debilitating depression to euphoric recklessness.

In the original 2008 study, researchers at Brown University School of Medicine found that of 145 adults who said they had been diagnosed with bipolar disorder, 82 (57 percent) turned out not to have the condition when given a comprehensive diagnostic interview.

In this latest study, published in the Journal of Clinical Psychiatry, the researchers used similar standardized interviews to find out which disorders those 82 patients might have.

Overall, they found, nearly half had major depression, while borderline personality disorder, post-traumatic stress disorder (PTSD), generalized anxiety and social phobia were each diagnosed in roughly one-quarter to one-third.

When the researchers then compared the patients with 528 other psychiatric patients who had never been diagnosed with bipolar disorder, they found that those in the former group were nearly four times more likely to have borderline personality disorder.

They were also 70 percent more likely to have major depression and twice as likely to have PTSD.

Some of other diagnoses were less common but still seen at elevated rates among the patients previously diagnosed with bipolar disorder. These included antisocial personality disorder and impulse-control disorder.

Over diagnosis of bipolar disorder is concerning, in part, because it is typically treated with mood-stabilizing drugs that can have side effects — including effects on the kidneys, liver, and metabolic and immune systems, explained lead researcher Dr. Mark Zimmerman, an associate professor at Brown and director of outpatient psychiatry at Rhode Island Hospital.

In addition, he told Reuters Health in an email, over diagnosis means some patients are likely not getting the appropriate care for the problems they do have.

Bipolar disorder shares certain characteristics with some other psychiatric conditions. Borderline personality disorder, for instance, is marked by unstable mood, impulsive behavior and problems maintaining relationships with other people.

But Zimmerman and his colleagues suspect that some doctors are over diagnosing bipolar disorder because — unlike certain other causes of mood disturbance — it does have effective drug therapies.

There are no medications approved specifically for treating borderline personality disorder, for instance, but research suggests that some forms of “talk therapy” are effective.

“We believe that clinicians are inclined to diagnose disorders that they feel more comfortable treating,” Zimmerman explained.

“The increased availability of medications that have been approved for the treatment of bipolar disorder might be influencing clinicians who are unsure whether or not a patient has bipolar disorder or borderline personality disorder to err on the side of diagnosing the disorder that is medication-responsive,” he added.

This “bias,” Zimmerman said, is reinforced by drug company marketing, which highlights certain studies that have suggested that bipolar disorder goes unrecognized in many people.

Female kidney recipients whose donated organ came from a deceased male face an increased risk for failure in the first year after their transplant, Canadian researchers have found.

The risk is short-term, though, and may stem from proteins on male donor cells, the researchers said. Their study found that the risk goes away after 10 years.

The researchers analyzed data on 117,877 adults who had kidney transplants in the United States between 1990 and 2004. All kidneys came from deceased donors. Within a year, transplant failure had occurred in 16,135 people, and 6,878 had died. Among the 97,906 people who were followed for up to 10 years after their transplant, there were 35,084 transplant failures and 22,566 deaths.

Compared with all other gender combinations, female recipients of male donor kidneys had a 12 percent greater risk of failure and a similar increased risk for death a year after the transplant. They had no increased risk for failure or death after 10 years.

The researchers, from the University of Toronto and University of British Columbia, said that H-Y antigens, derived from the male chromosome and not found in women, might cause an adverse immune response in women who receive kidneys from men who had died.

They recommended that “future research should examine the potential mechanisms underlying the H-Y effect in order to better understand the specific role of minor histocompatibility antigens in determining kidney allograft outcomes.”

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‘SPELLING MISTAKE’

According to Goldstein’s study, published in the journal Nature, it may be because of a “spelling mistake” — a one-letter error in the genetic code near the Interleukin-28B or IL28B gene, which plays a role in fighting off infections.

“If you look at individuals with the good response genotype, about 80 percent of them will be cured. If you look at individuals with the poor-response genotype, about 30 percent of them will be cured,” Goldstein said in a telephone interview. “That is just a huge, huge difference.”

The discovery came from a clinical trial of 1,671 people with the most common form of the disease in the United States and Europe who were taking the two most common hepatitis C therapies.

It was funded by Schering-Plough, maker of one of two standard hepatitis C regimens — a combination of Pegintron and the antiviral ribavirin. Roche Holding AG makes the other, known as Pegasys.

They found having a favorable genotype made a significant difference in treatment response across all populations in the study, but because it occurs most often in whites of European ancestry, it helps explain why blacks fare less well on standard treatments.

Goldstein said few discoveries involving inherited genetic variations are specific enough to guide treatment decisions, but he thinks this is one.

“It is very difficult for me to imagine this wouldn’t be something that both the patient and the clinician would want to know about in deciding on a course of treatment,” he said.

“Right now, absent genetic information, if a patient comes into the clinic and they have no signs of liver damage, a decision is often reached to postpone treatment because the treatment is unpleasant and it often doesn’t work.”

He said the finding does not mean poor responders should not be offered therapy but it may alter their decision-making.

Goldstein said patients who are poor responders to standard treatments who have no liver damage might want to wait for the arrival of a new class of drugs called protease inhibitors.

The drugs are now in mid-stage development by Schering-Plough and Vertex Pharmaceuticals Inc.

By Julie Steenhuysen

CHICAGO (Reuters) - A slight difference in a person’s genetic code could determine whether they respond to a grueling round of treatment for hepatitis C infection or not, U.S. researchers said on Sunday.

Tests looking for that deviation could be used to help decide which patients are most likely to benefit, they said. The finding may also explain why some racial and ethnic groups fare more poorly on standard treatments than others.

“This discovery enables us to give patients valuable information that will help them and their doctors decide what is best for them,” genetics researcher David Goldstein of Duke University in Durham, North Carolina, said in a statement.

Hepatitis C is a blood-borne liver disease that can lead to chronic liver problems, liver cancer, cirrhosis and death. The virus affects an estimated 3.2 million people in the United States alone and 170 million worldwide.

Treatment typically involves 48 weeks of interferon plus the antiviral drug ribavirin. Some patients develop such taxing side effects that they stop treatment. Blacks are less likely to respond than whites.

Until now, no one has known why.

No one knows for sure but some say it is related to the word levitate, in other words, levitating your penis in order to have sex! Others however say that it derives from the Latin word vita which means to live or life, but no person knows for sure except for the creators.