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Black patients who suffer cardiac arrest in the hospital are much less likely to survive than white patients, a new study finds.

Most of this disparity appears to result from the hospital in which black patients receive care, although other factors play a role as well, the researchers said.

“We know that survival after having a cardiac arrest in the hospital setting has always been historically low,” said lead researcher Dr. Paul S. Chan, a cardiologist at St. Luke’s Mid-America Heart Institute in Kansas City. “The rate of survival has been about 30 to 33 percent on average.”

But the survival rates for blacks were significantly lower, 25 percent vs. 37 percent for whites, Chan said.

“This 12 percent absolute difference in survival is larger than any survival I can think of in terms of a racial disparity, in any other medical condition,” he said.

The report is published in the Sept. 16 issue of the Journal of the American Medical Association.

For the study, Chan and colleagues used data from the National Registry of Cardiopulmonary Resuscitation to look at differences in survival among patients with in-hospital cardiac arrest.

They collected information on 10,011 patients, about 19 percent of whom were black, from 274 hospitals. These patients had all been defibrillated after a cardiac arrest.

The lower rates of survival to hospital discharge for blacks reflected lower rates of successful resuscitation (55.8 percent for blacks vs. 67.4 percent for whites) and survival after resuscitation (45.2 percent for blacks vs. 55.5 percent for whites), the researchers noted.

About a third of the difference can be explained by the patients themselves, Chan said, “Black patients were sicker when they had a cardiac arrest than white patients,” he said.

Another third of the difference was explained by the hospitals many black patients were in, Chan said.

“This suggests that black patients were having cardiac arrests in hospitals that, on average, did a lot worse, in terms of survival, for all their patients, compared with white patients who went to hospitals that performed better, and patients were more likely to live in those hospitals,” he said.

In addition, the quality of care after resuscitating a patient was worse in hospitals treating mostly black patients compared with care in hospitals treating white patients, Chan said.

“The hospital effect is huge and substantial, and is a contributor to the difference between black and white survival,” he said. “If we can improve survival in those lower-performing hospitals at which black patients are more likely to be having cardiac arrest, we can eventually narrow the difference between black and white survival.”

The remaining difference in survival between blacks and whites could not be explained, Chan said.

There did not seem to be a difference between the treatment blacks and whites received, so racism did not seem to play a role in care between blacks and whites, he said.

“We cannot exclude it fully,” Chan said. “But it’s really hard to imagine that a physician would treat a black patient differently than a white patient during a cardiac arrest.”

Dr. Kim A. Williams, director of nuclear cardiology at the University of Chicago, was surprised that the disparity between blacks and whites wasn’t greater.

“I am truly shocked at the results — only 11 percent less initial resuscitation success,” Williams said. “I thought the differential was far greater than this study demonstrates, but I am not surprised that the results are being attributed, at least in part, to the facilities involved rather than just the co-morbidities of the patients.

“Any attempts to improve this egregious disparity must start with the underlying risks and disease differences identified in this study, which would involve pre-morbid education, prevention and screening, and once risks are identified, better access to affordable chronic care and medications,” he said. “It’s clearly a system problem.”

People with milder symptoms of celiac disease face a slightly higher risk of dying than other people, a new study finds.

Cancer and heart disease were the main causes of death in the patients studied, and the risk was higher in people who had had small-intestinal biopsies in childhood, the researchers found.

Celiac disease affects about 1 percent of people in the Western world, the researchers said, and it is triggered by exposure to gluten, a protein found in barley, wheat and rye. It frequently causes diarrhea and weight loss.

According to the study, which appears in the Sept. 16 issue of the Journal of the American Medical Association, celiac disease is thought to be connected to higher risk of disease, but less is known about “nonspecific small-intestinal inflammation without villous atrophy,” a kind abnormality.

Swedish researchers found the risk of death increased by 39 percent in patients with celiac disease and 35 percent with latent celiac disease.

The research “reinforces the importance of celiac disease as a diagnosis that should be sought by physicians. It also suggests that more attention should be given to the lesser degrees of intestinal inflammation and gluten sensitivity,” wrote Dr. Peter H. R. Green, of Columbia University College of Physicians and Surgeons, in a commentary.

In people with newly diagnosed type 2 diabetes, the glucose-lowering medications metformin and insulin don’t appear to reduce the inflammation associated with heart disease, new research suggests.

Even though these medications helped reduce glucose levels, the researchers found they didn’t affect inflammatory markers any more than a placebo drug did, according to a study published in the Sept. 16 issue of the Journal of the American Medical Association.

“Heart disease is one of the many co-morbidities associated with diabetes,” explained study author Dr. Aruna Pradhan, an assistant professor at the Harvard Medical School and Brigham and Women’s Hospital in Boston, and a cardiologist at the VA Boston Medical Center. “We thought by lowering glucose levels that we would also address inflammation. But, we found that going lower in glucose levels doesn’t impact inflammation, which is a risk factor for heart disease.”

This study comes on the heels of other recent studies on diabetes and cardiovascular disease. Some suggested that intensive glucose control couldn’t affect heart disease risk, while a recent meta-analysis suggests that good blood sugar levels could reduce death from heart attack, according to background information in Pradhan’s study.

Almost 24 million Americans have diabetes, mostly type 2 diabetes, according to the American Diabetes Association. Risk factors for developing the disease include being overweight and being over 40, though younger and thinner people can also develop the disease. In type 2 diabetes, the body either doesn’t produce enough insulin or can’t use insulin effectively.

The current study included 500 men and women with type 2 diabetes diagnosed two years earlier on average. Slightly more women than men were included, and most of the study volunteers had a body-mass index above 30, which is considered obese. The majority of the study participants were white, and about one-quarter of the group were smokers.

The volunteers were randomized into one of four groups: placebo alone, placebo plus insulin glargine (Lantus), metformin (an oral anti-diabetes medication) alone or metformin plus insulin glargine. Study volunteers also received advice on diet and weight.

Overall, the volunteers lost an average of 3.2 pounds during the 14-week study, except for the insulin and placebo group.

As for markers of inflammation, the researchers found reductions in inflammation (as measured through levels of C-reactive protein, IL-6 and tumor necrosis factor receptor 2) for all of the groups. The insulin-plus-placebo group, however, had the smallest reduction in inflammatory markers. For example, C-reactive protein levels went down in the placebo group by 19 percent, in the metformin group by 16 percent and the metformin and insulin group by 20 percent. However, the insulin plus placebo group went down just 3 percent.

Pradhan said the researchers adjusted the data to account for the weight loss, and still found a similar effect. She said it may be that the weight changes affected the distribution of fat, and that abdominal fat tends to have more of an effect on inflammation.

“While these two agents didn’t lower inflammation [any more than the placebo], they did lower glucose levels and are excellent drugs for preventing microvascular outcomes, like eye and kidney diseases,” said Pradhan. The findings also confirm that diet and exercise can affect inflammation levels, she added.

“While this is a well-conducted study, there are no big surprises here,” said Dr. Vivian Fonseca, chief of endocrinology at Scott & White Clinic in Temple, Tex., and Texas A&M Health Sciences Center, College Station. “There are many drugs that benefit people and reduce cardiovascular risk without decreasing inflammation, and there are drugs that reduce inflammation that have sometimes killed people from cardiovascular disease.”

“We’re trying to look at this problem the other way,” said Fonseca. He and other researchers across the country will test an anti-inflammatory medication, salsalate, to see if lowering inflammation directly can have an impact on blood glucose levels.

U.S. college students don’t get enough sleep, and stress is the prime reason, a new study reports.

About 68 percent of college students who were surveyed said that worries about school and life keep them awake, with one-fifth saying this occurs at least once a week. The study, which appears online in the Journal of Adolescent Health, found that less than a third of the 1,125 survey participants get the eight hours of sleep at night that people their age need.

“Students underestimate the importance of sleep in their daily lives,” study co-author Roxanne Prichard, an assistant professor of psychology at the University of St. Thomas, in St. Paul, Minn., said in a news release from the journal’s publisher. “They forgo sleep during periods of stress, not realizing that they are sabotaging their physical and mental health.”

Lack of sleep can cause problems with a person’s immune and cardiovascular system and increase the likelihood of other health risks, such as weight gain, she said.

About three in five of the students said they have irregular sleep-wake patterns, and many said they use drugs or alcohol regularly to help them either sleep or stay alert, the survey found. The regular use of stimulants and sedatives can increase the chance of becoming addicted to them.

Weekday all-nighters are pulled at least once a month by 20 percent of those polled, and 35 percent said they stayed up until 3 a.m. at least once a week. Skipping three or more classes in a month or falling asleep in class was common among 12 percent of the poor sleepers, the researchers noted.

Parents of young children identified fewer than half of the potential safety hazards for kids in a home, but did far better than either health-care professionals or day-care workers, a new study finds.

The University of Alabama at Birmingham study also found that the mothers and fathers recognized fewer hazards when asked to note possible issues for their children as opposed to other toddlers in general, suggesting they thought their children knew better or were less vulnerable than others.

The study had the three groups of adults place stickers on what they considered safety issues in a mock living room, child’s bedroom and bathroom. The researchers placed items such as prescription medication, cleaning products and marbles in the rooms, in addition to the inherent hazards such as the toilet and sink in the bathroom.

The parents, whose children were between 1 and 3 years old, marked only 47 percent of the safety hazards when asked to identify those that posed a risk for other children, and only 40 percent when asked to find ones that might be an issue for their children, according to the findings to be published in Accident Analysis and Prevention. Day-care employees noted only 37 percent of the hazards, while health-care professionals marked only 29 percent of them.

“While there were no benchmarks to assess whether this is a good or bad rate of recognition, it is concerning if it approximates behavior in real homes,” the authors, doctoral student Joanna Gaines and pediatric psychologist David Schwebel of the University of Alabama at Birmingham, said in a news release.

The National Center for Injury Prevention and Control says accidents are the leading cause of death for toddlers in the United States. More than 1,300 children aged 1 and 2 years died from unintentional injuries in 2005.

While formal schooling did not affect how well they recognized the hazards, Gaines noted that adults with more parent-related education, such as taking CPR courses or just reading parenting magazines, did better at spotting the potential safety issues.

Women who breast-feed their babies even for short periods of time may lower their risk of developing premenopausal breast cancer if they have a family history of the disease.

“We saw a 59 percent lower risk of breast cancer among women with a family history who had ever breast-fed,” stated Dr. Alison Stuebe, lead author of a study appearing in the Aug. 10/24 issue of the Archives of Internal Medicine. “It is surprising to see this really strong association with a pretty decreased risk.”

Stuebe is an assistant professor of obstetrics and gynecology at the University of North Carolina at Chapel Hill School of Medicine, but she conducted the study while affiliated with Brigham and Women’s Hospital/Harvard Medical School in Boston.

The risk reduction was seen in women who had breast-fed for as short a period as three months.

Numerous other benefits of breast-feeding have been found, not just for babies but for mothers as well.

A study released in April, for instance, found that women in their 60s who had breast-fed for more than 12 months over their lives were nearly 10 percent less likely to develop cardiovascular disease, and significantly less likely to develop heart disease risk factors, such as high blood pressure, diabetes and high cholesterol.

Previous research on the connection between breast cancer and breast-feeding has been limited, although other, less rigorous, studies have also suggested a decrease in risk.

This study looked at about 60,000 women who had given birth at least once and were participating in the Nurses’ Health Study II.

The lowering in the risk of breast cancer was seen only in women who had breast-fed and who had a mother or sister who had had the malignancy. And it only applied to premenopausal breast cancer.

The lowering of risk was about the same as seen with hormonal treatments such as tamoxifen in women at high risk for a malignancy, the authors stated.

There was no reduced risk in women who did not have a family history of the disease. Nor was there any difference depending on how long the mother breast-fed or the intensity of breast-feeding (whether the baby was breast-fed exclusively or not).

The reduced risk did not seem to have any link with hormones, given that the risk did not differ with the amount of time a woman went without a period while breast-feeding.

The researchers postulated other hypotheses to explain the link.

“It may be something about the first couple of days postpartum if the woman doesn’t breast-feed,” Stuebe said. “The breast tissue has to shut down, and there’s a lot of inflammation and discomfort. Perhaps on a molecular level there’s going some kind of damage.”

This theory is supported by the fact that women who used medication to stop lactating also had a lower risk.

“This data would suggest it’s more of the effect of milk being taken out of the breast tissue after pregnancy that’s beneficial,” Stuebe said. “We know that just being pregnant reduces the risk of breast cancer compared with not having been pregnant. Getting milk out afterwards appears to be part of the phenomenon.”

The real value of the study, added Dr. Richard Bleicher, co-director of the breast surgery fellowship at Fox Chase Cancer Center in Philadelphia, may be less in the clinical implications but in the fact that it helps point researchers towards avenues for understanding the mechanisms of breast cancer.

Eating a Mediterranean diet, which emphasizes fruits, vegetables, legumes and healthy fats, and increasing physical activity levels can reduce the risk of developing Alzheimer’s disease, a new study shows.

The latest research, published in the Aug. 12 issue of the Journal of the American Medical Association, is more evidence that healthy living can help ward off cognitive decline.

Following both healthy habits is a plus, said study author Dr. Nikolaos Scarmeas, an assistant professor of neurology at Columbia University Medical Center in New York City. “There is some evidence [already] that a healthy diet, the Mediterranean diet, may be protective for our risk of getting Alzheimer’s disease,” he said. “In the current study we wanted to see if there was an independent effect of physical activity and diet.”

So Scarmeas and his team looked at 1,880 men and women without dementia living in New York, average age 77, and gave them tests every 1.5 years from 1992 through 2006, evaluating how well they followed a Mediterranean-type diet and their weekly participation in various physical activities. Those in the highest group got a median of 1.3 hours of vigorous activity or 2.4 hours of moderate-intensity exercise every week.

Scarmeas’ team followed the elders for an average of 5.4 years, finding that 282 developed Alzheimer’s disease during that time.

“There was an association between both a healthy diet and physical activity and reducing risk for Alzheimer’s disease,” Scarmeas said.

Those who ate well and exercised had a 60 percent reduction in the risk of developing Alzheimer’s disease compared with those who didn’t follow either good health habit, he said. “It’s a very significant reduction,” he added.

Exactly which components of the Mediterranean diet seem to confer benefit isn’t known. “It could be there are individual elements of the diet that are important,” Scarmeas said. “But it could be the interaction.”

In another study published earlier this year, Scarmeas found that those who adhere to a Mediterranean diet had a lower risk of developing cognitive impairment, and a lower risk of developing Alzheimer’s disease if they already had cognitive impairment.

In a second study in the same journal, researchers (including Scarmeas) looked at 1,410 French adults and found adherence to a Mediterranean diet was linked to slower decline on one cognitive test but not others. They didn’t find high adherence to the heart-healthy diet linked with the risk for dementia.

In an editorial, the Mayo Clinic’s Dr. David Knopman writes that a healthy diet may help prevent Alzheimer’s but does not seem to occur in isolation.

“For such a benign intervention as diet and exercise, 60 percent [reduction in Alzheimer’s] is substantial,” said Dr. Greg Cole, associate director of the Mary S. Easton Center for Alzheimer’s Disease Research at the University of California Los Angeles David Geffen School of Medicine.

Already, about 5.3 million Americans have Alzheimer’s disease, according to the Alzheimer’s Association, and up to 16 million may have it by 2050.

“So, the 60 percent reduction from diet and exercise can have a huge impact because we are talking about so many millions of people,” Cole said.

The findings are in line with what the Alzheimer’s Association already recommends in its “Maintain Your Brain” program, said William H. Thies, vice president for medical and scientific relations for the organization.

“One of the things that is important [to note] is, they are looking at normal people,” he said, not those who already have the disease. “You aren’t going to cure Alzheimer’s disease by eating lots of olives.”

It’s nearly impossible to completely avoid spring allergies if you live in an area where plants grow. However, you can ease sniffling, sneezing, and watery eyes by avoiding your main allergy triggers. Here are a few tips.

* Try to stay indoors whenever the pollen count is very high (pollen counts usually peak in the mornings).
* Keep your doors and windows closed whenever possible during the spring months to keep allergens out. An air purifier may also help.
* Clean the air filters in your home often. Also, clean bookshelves, vents, and other places where pollen can collect.
* Wash your hair after going outside, because pollen can collect there.
* Vacuum twice a week. Wear a mask because vacuuming can kick up pollen, mold, and dust that were trapped in your carpet.

If you’ve never been formally diagnosed with spring allergies but you notice that your eyes and nose are itchy and runny during the spring months, see your doctor. Your doctor may refer you to an allergist for tests.

The allergy specialist may do a skin test, which involves injecting a tiny sample of a diluted allergen just under the skin of your arm or back. If you’re allergic to the substance, a small red bump (called a wheal or hive) will form. Another diagnostic option is the radioallergosorbent test or RAST. RAST is a blood test that detects antibody levels to a particular allergen. Just because you are sensitive to a particular allergen on a test, though, doesn’t mean that you’ll necessarily start sneezing and coughing when you come into contact with it.

The symptoms of spring allergies include:

* Runny nose
* Watery eyes
* Sneezing
* Coughing
* Itchy eyes and nose
* Dark circles under the eyes

Airborne allergens also can trigger asthma, a condition in which the airways narrow, making breathing difficult and leading to coughing, wheezing, and shortness of breath.