Today’s ubiquitous MP3 players permit users to listen to crystal-clear tunes at high volume for hours on end — a marked improvement on the days of the Walkman. But according to Tel Aviv University research, these advances have also turned personal listening devices into a serious health hazard, with teenagers as the most at-risk group.

One in four teens is in danger of early hearing loss as a direct result of these listening habits, says Prof. Chava Muchnik of TAU’s Department of Communication Disorders in the Stanley Steyer School of Health Professions at the Sackler Faculty of Medicine and the Sheba Medical Center. With her colleagues Dr. Ricky Kaplan-Neeman, Dr. Noam Amir, and Ester Shabtai, Prof. Muchnik studied teens’ music listening habits and took acoustic measurements of preferred listening levels.

The results, published in the International Journal of Audiology, demonstrate clearly that teens have harmful music-listening habits when it comes to iPods and other MP3 devices. “In 10 or 20 years it will be too late to realize that an entire generation of young people is suffering from hearing problems much earlier than expected from natural aging,” says Prof. Muchnik.

Hearing loss before middle age

Hearing loss caused by continuous exposure to loud noise is a slow and progressive process. People may not notice the harm they are causing until years of accumulated damage begin to take hold, warns Prof. Muchnik. Those who are misusing MP3 players today might find that their hearing begins to deteriorate as early as their 30′s and 40′s — much earlier than past generations.

The first stage of the study included 289 participants aged 13 to 17. They were asked to answer questions about their habits on personal listening devices (PLDs) — specifically, their preferred listening levels and the duration of their listening. In the second stage, measurements of these listening levels were performed on 74 teens in both quiet and noisy environments. The measured volume levels were used to calculate the potential risk to hearing according to damage risk criteria laid out by industrial health and safety regulations.

The study’s findings are worrisome, says Prof. Muchnik. Eighty percent of teens use their PLDs regularly, with 21 percent listening from one to four hours daily, and eight percent listening more than four hours consecutively. Taken together with the acoustic measurement results, the data indicate that a quarter of the participants are at severe risk for hearing loss.

Dangerous decibels

Currently, industry-related health and safety regulations are the only benchmark for measuring the harm caused by continuous exposure to high volume noise. But there is a real need for additional music risk criteria in order to prevent music-induced hearing loss, Prof. Muchnik says. In the meantime, she recommends that manufacturers adopt the European standards that limit the output of PLDs to 100 decibels. Currently, maximum decibel levels can differ from model to model, but some can go up to 129 decibels.

Steps can also be taken by schools and parents, she says. Some school boards are developing programs to increase awareness of hearing health, such as the “Dangerous Decibels” program in Oregon schools, which provides early education on the subject. Teens could also choose over-the-ear headphones instead of the ear buds that commonly come with an iPod.

In the near future, the researchers will focus on the music listening habits of younger children, including pre-teens, and the development of advanced technological solutions to enable the safe use of PLDs.

The findings are published in the current edition of the journal Science.

“The hypothalamus is an area in the brain that integrates signals coming from our gut and fat telling our brain that we need food or we’ve had enough calories,” said Dr. Mariella De Biasi, associate professor of neuroscience and assistant director of the Center on Addiction, Learning and Memory (CALM) at BCM.

In the study, lead investigator Dr. Marian Picciotto, Yale University School of Medicine, and her research team focused on nicotine receptors expressed in the hypothalamic neurons that control the motivation to eat. In mice, they were able to determine that a particular nicotinic receptor subtype, the α3β4 nicotinic receptor, can influence how much a subject eats. They found that when nicotine binds to this receptor, pro-opiomelanocortin (POMC) neurons are activated, beginning the process that leads to appetite suppression.

“Identifying this receptor is important for the understanding of the mechanisms related to addiction, weight and smoking. Right now these results are only in mice, but this could open the door to finding therapeutic measures to help people quit smoking without gaining weight,” said De Biasi. “For many people weight gain is a deterrent to quitting smoking, and our results suggest that drugs that stimulate the 34 nicotinic receptor might help to limit weight gain following smoking cessation.”

De Biasi adds that choosing to smoke, or to not quit, because of how it affects a person’s weight is extremely dangerous. Smoking contributes to cardiovascular disease, certain types of cancer including lung cancer, reproductive disorders and premature wrinkling, just to name a few. Any benefit from weight loss is ineffectual when these side effects are taken into account.

De Biasi concludes that this study “is not only important for the people that are trying to quit smoking, but the results provide a target for the development of drugs that might help to control obesity and related metabolic disorders”.

Researchers originally set out to compare the efficacy of two antibiotics commonly used to treat staph skin infections, randomly giving 191 children either cephalexin, a classic anti-staph antibiotic known to work against the most common strains of the bacterium but not MRSA, or clindamycin, known to work better against the resistant strains. Much to the researchers’ surprise, they said, drug choice didn’t matter: 95 percent of the children in the study recovered completely within a week, regardless of which antibiotic they got.

The finding led the research team to conclude that proper wound care, not antibiotics, may have been the key to healing.

“The good news is that no matter which antibiotic we gave, nearly all skin infections cleared up fully within a week,” says study lead investigator Aaron Chen, M.D., an emergency physician at Hopkins Children’s. “The better news might be that good low-tech wound care, cleaning, draining and keeping the infected area clean, is what truly makes the difference between rapid healing and persistent infection.”

Chen says that proper wound care has always been the cornerstone of skin infection treatment but, the researchers say, in recent years more physicians have started prescribing antibiotics preemptively.

Although the Johns Hopkins investigators stop short of advocating against prescribing antibiotics for uncomplicated MRSA skin infections, they call for studies that directly measure the benefit — if any — of drug therapy versus proper wound care. The best study, they say, would compare patients receiving placebo with those on antibiotics, along with proper wound cleaning, draining and dressing.

Antibiotics can have serious side effects, fuel drug resistance and raise the cost of care significantly, the researchers say.

“Many physicians understandably assume that antibiotics are always necessary for bacterial infections, but there is evidence to suggest this may not be the case,” says senior investigator George Siberry, M.D., M.P.H., a Hopkins Children’s pediatrician and medical officer at the Eunice Kennedy Shriver Institute of Child Health & Human Development. “We need studies that precisely measure the benefit of antibiotics to help us determine which cases warrant them and which ones would fare well without them.”

The 191 children in the study, ages 6 months to 18 years, were treated for skin infections at Hopkins Children’s from 2006 to 2009. Of these, 133 were infected with community-acquired MRSA, and the remainder had simple staph infections with non-resistant strains of the bacterium. Community-acquired (CA-MRSA) is a virulent subset of the bacterium that’s not susceptible to most commonly used antibiotics. Most CA-MRSA causes skin and soft-tissue infections, but in those who are sick or have weakened immune systems, it can lead to invasive, sometimes fatal, infections.

At 48-hour to 72-hour follow-ups, children treated with both antibiotics showed similar rates of improvement — 94 percent in the cephalexin group improved and 97 percent in the clindamycin group improved. By one week, the infections were gone in 97 percent of patients receiving cephalexin and in 94 percent of those on clindamycin. Those younger than 1 year of age and those whose infections were accompanied by fever were more prone to complications and more likely to be hospitalized.

“Previous studies show that these disorders seriously affect quality of life, and our new studies show that people who snore violently, and particularly those who suffer from sleep apnoea, narcolepsy and obesity-related respiratory difficulties, are more frequently in contact with the health service than others; they take more medicine, they are unemployed more often and have lower average incomes than healthy people- The more serious their disorders, the greater the socio-economic costs.”

Patients with sleep apnoea or obesity-related respiratory difficulties incur medicine and hospital costs two to three times higher than healthy control subjects. The total health costs were twice as high, and unemployment was 30 per cent higher. Patients who suffered from obesity-related respiratory difficulties had the lowest rate of employment. When patients were in work they earned 30 per cent less than healthy control subjects, an indication of lower educational attainment and an effect of the health impact of their disorder.

Every violent snorer costs society €705; the figure for sleep apnoea is €3860, while obesity-related respiratory difficulties cost €11 320. These socio-economic consequences are present up to eight years before patients are finally diagnosed with sleep apnoea and obesity-related respiratory difficulties. The figures cover direct costs such as more frequent visits to the doctor, hospital admissions or medicine use, and indirect costs by way of lost labour, lower earnings and greater unemployment. The researchers also noted that the patients were more likely to be on welfare than healthy subjects, and more likely to be on prescription medicines subsidised by the state.

In addition to these costs there are also the actual costs of welfare payments. Patients who suffer from snoring, sleep apnoea or obesity-related respiratory difficulties received an average of €147, €879 and €3263 in extra welfare payments.

“Our study is the first to look at the actual socio-economic cost of the three disorders,” Professor Jennum continues. In the last couple of years he has conducted several studies into the socio-economic costs of sleep disorders such as narcolepsy, where researchers found higher medicine consumption, more hospital admissions, and 30 per cent greater unemployment when the disease was undiagnosed and untreated. So there is plenty of potential for ensuring earlier intervention, diagnosis and therapy.

“In the last few years we have become better at diagnosing and treating sleep apnoea and obesity-related respiratory difficulties. This may help our patients, because we know that there are lots and lots of people out there who are terribly tired in the daytime without being diagnosed and without knowing why. If you sleep badly at night for long periods at a time this may be due to various sleeping disorders, most of which we can treat nowadays. So it is important for people with sleep disorders to get in touch with the health service; otherwise their health, education, ability to work, and thereby their finances may be affected.”

“Upper respiratory infections are the most common acute illnesses in the world,” said Ian Paul, M.D., M.Sc., associate professor of pediatrics and public health sciences. “Symptoms caused by these infections are disruptive for children, and often disturb sleep for both ill children and their parents, with an impact on subsequent daytime activities. Safe and effective, evidence-based treatments are desperately needed by parents and healthcare providers for children.”

Recent studies by Paul and colleagues at the Penn State College of Medicine looked at the efficacy of oral over-the-counter treatments such as dextromethorphan and diphenhydramine for upper respiratory infection symptoms. They found the preparations no more effective than a placebo. Vapor rubs, containing menthol, camphor and eucalyptus oils, have been used for over a century without published evidence to support their use.

“The American Academy of Pediatrics does not support the use of over-the-counter oral cough and cold medications for children due to a lack of evidence of efficacy and the potential for side effects,” Paul said. “The question of whether clinicians can recommend a vapor rub topical treatment to treat cold symptoms required evaluation.”

Paul and his research team recruited 138 children ages 2 to 11 for the study. Parents assessed their child’s symptoms the night before enrollment in the study. Each child was then randomly assigned to one of three treatment groups: Vicks® VapoRub®, petroleum jelly placebo, and no treatment. Parents of children receiving the vapor rub or petroleum jelly massaged the treatment into their child’s neck and chest 30 minutes before bedtime.

The randomized study was partially double-blinded. Medical staff did not know what treatment each participating family received when distributing their sealed specimen cup-containing envelope. Parents of children who received the vapor rub or petroleum jelly were blinded to their treatment group. To accomplish this, given the characteristic scent of vapor rubs, parents received their own specimen cup of vapor rub that they were instructed to apply between their own upper lip and nose before opening their child’s treatment in order to ensure they could not detect the smell of their child’s treatment. Parents of children in the no treatment group received an empty specimen cup.

Parents then completed a second survey the following morning assessing their child’s cough, sleep, congestion and runny nose.

In comparisons across the three treatment groups, parents reported that the vapor rub provided significantly greater relief as measured by cough frequency, cough severity, congestion and the child’s ability to sleep. Parents also rated their own sleep as most improved in the vapor rub group when compared across the three study groups. Paired comparisons between the vapor rub group and the no treatment group demonstrated the superiority of the vapor rub for all study outcomes except runny nose. Paired comparison of the vapor rub group to the petroleum jelly group showed vapor rub improved child’s sleep, parent’s sleep and the combined symptom score. The petroleum jelly placebo was not significantly better than no-treatment for any study outcome.

The most common side effect cited with the use of the vapor rub was a burning sensation of the skin, reported by 28 percent of participants receiving that treatment. No side effects were reported with use of petroleum jelly.

The results of this study suggest that an old, commonly used remedy is effective at providing symptomatic relief from night-time cold symptoms with the added benefit of improving sleep for children with colds and their parents,” Paul said. “Vapor rubs have been used for generations, but this study demonstrates that this therapy is indeed effective.” The research results appear in the December issue of “Pediatrics.”

Falls Church, VA – Inova Health System and the Center for Liver Diseases at Inova Fairfax Hospital have received a gift of $5 million to study liver disease, obesity and obesity-related liver diseases. Donated by Betty and Guy Beatty, the grant will fund research, staff, and infrastructure upgrades in the Betty and Guy Beatty Center for Integrated Research located in the Claude Moore Building on the Inova Fairfax Hospital Campus.

“To date, this is the largest gift to our research in the history of Inova Health System,” said Zobair Younossi, MD, MPH, Vice President for Research, Inova Health System, and the executive director of the Center for Liver Diseases at Inova Fairfax Hospital. “We’re privileged to have this gift that not only advances science, but also improves care for the patients in our community.”

Nationwide, nearly one-third of the U.S. adult population is obese, making obesity a significant public health challenge. In addition, obesity-related liver disease is one of the most common forms of liver disease worldwide. For more than 15 years, Dr. Younossi and his research team have pioneered cutting-edge research related to obesity-related liver disease. Inova’s research in this area has gained international recognition for its contribution to the scientific community. Younossi will lead this newly created “Beatty-Younossi Liver and Obesity Research Program.”

Mr. and Mrs. Beatty initially provided funds to build the Betty and Guy Beatty Center for Integrated Research, which opened in 2008. The center is designed as a unique research floor that integrates various components of research under one roof.

“Over the past two years, Betty and Guy Beatty Center for Integrated Research has provided us with a great opportunity to perform cutting-edge research in a number of chronic diseases, including obesity-related liver disease”, said Dr. Younossi.

“We believe this new research fund will have a profound impact on our scientific efforts in these important areas as well as accelerate our other research efforts throughout Inova Health System,” said John Fay, Vice President, Foundation, Inova Health System.

Why keep food cold? Harmful bacteria multiply rapidly in the “Danger Zone” — the temperatures between 40 and 140 °F. So, perishable food transported without an ice source won’t stay safe long. Here are safe handling recommendations to prevent foodborne illness from “bag” lunches.

Begin with Safe Food
Perishable food, such as raw or cooked meat and poultry, must be kept cold or frozen at the store and at home. Eggs should be purchased cold at the store and kept cold at home. In between, transport perishable food as fast as possible when no ice source is available. At the destination, it must be kept cold. Food should not be left out at room temperature more than 2 hours (1 hour if the temperature is above 90 °F).

Prepackaged combos that contain luncheon meats along with crackers, cheese, and condiments must also be kept refrigerated. This includes luncheon meats and smoked ham which are cured or contain preservatives.

Keep Everything Clean
Wash your hands before you prepare or eat food. Wash cutting boards, dishes, utensils, and countertops with hot, soapy water after preparing each food item and before you go on to the next item. A solution of 1 tablespoon of unscented, liquid chlorine bleach in 1 gallon of water may be used to sanitize surfaces and utensils. Keep family pets away from kitchen counters.

Don’t Cross-Contaminate
Harmful bacteria can spread throughout the kitchen and get onto cutting boards, utensils, and countertops. Always use a clean cutting board. When using a cutting board for food that will not be cooked, such as bread, lettuce, and tomatoes, be sure to wash the board after using it to cut raw meat and poultry. Use one cutting board for fresh produce and a separate one for meat and poultry.

At lunchtime, discard all used food packaging and paper bags. Do not reuse packaging because it could contaminate other food and cause foodborne illness.

Packing Lunches
Pack just the amount of perishable food that can be eaten at lunch. That way, there won’t be a problem about the storage or safety of leftovers.

It’s fine to prepare the food the night before and store the packed lunch in the refrigerator. Freezing sandwiches helps them stay cold. However, for best quality, don’t freeze sandwiches containing mayonnaise, lettuce, or tomatoes. Add these later.

Insulated, soft-sided lunch boxes or bags are best for keeping food cold, but metal or plastic lunch boxes and paper bags can also be used. If using paper lunch bags, create layers by double bagging to help insulate the food. An ice source should be packed with perishable food in any type of lunch bag or box.

Keeping Cold Lunches Cold
Prepare cooked food, such as turkey, ham, chicken, and vegetable or pasta salads, ahead of time to allow for thorough chilling in the refrigerator. Divide large amounts of food into shallow containers for fast chilling and easier use. Keep cooked food refrigerated until time to leave home.

To keep lunches cold away from home, include a small frozen gel pack or frozen juice box. Of course, if there’s a refrigerator available, store perishable items there upon arrival.

Some food is safe without a cold source. Items that don’t require refrigeration include whole fruits and vegetables, hard cheese, canned meat and fish, chips, breads, crackers, peanut butter, jelly, mustard, and pickles.

Keeping Hot Lunches Hot
Use an insulated container to keep food like soup, chili, and stew hot. Fill the container with boiling water, let stand for a few minutes, empty, and then put in the piping hot food. Keep the insulated container closed until lunchtime to keep the food hot — 140 °F or above.

Microwave Cooking/Reheating
When using the microwave oven to reheat lunches, cover food to hold in moisture and promote safe, even heating. Reheat leftovers to at least 165 °F. Food should be steaming hot. Cook frozen convenience meals according to package instructions.

In a July 22 letter, the Food and Drug Administration (FDA) reminds health professionals that using unapproved IUDs raises concerns about effectiveness and safety—as well as the potential for fraud and counterfeiting.

“Federal law requires that IUD/IUSs (intrauterine systems) be FDA-approved prior to marketing. This law is designed to protect patients from products that are unsafe and ineffective,” Theresa Toigo, FDA’s liaison with health professionals, says in the letter. “The recent issue with patients in Rhode Island unknowingly receiving imported, unapproved IUD/IUSs highlights the unacceptable risk patients may be exposed to when a product’s identity, purity, source, handling, and storage cannot be verified.”

Still, patients can use their FDA-approved IUDs with confidence, Toigo says.

FDA experts say women who received unapproved IUDs from practitioners in Rhode Island, Massachusetts, and Kentucky could be at an increased risk for unwanted pregnancy.

The small, T-shaped devices—often made of flexible plastic or copper wire—are inserted into a woman’s uterus to prevent pregnancy. Some IUDs also deliver small amounts of hormone as added protection from pregnancy.

FDA says women should not try to remove IUDs by themselves. The agency is advising women who think they may have an unapproved IUD to use another form of birth control—such as condoms, birth control pills, or the patch—and contact their health care professional. Women may want to ask:

• What advantages are there for keeping my IUD in?
• Should I think about having my IUD removed?
• If I keep my IUD in, how long should I use another form of birth control?
• If I want my IUD removed, can I get a new, FDA-approved one?
• I don’t want to use condoms. Will other birth control products, such as the pill, patch, or ring, be equally effective?
• Will this affect my ability to get pregnant in the future?
• What should I do if I think I’m pregnant?

Nationwide Problem

What started out as a Rhode Island investigation has spread beyond the state’s borders. The FDA is aware of the use of these unapproved products in several states and is continuing to investigate.

FDA says doctors, nurses, midwives—and possibly patients themselves—might buy unapproved products from what appear to be Canadian or other foreign websites in a bid to save money. Purchasing medical products from websites that are outside of the U.S. may be illegal and may increase the risk of receiving a potentially harmful product, since many websites sell products that are not FDA-approved and could be manufactured in other countries.

“Unapproved products bring a lot of unknowns into the equation,” says FDA compliance officer Kathleen Anderson. “An Internet ad may claim to sell IUDs made in Canada, but there’s no way to be sure. They might have been made anywhere in the world and in unsanitary or undesirable conditions.”

Advice for Consumers

FDA investigators routinely monitor the Internet for the sale of unapproved drugs and devices in an effort to protect the public, but the rapidly growing number of websites trafficking in fraudulent medical products means consumers must remain alert.

Experts advise consumers to learn how to buy health-related products safely over the Internet. Legitimate Internet pharmacies are licensed by the appropriate state board of pharmacy and follow laws and regulations of the state where they operate.

Legitimate Internet pharmacies will also display a seal from the National Association of Boards of Pharmacy—known as VIPPS seal or Verified Internet Pharmacy Practice Sites. VIPPS pharmacies are listed at vipps.nabp.net/verify.asp⁴.

FDA is also asking the public to report information about the distribution of unapproved IUDs. To contact the agency’s criminal investigators visit www.fda.gov/oci⁵.

This article appears on FDA’s Consumer Updates page⁶, which features the latest on all FDA-regulated products.

Chili peppers contain an ingredient that may cause weight loss and fight fat.

Capsaicin, the stuff that gives chili peppers their kick, may cause weight loss and fight fat buildup by triggering certain beneficial protein changes in the body, according to a new study on the topic. The report, which could lead to new treatments for obesity, appears in ACS’ monthly Journal of Proteome Research.

Jong Won Yun and colleagues point out that obesity is a major public health threat worldwide, linked to diabetes, high blood pressure, heart disease, and other health problems. Laboratory studies have hinted that capsaicin may help fight obesity by decreasing calorie intake, shrinking fat tissue, and lowering fat levels in the blood. Nobody, however, knows exactly how capsaicin might trigger such beneficial effects.

In an effort to find out, the scientists fed high-fat diets with or without capsaicin to lab rats used to study obesity. The capsaicin-treated rats lost 8 percent of their body weight and showed changes in levels of at least 20 key proteins found in fat. The altered proteins work to break down fats. “These changes provide valuable new molecular insights into the mechanism of the antiobesity effects of capsaicin,” the scientists say.

In this report …

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• Report summary, 197 kb.

• Entire Report, 800 kb.