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, April 27 — Group visits to a doctor are effective for Parkinson’s disease patients, researchers say.

The new study included 14 patients who received care through group visits with their regular doctor over one year and 13 patients who received usual care. The study participants had mild to moderate Parkinson’s disease.

Patients in the usual care group had 30-minute appointments with their doctor every three to six months. The group visits lasted 90 minutes and were scheduled every three months. During these group appointments, time was taken to make introductions, receive patient updates, and discuss and provide education on a topic selected by the patients. The group session also allowed for time to answer questions from patients or their caregivers.

In addition, before or after each group session, each patient had a 10-minute individual appointment with the doctor.

By the end of the year, there were no differences in how patients receiving group or individual care rated their quality of life. None of the patients who had group visits reported confidentiality issues, the investigators noted.

The findings, published in the April 27 online edition of the journal Neurology, suggest that group visits could address limitations of support groups and traditional doctor visits, said study author Dr. E. Ray Dorsey of Johns Hopkins University School of Medicine.

“While both support groups and traditional visits have clear benefits, a survey of people with Parkinson’s showed that they desire a credible group leader for their support groups and more information for them and their caregivers about their disease,” Dorsey said in an American Academy of Neurology news release.

“Group visits can address these limitations. They also give physicians the opportunity to observe their patients for a longer period of time and appreciate disease characteristics such as fluctuations in their symptoms and daytime sleepiness that may not readily be appreciated during a routine 20- to 30-minute office visit,” Dorsey added.

More information

We Move has more about Parkinson’s disease.

TUESDAY, April 26 — Girls are much less likely than boys to be placed on a kidney transplant waiting list, a new study finds.

Researchers analyzed data from almost 4,500 dialysis patients younger than 21 years of age at 150 kidney treatment centers in Canada, Costa Rica, Mexico and the United States. The results showed that girls were 22 percent less likely than boys to be placed on a waiting list for a new kidney.

There were no obvious reasons, such as medical factors or family preference, to account for this gender difference, said the researchers at the University of California Davis School of Medicine.

They also found that girls were less likely to have pre-emptive kidney transplants and less likely to have a living-related donor.

The study was published online April 20 in the journal Pediatric Transplantation.

The sooner a young person with advanced chronic kidney disease receives a new kidney, the better their long-term health and the longer the life of the kidney, experts said.

“If the goal is to get them transplanted as soon as possible, then they need to be wait-listed as soon as possible,” study lead author Stephanie Nguyen, assistant professor of pediatric nephrology, said in a UC Davis news release. “The longer they’re waiting for a transplant, the worse their outcomes will be.”

Another expert at UC Davis agreed. “Children who face kidney transplant fare best when they receive the organ without undergoing dialysis,” explained Dr. Lavjay Butani, professor of pediatric nephrology in the UC Davis School of Medicine and chief of pediatric nephrology. Butani, who has conducted his own study into the issue, noted that, “the longer the dialysis prior to the operation, the worse is the survival of the kidneys.”

He said the new study “poses important questions that need to be addressed, to better explore and understand the reasons behind this gender difference in access to organ transplant.”

According to Nguyen, doctors must be sure to carefully monitor the transplant evaluation process and to ensure that girls are given the same chance as boys to receive a new kidney as soon as possible.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about kidney failure in children.

, April 27 — The prehistoric-looking armadillo, already the state animal of Texas, now has a new claim to fame: leprosy.

A new study finds that armadillos carry the bacterium that causes leprosy, and have somehow passed the disease to several dozen humans in the southern United States.

“We’ve confirmed a long-suspected link between leprosy in humans and armadillos,” said the study’s lead author, Richard Truman, from the Bureau of Primary Health Care at the Health Resources and Services Administration’s National Hansen’s Disease Program at Louisiana State University in Baton Rouge.

Truman said it’s important to realize that the risk of contracting leprosy (also known as Hansen’s disease) from armadillos “is still infinitesimally small.”

“The last thing we want is to induce panic in the population and incite a slaughter of armadillos. The best way to combat further infection is through education and prudence,” the study’s senior author, Stewart Cole, from the Global Health Institute in Lausanne, Switzerland, said in a news release.

James Krahenbuhl, director of the National Hansen’s Disease Program, agreed. “This study doesn’t change the risk of acquiring Hansen’s disease from armadillos. It doesn’t increase the risk. In fact, we’re hoping publicity should decrease the risk by encouraging the public to decrease their contact with armadillos,” he said.

Leprosy, caused by Mycobacterium leprae, is characterized by disfiguring skin lesions and peripheral nerve damage. The disease has been around since Biblical times, and was likely brought to North America by European settlers. People with leprosy were once shunned, and often forced to live in “leper colonies.” Fortunately, the disease is treatable today, though it requires a long course of antibiotics.

Krahenbuhl said the treatment consists of a “cocktail” of three antibiotics ideally taken for two years. “The key is to diagnose early to prevent deformity and disability. Once these occur, they’re irreversible. And, this is problematic because most physicians aren’t even aware that the disease still exists,” he said.

Although rare in the United States, leprosy still affects many people in tropical and semitropical areas. Almost 250,000 cases were reported worldwide in 2008. In the United States, the authors estimate that about 150 people develop Hansen’s disease each year. And, most of these have traveled to parts of the world where leprosy is more common.

But the researchers noticed that about one-third of new cases developed in people who hadn’t left the country, and most of these people lived in Louisiana or Texas.

Since the 1970s, armadillos have been suspected of being potential carriers of the disease. Their low body temperature makes them ideal incubators for the bacteria, according to the authors.

Using DNA analysis, the researchers were able to identify a unique strain of M. leprae that was present in 28 of 33 armadillos tested and 25 of 39 U.S. residents who lived in areas where exposure to armadillos would be possible.

Results of the study are published in the April 28 issue of the New England Journal of Medicine.

“The researchers used the same type of DNA analysis that’s used in foodborne illness outbreaks. It’s how we know that a certain strain of salmonella is responsible for a particular outbreak,” explained Dr. Kenneth Bromberg, director of the Vaccine Research Center at the Brooklyn Hospital Center in New York City.

“This is a warning for people in the south and southwest who might have environmental exposure to stay away from armadillos,” said Bromberg.

The study authors recommend that frequent direct contact with armadillos should be discouraged, as should consumption of armadillo meat.

More information

To learn more about leprosy, visit the U.S. Centers for Disease Control and Prevention.

TUESDAY, April 26 — Every time her teenage daughter Jordyn leaves the house, Nancy Geller worries about the food her daughter might choose to eat. Jordyn has a severe peanut allergy, and exposure to even a small amount of a peanut-containing food could cause a life-threatening allergic reaction.

“It’s a big worry, especially now that she’s a teenager and is eating out with her friends,” said Geller, who lives in Croton on Hudson, N.Y.

Geller isn’t alone with her concerns. According to the Food Allergy and Anaphylaxis Network (FAAN), as many as 12 million Americans have a food allergy. Milk, eggs, peanuts, tree nuts, shellfish, soy and wheat are responsible for most food allergies, according to FAAN.

While it’s easy to control your environment at home to be sure you or your allergic children aren’t exposed to the offending food, many people choose to eat food prepared in restaurants, where the risk of being exposed to a food allergen is much greater.

Still, many feel if they let the waitstaff know about the allergy, they can be assured a safe meal. But new research indicates that that’s not always the case.

In a study that included managers, waiters and chefs at 90 restaurants in Brighton, a popular British resort town, researchers found that just a third said they’d had specific food allergy training. However, 81 percent said they still felt confident they could provide a safe meal to a customer with food allergies.

When the researchers pressed for more specific information, they found that 38 percent of restaurant workers erroneously believed that people with food allergies could drink water to dilute the allergen and lessen the severity of the allergic reaction. Another 23 percent mistakenly thought that eating a small amount of a food allergen would be safe.

About one in eight restaurant workers didn’t realize that food allergies could cause death. Sixteen percent believed that cooking food could prevent food allergies, and 21 percent mistakenly thought they could simply remove the food allergen from the finished meal and it would be safe.

Results of the study were published in the May issue of the journal Clinical and Experimental Allergy.

Christopher Weiss, vice president of advocacy and government relations for FAAN, said the U.K.’s study results are similar to those of a study done in the United States.

“I wasn’t overly surprised by the results. But, if you look at today versus five years ago, we’ve made significant advancements. Overall though, we’ve still got a way to go before the vast majority of restaurant workers understand food allergy,” he said.

There was some good news from the U.K. study: Almost half of those surveyed expressed an interest in learning more about food allergies. In the U.S. study, Weiss said that figure was 60 percent.

“So, we developed a training guide with the National Restaurant Association along with a video that’s easy to watch. The more restaurants that take advantage of these tools, the better,” said Weiss.

Sue Hensley, a spokesperson for the National Restaurant Association, echoed Weiss’ sentiments, and said her organization “is working diligently to address the issue of food allergic customers in restaurants by educating our restaurants and their employees on food allergens.”

Geller said that there has been a noticeable difference in food allergy awareness where she lives — the New York metro area — in the past few years. “In the past, many restaurants just wouldn’t take any responsibility. It was very tough to feel comfortable in a restaurant. Now, we definitely see more understanding,” she said.

For others dealing with food allergies, Geller advised talking to the waitstaff and letting them know what your specific needs are.

Weiss added that a lot of people with food allergies also call restaurants in advance, or go in and visit before they go to eat so that they can “gauge whether or not that facility would be able to serve them a safe meal.”

More information

The Food Allergy and Anaphylaxis Network, in cooperation with the National Restaurant Association, has educational materials available for restaurants on its Web site.

, April 27 — The growing number of people with Alzheimer’s disease in the United States means that more people are becoming caregivers, a responsibility that health experts warn can pose risks to body and mind.

But caregivers can take various steps to protect their health, says Rebecca Axline, a clinical social worker at the Nantz National Alzheimer Center in Houston.

To keep stress in check, for instance, she emphasizes the need to find time and ways to reenergize, to keep meaningful things in your life and to remain social and participate in your favorite activities.

Axline also offered communication techniques that can help reduce caregivers’ stress and frustration:

Always identify yourself and call the person you’re caring for by name.Talk slowly and clearly. Use short sentences and break down instructions into steps.Ask one question at a time and wait patiently for a response. Repeat information and questions. Clarify and give visual clues, such as pointing to an object or location. Avoid vague words.Use positive rather than negative instructions, such as “walk carefully” instead of “don’t trip.”Don’t get into power struggles with the person, such as arguing about something that’s possibly been forgotten.

Getting adequate rest — at least seven to eight hours of uninterrupted sleep a night — and eating well, Axline said, also are key to keeping a caregiver’s body and mind healthy. If there’s no time to cook, caregivers should ask for help from family, friends or neighbors.

Building a support team is important, she said. The doctor and treatment team, including the social worker, for the person receiving care, as well as the local Alzheimer’s Association can help create a care program that works for the recipient and caregiver alike.

More than 5 million Americans have Alzheimer’s disease, a number that experts predict will rise to 16 million by 2050. Women are more likely than men to develop Alzheimer’s and are also more likely to become caregivers.

More information

The U.S. National Institute on Aging offers an Alzheimer’s caregiver guide.

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THURSDAY, April 28 — Women are much more likely than men to sustain kidney damage after undergoing a common heart imaging test called coronary angiography, a new study has found.

During the procedure, an iodine contrast dye is used to enhance images of the heart’s blood vessels and chambers. But the dye may cause the kidney’s blood vessels to narrow, damaging the organ, explained Dr. Javier Neyra, an internal medicine resident at Henry Ford Hospital in Detroit and the study’s principal investigator.

The side effect, known as radiocontrast-induced nephropathy, can cause kidney dysfunction within 24 to 72 hours after the dye has been injected. In the United States, it is the third-leading cause of hospital-acquired kidney damage, after surgery and high blood pressure, according to the study.

“Because men and women patients receive the same amount of dye during a coronary angiogram, it’s possible the amount is just too much for a woman’s body to handle given her smaller size,” Neyra said in a hospital news release. “Perhaps a woman’s height and weight ought to be factored into the dosage.”

For their study, the researchers followed 1,211 people who had a coronary angiogram between January 2008 and December 2009. They found that women were 60 percent more likely than men to develop radiocontrast-induced nephropathy — 20 percent versus 13.6 percent.

The findings were to be presented at a National Kidney Foundation meeting in Las Vegas. Experts note that research presented at meetings should be considered preliminary because it is not subjected to the rigorous scrutiny given to research published in medical journals.

More information

The U.S. National Heart, Lung and Blood Institute has more about coronary angiography.

THURSDAY, April 28 — Men who are both obese and tall face a much higher risk for developing potentially fatal blood clots, though overall the risk remains quite small, according to a new study.

The researchers report that extra weight and extra inches together seem to raise the risk more than either alone.

“Tall and obese men had more than a fivefold higher risk, compared to short and lean men,” said the study’s co-author, Sigrid K. Braekkan, who warns the vertically and horizontally gifted to avoid sitting in one place for too long.

Women also face a higher risk if they’re both obese and tall, but just being tall alone doesn’t seem to be a problem, the study found.

The clots lead to a condition known as deep vein thrombosis, which may be best known as an affliction that strikes passengers on long plane flights who don’t have much chance to move around. Immobilization of the legs can contribute to the condition.

Other causes include injury and a genetic condition that makes people’s blood more likely to clot. “And there are some people who seem to get clots when they don’t have any clear, obvious risk factors,” said Dr. Victor Tapson, director of the Center for Pulmonary Vascular Disease at Duke University.

Though the clots start in the leg, they can move to the lung, where they may cause a deadly pulmonary embolism. Venous thromboembolism is the term used to describe the two conditions — deep vein thrombosis and pulmonary embolism — together.

In the new study, published online April 28 in Arteriosclerosis, Thrombosis and Vascular Biology, researchers collected data on 26,714 people from 1994 to 2007, including 461 reports of venous thromboembolism.

Obese and tall men — those at least six feet tall — had more than five times the risk for a clot, compared with normal-weight men shorter than 5 feet 7 inches. The risk was three times higher for women who were obese and at least 5 feet 6 inches than for normal-weight women shorter than 5 feet 3 inches.

The higher risk for tall people appears to be related to their circulatory system. “The distance for blood to return to the heart and lungs is longer,” Braekkan said. “Since the blood must be pumped upwards against the force of gravity by the calf-muscle pump, the longer distance may cause reduced flow in the legs and, thereby, higher risk of clotting.”

He said that obesity causes pressure in the abdomen that may hinder the ability of the calf-muscle pump to send blood back up into the body.

The study found, however, that the risk for developing blood clots remained low, even for the tall and obese.

But what should obese and tall people do to lower their risk even more? Until pounds can be shed, the best thing to do is to avoid situations where you’re not moving for long periods of time, Tapson said.

Even in the cramped space of a plane, try “just moving your legs, shifting your legs, going up and down on your toes and flexing your feet back and forth to keep your calf muscles stimulated,” he said. It’s also a good idea to keep hydrated (and alcohol doesn’t help on that front). Some people use elastic socks, although Tapson said they may be troublesome if they crimp the legs.

More information

The U.S. National Heart, Lung and Blood Institute has more on deep vein thrombosis.

THURSDAY, April 28 — A new study helps confirm what many Americans with arthritis may already know: the illness can greatly diminish quality of life.

Researchers analyzed data from 1 million adults who took part in the national Behavioral Risk Factor Surveillance System survey in 2003, 2005 and 2007. Poor or fair health was reported by 27 percent of respondents with arthritis compared to 12 percent of those without arthritis.

Compared to other adults, those with arthritis had a higher average number of physically unhealthy days per month (seven versus three), mentally unhealthy days (five versus three), total unhealthy days (10 versus five) and activity-limited days (four versus one), according to the report published online April 28 in the journal Arthritis Care & Research.

The study also found that people with arthritis-related limitations to normal activities had poorer health-related quality of life than those without such limitations.

Values for all five measures of health-related quality of life were two to three times worse in adults with arthritis compared to those who were arthritis-free. The five measures included: demographics (age, sex, ethnicity/race); social factors (employment status, education and income levels); health care factors (access and cost barriers to obtaining care); health behaviors (smoking, alcohol use, physical activity levels); and health conditions (diabetes, weight, high blood pressure).

Low family income, inability to work, being unable to afford care and having diabetes were all strongly associated with poor health-related quality of life, Sylvia Furner, of the School of Public Health at the University of Illinois at Chicago, and colleagues noted.

In addition, adults with arthritis who were physically active were less likely to report fair or poor health, the study authors pointed out.

“Given the projected high prevalence of arthritis in the U.S., interventions should address both physical and mental health,” Furner concluded. “Increasing physical activity, reducing [co-existing disorders], and increasing access to health care could improve the quality of life for adults with arthritis,” she explained in a journal news release.

About 50 million American adults have doctor-diagnosed arthritis and that number could climb to 67 million by 2030, according to the U.S. Centers for Disease Control and Prevention.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more about arthritis.

THURSDAY, April 28 — Your social status affects how your brain reacts to other people, researchers have found.

In the new study, brain activity in volunteers was measured using functional MRI. Those with higher socioeconomic status experienced increased brain activity when shown information about others at their social level, while people with lower socioeconomic status had greater response to others like them, the investigators found.

The heightened activity occurred in an area called the ventral striatum, a main part of the brain’s “values” system, according to the report published in the April 28 online edition of the journal Current Biology.

“The way we interact with and behave around other people is often determined by their social status relative to our own, and therefore information regarding social status is very valuable to us,” study author Caroline Zink, of the U.S. National Institute of Mental Health, said in a journal news release. “Interestingly, the value we assign to information about someone’s particular status seems to depend on our own status.”

The findings have important implications for our social behavior and social lives, according to Zink.

She noted that a person’s socioeconomic status, which is based on factors such as habits and accomplishments as well as monetary value — can change, and it’s not clear how the brain responds to those changes.

However, she added, “As humans, we have the capacity to assess our surroundings and context to determine appropriate feelings and behavior. We, and our brain’s activity, are not static and can adjust depending on the circumstances. As one’s status changes, I would expect that the value we place on status-related information from others and corresponding brain activity in the ventral striatum would also change.”

More information

The American Psychological Association has more about socioeconomic status.