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To help ensure the health and safety of young athletes, CDC developed the Heads Up: Concussion in Youth Sports initiative to offer information about concussions—a type of traumatic brain injury—to coaches, parents, and athletes involved in youth sports. The “Heads Up” initiative provides important information on preventing, recognizing, and responding to a concussion.

CDC wants to equip coaches, parents, and young athletes across the country with the “Heads Up: Concussion in Youth Sports” tool kit, which contains a:
Fact sheet for coaches on concussion
Fact sheet for athletes on concussion
Fact sheet for parents on concussion
Clipboard with concussion facts for coaches
Magnet with concussion facts for coaches and parents
Poster with concussion facts for coaches and sports administrators
Quiz for coaches, athletes, and parents to test their concussion knowledge

People who develop the condition tend to have “weaker quads and hamstrings,” study co-author Darin Padua, said in a news release. “As a result, they don’t bend their knees as much when doing tasks, such as running or jumping. That means the contact area between the kneecap and the femur is smaller, so pressure is focused and pinpointed on a smaller area.”

That, in turn, leads to runner’s knee, also known as patellofemoral pain syndrome, said Padua, an associate professor of exercise and sport science at the University of North Carolina at Chapel Hill. Runner’s knee, which affects an estimated one in four people who are physically active, can lead to osteoarthritis.

The research appears to be the first of its kind to study athletes both before and after they develop runner’s knee, Padua said.

The researchers studied nearly 1,600 midshipmen from the U.S. Naval Academy. Of those, 40 people — 24 women and 16 men — developed runner’s knee over several years.

The study authors noted that those with weaker hamstring and quadriceps muscles, a larger “navicular drop” (flattening of arches in the foot) and less flexible knees were several times more likely to develop the condition.

A new study suggests that nighttime urination, or nocturia, is comparable to loud snoring as a marker for obstructive sleep apnea, a disorder in which soft tissue in the throat blocks the flow of air into the lungs, disrupting sleep.

Previous studies established a link between nocturia and sleep apnea, a potentially serious condition that affects about 25 percent of U.S. men and 10 percent of U.S. women, the researchers said. But they believe this is among the first to show that screening for nocturia could help doctors identify patients with apnea.

The study also suggests that a common treatment for sleep apnea — positive airway pressure (PAP) therapy — can reduce symptoms of nocturia, thereby improving sleep and preventing debilitating falls among elderly people who get out of bed at night to use the bathroom.

PAP involves wearing a pressurized air mask while sleeping.

Typically, doctors screen for apnea by assessing patients’ weight (the condition is associated with overweight/obesity) and asking if they snore heavily, notice breathing problems at night or feel tired during the day (because of interrupted sleep). But because many patients, especially those who sleep alone, are unaware that they snore, apnea often goes undiagnosed.

“When you ask people about symptoms like snoring and gasping, they tend to say, ‘No, I don’t have them’,” said study author Edward Romero, research coordinator at the Sleep & Human Health Institute in Albuquerque, N.M. “But it’s very easy for them to realize that they wake up at night to go to the bathroom.”

One of Romero’s co-authors, institute director Dr. Barry Krakow, said doctors and patients are quick to blame nocturia on diabetes, prostate enlargement and other medical conditions with which it is associated. “I see patients all the time who think they’re waking up to urinate because they have prostate trouble or a small bladder,” Krakow said. “About 80 percent of the time we discover that apnea is the cause of their problem.”

Besides nocturia and snoring, symptoms of sleep apnea include daytime drowsiness, memory problems and depression. Untreated sleep apnea can lead to high blood pressure, blood clots and heart disease.

For the study, published online recently in Sleep and Breathing, the researchers reviewed data on 1,007 adults treated at two sleep clinics in New Mexico between 2005 and 2007. Of the participants, 797 were diagnosed with sleep apnea, 777 reported snoring and 839 reported nocturia. Neither snoring nor nocturia was proof of apnea, but the two symptoms were similar in their power to predict it: snoring was reported by 82.6 percent of apnea sufferers, and 84.8 percent of apnea sufferers reported nocturia.

The authors propose further research be conducted to confirm the effectiveness of nocturia as an apnea screening tool.

Mary Umlauf, a professor at the University of Alabama Capstone College of Nursing in Tuscaloosa and a noted nocturia researcher, said the study could play an important role in dispelling “old wives’ tales” about nocturia.

“Many health-care providers and ordinary people think of nocturia as a urological or gynecological problem,” she said. “They don’t understand that sleep apnea can cause the body to produce too much urine at night.

“People who wake up to urinate shouldn’t assume that it’s my prostate, or ‘I’m just old’,” she said.

Here are suggestions from the Nemours Foundation to help comfort little ones who are teething:
Use a warm, wet cloth to wipe down baby’s face and remove any drool. This may help prevent a rash.
Offer baby something soothing, such as a teething ring or a wet washcloth that’s been chilled in the freezer for about 30 minutes. Be sure to wash the cloth after each use.
Treat baby to a gentle gum massage, making sure to use a clean finger.
Ask your doctor if it’s safe to give baby acetaminophen. Make sure your doctor approves a specific dose and frequency.

Never tie a teething ring to baby, especially around the neck, as it could cause strangulation.

The American Academy of Family Physicians offers this list of possibilities:
Side effects, such as dizziness or nausea.
An interaction with another drug.
An interaction with a food or beverage.
An allergic reaction.
A sensitivity that results from use of the drug, such as sensitivity to the sun.

The germ that causes the condition, known as Clostridium difficile, can create serious symptoms, including diarrhea and an inflammation of the colon, that can be fatal. The infection can be difficult to treat because the bacteria have become immune to some drugs.

The bacteria have been found mostly in hospitals, nursing homes and similar facilities.

“Recent reports have shown increasing incidence and severity of C. difficile infection, especially in the older population,” Dr. Darrell Pardi, a Mayo Clinic gastroenterologist and senior author of a study on the situation, said in a Mayo news release. “Our study examines why the cases are on the rise and who is getting the infection.”

The findings were presented recently at the American College of Gastroenterology annual meeting, in San Diego.

The researchers examined 385 cases of disease caused by the germ from 1991 to 2005 to see if more were being acquired in places other than a hospital.

They found that people who got sick outside of a hospital were younger — a median of 50 years old versus 72 — and had less severe cases.

“The growing incidence of C. difficile infection in both inpatient and outpatient settings could be linked to the increasing usage of antibiotics and to the possibility that C. difficile may be getting resistant to some of our newer antibiotics,” Pardi said.

Health experts have gotten better at spotting the bacteria in hospitals and nursing homes, he said, but “now doctors and patients need to be more aware that you can get this infection as an outpatient and that a case of diarrhea or abdominal cramps at home could become serious.”

The germ kills an estimated 5,000 people in the United States each year, according to the U.S. Centers for Disease Control and Prevention.

“There is a potential collision here,” Dr. Francis Collins, director of the National Institutes of Health said at a forum sponsored by the American Association for the Advancement of Science.

Collins, a genetics pioneer tapped by President Barack Obama in July to head the NIH, said studies that lump together large groups of people to test the effectiveness of treatment A versus treatment B run the risk of overlooking clusters of people for whom a drug might have a dramatic effect.

“That’s going to get lost in the wash by considering everybody equivalent, which we know they are not,” said Collins, who helped lead the Human Genome Project that in 2003 produced a sequence of all the DNA in people.

“The antidote to that is pretty straightforward,” said Collins, saying that studies need to include genetic information that allows researchers to find such responses.

Backers of comparative effectiveness research, who include insurers and large employers, see the government-funded studies as a way to learn which treatments work best. But Collins said the studies should be well crafted.

“We need to be mindful of the goal of comparative effectiveness research and not lose all that we have gained in understanding how individuals differ and how that could be factored into better diagnostics and preventive strategies,” Collins told the meeting, which was broadcast on the Internet.

COST-CUTTING POTENTIAL

There is already evidence that personalized medicine can help reduce health costs, Collins said, pointing to Genomic Health’s Oncotype DX, a genetic test that can predict the recurrence of breast cancer.

“This test allows those individuals at low risk for recurrence to know they are at low risk and make a decision about whether to forgo chemotherapy, with all of its adverse consequences, based on that information,” Collins said.

He said the test costs $3,500, and most women who get tested and discover they are at low risk decide to forego chemotherapy, saving an average of $2,000 per patient in additional costs from chemotherapy treatment.

“In 2009, roughly 50,000 women are going through this process, predicting we will therefore save the healthcare system $100 million this year based on the availability of this kind of personalized medical test,” Collins said.

Dr. Margaret Hamburg, commissioner of the U.S. Food and Drug Administration, told the meeting that many clinical trials are structured to determine if a drug is safe and effective in a large group of patients, but the drugs often leave out the why — why certain patients benefit while others do not.

The FDA increasingly is approving drugs with companion diagnostic tests using biomarkers — such as specific proteins or genes — that improve the odds that a new, high-cost biotechnology drug will work.

She said studies that look at the genetic profile of patients and its role in how drugs work could strengthen a drug’s application, lending more scientific certainty about why a new drug works.

“Perhaps then we could see more new drug applications in the pipeline that are more likely to succeed,” she said.

One of two studies released on Wednesday provided the first evidence that fructose helps raise blood pressure. It also found that the drug allopurinol, used to treat gout, can alleviate the effect by reducing uric acid levels in the body.

The second study, which measured fructose intake in mice, suggested that people who consume junk foods and sweetened soft drinks at night could gain weight faster than those who don’t.

“These results suggest that excessive fructose intake may have a role in the worldwide epidemic of obesity and diabetes,” said Dr. Richard Johnson of the University of Colorado-Denver, who studied the link between blood pressure and men.

The findings provide the latest evidence of ties between sugar-rich diets and health problems that have prompted some experts to call for a tax on sugary soft drinks.

Fructose accounts for about half the sugar molecules in table sugar and in high-fructose corn syrup, the sweetener used in many packaged foods.

Johnson and colleagues at the Mateo Orfila Hospital in Spain studied 74 men given 200 grams of fructose per day on top of their regular diet. That amount is well above a daily intake of 50 grams to 70 grams of fructose consumed by most American adults.

Half the men were also given allopurinol.

After two weeks, the men who received only the fructose registered increases of six millimeters in systolic blood pressure — the top reading — and about three millimeters in diastolic or the bottom reading, the researchers told an American Heart Association meeting in Chicago.

REVERSIBLE EFFECT

Most of their blood pressure readings returned to normal levels after two months.

The men who did not get allopurinol also were twice as likely to develop metabolic syndrome, measured by risk factors such as too much abdominal fat, high blood pressure and poor cholesterol readings.

By contrast, those given allopurinol and fructose had significantly lower uric acid levels, and virtually no increase in systolic blood pressure or higher risk of metabolic syndrome.

For the second study, researchers in Ohio studied mice given fructose water to drink. Some had unrestricted access, while others received it during the day or at night.

“The first thing we noticed was that the mice on restricted access rushed to their drinking bottles to load up on the sweetened beverage, similar to teenagers who drink too many soft drinks,” said Mariana Morris of Wright State University in Dayton, Ohio.

The mice that drank fructose water during their regular daylight sleeping hours gained more weight and had higher stress hormone levels than the other mice.

“This model may be similar to the human condition of night time bingeing of fructose-laden foods and beverages,” Morris said.

The American Heart Association says women should eat no more than 100 calories of added processed sugar per day, or six teaspoons (25 grams), while most men should keep it to just 150 calories or nine teaspoons (37.5 grams). On average Americans consume 22 teaspoons (90 grams) or 355 calories of added sugar each day.

In addition, people with sickle cell trait can potentially pass the disease on to their children.

It’s important to know whether or not you have sickle cell trait. Sickle cell trait is diagnosed with a simple blood test. People at high risk for having sickle cell trait are those whose ancestors come from Africa, South or Central America, the Caribbean, Mediterranean countries, India, and Saudi Arabia.
The Cost of Sickle Cell Disease

Sickle cell disease is a major health concern. People with sickle cell disease can have lifelong disabilities. The average life expectancy is 42 years for men and 48 years for women.1 In addition, the cost to people with the disease and the health care system is high. For example, hospital stays due to complications of sickle cell disease cost an estimated at $475 million during the period 1989–1993.2
A Public Health Approach

Right now, there are no data systems to find out how many people have sickle cell disease in the United States. CDC, in partnership with the National Institutes of Health (NIH), is working to develop a pilot surveillance system to help learn more about how many people have the disease and how it affects them.

In addition, CDC is helping to educate people a bout this disease. We have a website with information about the disease and tip sheets on how to stay healthy, how to prevent infections, and when to see the doctor. We are also developing new materials to help people better understand certain drug therapies and to raise awareness among students, teachers, and others in the community.
Help Spread the Word

Every September—during National Sickle Cell Awareness Month—community organizations, families, and others join together to spread the word about sickle cell disease.