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Children who aren’t allowed to watch R-rated movies are much less likely to start drinking alcohol at an early age, a new study suggests.

Researchers questioned nearly 3,600 middle-school children in New England and followed-up about two years later. In that time, 3 percent of the kids who said their parents never allowed them to watch R-rated movies said they had started drinking alcohol, compared with 19 percent of those who were sometimes allowed to watch R-rated movies and 25 percent of those who said they were allowed to watch such movies “all the time.”

The findings are reported in the May issue of the Journal of Studies on Alcohol and Drugs.

The results highlight how important it is for parents to monitor their children’s media exposure, said Dr. James D. Sargent, a pediatrics professor at Dartmouth Medical School in Hanover, N.H., and an author of the study.

“We think this is a very important aspect of parenting, and one that is often overlooked,” Sargent said in a news release from the journal.

He added that the new findings supplement the work of previous studies that have linked exposure to R-rated movies and shows with adult content to early drinking, early smoking, sex at a young age and violent behavior.

“The research to date suggests that keeping kids from R-rated movies can help keep them from drinking, smoking and doing a lot of other things that parents don’t want them to do,” Sargent said.

Depictions of alcohol consumption appear in about 90 percent of R-rated movies, Sargent said, which may be one reason why children who see such movies are more likely to start drinking at a young age. But he noted that previous studies have suggested that children who watch R-rated movies become more prone to “sensation seeking” and “risk taking.”

“We think seeing the adult content actually changes their personality,” he added.

People discharged from the hospital with noncardiac (not heart-related) chest pain may require more aggressive cardiovascular risk management than they typically receive, a new study has found.

Noncardiac chest pain can be caused by a number of problems, including panic attack, musculoskeletal pain, gastroesophageal reflux disease (GERD) and esophageal hypersensitivity.

The study included 320 patients who were admitted to the hospital with what was believed to be unstable angina, evaluated and discharged with a diagnosis of noncardiac chest pain. After the initial diagnosis of noncardiac chest pain, 49 percent of patients were re-evaluated in the emergency department and 42 percent underwent repeated cardiology evaluations.

Only 15 percent of the patients had gastrointestinal (GI) consultations. Of those, 38 percent had esophagogastroduodenoscopy, 4 percent had manometry (13 tests) and 2 percent had pH probes (six probes), the study authors reported.

“Patients in this study received few GI consultations and underwent even fewer GI tests. Further study is needed to determine whether patients with noncardiac chest pain would benefit from more frequent GI consultations and more diverse use of GI testing modalities,” study co-investigator Dr. Michael Leise, of the Mayo Clinic, said in a news release.

The study also found that patients with noncardiac chest pain didn’t have a significantly higher overall rate of death than expected, but a substantial number of cardiac deaths occurred in these patients.

“We speculate that cardiac death in patients with noncardiac chest pain may relate to overlapping risk factors for GERD and coronary artery disease, including obesity, obstructive sleep apnea, diabetes mellitus and smoking,” Leise said.

He said until more is known about cardiac death in patients with noncardiac chest pain, doctors should screen these patients for cardiac risk factors, such as high blood pressure, high cholesterol and diabetes, and aggressively manage these conditions.

The study is published in the issue of Mayo Clinic Proceedings.

Platelet-rich plasma accelerates healing and bone formation after tooth extraction, a new study shows.

Poor healing after tooth removal can result in excessive jaw bone loss that may delay the use of dental prosthetics or implants, require expensive reconstructive surgery, or be impossible to repair, according to the researchers.

The study included patients who had surgery to remove wisdom teeth. One extraction site was treated with platelet-rich plasma (PRP) while the site on the other side of the mouth was used as a control. During 24 weeks of follow-up, the patients were checked for jaw bone density, healing, bleeding, inflammation, pain and facial swelling.

“The PRP treatment has a positive effect on bone density immediately following tooth extraction,” while the control sites showed a decrease in bone density in the first week after surgery, the researchers said.

“It took approximately six weeks for the control sites to reach the same bone density that the PRP-treated site had reached by week one,” they wrote. “The immediate start of bone formation seen with PRP treatment is of clinical relevance because it is the initial two weeks following bone manipulation oral surgery that are important.”

PRP had little effect on bleeding, inflammation, pain and facial swelling.

Using PRP to promote faster jaw bone formation may reduce the waiting time for dental prosthetics or implants to two to four months instead of the current four to six months, according to the researchers.

The study was recently published in the Journal of Oral Implantology.

Countries in eastern Europe and central Asia face spiralling AIDS epidemics if they fail to help people who inject drugs and stop the spread of infection, the head of the United Nations agency for HIV/AIDS said on Friday.

Michel Sidibe told Reuters countries such as Russia, Ukraine and others could halt or buck the global downward trend in new HIV infections if they ignored the threat posed by drug users and failed to introduce effective “harm reduction” steps.

“HIV infection has slowed down globally, but it is expanding in this region of eastern Europe and central Asia,” he said. “We’re not seeing anything like this in any other region of the world.”

Sidibe, who was due to address a conference on harm reduction in the British city of Liverpool on Sunday, said of the 3.7 million people in the region who inject drugs, a quarter have the human immunodeficiency virus that causes AIDS.

Drug users, often criminalized and marginalized from health and social services, can spread the virus by sharing needles with an HIV-infected person or pass it on by having unprotected sex.

Infection prevention steps like providing needles, condoms and substitute drugs like methadone — collectively known as harm reduction — are seen by many experts as key to halting the spread of HIV and AIDS, but some governments are reluctant to provide them for fear of being seen to condone drug use.

Sidibe warned newly-emerging and growing pockets of HIV spread among drug users could propel a wave of infections and undermine gains in curbing sexual transmission of the disease.

“What is unacceptable is knowing there is this multitude of epidemics among drug users, we have on average each drug user getting less than two clean needles a month, and only about four percent of those living with HIV getting treatment,” he said.

About 33.4 million people worldwide are infected with the AIDS virus. Since AIDS emerged in the 1980s, almost 60 million people have been infected and 25 million have died.

A report published last month showed that more than 90 percent of the world’s 16 million injecting drug users are offered no help to avoid contracting AIDS.

EFFECTIVE AND COST-EFFECTIVE

Sidibe said there was now “rock solid scientific evidence” to show harm reduction measures were effective in cutting the numbers of new infections with HIV.

He pointed to a 2002 study conducted in 103 cities in 24 countries which found the HIV infection rate fell by an average of almost 19 percent a year in places with needle and syringe programs, but increased by an average of 8.1 percent a year in cities with no such policies.

“But people are scared … and there is a lack of proper understanding of harm reduction,” he said.

Sidibe called on Russia, where the government outlaws the heroin substitute methadone, to show leadership for the region and recognize that protecting drug users, not punishing them, would cost less and help more in the long run.

The UNAIDS chief said in Ukraine protecting a drug user from HIV/AIDS infection would cost less than $100, a fraction of the estimated $825 a year it costs to treat someone with AIDS drugs.

Sidibe pointed to countries like China, which has moved in recent years from a zero-tolerance approach to injecting drug users to what he described as a more “pragmatic” policy of helping them reduce HIV/AIDS infection risk.

“Today they have one of the biggest programs in Asia,” he said. “Our goals will be reached only if we persuade all governments and authorities that harm reduction is more effective than punishment.”

In another sign of a link between gum disease and premature birth, a new study finds that pregnant women with periodontal disease who undergo successful treatment are less likely to give birth early.

Researchers from the University of Pennsylvania in Philadelphia and Washington University in St. Louis studied 872 women with and without gum disease who were pregnant for between six and 20 weeks. Of that group, 160 with gum disease were treated and later evaluated to see whether the treatment had been successful.

About 7 percent of the women without gum disease gave birth before 35 weeks’ gestation; the rate was 23.4 percent among those who had gum disease, the researchers found.

The study authors also found that women whose periodontal treatment failed were more likely to have premature infants.

The findings are scheduled to be presented Friday at the annual meeting of the American Association for Dental Research in Washington D.C.

SOURCE: International & American Association for Dental Research.

For women who have had breast cancer surgery, the question of whether or not to wait before receiving radiation therapy has been answered by new research that suggests that the longer women wait, the greater the chance of cancer recurrence.

The findings, published in the March 3 online edition of BMJ, are based on an analysis of national cancer records for 18,050 American women who were diagnosed with early-stage breast cancer between 1991 and 2002, at age 65 or older.

All of the women underwent breast-conserving surgery and radiation therapy, but not chemotherapy.

Among the 30 percent of the women in the study who began radiation therapy more than six weeks after surgery, the researchers found that 4 percent went on to develop local recurrences within five years.

The researchers, led by scientists from the Dana-Farber Cancer Institute in Boston, also discovered that the risk of recurrence appeared to decline the sooner radiation treatment began. This suggests that it’s a bad idea to wait to begin radiation therapy, and the treatment should start as soon as possible after surgery, the authors of the report noted in a news release from the journal’s publisher.

The researchers also found that black and Hispanic women took longer, on average, to begin radiation treatment.

SOURCE: BMJ, news release.

Healthy eating habits lead to longer survival for ovarian cancer patients, U.S. researchers say.

In a study of 351 women with incident epithelial ovarian cancer, the researchers found that higher total fruit and vegetable consumption, higher vegetable consumption alone, and healthy grain consumption were associated with longer survival. High consumption of “less-healthy” meats was associated with shorter survival.

The findings “suggest that food patterns three to five years prior to a diagnosis of epithelial ovarian cancer have the potential to influence survival time,” Therese A. Dolecek, research associate professor of epidemiology at the University of Illinois at Chicago, and colleagues wrote in their report published in the March issue of the Journal of the American Dietetic Association.

“The pre-diagnosis food patterns observed to afford a survival advantage after an epithelial ovarian cancer diagnosis reflect characteristics commonly found in plant-based or low-fat diets. These diets generally contain high levels of constituents that would be expected to protect against cancer and minimize ingestion of known carcinogens found in foods,” the researchers wrote.

“The authors provide new evidence that dietary factors, particularly total fruit and vegetable, red and processed meat, and milk intakes may influence ovarian cancer survival,” Cynthia A. Thomson, an associate professor of nutritional sciences at the University of Arizona, Tucson, and Dr. David S. Alberts, director of the Arizona Cancer Center in Tucson, wrote in an accompanying editorial. “These findings corroborate earlier work . . . and are among only a select few studies of dietary associations with ovarian cancer recurrence and/or prognosis despite a significant and growing body of literature suggesting diet may influence ovarian cancer risk.”

According to background information in a news release about the study from the journal’s publisher, 21,550 new diagnoses of ovarian cancer and 14,600 deaths from the disease were estimated to occur in the United States in 2009. Ovarian cancer is often diagnosed in the late stages and the five-year survival rate is about 45 percent.

SOURCE: Journal of the American Dietetic Association.

Eating plenty of potassium-rich foods such as leafy greens, potatoes and bananas may reduce the risk of stroke and coronary artery disease, according to Italian researchers.

The new analysis was based on 10 studies published between 1966 and 2009 that included almost 280,000 adults. During follow-ups that ranged from five to 19 years, there were over 5,500 strokes and almost 3,100 coronary heart disease events, the investigators found.

Higher potassium intake was associated with a 19 percent lower risk of stroke and an 8 percent lower risk of coronary heart disease. The findings support global recommendations for people to increase their consumption of potassium-rich foods in order to prevent vascular disease, said Dr. Pasquale Strazzullo, of the University of Naples, and colleagues.

Other foods high in potassium include soybeans, apricots, avocados, plain non-fat yogurt, prune juice, and dried beans and peas.

The findings were presented Wednesday at the American Heart Association’s Nutrition, Physical Activity and Metabolism conference in San Francisco.

Another study presented at the meeting found that a diet high in raw fruits and vegetables may help protect against stroke.

In that study, the researchers examined the incidence of stroke among more than 20,000 men and women, aged 20 to 65, who were free of cardiovascular disease at the start of the study. During 10 years of follow-up, there were 233 strokes among the participants.

After they adjusted for a number of factors, the researchers found that people with a high intake (more than 262 grams per day) of raw fruits and vegetables were 36 percent less likely to suffer a stroke than those with a low intake (less than 92 grams per day) of raw fruits and vegetables.

However, there was no association between stroke risk and a high intake (more than 233 grams per day) or low intake (less than 113 grams per day) of processed fruits and vegetables, said Linda Oude Griep of Wageningen University, the Netherlands.

SOURCE: American Heart Association

The commonly used diabetes medication metformin sometimes has such an unpleasant odor that people may stop taking it, experts say.

But they recommend that people let their doctors know if the smell of this oral drug is an issue for them, because different formulations — especially the extended-relief version — tend to have a milder odor, if any at all, reports a letter in the Feb. 16 issue of the Annals of Internal Medicine.

“Metformin is an excellent drug, but the immediate-release formulation may have an odor to it. The smell is fishy or like the inside of an inner tube, and in a patient’s mind, because it smells like something that has gone bad, they may think the drug isn’t good,” explained one of the letter’s authors, J. Russell May, a clinical professor at the University of Georgia College of Pharmacy at the Medical College of Georgia.

However, May said, “some metformin products on the market are extended-release and the drug is embedded and released slow, over time. These products have much less smell, if any.”

May and his colleagues wrote the letter to the journal to raise awareness of this issue, especially because nausea is a commonly reported side effect of metformin. “Is it nausea from the medication, or is it because it smells bad?” May said.

Physicians at the Medical College of Georgia had two adult male patients with type 2 diabetes complain of the “dead fish” odor of metformin. The smell was significant enough that both of the men stopped taking the medication. One of the men switched to the extended-release version of the drug and no longer had any problems; the second man refused to try the extended-release version.

May and his colleagues searched the medical literature to see whether problems with the smell of metformin were common, but they found no reports.

Then they searched the Internet and found reports on hundreds of posts to message boards about the smell of metformin, and in an informal survey of pharmacists, several said they could easily identify metformin by its unique “old locker-room sweat sock” odor.

Bristol-Myers Squibb is one of a number of companies that manufacture metformin, and although the company won’t comment on drugs made by others, a spokesman, Ken Dominski, released this statement on metformin’s odor:

“Bristol-Myers Squibb is aware that the inherent characteristics of metformin have been associated with a mild odor upon opening of the bottle, so these type of reports are not unexpected. It’s important to note there has been no correlation between an odor and the efficacy of metformin, which has been on the market in the U.S. since 1995.”

“Patients actually put up with a lot of side effects and discomfort from medications, and most doctors would like to know that, because there are probably some underreported experiences with medications that we don’t know about, and this may be one of them,” said Dr. Elbert Huang, assistant professor of medicine at the University of Chicago. “As doctors, we can’t take every medication, so we don’t always understand what it’s like. But, one thing is clear, if we make people miserable, we’ve defeated the purpose of the medication.”

If the smell of metformin bothers you, Huang added, you shouldn’t discontinue the medication, but you should definitely let your doctor know. A different formulation may be available to you.

One easy solution May proposed is simply to hold your nose while taking the drug.

SOURCES: J. Russell May, Pharm.D., clinical professor, University of Georgia College of Pharmacy, Medical College of Georgia, Augusta, Ga.; Elbert S. Huang, M.D., M.P.H., assistant professor of medicine, University of Chicago; statement, Bristol-Myers Squibb