Black patients' aversion to hospice is studied

Doctors have long known that African American patients are less likely than whites to use hospice for end-of-life care, but the reasons were elusive.

A new study by University of Pennsylvania researchers points to eligibility criteria for hospice services as a possible factor.

Medicare and other insurers require patients to give up cancer treatment to be eligible for hospice, which includes visiting nurses, chaplains, home health aides, social workers and counselors.

David J. Casarett and his colleagues interviewed 283 patients at six Penn oncology clinics and found that blacks had stronger preferences for continuing their cancer treatments. The team also found that African American patients had a "greater perceived need" for hospice service. When they factored in economic characteristics, they found poorer patients wanted more services.

They concluded that needs-based eligibility criteria would be more fair. For instance, a patient's need for pain or symptom management could be considered. Their research will be published in the Feb. 1 issue of Cancer, the journal of the American Cancer Society.

- Sandy Bauers

Weight gain linked to self-perceptions

Women who delude themselves about their weight are more likely to gain too much during pregnancy.

Temple University researchers found that overweight women who thought they were normal were at risk for excess baby weight. So were normal-weight women who thought they were fat. The findings were published last week in the journal BMC Pregnancy and Childbirth.

The authors studied 1,537 women, 508 of whom tipped the scales in the overweight or obese range. Thirteen percent of that group thought they were normal. The researchers speculate that since these women aren't aware that they are overweight, they may have more trouble following pregnancy weight-gain guidelines: just 10 to 15 pounds for overweight women, 25 to 35 pounds for normal weight women.

Harder to explain were the women who thought they were fat but weren't. Of the 1,029 normal weight women, 14 percent thought they were overweight or obese. The researchers speculated that they gained too much during pregnancy because they were suffering body dissatisfaction and might be predisposed to binge eating.

Either way, doctors warn that gaining more than the recommended amount can increase a woman's chances of needing a C-section and of having a large baby. And it can put a woman at risk for a host of health problems if she can't slim back down after the baby is born.

- Faye Flam

Elderly warned about drug-mixing

You've heard it before: Read drug inserts carefully for potential interactions with supplements, and be sure to tell your doctor what you take, no matter how benign it seems.

A new study suggests that at least two million older Americans are taking a combination of drugs or supplements that can be a risky mix. One in 10 older men are taking potentially harmful combinations, according to the research in the current Journal of the American Medical Association. The report is based on a study of nearly 3,000 interviews with people ages 57 to 85.

Among the most common problematic combinations: warfarin, a potent prescription clot-fighting drug, increases the risk of excess bleeding when taken with aspirin, another blood-thinner. The same risk applies when warfarin and garlic pills are taken together, and when aspirin is taken with over-the-counter ginkgo supplements. Lisinopril, a blood pressure drug, can cause abnormal heart rhythms when taken with potassium. And combining cholesterol-lowering statin drugs with over-the- counter niacin increases risks for muscle damage.

The Institute for Safe Medication Practices recently launched a Web site that allows consumers to enter names of their medications to check for any potentially dangerous interactions. Go to

- Associated Press

Less sleep found to increase risk of coronary artery disease

More evidence that sleep matters: People in their 30s and 40s who got less of it were more likely to develop the early buildup of plaque in the arteries of their heart.

The provocative study, published in the current Journal of the American Medical Association, is the first to link an objective measure of the duration of sleep to an established method for assessing risk of coronary artery disease.

The study followed for five years 495 healthy people ages 35 to 47 who did not have artery disease. CT scans at the beginning looked for the presence of calcium in their arteries. Their sleep patterns were tracked using a wrist device that is considered an objective measure of the amount of sleep obtained during the night.

At the end of the study, they underwent another scan. About 6 percent of those who got seven or more hours of sleep had developed at least some calcification in their arteries, a sign of early heart disease. That compared with 11 percent who got five to seven hours and 27 percent who got less than five hours, said senior author Diane Lauderdale of the University of Chicago.

The study took into account other known risk factors for heart disease, including sleep apnea, cholesterol, blood pressure, body weight, diabetes and depression. In fact, an extra hour of sleep had the same effect on heart disease risk as lowering systolic blood pressure (the upper reading) by 16.5 points.

- McClatchy-Tribune News Service