TUESDAY, Nov. 18 (HealthDay News) -- In the not-so-distant future, American seniors may turn to helpful, uncomplaining robots to fill the worrisome "care gap" that many face today.

One of these autonomous devices, called the uBOT-5, is already capable of carrying out simple tasks while it monitors the home environment. The robot can even spot trouble -- such as a person falling down -- and call 911 if necessary.

The freestanding device can also bring a faraway loved one into an aging person's home via video Internet hook-up.

"So, if I'm at work, and it's lunch hour and I want to poke in on Dad, I can get on the Internet and basically 'step inside' the robot," said uBOT-5 co-inventor Rod Grupen, who directs the Laboratory for Perpetual Robotics at the University of Massachusetts, Amherst. With their face appearing via video on the front of the robot's head, the virtual visitor can converse with their loved one while moving the robot around, doing some cleaning, for example, or retrieving a dropped TV remote.

Any "authorized user" can jump into and guide the robot, Grupen said. "So, if you can't get to your doctor, your doctor can now come to you," he said. In fact, the UMass team hopes that the uBOT-5 will someday be capable of running simple medical tests, such as measuring blood pressure or blood sugar.

And because it's fully mobile, with Segway-like wheels, virtual visits from others should include much of the house, and beyond. "Your granddaughter on the West Coast can get into the robot and visit with you outside in the garden, you can have a two-way conversation with audio/video, hold hands and go show them the flowers you just planted," Grupen said.

There's a huge and growing need for robotic home assistants that might help care for the elderly or disabled and allow them to stay in their homes, Grupen believes. According to U.S. Census figures, the number of Americans age 65 or over will double by 2030, and two-thirds will need some form of long-term care. At the same time, there's a dearth of nurses and home health-care aides to care for them; experts predict a shortage of 800,000 nurses by 2020.

The uBOT-5's design was inspired by the human body. Its myriad sensors mimic human eyes and ears, constantly scanning its environment. It is even programmed to detect and respond to worrisome aberrations, including a fallen, unresponsive human. The robot's arms are each capable of handling 2.2-pound loads, and they can extend to reach high or pick things up off the floor (a dropped pill bottle, a package in a foyer, for example). The robot can lie prone to scoot itself under a bed (and then right itself), and it may even someday help with household cleaning and grocery shopping, Grupen said.

And the cost? Right now, the prototypes at UMass cost $65,000 apiece, but Grupen envisions a day when commercial versions would be sold for $5,000 plus a monthly Internet hook-up fee, much like today's computers.

And the uBOT-5 isn't the only such device in the pipeline. Over at Massachusetts Institute of Technology, researcher Nicolas Roy, at the institute's Computer Science and Artificial Intelligence Laboratory, has developed an "autonomous wheelchair" that only requires a command to whiz users from one spot to another in a hospital or nursing home.

When first delivered to a facility, the wheelchair -- rigged out with high-tech scanning software -- has no knowledge of the particular layout. But staff will uncrate it, turn it on, and give it a verbal guided tour, walking it past different rooms and nursing stations.

"You talk to it like you'd talk to a new person, a new nurse. And as a side effect of the thing being walked through the facility once or twice, the wheelchair has now been demonstrated a route between all the points," explained co-developer Seth Teller, who helps lead the lab's Robotics, Vision and Sensor Networks Group.

After that, a wheelchair-bound stroke patient or quadriplegic need only say, "Take me to Room 451" for the chair to understand and then do just that. The device will be launched as a prototype ready for testing in a Boston-area nursing home within two years, Teller said.

Finally, at Georgia Tech, researchers led by assistant professor Charlie Kemp are making their own home-care robots, inspired by the agile intelligence of service dogs.

"We're using service dogs to answer three important questions: What tasks would be good for a [home] robot to perform? How should people interact with the robot, to tell it to do these tasks? And how can the robot actually perform these tasks, given the complexities of the home?" Kemp said.

Service dogs and the disabled people they help are providing the answers. The new robot is being designed to move about and perform tasks such as opening drawers, turning doorknobs and working light switches, Kemp said. Users indicate what they'd like done by using a laser pointer, and homes are modified slightly to help the robot, just as homes are subtly tweaked to aid service dogs. "Things like tying a small towel to a doorknob" to facilitate grasping, Kemp explained.

The robot may not ever replace a great service dog, but Kemp noted that the average disabled American now pays $16,000 for a properly trained canine, and waiting lists now stretch for years.

"I think there's a real need," he said. "So, the hope is that people will support this sort of work. Then, we'll be able to deliver these things when people need them."

More information

There's more on the uBOT-5 at the University of Massachusetts, Amherst.

(HealthDay News) -- If you have chronic back pain, it can periodically put you out of commission and onto the couch.

Once you're feeling better, exercise can help prevent another bout with an aching back.

You should always check with your doctor before you begin any new activity. But here are some general guidelines about exercise and back pain, courtesy of the University of Michigan Health System:

• Low-impact exercises such as walking, swimming or biking generally are safe for a sore back.
• If your muscles feel sore or tight, take a warm shower before exercising.
• Wear loose clothing, and don't wear shoes.
• Stop any exercise that causes pain
• Avoid exercises such as sit-ups, hip twists, toe touches, or any that involve backward arching.
• Avoid impact sports such as soccer, football and volleyball.
• Avoid any activity that may stress your back, such as lifting heavy weights.

THURSDAY, Nov. 13 (HealthDay News) -- Performing an electrocardiogram (EKG) -- the standard test for measuring the activity of the heart -- is of little use in predicting future coronary problems for people who are examined because of chest pain, a British study suggests.

"In patients with stable chest pain, suspected angina, the resting EKG was of no incremental prognostic value as a means of assessing the risk of patients having further coronary events," said study author Dr. Adam Timmis, a professor of clinical cardiology at London Chest Hospital. The findings were published in the Nov. 14 online issue of the BMJ.

Chest pain is the most common reason people seek medical attention for possible heart trouble, and an EKG, also known as an ECG, is a common test for such people, Timmis said. "We were interested in the value of the EKG as a stand-alone predictor, its incremental value in addition to taking a history, doing a physical examination and so on," he said.

Timmis and his colleagues followed 8,176 patients with no history of heart disease who were referred to chest pain clinics because of suspected angina. All had EKGs done while they were resting, and 60 percent of them also had EKGs while they exercised. All had the usual clinical assessment, recording data such as age, sex, duration of symptoms, smoking status, high blood pressure history and medications they were taking.

The patients who had exercise EKGs done were split into two groups: "summary" results were recorded for 4,848, while additional "detailed" results were recorded for 1,422. All were then followed for several years. The researchers found that 47 percent of the coronary events that occurred happened to people whose exercise EKGs did not indicate any heart problems.

"We found that the exercise EKG had no added value over and above the clinical assessment," Timmis said.

The EKG does have some role in diagnosis, helping to determine whether the chest pain is caused by a heart problem, Timmis noted.

"The study is a reminder of the importance of taking a detailed history and making a thorough physical examination, and that additional information from the EKG is helpful in some patients but does not predict risk in everyone," Dr. Beth Abramson, director of the Cardiac Prevention Centre at St. Michael's Hospital in Toronto, wrote in an accompanying journal editorial.

The study showed that the combination of an EKG and a stress test can be helpful because "an abnormal EKG and abnormal stress test independently predicted adverse events, such as death or acute coronary syndrome in the cohort study," Abramson wrote.

But some people with normal EKGs and normal stress tests in the study did have coronary events, "so the study cannot provide an answer about which approach should be used in patients with a normal EKG," she wrote. "These patients need to have their cardiac risk factors assessed regularly by their general practitioner and, if necessary, modified."

The study also showed that "the stress test and EKG are not foolproof indicators of risk," Abramson wrote. "However, even though these tests cannot predict all future events, they are a necessary extension of the physical examination in patients with suspected angina."

Timmis said, "We are looking for better tests to classify patients in terms of risk." Some newer methods show promise, "but all these tests need to be assessed not for their standalone value but for clinical value in these patients."

More information

More details on EKGs are described by the U.S. Library of Medicine.

MONDAY, Nov. 10 (HealthDay News) -- An analysis of 33 studies on drugs known as beta blockers has concluded that they are not useful in any surgical procedure other than heart surgery. In fact, using beta blockers for non-coronary surgery may actually increase the risk of stroke, the scientists say.

The researchers who conducted the study -- known as a meta-analysis -- recommend that the guidelines committees of both the American College of Cardiology and the American Heart Association "soften" their recommendations that beta blockers be used to prevent surgical complications in non-coronary operations.

"Our study says that if you look at the overall picture, do a meta-analysis, studies that are not particularly well-done come to the conclusion that they are useful," said Dr. Franz Messerli, professor of medicine at Columbia University and an author of a report published online by The Lancet to coincide with the annual heart meeting now underway. "But if you look at the high-quality studies, there are distinctly more strokes with beta blockers." Beta blockers are drugs that inhibit adrenaline and slow the nerve impulses to the heart. They can also be used to treat irregular heartbeat, known as arrhythmia.

The meta-analysis did show a 35 percent reduced risk of heart attacks and a 64 percent reduction in less serious heart artery blockages among the more than 12,000 participants in all the studies where beta blockers were prescribed before surgery. But there was no overall reduction in total deaths, heart failure or deaths due to heart disease, and a doubled risk of nonfatal stroke.

Beta blocker usage was also associated with a high risk of bradycardia, low heart rate requiring medical treatment, which occurred in 1 of every 22 people getting beta blockers, and of lower blood pressure dangerous enough to require treatment.

In September 2008, researchers writing in the Journal of the American College of Cardiology concluded that beta blocker drugs don't prevent development of heart failure in people with high blood pressure and should not be used as first-line treatment for hypertension.

The increased risk of stroke, occurring in 1 of every 293 beta blocker recipients, is especially important, Messerli said. "Stroke is one of the most devastating complications of cardiovascular disease," he said. "For that reason, we would be very reluctant to use beta blockers in noncomplicated patients."

There is a presurgical role for beta blockers in many cases, Messerli said. "If a patient has coronary artery disease, he or she should certainly be on beta blockers," he said. "If they are on beta blockers already, they should remain on beta blockers. But if there is no particular cardiovascular risk, beta blockers should not be prescribed for noncardiac procedures."

Existing recommendations that call for routine use of beta blockers before surgery should be revised, Messerli said. "This is regarded as a quality measure for physicians," he said. "If they don't prescribe a beta blocker, it is considered to be falling short of a quality measure. Since the data are relatively soft, it certainly should not be a quality measure."

But an argument for use of beta blockers before surgery was made in an accompanying comment to the study by Dr. Don Poldermans, professor of medicine at Erasmus Medical Center in Rotterdam, the Netherlands. One major problem with studies showing difficulties when beta blockers were prescribed was that the doses were too high, Poldermans said.

"A low dose is safe, so why not use it?" Poldermans said, citing a study that he presented to the American Heart Association's annual scientific sessions, in New Orleans.

The study of 1,066 people who underwent surgery and were classified as being of intermediate risk of cardiovascular complications found that 2.1 percent of those getting a moderate daily dose of bisoprolol, a widely used beta blocker, suffered heart attacks or died of heart disease, compared to 6 percent of those not getting the beta blocker, Poldermans reported.

What might help decide the issue would be "a study to clarify dose and regimen" of beta blockers before surgery, he said. But such a study might be difficult to do, because the dangers of high-dose beta blockers are clear, Poldermans said.

"I would be very careful with high doses of beta blockers," he said. "There could be an increased risk of stroke. But a low dose is safe, so why take a high dose?"

More information

Learn why and how beta blockers are used from the Texas Heart Institute.

SUNDAY, Nov. 9 (HealthDay News) -- Despite certain risk factors, Hispanic patients were 57 percent less likely than Caucasians to undergo coronary artery bypass surgery (CABG) one year after successful angioplasty to open blocked coronary arteries, a new study found.

It also found that Hispanics were less likely to have any kind of repeat revascularization (artery opening) procedures, more likely to have diabetes (increasing their risk for heart attack), and more likely to have long lesions blocking their arteries -- an average length of 15.4 millimeters vs. 14.1 millimeters in whites.

The study included 542 Hispanic and 1,357 white patients who had percutaneous coronary intervention (PCI), such as angioplasty, from 1999 to 2006. The Hispanic patients were, on average, three years younger than the white patients, but were more likely to have: hypertension (80.4 percent vs. 72.3 percent), diabetes (49.2 percent vs. 27.8 percent), and insulin-treated diabetes (15 percent vs. 7.4 percent).

However, Hispanic patients had less peripheral artery disease (5.6 percent vs. 10.3 percent); prior heart attack (25.8 percent vs. 30.9 percent), and prior PCI (27.8 percent vs. 34.1 percent).

Whites and Hispanics had similar rates of heart attack and death one year after PCI, said the study, expected to be presented Sunday at the American Heart Association's Scientific Sessions, in New Orleans.

"It's interesting that Hispanics were younger and had more risk factors," study author Dr. Shailja V. Parikh, a fellow in the department of internal medicine, division of cardiology at the University of Texas Southwestern Medical Center at Dallas, said in an AHA news release.

"With higher rates of insulin-treated diabetes, hypertension and longer lesion lengths, one would expect Hispanic patients to have higher rates of repeat revascularization either through CABG or PCI. However, despite having these risk factors for increased rates of restenosis (artery narrowing), Hispanics were found to be revascularized less often after initial PCI than their Caucasian counterparts," Parikh said.

"It is possible that a referral bias exists in which Hispanic patients are not being referred for coronary artery bypass surgery as commonly as Caucasians. Or, there may be mediating factors intrinsic to the Hispanic patient that could be protective toward restenosis," Parikh added.

More information

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

THURSDAY, Nov. 6 (HealthDay News) -- Very young children who sustain a head injury may be more likely to be diagnosed with attention-deficit hyperactivity disorder (ADHD) later, researchers report.

The head injury is not a cause of ADHD, but rather a result of excessive risk-taking, according to the paper published in the Nov. 8 online edition of the British Medical Journal.

"There have been studies done that link moderate to severe traumatic brain injury in older children to ADHD," said lead researcher Dr. Heather Keenan, an associate professor of pediatrics at the University of Utah in Salt Lake City. "There has been some suggestion that mild traumatic brain injury could also be linked to ADHD."

The researchers wanted to know whether or not head injury that occurs before the age of 2 might cause ADHD. A diagnosis of ADHD cannot be made before that age, Keenan noted.

"It is hard to figure this out, because we don't know whether or not the kids would have gone on to develop ADHD regardless of the head injury," Keenan said.

For the study, Keenan's group collected data on 62,088 children who were registered in a British health improvement network database. The researchers compared the children with head injuries to two other groups: children with a burn/scald injury before the age of 2, and all the other non-injured children.

"We wanted to make sure that if we saw a relationship between head injury and ADHD, it wasn't just that kids with early injuries were showing behavioral traits that would make them more likely to be diagnosed versus the head injury itself," Keenan said.

The researchers found that children with early head injury did have a 90 percent higher incidence of ADHD diagnosis before they were 10, compared with children in the general population. However, children with a scalding injury also had a higher risk of being diagnosed with ADHD, 70 percent to be exact. "Therefore, the head injury did not appear to cause the ADHD," Keenan said.

Keenan thinks this finding may mean that some very young children are already showing behavioral traits that are the hallmarks of ADHD.

"Children with early injury should receive routine developmental and behavioral surveillance by their pediatrician, as well as injury prevention counseling," Keenan said. "Early injury may be an indicator of attention problems in some children."

Dr. Jon A. Shaw, director of the Division of Child and Adolescent Psychiatry and Behavioral Sciences at the University of Miami, agreed that early injury may signal a future diagnosis of ADHD.

"The finding that head injury or burn injury occurring before 2 years of age are equal risk factors for a diagnosis of ADHD before 10 years of age is a surprising, but interesting, finding," Shaw said.

ADHD is a highly heritable disease. Approximately 85 percent of ADHD children have a family history of ADHD, Shaw said. "Children with ADHD are impulsive, hyperactive, distractible and inattentive, and are accident-prone, and thus more likely to put themselves at risk for injury," he said.

More information

For more information on ADHD, visit the U.S. National Institute of Mental Health.

THURSDAY, Nov. 6 (HealthDay News) -- Most prescription drug users would be unhappy if one of their medications was switched to another in the same class without their knowledge or their doctor's approval, a new survey shows.

The practice, known as therapeutic substitution, is usually done as a cost-saving measure.

"People may not know about it, but it's happening, and if it is happening, it should be happening with full transparency, and patients and doctors should be in on this," said Sally Greenberg, executive director of the National Consumers League. "It's not necessarily something that we're condemning."

But others feel the practice is not unduly widespread and, even when it is used, that doctors and patients rarely go uninformed.

"I think they're making much ado about nothing. I can't imagine this goes on without the doctor's or patient's knowledge," said Robert Freeman, a professor of pharmaceutical sciences at Texas A&M Health Science Center Irma Lerma Rangel College of Pharmacy in Kingsville. "It would be insane to do this without informing the patient or without the physician knowing. Just think about the tort ramifications."

Curtis Haas, director of pharmacy at the University of Rochester Medical Center, said the practice is "not uncommon," but added that, "it's hard to believe pharmacists would change patient medications and not talk to them about it."

In New York, where Haas practices, a pharmacist would have to communicate directly with the doctor to get a new prescription authorized before another medication could be dispensed.

Prescription switching is the practice of dispensing a different drug, albeit one still in the same class of medications, as the drug originally prescribed.

According to Greenberg, exact numbers on the practice are elusive, but financial concerns are usually the reason for the switch.

"It's the 80/20 rule, the idea being that if the vast majority of people are using one drug versus the other that when you apply this to a large population, that drug will be the most cost-effective with no compromise in quality," Haas said.

The cholesterol-lowering drugs known as statins have been targeted for therapeutic substitution, as have proton pump inhibitors, which are used to treat acid reflux. "To most people's knowledge, there are no important differences if given in equivalent doses," said Haas.

Pfizer, which makes Lipitor (atorvastatin), funded this survey.

These surveyors contacted 1,387 adults who had filled a prescription in the past year. Two-thirds had never heard of therapeutic substitution, while 10 percent reported they had personally experienced the practice in the past two years.

Among the survey's other findings:

• Seventy percent of respondents said they would be "very" or "extremely" concerned if their prescription had been switched without their doctor's knowledge; 77 percent oppose the practice without doctor or patient consent.
• One-third of those who said they or a family member had experienced therapeutic substitution said the doctor had not been consulted beforehand, while two-thirds said the family member was not consulted.
• Forty-seven percent said they or the family member were dissatisfied with what had happened, adding that the switch had not saved them money.
• One-third felt the substituted medication was as effective as the original drug.

More information

The National Consumers League has a public education campaign on the practice.

THURSDAY, Oct. 30 (HealthDay News) -- The cardiac benefits of wine have been touted for years, but heavy metal contamination found in some European red and white wines could turn a health benefit into a hazard, British researchers report.

Heavy metals have been linked to neurological problems such as Parkinson's disease and may also increase oxidative stress, which can lead to chronic inflammatory disease and cancer, the researchers noted.

"We used literature reports of concentrations of metals in wines originating from 16 countries to determine the Target Hazard Quotients (THQ) for these wines," said lead researcher Declan Naughton, a professor of biomolecular sciences at Kingston University in South West London. "Many of the wines gave very high THQ values, which is concerning."

Among wines from Portugal, Austria, France, Spain, Czech Republic, Hungary, Germany, Serbia, Argentina, Brazil, Italy, Jordan, Macedonia, Slovakia and Greece, only three countries had wines that posed no hazard from heavy metals.

Based on the wines analyzed, only those from Argentina, Brazil and Italy had THQ values that were below 1.0.

The report was published in the Oct. 30 online edition of Chemistry Central Journal.

For the study, Naughton and his colleague Andrea Petroczi used the THQ, a formula developed by the U.S. Environmental Protection Agency to look for seven heavy metals in wines. These included vanadium, copper, manganese, nickel, zinc, chromium and lead.

Naughton and Petroczi found that most wines had THQ values much higher than 1.0. In fact, THQ values typically ranged from 50 to 200. Red and white wines from Hungary and Slovakia reached THQ levels of 300.

"For consumption of 250 mL (8.5 oz.) daily, these wines give very high THQ values and may present detrimental health concerns through a lifetime," Naughton said.

Because heavy metals can pose a health threat, Naughton and Petroczi recommend that levels of metal ions should appear on wine labels. "This would help inform customer choice," Naughton said. "In addition, where necessary, further steps should be introduced to remove key hazardous metal ions during wine production."

No wines from the United States were included in the study, so it is not possible to tell the heavy metal content of wines produced in this country. One critic of the study does not think U.S. wines contain dangerous levels of heavy metals.

"The U.S. [Alcohol and Tobacco] Tax and Trade Bureau routinely performs market basket surveys in the U.S. to test wine and alcohol for a number of components, including heavy metals," explained Gladys Horiuchi, communications manager at the Wine Institute of California.

Joan R. Davenport, a professor of soil science in the Department of Crop and Soil Sciences at Washington State University, thinks a lot more study needs to be done to figure out how these heavy metals are ending up in wine.

"Knowing what I know about not only growing wine grapes but the whole process of turning them into wine and looking at some of the countries where these wines came from, it makes me wonder what may happen in the processing," Davenport said.

A lot of the heavy metals found in the wines in the study, exist in only very small quantities in soil, Davenport said. "The likelihood of that being in the grapes isn't very likely," she said. The contamination could be coming from the metal barrels used in processing the wine, she added.

Davenport isn't worried that these metals are a health problem. "I'm not going to drink any less wine," she said. "Enjoy what you enjoy in moderation. But if you like only Hungarian wine, you might be in more trouble than if you like Argentinean wine."

More information

For more about wine and heart disease, visit the American Heart Association.

(HealthDay News) -- Eczema, medically called atopic dermatitis, is a condition that causes patches of itchy, scaly and red skin.

Depending on the condition's severity, soothing moisturizers, mild soaps, or wet dressings can help ease symptoms.

The U.S. National Library of Medicine says the following conditions can make eczema worse, and should be avoided when possible:

• Dry skin.
• Exposing the skin to very warm or hot water for long periods.
• Exposing the skin to environmental irritants.
• Stress.
• Changes in temperature.
• Sweating.

TUESDAY, Oct. 28 (HealthDay News) -- The more people who get the flu vaccine, the better it is for everyone, according to two new studies.

In the first study, researchers from the Institute for Clinical Evaluative Sciences in Toronto and colleagues found that a universal vaccination program implemented in the Ontario province in 2000 helped lower flu-related deaths, hospitalizations, and visits to emergency departments and doctors' offices there. Under the program, the Ontario government offers and promotes free flu vaccinations to everyone over the age of 6 months.

However, the study also showed that only 38 percent of all household members still received the shots, and that the increase in immunization rates did not reduce mortality and health-care use in older people, particularly those over 75 years of age, as much as it did in younger people. This suggests that higher immunization rates of younger people might still help protect older people from the flu, the researchers said.

The second study, done by a team at University Medical Center, Utrecht, in the Netherlands, found that vaccinating all health-care workers in a 30-bed nursing home department could reduce patient infections by up to 60 percent. They also calculated that vaccinating seven health-care workers would, on average, prevent one patient at the home from developing the flu.

This study in "herd immunity" found that it was not possible to fully protect all the patients; however, it concluded that increasing worker vaccination does lead to lower risk of patients developing influenza.

Both studies were published this week in the open access journal PLoS Medicine.

More information

The U.S. Centers for Disease Control and Prevention has more about seasonal flu.