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NEW YORK (Reuters Health) - Among seniors, an increase in the ratio of their arm span to their height -- indicating a probable loss of height -- is strongly associated with shortness of breath and reduced lung capacity, according to a new study.

"Many physicians, who regularly care for older individuals, have suspected an association between loss of height and symptoms of shortness of breath," Dr. Maw P. Tan noted in comments to Reuters Health.

It may just be a matter of reduced space for the lungs, Tan explained. "I recall a consultant geriatrician I once worked for saying, 'I think she's just ran out of space', in response to a breathless older female patient of small stature after numerous 'normal' tests for her heart and lungs."

Arm span measurement is normally close to standing height, so Tan, from Newcastle University in the UK, and others used the arm span-to-height ratio as a measure for loss of height in a study involving 66 subjects 61 to 81 years old with a variety of disorders.

As the arm span-to-height ratio increased, lung function decreased while breathlessness increased, the researchers report in the medical journal Chest.

"The results of the study were far more profound that we expected, given the relatively small number of subjects involved," Tan said. "We postulate that this loss of height results in reduced lung volume which then results in shortness of breath."

Furthermore, they also uncovered "the possibility of ensuing cardiac complications, further highlighting the potential clinical importance of the discrepancy between arm span and standing height," the investigators note in their report.

SOURCE: Chest, February 2009.

Copyright © 2009 Reuters Limited.

LONDON (Reuters) - Passive smoking appears to significantly raise a person's risk of dementia and other forms of cognitive problems, British and U.S. researchers said on Friday.

Their report published in the British Medical Journal found a 44 percent increased risk for people exposed to high levels of second-hand smoke, and is the first large-scale study to show the association between the two.

"Our results suggest that inhaling other people's smoke may damage the brain, impair cognitive functions such as memory, and make dementia more likely," David Llewellyn of Britain's University of Cambridge, who led the study, said in a statement.

Research has tied passive smoking to a range of conditions including lung cancer and heart disease. More than half of children worldwide are exposed to second-hand smoke in their homes, according to the World Health Organization.

Previous studies have also identified smoking as something that increases the chances of dementia and other forms of cognitive impairment but it was not as clear whether the same held true for second-hand smoke.

Llewellyn and colleagues examined saliva samples from nearly 5,000 non-smoking adults over the age of 50 using data from three separate British health surveys.

Then they tested the saliva for cotinine -- a product of nicotine found in saliva for about 25 hours after exposure to second-hand smoke -- to measure exposure to cigarettes.

Tests aimed at gauging brain function such as verbal memory and keeping track of time showed an association between exposure to second-hand smoke and cognitive impairment.

One possible explanation is that exposure to second-hand smoke increases the risk of heart disease and stroke, conditions known to boost the odds of dementia and other cognitive problems, the researchers said.

"Given the ongoing international policy debate on exposure to second-hand smoke, this is a topic of major public health significance," the researchers wrote.

Copyright © 2009 Reuters Limited.

NEW YORK (Reuters Health) - Many people with lower back pain caused by spinal disc degeneration need not resort to surgery for relief, according to a research review.

In fact, researchers say, non-invasive treatments -- including physical therapy and anti-inflammatory painkillers -- should be the first, and often only, measure for most people with the problem.

Spinal discs can be damaged by trauma to the spine, repetitive strain on the back, or the aging process -- and these disc problems are a common cause of chronic lower back pain.

Different types of surgery, including replacement of damaged discs, are options for patients with serious pain. However, in most cases, a conservative approach is best, according to the new review, published in the Journal of the American Academy of Orthopedic Surgeons.

About 90 percent of people with lower back pain can expect to recover within three months, even without treatment, say the researchers, and most will have some improvement within six weeks.

Moreover, there are still questions about the long-term effectiveness of surgery for disc-related back pain.

"Recently, disc replacement surgery has been proposed as a cure or treatment for symptomatic lumbar disc disease," lead researcher Dr. Luke Madigan, of the Knoxville Orthopedic Clinic in Tennessee, said in a written statement.

However, he said, so far studies suggest the surgery is only about as effective as an older technique known as spinal fusion, in which the surgeon joins two or more vertebrae to help stabilize the problematic area of the spine. The success rate with that procedure has been between 50 percent and 60 percent.

The longer-term effectiveness of disc replacements is still unclear. "Long-term outcomes are still to be published and caution should be exercised with their use," Madigan said.

On the other hand, studies suggest that physical therapy, including exercises to strengthen the abdominal muscles and education on how to lift objects safely -- using the legs, not the back -- often helps people with disc-related back pain.

Similarly, non-steroidal anti-inflammatory drugs, like ibuprofen and naproxen, often bring short-term pain relief.

"Surgery should be the last option," Madigan said, "but too often patients think of surgery as a cure all and are eager to embark on it."

For their part, he added, surgeons should carefully consider each patient's situation and suggest surgery only to those who are "truly likely to benefit from it."

SOURCE: Journal of the American Academy of Orthopedic Surgeons, February 2009.

Copyright © 2009 Reuters Limited.

NEW YORK (Reuters Health) - Computers may be more than a proverbial pain in the neck; using them for extended periods may actually cause or aggravate neck pain, at least in teenage schoolkids.

Among students enrolled in grades 10 to 12 at schools in Western Cape, South Africa, "there was a steady increase in the report of neck pain as the number of hours using the computer per week increased," physiotherapist Leonie Smith told Reuters Health.

In 2006, Smith, at Stellenbosch University in Tygerberg, South Africa, and colleagues assessed duration of computer use and reports of headache and neck pain among 1073 students (65 percent girls), who were 16 years old on average.

Nearly half the students (48 percent) attended schools that used computers, the researchers report in the journal Cephalalgia.

Of the students enrolled in schools with computer training, 43 percent used computers for 8.5 hours or more per week. The investigators noted similar duration of use in just 5.5 percent of the students enrolled in schools without computer training.

"No clear association could be found between high hours of computer use and the presence of headaches," said Smith, despite common reports of headache among the students, and particularly female students.

By contrast, neck pain was more common among students who also reported longer hours of computer use, regardless of computer availability at school.

For instance, among the students who spent 5 or fewer hours using a computer each week, about 16 percent reported neck pain; among students reporting 25 to 30 hours of computer use a week, nearly 48 percent reported neck pain.

Smith's team says their findings "have confirmed the need to educate new computer users (school students) about appropriate ergonomics and postural health."

SOURCE: Cephalalgia, February 2009.

Copyright © 2009 Reuters Limited.

NEW YORK (Reuters Health) - As a treatment for severe ankle sprain, a mechanical support -- especially a 10-day below-knee cast -- leads to faster recovery than does a tubular compression bandage, new research shows.

Not all mechanical supports tested showed a benefit, however. The Bledsoe boot, a lightweight and removable device that limits motion, was no better than compression bandages in promoting recovery.

In the study, 584 subjects seen in eight emergency departments across the UK were randomly assigned to be treated with a 10-day below-knee cast, an Aircast brace, a Bledsoe boot, or a double-layer tubular compression bandage.

The subjects were followed for 9 months. The below-knee cast and the Aircast brace led to better ankle function at 3 months than did the compression bandage, Dr. Sarah E. Lamb, from the University of Warwick, Coventry, UK, and colleagues report in the Lancet medical journal.

Moreover, the below-knee cast had the added benefits of improving pain, symptoms, and activity.

The Bledsoe boot, as noted, offered no benefits over the compression bandage, the researchers report.

Still, by 9 months, no significant differences in any outcomes were noted between any of the mechanical support devices or the compression bandage, the report indicates.

SOURCE: Lancet, February 14, 2009.

Copyright © 2009 Reuters Limited.