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Seniors who eat plenty of fruits and vegetables and who have good cognitive function are much less likely to die from heart disease than those who have poorer cognitive function and eat fewer fruits and vegetables, a new study has found.

Cognitive function refers to the ability to think, remember, plan and organize information.

Researchers at the Drexel University School of Public Health in Philadelphia analyzed diet and cognitive data on 4,879 people (3,101 women and 1,778 men), age 70 and older, who took part in the U.S. Longitudinal Study of Aging. The participants were followed for an average of seven years.

The analysis revealed that:
Those who ate three or more servings of vegetables daily had a 30 percent lower risk for dying from heart disease and a 15 percent lower risk for dying from any cause during the follow-up period than those who ate fewer than three servings of vegetables a day.
There was a significant association between higher consumption of fruits and vegetables and decreased prevalence of cognitive impairment.
People who scored high on cognitive functions tests were less likely to die from heart disease or any other cause during the follow-up than were those with low scores.

The study was to be presented Wednesday at the American Heart Association’s annual meeting in Orlando, Fla.

The U.S. Veterans Administration has taken the lead in improving patient safety, but its efforts are still a work in progress as surgical errors in and out of the operating room persist, a new study shows.

Each day in the United States, there are five to 10 incorrect surgical procedures performed, some with devastating effects, the researchers noted. Typical problems are surgery performed on the wrong site or wrong side of the body, using an incorrect procedure or using it on the wrong patient.

“In 2003, we put out a directive that said this is the way you are going to do it, if you are going to minimize the chance of things happening,” said lead researcher Dr. James P. Bagian, director of the VA National Center for Patient Safety.

“Up until today, I can tell you, we have not had any reports where people have followed the procedures as they’re written and ever had one of these problems,” he said.

The report is published in the November issue of the Archives of Surgery.

For the study, Bagian’s group reviewed 342 surgical problems from 130 VA hospitals from 2001 to the middle of 2006. Problems were divided into those happening in the operating room and those happening outside the operating room. Typically, these procedures were done in VA clinics or at the patient’s bedside.

Among the cases the researchers looked at were 212 adverse events, where wrong procedures were performed or the procedure was performed in the wrong patient, or at the wrong site. In addition, there were 130 “close calls,” where a problem was recognized before the procedure was done.

“A close call, where they said by following the procedure we caught this, I count that as a save,” Bagian noted.

Adverse events occurred once in every 18,000 procedures, Bagian said.

The most common cause of errors was poor communication among the surgical team members, Bagian said. This accounted for 21 percent of the problems. These communication problems often happen early in surgical procedures, and interventions such as a final “time-out” moment before making the first incision may be too late to correct them, the researchers noted.

Of the adverse events, 50.9 percent occurred in the operating room and 49.1 percent occurred elsewhere. The most adverse event reports were in ophthalmology and invasive radiology (21.2 percent). Orthopedics accounted for the second highest rate of problems in the operating room, after ophthalmology.

The most harm was caused by pulmonary cases where fluid was removed from the wrong side of the chest or the procedure was done at an incorrect place on the chest, the researchers said.

Bagian noted that good numbers for evaluating medical errors are hard to come by. It may be that the specialties reporting the most errors are just more honest, he said, or their mistakes are harder to hide.

The VA continues to evaluate problems and work toward an even better safety record, Bagian said.

Dr. Jeffrey M. Rothschild, an associate physician at Brigham and Women’s Hospital, and an instructor in medicine at Harvard Medical School, said the “VA system is further ahead than most places so finding as many as they did makes you wonder how many one would find in community and academic centers.”

Rothschild thinks that more care needs to be taken in making sure the procedure, the patient and the site for the procedure are right before starting any procedure.

“Our systems are still not robust enough to prevent human error from slipping through,” he said.

There is probably more cases of surgical error outside the VA, Rothschild said. “The VA is probably less of an issue, because they were one of the first systems to really take on safety,” he said. “The VA system is better and more advanced.”

Diarrhea in infants is common, often a quick bout caused by a virus. But in some cases among young children, diarrhea can quickly become dangerous, says the U.S. National Library of Medicine.

If you have a newborn younger than 3 months, call your child’s pediatrician at the first sign of diarrhea, the agency advises.

In any child, bloody diarrhea or a case that lasts longer than two days also should prompt a call to the doctor.

While your child has diarrhea, make sure he or she drinks lots of fluids. A drink that contains electrolytes is best to help prevent dehydration. For young infants, continue nursing, and ask your doctor about giving extra fluids.

Wide sections of the Southeast, Appalachia, and some tribal lands in the West and Northern Plains have the nation′s highest rates of obesity and diabetes, according to estimates released today by the Centers for Disease Control and Prevention. In many counties in those regions, rates of diagnosed diabetes exceed 10 percent and obesity prevalence is more than 30 percent.

The estimates, in this week′s Morbidity and Mortality Weekly Report, are the first to provide county–level snapshots of obesity across the United States. They also update diabetes county–level estimates released in 2008.

Eighty–one percent of counties in the Appalachian region that includes Kentucky, Tennessee, and West Virginia have high rates of diabetes and obesity. So do three–quarters of counties in the southern region that includes Alabama, Georgia, Louisiana, Mississippi, and South Carolina.

“Diabetes is costly in human and economic terms, and it′s urgent that we take action to prevent and control this serious disease,” said Dr. Ann Albright, director of CDC′s Division of Diabetes Translation. “The study shows strong regional patterns of diabetes and can help focus prevention efforts where they are most needed.”

The estimates come from the agency′s Behavioral Risk Factor Surveillance System (BRFSS), which uses self–reported data from state–based adult telephone surveys, and 2007 census information. The information may help public health workers, health care providers, community organizations, and policymakers focus on high–risk regions to prevent type 2 diabetes and its complications as well as other chronic diseases linked to obesity, including heart disease, stroke, and some cancers.

The proportion of U.S. adults who are obese was 26.1 percent in 2008, according to BRFSS data. CDC estimates that nearly 8 percent of the population, or about 24 million people, have diabetes. Of these, 5.7 million are undiagnosed.

“The small–area estimates for obesity will be an important tool to help communities better understand and battle this serious public health problem. Communities are in the best position to prevent and reduce obesity among their citizens through innovative programs,” said Dr. William H. Dietz, director of CDC’s Division of Nutrition, Physical Activity and Obesity.

The medical costs of obesity reached an estimated $147 billion in 2008, and the medical costs of diabetes were $116 billion. People with diagnosed diabetes have medical costs that are 2.3 times higher than those without the disease.

Obesity is one of several factors linked to type 2 diabetes. Where people live, how much money they earn, their culture and their family history also play a role. An unhealthy diet, lack of physical activity, and socioeconomic factors contribute to both obesity and type 2 diabetes as well as to complications of diabetes. Some population groups also are at higher risk, including a number of racial and ethnic minorities.

CDC and its partners are working on a variety of initiatives to prevent type 2 diabetes and to reduce obesity. CDC has recommended 24 community strategies to prevent obesity, from providing greater access to healthy foods to redesigning communities to encourage more physical activity. The agency is also in a new partnership with state, federal, and nonprofit agencies targeting health disparities in Mississippi, which has the nation′s highest obesity rate and one of the highest rates of diabetes. CDC′s national diabetes prevention and control program provides resources and technical assistance to state health departments, national organizations, and communities.