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Children who experience frequent stomach aches can use their imagination to reduce their pain, new study findings suggest.

The study included 34 participants, aged 6 to 15 years, with functional abdominal pain, which is a persistent pain with no identifiable underlying disease. All the children received standard medical care, but 19 also received eight weeks of guided imagery therapy, which is similar to self-hypnosis.

The audio recordings for the guided imagery therapy consisted of four bi-weekly, 20-minute sessions and 10-minute daily sessions. The therapy offered the children suggestions and imagery for reducing abdominal discomfort. For example, in one session they were told to imagine a special shiny object melting in their hand. They then placed the hand on their abdomen, spreading warmth and light from the hand into the belly in order to create a protective barrier that prevents anything from irritating the belly.

The children in the guided imagery group were almost three times more likely to experience improvement in their abdominal pain than those who received standard treatment alone, the researchers found. The benefits of the guided imagery lasted for six months after the end of the sessions.

“What is especially exciting about our study is that children can clearly reduce their abdominal pain a lot on their own with guidance from audio recordings, and they get much better results that way than from medical care,” study lead author Miranda van Tilburg, an assistant professor in the gastroenterology and hepatology division of the University of North Carolina School of Medicine, and a member of the UNC Center for Functional GI and Motility Disorders, said in a university news release.

“Such self-administered treatment is, of course, very inexpensive and can be used in addition to other treatments, which potentially opens the door for easily enhancing treatment outcomes for a lot of children suffering from frequent stomach aches,” she added.

Studies on whether mobile phones can cause cancer, especially brain tumors, vary widely in quality and there may be some bias in those showing the least risk, researchers reported on Tuesday.

So far it is difficult to demonstrate any link, although the best studies do suggest some association between mobile phone use and cancer, the team led by Dr. Seung-Kwon Myung of South Korea’s National Cancer Center found.

Myung and colleagues at Ewha Womans University and Seoul National University Hospital in Seoul and the University of California, Berkeley, examined 23 published studies of more than 37,000 people in what is called a meta-analysis.

They found results often depended on who conducted the study and how well they controlled for bias and other errors.

“We found a large discrepancy in the association between mobile phone use and tumor risk by research group, which is confounded with the methodological quality of the research,” they wrote in the Journal of Clinical Oncology.

The use of mobile and cordless phones has exploded in the past 10 years to an estimated 4.6 billion subscribers worldwide, according to the U.N. International Telecommunication Union.

Research has failed to establish any clear link between use of the devices and several kinds of cancer.

The latest study, supported in part by the U.S. Centers for Disease Control and Prevention, examined cases involving brain tumors and others including tumors of the facial nerves, salivary glands and testicles as well as non-Hodgkin’s lymphomas.

It found no significant association between the risk of tumors and overall use of mobile phones, including cellular and cordless phones.

MILD RISK

Myung’s team said eight studies that employed “high quality” methods to blind participants against bias found a mild increased risk of tumors among people who used mobile phones compared with those who never or rarely did.

An increased risk of benign, not malignant, tumors was also found among people who used the phones for a decade or longer.

The “high quality” studies were funded by the Swedish Work Environment Fund, the Orebro Cancer Fund and the Orebro University Hospital Cancer Fund, Myung’s team said.

By contrast, studies that used “low quality” methods to weed out bias found mobile users were at lower risk for tumors than people who rarely used the devices.

Myung’s team suggested those results could be marred by random errors and bias because of the quality of the methods.

Funding for some of the lower-quality studies included two industry groups, the Mobile Manufacturers Forum and the Global System for Mobile Communication Association, the researchers said.

Overall, the studies examined were not broad enough to shed light on whether mobile phone use could cause tumors. Myung’s team said larger studies of a type called cohort studies are needed to answer that question.

Such studies follow a group of people who share a characteristic, in this case cellphone use, and compare them with other groups over time.

The only cohort study published to date showed no association between mobile phone use and tumors. But the study, conducted in Denmark, relied on telephone subscriptions and did not evaluate actual exposure to mobile phones.

A less-invasive method of abdominal aortic aneurysm (AAA) repair reduces the short-term risk of death, according to a new U.S. study.

The interim findings are from a nine-year multicenter trial comparing patient outcomes after endovascular and open surgical repair of AAA. The report included postoperative outcomes of up to two years (average 1.8 years of follow-up) for 881 patients, aged 49 or older, who had endovascular repair (444) or open repair (437).

Endovascular repair is performed through a catheter inserted into an artery. Open repair involves an abdominal incision. Of the 45,000 patients in the United States who undergo elective repair of an unruptured AAA each year, more than 1,400 die in the perioperative period — the first 30 days after surgery or inpatient status. There’s limited data available about whether short-term survival is better after endovascular repair compared to open repair.

The interim study found that the rate of death after surgery was lower for the endovascular group than for the open surgery group at 30 days (0.2 percent versus 2.3 percent) and at 30 days or during hospitalization (0.5 percent versus 3 percent). There was no significant difference in all-cause death at two years (7 percent versus 9.8 percent) or in death after the perioperative period (6.1 percent versus 6.6 percent).

The researchers also found that patients in the endovascular repair group spent less time in surgery, lost less blood, and spent less time on mechanical ventilation.

“Hospital and ICU stays were shorter with endovascular repair and need for transfusion was decreased. No significant differences were observed in major morbidities, secondary procedures, or aneurysm-related hospitalizations,” wrote Dr. Frank A. Lederle, of the Veterans Affairs Medical Center, Minneapolis, and colleagues. “Longer-term data are needed to fully assess the relative merits of the two procedures.”

Attending surgeons and obstetricians/gynecologists who get fewer than six hours of sleep between procedures risk increasing the rate of surgical complications, according to Harvard researchers.

A lot of attention has been paid to the long hours that residents and interns work and the increase in medical errors brought on by their fatigue, but the new study found the same problems among practicing physicians.

“Attending surgeons and obstetricians/gynecologists, like resident physicians and nurses, are vulnerable to the effects of fatigue and extended work shifts on performance and patient care,” said Dr. Jeffrey M. Rothschild, a physician at Brigham and Women’s Hospital in Boston and the lead researcher on the study.

“The risk of performing post-nighttime cases without sufficient rest may be especially important in hospitals without backup support or house staff physicians to assist a fatigued attending physician,” he added.

The report is published in the Oct. 14 issue of the Journal of the American Medical Association.

For the study, Rothschild’s group assessed how working at night and sleep affected the rate of surgical complications in procedures done the next day. Specifically, they looked at the 919 surgical and 957 obstetrical procedures done the day after a doctor had worked at night and compared them with 3,552 surgical and 3,945 obstetrical procedures done without preceding night work.

When doctors worked overnight but still had sufficient sleep, there was not a significantly increased risk for complications on procedures performed the next day, Rothschild said.

“However, if the opportunity for sleep prior to the post-nighttime procedure was less than six hours, there was a 2.7-fold greater risk of procedural complications, such as infection, wound failure and bleeding,” he said. The study also found a higher rate of complications when procedures were performed after a doctor had worked a shift of more than 12 hours, although Rothschild said the rate increase was not statistically significant.

Complications occurred in 5.4 percent of procedures done the day after the doctor had worked at night, compared with 4.9 percent of procedures done without having worked the previous night, the study found.

For doctors who got six or fewer hours of sleep, the complication rate rose to 6.2 percent, compared with 3.4 percent for procedures done by doctors who got more than six hours of sleep. The rate of complications was 6.5 percent for doctors who’d worked more than 12 hours before a procedure, compared with 4.3 percent for those who’d worked fewer than 12 hours.

Rothschild said that attending physicians should consider several approaches to reduce the risks of unsafe levels of fatigue during procedures. These include having large physician groups avoid scheduling elective procedures for doctors who have overnight on-call responsibilities and using hospital-based physicians to cover nighttime emergencies, he said.

“Adequate backup personnel should be available during the day to relieve or assist physicians whose fatigue may impair performance,” Rothschild said. “For emergency situations where it is necessary to perform life-saving procedures following overnight work, the appropriate use of caffeine should be considered.”

“In addition, attending physicians should try to avoid or cancel or postpone elective procedures if, when following overnight emergency cases, they do not get sufficient rest before the scheduled elective case,” he added.

Dr. David A. Lubarsky, a professor, chairman of anesthesiology and senior associate dean for quality safety and risk prevention at the University of Miami Miller School of Medicine, agrees that attending physicians — not just residents and interns — should have their hours limited.

“I have eliminated all 24-hour shifts for anesthesiologists,” Lubarsky said. “It did increase staffing costs, but I do believe it decreased our error rates.”

Lubarsky noted, though, that working long hours is part of the medical culture.

“It takes years of training to get to where you are going to be able to practice,” he said. “And people who are unable to function on little sleep — and there are many — they just don’t make it through the program. You’ve got to have that level of dedication and intestinal fortitude.”

However, Lubarsky said, good doctors are better doctors when they have had enough sleep.

Nonetheless, many doctors believe they can function just as well on little rest.

Doctors are trained to “think they are critical to the care of the patient, and they don’t like handing that off,” Lubarsky said. “To get where we need to be, we have to get more of a team-based approach to the provision of care. We’re just not there yet.”