THURSDAY, Sept. 27 (HealthDay News) -- The drug norepinephrine may come to the rescue of trauma victims suffering from heavy blood loss and shock, a French study in rats suggests.

"This is the first scientific study showing the benefits of using norepinephrine in hemorrhagic shock," said study author Dr. Marie-Pierre Poloujadoff, an emergency physician at one of the University of Paris' hospitals.

Uncontrolled bleeding is a "huge problem" for human victims of gunshot wounds, automobile accidents and other traumatic injuries, Poloujadoff said. A steep drop in blood volume can quickly lead to hemorrhagic shock.

Once the victim is in surgery, the surgeon will be able to control the shock. However, "the problem is what to do between the accident and surgery," Poloujadoff said. Long delays can be fatal, she said.

In cases involving major blood loss, physicians try and supply the body with fluids so that the heart will keep pumping and blood pressure won't drop too low, she added. But if there is too much fluid, that can actually speed bleeding, decrease coagulation or dilute the blood so it doesn't adequately carry oxygen to the brain.

To control the balance between getting fluids but not too much, emergency physicians may use "vasoconstrictors" -- drugs that narrow blood vessels. The vasoconstrictor norepinephrine is often used in emergency rooms because it's effective against toxic shock.

The unavailability in France of vassopressin, a vasoconstrictor used in the United States, led to the idea of testing norepinephrine, Poloujadoff said.

The animal study involved four groups of 10 rats. Each group received a different dose of norepinephrine, which was used in rats showing normal blood pressure or low blood pressure. The animals were experimented on while under anesthesia.

The researchers sought to replicate emergency room situations resembling those of human patients who might be cared for after copious bleeding linked to head injury.

At specific doses, norepinephrine combined with standard resuscitation fluids significantly boosted the rats' odds of survival, the French team found.

Poloujadoff said she hopes these results will provide scientific justification to begin clinical research in human on the use of norepinephrine in these scenarios.

The study was published in the October issue of Anesthesiology.

But until more studies are done, the impact of the French results may be limited, said Dr. Philip Levin, chief of anesthesia and director of perioperative services at Santa Monica UCLA Medical Center and Orthopedic Hospital.

"If I read this in one of my journals, it would sound interesting, but I'd wait until we get human studies and larger studies before I'd change my habits," he said.

Another expert agreed.

Dr. Ron M. Walls, a professor of medicine at Harvard Medical School, said that the use of norepinephrine might have some benefit but that, "first we need to know a lot more and have more studies before we could consider this in humans."

Ideas about fluid resuscitation in humans have changed over the last 10 years, he said. Current theory involves the use of fluid to keep vital organs perfused, rather than trying to use enough fluid to restore normal blood pressure, said Walls, who is also chairman of emergency medicine at Brigham and Women's Hospital, in Boston.

"You don't want to constrict the blood vessels more, you want to perfuse the blood," he said.

However, Walls believes the norephinephrine idea might merit further study, especially from the perspective of trying to keep trauma victims alive until they can reach a hospital.

"There's so much blood loss from trauma around the world from both combat and non-combat situations," he said. "If you thought of this in Cleveland, it might not make so much difference, but if you're looking at a victim of a bus accident in sub-Saharan Africa, it might make more of a difference."

More information

There's more on treating bleeding at the National Library of Medicine.

MONDAY, Sept. 24 (HealthDay News) -- Pointing to a disconnect between doctors and some of their neediest patients, a new study suggests that large numbers of physicians fail to spot symptoms that raise suicide risk.

U.S. researchers recruited actresses to act as patients and visit physicians while showing signs of depression or a similar disorder.

Only 36 percent of the doctors asked the "patients" about suicidal thoughts, the team found.

"There is often a window of opportunity for doctors to screen for suicidality and intervene appropriately, but, as we found, they frequently miss this opportunity," said study lead author Dr. Mitchell Feldman, professor of medicine at the University of California at San Francisco.

According to Feldman, an estimated 2 percent to 7 percent of patients who visit primary-care physicians are thinking about suicide. In fact, as many as 75 percent of people who commit suicide visited a primary-care provider in the 30 days before killing themselves, the research shows.

Still, patients at risk of suicide rarely mention the topic directly to physicians, leaving it up to doctors to figure out what's going on.

"Remarkably little is known about the factors that influence whether primary-care physicians broach the topic of suicide with their depressed patients," Feldman said.

In the new study, researchers recruited 152 physicians from northern California and Rochester, N.Y., to take part. All were told they would get unannounced visits by actors portraying patients who would tape-record their conversations.

A total of 18 actresses visited the doctors playing two types of patients -- a person with major depression or a person with an "adjustment disorder," a catch-all term encompassing a variety of mental problems. Some of the "patients" asked for medication.

The findings are published in the September/October issue of the Annals of Family Medicine.

Doctors were more likely to pursue the prospect of suicide if the "patients" said they had major depression or asked for medication. Doctors who had personal experience with depression were three times more likely to look into suicide.

"Most physicians are not adequately trained to diagnose and treat mental and behavioral problems generally, and this problem is magnified with an issue like suicide that may evoke discomfort in some physicians who will then avoid the topic," Feldman said. "Some mistakenly believe that if they inquire about suicide, they will prompt the patient to consider it."

Feldman added: "I describe suicide as another of the Pandora's Box issues -- like domestic violence -- that doctors may avoid broaching for fear that once they bring it up, they will be unable to contain the patient's emotional responses. And, in addition, they will put themselves way behind schedule."

David Rudd, chair of the psychology department at Texas Tech University, agreed with Feldman. Rudd, who's familiar with the study findings, blamed physician inaction on inadequate training, a fear of making things worse, and "anxiety and apprehension about handling suicidal crises."

What to do? Feldman said doctors need better education about suicidal patients, and patients need to know more about depression and feel comfortable asking for help. "We found that patients who make requests get more thorough and appropriate care including more inquiries about suicide from their physician."

Rudd put it this way: "Physicians are the primary access point for the majority of distressed, suicidal patients. This is critical to saving lives."

More information

Learn more about suicide from the U.S. National Institutes of Health.

FRIDAY, Aug. 24 (HealthDay News) -- Some people use lip balm so often that it's almost like an addiction.

"For many people, it is quite difficult for them to stop using lip balm because they've become so used to their lips having more moisture content than they had in the past," Dr. Lisa Garner, a dermatologist at Baylor Medical Center in Garland, Texas, said in a prepared statement.

This lip balm "addiction" isn't a problem as long as you don't develop an allergy to any of the ingredients.

"On occasion, you may develop an irritation or sensitivity to one of the ingredients that may make your lips feel dry, because you're actually having a reaction to the lip balm," Garner said.

Flavoring, fragrances or added preservatives may be the source of the problem if you do have problems with a lip balm. Switching to an unflavored or unscented type of lip balm may solve the problem, Garner said.

Lip balms work by sealing in natural moisture and, in terms of effectiveness, there isn't much difference between a 99-cent lip balm and more expensive brands, experts say.

More information

For more on addictions, visit The University of Utah  .

THURSDAY, Aug. 23 (HealthDay News) -- If you've ever been of "two minds" about doing something, a new study may explain why.

Scientists say one part of the brain is responsible for initiating action, while a totally separate area is in charge of not taking that action.

This newly identified region, involved in an aspect of self-control, may change conceptions of human free will, the researchers said. It could also explain the basis of impulsive as well as reluctant behavior, they added.

"The central issue is quite simple. If we want to do something, and we decide not to, how does that brain wire that?" said Rajesh Miranda, associate professor of neuroscience and experimental therapeutics at Texas A&M Health Science Center College of Medicine. "They showed the region in the brain that can act as a gate to suppress a plan to do something," said Miranda, who was not involved in the research.

"The big search in neuroscience is, are there general inhibiting or specific inhibiting circuits?" added another outside expert, Dr. John Hart, a spokesman for the American Academy of Neurology and a behavioral neurologist and cognitive neuroscientist at the University of Texas at Dallas. "This is another piece of the puzzle. . . . but does it generalize beyond that task to all life decisions? That has yet to be shown," he said.

This study and others like it are really in their infancy, Miranda pointed out. That's important to remember, since the findings could one day have legal and other implications.

"This kind of data could have implications for legal definitions of 'diminished capacity,' " he explained. "There's a potential for informing legal definitions of mental illness and things like that."

The study, which was published in the Aug. 22 issue of The Journal of Neuroscience, was conducted by researchers from University College London, in the United Kingdom, the Max Planck Institute in Leipzig, Germany, and Ghent University, Belgium.

Using functional magnetic resonance imaging (fMRI), the researchers studied the brain activity of participants in two situations -- when they acted out as they had planned, or when they decided not to follow their original intention.

Fifteen right-handed individuals (seven males and eight females, average age 26) participated in a "go-no-go" exercise. They were asked to press a button on a keyboard but first to indicate what time they were going to perform this action. They were also asked to choose instances in which they stopped before actually pressing the button.

When participants decided not to press the button, a specific area of the frontal lobe region of the brain lit up. When participants followed through, however, the area did not light up.

The executive-function frontal lobes, which have previously been identified with inhibition, are part of what makes humans human, neurologists say.

"These areas are the most expanded in humans as compared to animals," explained Dr. Kimford Meador, spokesman for the American Academy of Neurology and professor of neurology at the University of Florida, Gainesville. "The frontal lobe is important for initiation, for planning, personality, creativity."

"The frontal lobes distinguish us from lower-order creatures," added David Masur, director of neuropsychology in the department of neurology at Montefiore Medical Center and clinical professor of neurology at Albert Einstein College of Medicine, both in New York City. "We have larger frontal lobes, and these are what really are responsible for much of what we define as human behavior, social interaction, ability to plan, organize, some language ability, abstract reasoning or thinking."

For now, the implications of the research are esoteric but, down the line, who knows?

"Much of our society is based on the concept of not only free will but also 'free won't,' the inhibition of response," Masur explained. "The difference between us as intelligent ordered social creatures and the society that would run amok is the ability to inhibit our responses, the ability to take control if a situation calls for it, to stop acting in a particular way . . . Maybe down the line somebody can develop a drug or hormone or transmitter system that targets that particular area of brain which strengthens the ability to negate responses which are too impulsive."

"It's a fascinating mind-brain question about where does our free will begin and end," added Meador.

More information

There's more on how the brain is structured at Brainexplorer.org  .