TUESDAY, April 28 (HealthDay News) -- An interactive voice system makes it easier for medical staff to monitor patients who are taking warfarin or other blood thinners, a Canadian study reports.

People taking anticoagulants must be closely watched to prevent serious side effects such as blood clots and hemorrhage, which can be fatal. But, this type of monitoring is labor intensive, according to background information in the study.

The research involved 226 people who spoke English, did not have hearing problems and had stable anticoagulation control. About 80 percent had been taking warfarin for more than a year.

They were given instructions about their medication -- including dosage messages, appointment reminders and notices about missed appointments -- using an interactive voice system. Medical staff members reviewed daily Web reports of the automated calls and contacted individual patients when dosage messages were unsuccessful.

"The interactive voice response system was effective in communicating complex information, as 77.8 percent of messages were successfully delivered and did not require input from staff," wrote Dr. Alan Forster and his colleagues from the Ottawa Hospital Research Institute and the University of Ottawa. "Importantly, the interactive voice response system reduced the workload of clinic staff by 33 percent."

The study was published in the Canadian Medical Association Journal.

The findings lay the foundation for more information technology-based methods of oral anticoagulant management, Dr. Jerry Gurwitz, of the University of Massachusetts Medical School, wrote in an accompanying commentary. Gurwitz said that "any technology-based intervention that could improve the quality and efficiency of anticoagulation care, while reducing costs, would be extremely attractive."

More information

The American Heart Association has more about anticoagulant therapy  .

TUESDAY, April 28 (HealthDay News) -- Many over-the-counter painkillers and fever reducers will have to carry new warnings on the potential danger of liver damage and stomach bleeding, U.S. health officials said Tuesday.

Manufacturers will have to include these warnings on all their over-the-counter products containing acetaminophen (best known as Tylenol), and on all non-steroidal anti-inflammatory drugs (NSAIDs) drugs, according to new rules from the U.S. Food and Drug Administration (FDA).

NSAIDs include popular medicines such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve) and Excedrin.

"The regulations affect much of the U.S. population, because over-the-counter pain relievers and fever reducers are some of the most commonly used drugs," Matthew Holman, deputy director of FDA's Division of Nonprescription Regulation Development in the Office of Nonprescription Products, said during a late morning teleconference Tuesday.

The warnings also apply to any over-the-counter drug that contains acetaminophen and NSAIDs mixed with other drugs, Holman said.

The purpose of the new labeling is to raise awareness of potential liver damage from acetaminophen and the potential for stomach bleeding from NSAIDs, Holman said.

Products with acetaminophen will carry the warning that it may cause severe liver damage if you take more than the maximum daily dose or if you are also taking other drugs with acetaminophen, or if you have three or more drinks a day while taking the drug.

In addition, the label will also include a warning on using acetaminophen when taking the blood thinner warfarin, Holman said. People taking warfarin should ask their doctor about taking acetaminophen before they start the drug, he said.

"Every over-the-counter product containing a NSAID will have to include a stomach bleeding warning," Holman said.

The warning will highlight risk factors for severe stomach bleeding associated with the product. These include being 60 or older, having stomach ulcers or bleeding problems, taking a blood thinner or steroid, or taking other prescription or nonprescription NSAIDs, Holman said.

Consumers are also warned to ask their doctor about their risk of taking NSAIDs and to stop taking the drug and consult their doctor if there are any signs of stomach bleeding.

These signs include stomach pain that doesn't go away, vomiting blood or blood in the stool, Holman said.

More information

For more on the dangers of NSAIDs and acetaminophen, visit the U.S. Food and Drug Administration.

THURSDAY, April 23 (HealthDay News) -- Global warming may increase the severity of Lyme disease by changing the feeding habits of the deer ticks that transmit it, new research has found.

During its two-year life span, a deer tick goes through three stages: larval, nymphal and adult. To survive, a tick must obtain a blood meal during each stage.

If the source of the first meal (mouse, bird or other small animal) is infected with the bacterium that causes Lyme disease, the tick also becomes infected. The tick can then pass the infection to its next meal, which could be wildlife or a human, during its nymph stage.

The seasonal cycle of feeding for each stage of a tick's life determines the severity of infection in a given region, according to the study in the April issue of Applied and Environmental Microbiology.

In the moderate climate of the Northeastern United States, larval deer ticks feed in the late summer, long after the spring feeding of infected nymphs. This long gap between feeding times directly correlates to more cases of Lyme disease reported in the Northeast.

When there is a longer gap, the most persistent infections are more likely to survive, the study's co-author, Durland Fish, a professor of epidemiology at the Yale School of Public Health, said in a Yale news release. These persistent bacterial strains cause more severe disease in humans, leading more people to seek medical attention and resulting in more case reports.

But in the Midwest, greater extremes of temperature mean a shorter time in which ticks can feed and, therefore, a shorter gap between nymphal and larval feedings.

Midwestern wildlife and ticks tend to be infected with less persistent strains, which correlates with fewer cases of Lyme disease in the Midwest.

As the planet warms, the researchers said, the Upper Midwest could more closely resemble the Northeast: longer gaps between nymphal and larval feeding and stronger, more persistent strains of Lyme disease.

Other diseases, such as malaria, have been projected to expand the geographic region in which they occur in response to climate change, said Maria Diuk-Wasser, assistant professor of epidemiology at Yale and senior author of the study.

But she said this was the first study to show how the severity of disease can also be related to climate.

One of the first symptoms of Lyme disease is often a rash at the site of the bite. Though treatable with antibiotics, the disease can cause fatigue, chills, fever, headache, muscle and joint aches and swollen lymph nodes.

More information

The U.S. Centers for Disease Control and Prevention has more on Lyme disease.

FRIDAY, April 17 (HealthDay News) -- Jet lag-related sleep problems are caused by disruption of internal clocks in two neural centers, a finding that could lead to more effective treatments, say U.S. researchers.

The University of Washington research team found that jet lag upsets two separate, but linked, groups of neurons in a brain structure called the suprachiasmatic nucleus, below the hypothalamus at the base of the brain.

One group of neurons (ventral) is synchronized with deep sleep that results from physical fatigue, and the other group of neurons (dorsal) controls the dream state of rapid eye movement (REM) sleep, the researchers explained. Normally, these two groups of neurons are synchronized with each other, but they can be thrown out of synch by jet lag or shift work.

"When we impose a 22-hour light-dark cycle on animals, the ventral center can catch up, but the dorsal doesn't adapt and defaults to its own inner cycle," Horacio de la Iglesia, an associate professor of biology, said in a University of Washington news release.

When laboratory rats used to a 25-hour light-dark cycle were exposed to a 22-hour cycle, their deep sleep quickly adapted to the 22-hour cycle, but their REM sleep continued to follow a 25-hour cycle. This meant that REM sleep didn't occur in normal progression following deep sleep, the researchers noted.

"We found that after exposing rats to a shift of the light-dark timing that simulates a trip from Paris to New York, REM sleep needed six to eight days to catch up with non-REM, or deep, sleep, the sleep you usually experience in the first part of the night," de la Iglesia said.

The findings, published online April 16 in the journal Current Biology, may help fine-tune current jet lag treatments.

"We can go back to the treatments that are believed to be effective and see where they might be acting in the circuitry of these neuron centers, then refine them to be more effective," de la Iglesia said.

More information

The National Sleep Foundation has more about jet lag  .