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THURSDAY, Aug. 14 (HealthDay News) -- Safer triggers and training have helped reduce nail gun injuries, but safety regulations are needed to help protect residential carpenters, say Duke University Medical Center researchers.

Nail guns cause more injuries than people realize, according to study lead author Hester Lipscomb, a professor of occupational and environmental medicine.

"There are more than 35,000 visits each year in the U.S. to emergency departments for injuries from nail guns," she said in a Duke news release.

"Over the past three years, we have consistently found the sequential trigger twice as safe as the more commonly used contact trip trigger," she said.

The contact trip trigger allows the nail gun to fire any time the nose and trigger are both depressed, while the sequential trigger requires the nose piece to be pressed down before the trigger is pulled.

"The contact trip trigger allows workers to rapidly fire the tool and more frequently results in injuries from accidental discharges, double fires and ricocheting nails," Lipscomb said.

In this new study, she and her colleagues analyzed injuries among apprentice carpenters in St. Louis and the surrounding area.

"We found that carpenters with more training were better equipped to handle the tool and less prone to injury. Carpenters were best protected when they received both classroom training and hands-on instruction. Unfortunately, most residential carpenters, including immigrant workers, are less likely to get training compared to the union workers we studied," Lipscomb said.

"There are currently no regulations that require the sequential trigger be used or that define minimal training requirements, even though data suggests there should be," she noted.

The study was published in the American Journal of Industrial Medicine.

More information

The Canadian Centre for Occupational Health and Safety has more about nail guns  .

TUESDAY, Aug. 12 (HealthDay News) -- Epidural anesthesia may not only be the best way to control pain after major surgery, it may also improve post-operative survival, Canadian researchers report.

The use of epidural anesthetics for major surgery has been somewhat controversial. There doesn't seem to be much question that it effectively reduces pain, but its safety has caused some concern.

"Using an epidural for pain control after a major operation was safe and actually caused a slightly improved survival for patients who received an epidural," said lead researcher Dr. Duminda Wijeysundera, from Ontario's Institute for Clinical Evaluative Sciences, department of anesthesia, at Toronto General Hospital and the University of Toronto.

People generally have less pain and a lower risk of pneumonia if they use an epidural after a major operation, Wijeysundera said. "But a lot of people are nervous about having an epidural, because it involves a needle and a catheter being placed in their back," he said.

This procedure allows medication to be delivered around the nerves in the epidural space of the spine to prevent pain. Alternative methods of pain control include narcotic pain medication given by injection or via an intravenous line.

The new report was published in the Aug. 11 online edition of The Lancet.

For the study, Wijeysundera's group collected data on more than 259,000 patients who underwent a major noncardiac surgery between 1994 and 2004.

Twenty-two percent of patients received an epidural anesthetic. The researchers found that these people were at a slightly lower risk of dying after 30 days (1.7 percent) compared with patients who had not received an epidural (2.0 percent).

This means that to prevent one death, 477 patients would have to receive an epidural anesthetic, the researchers noted. In the United States, about one million people a year undergo a major operation, Wijeysundera said.

"This study provides reassuring information that epidural anesthetic is safe and may slightly increase the chance of surviving a major operation," Wijeysundera said. "These results may help patients make better informed choices about how they manage their pain after a major operation," he said.

"You need to control post-operative pain," noted one expert, Dr. Zeev N. Kain, chair of the Department of Anesthesiology and Perioperative Care at the University of California, Irvine. "Pain is not good for you, because it hinders your recovery," he said.

The bottom line, Kain said, is that epidurals are safe and should be used but not because of this very slight improvement in survival. He believes that -- especially for major procedures -- epidurals often relieve pain better than other methods.

"If you have surgeries to remove the pancreas or liver resection or a Whipple procedure, where they take half your abdominal cavity out, these are very painful procedures," Kain said. "For them, there is no question that the best pain relief is epidural," he said.

More information

For more on epidural anesthetic, visit the Medline Plus.

MONDAY, Aug. 11 (HealthDay News) -- A gene variation may explain why some people are more prone to anxiety disorders, such as post-traumatic stress, a new study says.

People carrying two copies of the Met158 variation of the catechol-O-methyltransferase (COMT) gene showed greater anxiety on a standard personality test and also were significantly more startled than others when shown a series of unpleasant pictures, according to findings published in the August issue of Behavioral Neuroscience.

Depending on ethnicity, about a quarter of the population carries two copies of Met158. The COMT gene produces an enzyme that breaks down the brain chemical dopamine, weakening its signal.

The study's German and American authors said their finding offers a biochemical explanation for why some people find it harder to regulate emotional arousal. Their sensitivity, combined with other genetic and environmental factors, may make them more likely to have anxiety disorders.

This finding also confirms suspicions that variations in the gene that regulates dopamine signaling may be linked to negative emotionality. The Met158 variation, the authors speculated, may increase dopamine levels in the brain's memory and emotional support systems, resulting in an "inflexible attentional focus" on unpleasant stimuli. Essentially, people with the Met158 carriers can't tear themselves away from something that's arousing -- even if it's bad.

A single gene variation, though, can explain only some anxious behavior, said one of the researchers.

"This single gene variation is potentially only one of many factors influencing such a complex trait as anxiety," study co-author Christian Montag said in a news release issued by the publication. "Still, to identify the first candidates for genes associated with an anxiety-prone personality is a step in the right direction."

Montag said that if further research continues to back this finding, one day "it might be possible to prescribe the right dose of the right drug, relative to genetic makeup, to treat anxiety disorders."

More information

The Center for Mental Health Services has more about anxiety disorders.

THURSDAY, Aug. 7 (HealthDay News) -- Blogs written by medical professionals may pose a threat to patient privacy, because the authors of the blogs may inadvertently reveal patient information, says a U.S. study that's the first to examine the issue.

The researchers analyzed the contents of 271 medical blogs and found that 56.8 percent contained enough information to reveal the author's identity.

Although obvious violations of patient privacy are rare, supposedly anonymous medical bloggers who provide information about their location, subspecialty or other personal details may reveal their identity to blog readers, noted Dr. Tara Lagu, Robert Wood Johnson Foundation Clinical Scholar, and colleagues at the University of Pennsylvania.

In some cases, patients described in medical blogs may be able to identify themselves, the researchers said. For example, three of the blogs in the study had recognizable photos of patients, including one with an extensive description of the patient and links to photos.

The researchers also found that some of the medical blogs allowed advertisements, and some promoted health -care products within the blog text. None of the bloggers who described products within the text adhered to medical ethics standards of providing information on conflicts of interest, or whether payment was received for promotion of the products.

The study was published online in the Journal of General Internal Medicine.

"While many medical blogs provide valuable information to the public, are respectful in tone and are written anonymously, others pose a threat to patient privacy and have the potential to threaten the integrity of the medical profession," Lagu said in a journal news release.

"Unfortunately, no professional organization has taken the initiative to provide guidance on this issue. As the number of medical blogs grows, professional organizations, medical educators, and the blogging community must address the challenge of this new medium by setting guidelines and standards for what is appropriate," Lagu said.

More information

The U.S. Department of Health and Human Services has more about patient privacy.