FRIDAY, Jan. 2 (HealthDay News) -- Clearing snow from your driveway and sidewalks can be physically challenging and dangerous work, so you need to take proper health and safety precautions, says the American Academy of Orthopaedic Surgeons (AAOS).

In 2007, more than 118,000 people were treated in U.S. hospital emergency rooms, doctors' offices, clinics and other medical facilities for injuries suffered while shoveling or doing other types of snow and ice removal, according to the U.S. Consumer Product Safety Commission. That same year, there were 15,000 snow blower-related injuries, triple the number in 2006.

"People tend to think of snow removal as just another household task, but it really involves a lot of bending and heavy lifting, particularly in wet snow," AAOS spokesman Dr. Robert Dunbar said in an academy news release. "It may be especially dangerous for people who do not regularly exercise, as their bodies, specifically back, shoulder and arm muscles, may not be prepared for that level of activity."

The AAOS offered advice on how to prevent injuries while shoveling or using a snow blower

• Get your doctor's opinion about whether you should be shoveling snow. If you have a medical condition or don't exercise regularly, consider hiring someone to remove snow.
• Wear light, layered, water-repellent clothing that provides both ventilation and insulation. It's also important to wear appropriate head coverings, as well as gloves/mittens and thick, warm socks. If you start getting too hot or cold, take a break.
• Be sure you can see what you're doing. Don't wear hats or scarves that block your vision. Watch for uneven surfaces and ice patches. Wear boots with slip-resistant soles.
• Clear snow early and often so that it doesn't build up into packed, heavy snow.
• Before shoveling, warm up your muscles with light exercise for 10 minutes. Be sure to include your leg muscles.
• Take frequent breaks and drink water to prevent dehydration.
• If you experience chest pains, shortness of breath or other signs of a heart attack, seek emergency medical care.
• Use a shovel that's comfortable for your height and strength. Don't use a shovel that's too heavy or too long for you. Push snow instead of lifting it, as much as you can. If you must lift snow, take small amounts at a time and lift with your legs. Don't throw snow over your shoulder or to the side. This requires a twisting motion that stresses your back.
• When using a snow blower, never stick your hands or feet in the machine. If snow becomes too compacted, stop the engine and wait at least five seconds. Use a solid object to clear snow or debris from the chute.
• Don't leave a snow blower unattended when it's running. If you have to leave the machine, shut off the engine.
• If you're using an electric snow blower, always keep on eye on the cord so you don't trip and fall.

More information

The U.S. Federal Emergency Management Agency has more about winter safety.

MONDAY, Dec. 29 (HealthDay News) -- The first catalog of tissue-specific changes associated with hundreds of diseases has been compiled by an international research team, who said the information could help improve understanding and treatment of numerous conditions such as heart disease, breast cancer, autism and Parkinson's disease.

"Disease processes in humans are far from being exhaustively understood and characterized, in part because they are the result of complex interactions between many molecules that may take place only in specific tissues or organs," co-author Kasper Lage, of the Massachusetts General Hospital Pediatric Surgical Research Laboratories, said in a news release from the hospital.

"Experiments to directly study these interactions in human patients would not be possible, which limits our understanding of how diseases arise and which molecules and genes are involved," Lage said.

In the research, supercomputers were used to "model biological processes in tissues across the human organism, based on the knowledge from millions of already published articles," explained co-author Niclas Tue Hansen, of the Center for Biological Sequence Analysis, Technical University of Denmark. "In this way, we were able to create an extensive map of the interactions of molecules in many diseases -- a sort of molecular manual -- without carrying out experiments in patients."

The research was reported in Proceedings of the National Academy of Sciences.

"Our findings have the potential to advance the knowledge of pathways, genes and proteins involved in hundreds of human disorders and perhaps contribute to better treatment strategies for some of these serious diseases," co-corresponding author Dr. Patricia Donahoe, a professor of surgery at Harvard Medical School, said in the news release.

More information

The catalog is available at the Web site of the Center for Biological Sequence Analysis.

WEDNESDAY, Dec. 17 (HealthDay News) -- A team of eight Cleveland Clinic surgeons has completed the nation's first near-total face transplant.

Surgeons replaced most of the woman's face, including about 80 percent of the skin surface of her face, total nose, most of the sinuses, upper jaw -- essentially everything except the upper eyelids, forehead, lower lip and chin -- with that of a deceased donor in an immensely complex procedure taking place just weeks ago.

"We have finally done it," said Dr. Maria Siemionow, director of plastic surgery research and head of microsurgery training at the Cleveland Clinic, who led the team. "This procedure went well according to the plan, and the patient is doing well. The surgery took 22 hours. The preparation to the surgery took about 20 years of work in the field of composite tissue transplantation."

Siemionow and other members of the team spoke at a Wednesday teleconference, punctuated by thunderous applause from the audience and pleas from members of the surgical team to respect the privacy of the recipient and the donor.

The patient, identified only as a female and a U.S. citizen, had suffered a major facial trauma in the middle of her face so that multiple parts of her face were missing, including skin, bone, nose, eyelids, upper lid, right eye. She could not smell and had trouble speaking and could not eat or breathe without a tracheostomy.

"She was really suffering whenever she appeared in a social situation, was called names, children were afraid of her, were running away. The patient was brave, and she was very stable and facing the world. However, it became very difficult for her just to go outside of her house," Siemionow said.

Doctors would not disclose what kind of trauma was responsible for the disfigurement, only that the patient had exhausted all existing, conventional procedures, a condition for eligibility for the rare procedure.

Although this is the first such procedure in the U.S., 38-year-old Isabelle Dinoire successfully underwent a partial-face transplant in France in 2005, after being mauled by her dog. Since then, two other face grafts have been performed, one in China in 2006 and another in Europe in 2007.

At the Wednesday press conference, Cleveland Clinic bioethicist Dr. Eric Kodish stressed that the patient, considered to be a participant in human subjects research, was "appropriately protected."

"We believe the ethical basis for this endeavor is beyond reproach," he said. "We can anticipate that some may be concerned that this will be used as a means of identity transfer or as a cosmetic technique. We will do the best to prevent this from happening and we believe society can reach consensus and put safeguards in place to prevent that. This must be limited to the medical context, and we do not think this should be used for cosmetic enhancement."

"This is not cosmetic surgery in any conventional sense," he continued. "The face is the physical embodiment of a person's identity, and human beings are inherently social creatures. A person who has sustained a trauma or other devastation to the face is generally isolated and suffers tremendously. The damage to quality of life cannot even be put into words."

The Clinic's Institutional Review Board approved the surgery in late 2004.

The sequence of events leading to the face transplant began in the middle of the night several weeks ago when Francis Papay, chairman of the clinic's dermatology and plastic surgery institute, received an phone call telling of a potential donor.

Other members of the already assembled surgical team were immediately contacted through a sort of "phone tree," then waited throughout the night to confirm the donor was a match.

Surgery began at 5:30 p.m. with specialists making sure the recipient's neck, which had already undergone multiple surgeries, would allow the procedure to continue. At just after five in the morning, the donor's facial tissue was brought to the recipient and, for the next 11 hours, the surgical team worked to connect the new tissue to the recipient.

The surgery was complete by 4:30 p.m. The recipient is still at the hospital and is taking immune-suppressive drugs but has shown no signs of rejection.

The patient, who will look neither like herself or the donor, has not yet seen her new visage but has felt it with her hands. "I must tell you how happy she was when we brought her hands to her face and she could feel she has a jaw, has a nose, has a full face in front of her," Siemionow said. "When the swelling goes down, she will be able to recognize her face."

"Our hope is that once the facial nerve is connected and grows through, that she can smile again," Papay added.

Dr. Risal Djohan, a plastic surgeon and another member of the team, read a letter from one of the woman's siblings. "We never thought for a moment our sister would ever have a chance at a normal life again," the missive read. "But thanks to the wonderful person who donated herself to help another, now she has a chance to live a normal life."

More information

The Cleveland Clinic has more on the procedure.

FRIDAY, Dec. 5 (HealthDay News) -- Antipsychotic drugs have traditionally been classified as "first" or "second" generation, but these classifications aren't valid and the drugs should be prescribed on a patient-by-patient basis, new research suggests.

Older drugs (first-generation) are cheaper than the newer "atypical" antipsychotic (second-generation) medications and have different side effects. But, the added cost of second-generation antipsychotics -- with an estimated $7.5 billion in U.S. sales in 2003 -- has led to debate about their benefits compared with first-generation drugs.

"In recent years there has been a number of new antipsychotic, and there had been controversy over which is the best," said study author Dr. John Davis, a research professor of psychiatry at the University of Illinois at Chicago.

"What we find is that different ones are better or worse in different ways," Davis said. "Therefore, the newer drugs can't be thought of as the same class. They each have their distinctive profile, with major differences between them."

The findings were published in the Dec. 5 online edition of The Lancet.

For the study, Davis and his colleagues reviewed 150 studies that included more than 21,000 patients. The researchers looked at overall effectiveness, side effects, depressive symptoms, relapse rates, quality of life, and weight gain, among other measures.

The analysis found four second-generation drugs, amisulpride (Solian), clozapine (Clozaril), olanzapine (Zyprexa) and risperidone (Risperdal) were more effective than first-generation drugs, with "small to medium effect sizes."

But, other second generation drugs, such as aripiprazole (Abilify), quetiapine (Seroquel), sertindole (Serdolect), ziprasidone (Geodon) and zotepine (Nipolept), were no more effective than first-generation drugs, the researchers reported.

And, only aripiprazole and ziprasidone among the second-generation drugs did not induce more weight gain than the first-generation drug haloperidol (Haldol), the study found.

Comparing first- and second-generation drugs, Davis's team also found that second-generation drugs produced fewer "extra-pyramidal" side effects such as unintentional muscle contractions, Parkinson-like symptoms and restlessness than Haldol.

However, only a few of these second-generation drugs reduced these side effects compared with low-dose Haldol, the researchers noted.

In addition to Haldol, other first generation antipsychotics include chlorpromazine (Thorazine), fluphenazine (Prolixin), mesoridazine (Serentil), perphenazine (Trilafon), and trifluoperazine (Stelazine), according to the U.S. National Institute of Mental Health.

Davis thinks that classifying these drugs as first- or second-generation should be abandoned. "For patients, there is a choice only some drugs are efficacious, only some drugs cause obesity, and only some cause tremor. The doctor should choose based on whether he wants to go for efficacy, primarily, or wants to avoid side effects and the patient's history," he said. "It's a value judgment about which one should be used."

Dr. Peter Tyrer, who's with the Department of Psychological Medicine at Imperial College London in England, and co-wrote an accompanying editorial in the journal, thinks these drugs should be evaluated on their own merit and not as part of a group of newer or older drugs.

"We should dump the labels of first- and second-generation in our descriptions of these drugs," he said. "They have been used primarily as a marketing ploy to convey the impression of a steady improvement in the benefit-risk ratio of these agents, an impression that has been exposed as completely inaccurate."

Dr. Thomas R. Insel, director of the U.S. National Institute of Mental Health, believes efforts are needed to find ways to tell which patients will respond to which of the many drugs available.

"Neither class of drugs is homogenous," Insel said. "There is not a huge difference between the classes when you look at efficacy. Where the differences emerge is largely with side effects."

"It would be wonderful," he added, "if we could know how to predict which patient is going to respond to which medication, but we don't know that yet. But we do know that just because somebody doesn't respond to the first one doesn't mean they are not going to respond to the next one."

Finding "biomarkers" that would predict which drug will work for a given patient is going to be the focus of new research, Insel said. "We really need to get serious about personalized medicine for psychiatric illnesses," he said.

More information

To learn more about antipsychotic drugs, visit the U.S. National Institute of Mental Health.