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Updated: 8 hours 19 min ago

17-Day Leech Treatment Helps Save Woman’s Ear After Dog Attack

8 hours 21 min ago

By Alan Mozes
HealthDay Reporter

WEDNESDAY, April 16, 2014 (HealthDay News) — A savage pit bull attack results in the total dismembering of a teenage girl’s ear. And though the ear remains fully intact, complications during the initial reattachment process raise the real risk she could lose her ear forever.

What’s a doctor to do?

If you’re Dr. Stephen Sullivan, a Rhode Island Hospital plastic surgeon, you turn to the visually repulsive yet uniquely beneficial blood-sucking power of leeches.

“The patient’s situation was very precarious,” Sullivan explained. “Because there are two types of blood vessels in the body. You have the ones that come from the heart to the tissues, which are arteries. And you have the ones that bring the blood back from the tissue to the heart, which are the veins. And in this patient’s case we were able to hook the arteries back up but not the veins. And you really need both.”

“So what we did,” Sullivan added, “was take something we find in nature — leeches — and apply it to medicine. Because leeches are very, very effective at what they do, which is sucking blood out.”

Sullivan, who’s also an assistant professor of plastic surgery at Brown University, joined his colleague Dr. Helena Taylor to present their story in the April 17 issue of the New England Journal of Medicine.

The dog attack in July 2013 left the 19-year old woman with her left ear ripped from her head, leaving an open wound. After preserving the ear, the surgical team started with a reconnection of a 0.3 millimeter-thick arterial branch.

“But we’re talking about a dog attack, so the severing of the ear was not a clean cut,” Sullivan said. “The edges weren’t crisp, and the chances for a good reconnection were generally pretty low. And because we couldn’t immediately reconnect the veins, one of the most serious problems we faced was a rising risk for congestion, in which internal pressure builds up because the blood has nowhere to go. Which means that no more fresh blood can enter, so it basically becomes a big clogged pipe.”

Enter the leeches.

Sullivan and Taylor placed the worms, horror-movie style, onto the side of the woman’s head. And then they began to do what leeches do best.

“They suck and drain away the blood,” Sullivan explained, “so more fresh blood can finally get in. And they do it quite efficiently. And while they’re at it, it gives the body the time to make its own new veins, which is something that the body can do very efficiently as well. So the goal is to use the leeches as a temporary drainage system, until the patient can regenerate their own drainage system.”

Still, Sullivan described the entire process as “touch and go.”

“I was hopeful, but at the same time this is not a commonly performed procedure,” he noted. “The FDA [U.S. Food and Drug Administration] approved leeches in 2004 for all sorts of amputation situations, with a detached finger probably being the most common type of scenario. But still, I would say that it’s been done less than 50 times around the world.”

After 17 days the leeches were finally removed, and the patient’s own ear was surgically reattached.

The result: a full recovery of the ear’s function and appearance.

“Her hearing was totally unaffected by this,” Sullivan said. “So I would say this is a perfect example of bio-inspiration, in which we take an organic talent and apply it successfully.”

Dr. Sam Marzo, ear expert and medical director of the Hearing and Balance Center at the Loyola University Health System, in Oakbrook Terrace, Ill., said that leech intervention is “not necessarily conventional, but useful.”

“First of all, it’s not at all unusual that the patient retained full hearing. You can cut off someone’s ear and they will still hear,” he said. “All the external ear does, in addition to being a nice place to put an earring, is to funnel sound into the ear canal. It doesn’t contribute much to hearing.”

“But of course you wouldn’t want to just pull a leech out of a swamp and throw it on an ear,” Marzo cautioned. He explained that medicinal-quality leeches are sold by companies and grown in a lab under low-bacteria conditions.

“And for this whole thing to work you do have to have enough blood supply present,” he said. “If the tissue is already dead and there’s already no viable blood supply, then leeches won’t work. But when used properly, and for the right reason, this can certainly work. I’ve done it myself.”

More information

To learn more about medicinal leech therapy, visit the Biotherapeutics Education and Research Foundation.

Categories: Health & Fitness

Why Spending Time on Hobbies Makes You a Better Person

9 hours 21 min ago

THURSDAY, April 17, 2014 (HealthDay News) — Creative activities outside of work may help boost your job performance, a new study suggests.

Personal endeavors after-hours help employees recover from on-the-job demands and improve skills such as problem-solving, the researchers report in the April 17 issue of the Journal of Occupational and Organizational Psychology.

Researchers surveyed 341 employees across the United States, asking about their creative activities and their work performance. The study also included 92 active duty U.S. Air Force captains who provided details about their creative pursuits and whose job performance was rated by coworkers and subordinates.

Many activities were defined as creative, ranging from writing short stories to playing video games. Whatever their creative activities, the participants “usually describe it as lush, as a deep experience that provides a lot of things for them,” Kevin Eschleman, an assistant professor of psychology at San Francisco State University, said in a university news release.

“But they also talk about this idea of self-expression and an opportunity to really discover something about themselves,” he added.

Eschleman and his colleagues found that having creative pursuits away from work had a positive effect on problem solving and assisting others while on the job,.

Employers can encourage their workers to do creative things outside work, but need to be careful about how they do it.

“One of the main concerns is that you don’t want to have someone feel like their organization is controlling them, especially when it comes to creative activities, because intrinsic motivation is part of that unique experience that comes with creative activity,” Eschleman explained.

He also said companies can encourage employees to be creative at work through events such as baking contests or having them decorate their offices with personal artwork. Employers can also offer workers discounts to local art studios or other types of creative activities.

More information

PBS explains the importance of encouraging creativity in children.

Categories: Health & Fitness

Move of the Week: Army Crawl Leg Extension

10 hours 21 min ago

This week, celebrity trainer Tracy Anderson shows us how to do the army crawl leg extension. This exercise targets your shoulders, back, chest, abs, glutes, and inner thighs.

Here’s how to do it: Lie facedown with your hands under your shoulders, elbows bent, right leg at 90 degrees with your inner thigh on the floor, and your left leg extended straight back on the floor. Push up until your arms are straight, bend your left leg until kneeling (keep your foot off the floor) and extend your right leg straight back. Lower down, pulling your right knee back into a 90-degree angle. Return to start. Do 30 to 40 reps, then repeat on the other side.

Trainer tip: Keep your gaze down so that your neck stays in a neutral position.

Try this move: Army Crawl Leg Extension

Categories: Health & Fitness

Oil-Swishing Craze: Snake Oil or All-Purpose Remedy?

10 hours 44 min ago

By Barbara Bronson Gray
HealthDay Reporter

FRIDAY, April 18, 2014 (HealthDay News) — Allison Bennett of Palm City, Fla., plans to swish daily. Sloshing coconut oil around her mouth for a quarter of an hour every day will make her teeth whiter, she believes.

Like Bennett, plenty of consumers are discovering an ancient practice called oil pulling, or oil swishing. Some people report the practice sweetens their breath; others say it treats gum disease, prevents tooth decay and even improves arthritis and asthma.

Oil pulling, which goes back 2,500 years, is based on Indian traditional medicine, or Ayurveda, said Marc Halpern, a chiropractor and president of the California College of Ayurveda, in Nevada City, Calif.

The practice is based on a core concept of Ayurveda: that oil is nourishing to body tissue, said Halpern. “In Ayurveda we oil all the tissues of the body, from head to toe, every day. Studies have shown there can be an antimicrobial and anti-inflammatory action.”

Halpern swishes oil. “I try to do everything within the realm of Ayurveda to see if it’s of value,” he said.

But even Halpern admits that oil pulling may not produce the broad range of benefits some boast. “People have reported all kinds of wonderful results from doing it, but you can’t attribute every result to the practice,” he said.

Hard evidence of the benefits and risks is hard to come by.

Bennett decided to try swishing after applying coconut oil to her 2-year-old daughter’s skin to treat eczema. In reading about how the oil worked, she learned about pulling. So she recently ordered another bottle of coconut oil and tried it.

“It wasn’t bad,” said Bennett, who swished for 10 to 15 minutes. “My mouth seemed quite clean after and my teeth seemed whiter even after just one time. I plan to make this a part of my daily routine each morning.”

Do experts in Ayurveda think pulling really works as a teeth whitener? “It hasn’t been studied,” said Halpern.

As for any downside, Halpern said some people feel a little nauseous when they swish. For that he recommends using oil for just five minutes, not the 20 minutes some recommend, and using less oil if need be.

“Between a teaspoon and a tablespoon is fine. There is no exact amount of oil that must be put in your mouth,” he said.

While Halpern said he believes swishing oil is safe, he recommends that people work with a trained and experienced Ayurveda practitioner to get a personalized “prescription” for the type of oil that best fits their needs and physical make-up.

Lydia Hall, a spokeswoman for the American Dental Association, said the association can’t comment on oil pulling because additional research is needed. And the National Institute of Dental and Craniofacial Research isn’t doing any research on oil pulling, said its spokesman, Bob Kuska.

Some experts say almost anything you do for your mouth is better than neglecting it.

“Anyone who wants to pay attention to their oral hygiene, it’s a good thing,” said Dr. Joseph Banker, a cosmetic dentist in Westfield, N.J. “But are there other things that they could be doing? Probably.”

Many “old remedies” were developed when there was no toothpaste, mouthwash, floss or toothbrushes, Banker said. Nowadays, inexpensive and widely available tools make it a lot easier to take care of your teeth and gums, he added.

As for whether swishing can whiten teeth, Banker is skeptical. “I don’t think the oil has an intrinsic effect other than the removal of plaque. It’s hard to find a study that states that. Anything that swishes around for 20 minutes may have some effect, even water.”

Yet if done daily, oil pulling may remove some tooth stain, Banker said. Also, if the process improves gum health, they will be pinker, which can often make the teeth look whiter, he said.

Banker recommends that people who want brighter teeth simply use whitening strips. “They’re easy to place, and you can stop using them if your teeth get sensitive.”

But could swishing do harm? “No. It’s the ones who ignore their mouths that have problems,” said Banker.

More information

Learn more about oral health from the U.S. Centers for Disease Control and Prevention.

Categories: Health & Fitness

Suddenly Health Insurance Is Not for Sale

10 hours 44 min ago

By Karen Pallarito
HealthDay Reporter

FRIDAY, April 18, 2014 (HealthDay News) — Darlene Tucker, an independent insurance broker in Scotts Hill, Tenn., says health insurers in her area aren’t selling policies year-round anymore.

People who didn’t try to sign up for health insurance by March 31 may now have to wait until the end of the year to buy a health plan — even outside the new Obamacare marketplaces, she noted.

“I’m very concerned that there are going to be people that develop health problems that begin walking into our doors and say, ‘I need to get health insurance … I need to be able to see the doctor,’” Tucker said. “And we’re going to have to tell them that nothing’s available.”

It’s a little-understood consequence of the Affordable Care Act, known as Obamacare.

Millions of uninsured Americans who missed the sign-up period — perhaps hoping to shop for coverage at their own convenience — may soon find they can no longer buy comprehensive coverage whenever they want.

“If somebody needs insurance in the middle of the year, in some places, they won’t have access to it,” said Kathryn Gaglione, a spokeswoman for the National Association of Health Underwriters in Washington, D.C., which represents health insurance agents and brokers across the nation.

For health insurers, it’s an economic decision. To stay viable, they need to attract a certain mix of people, including young, healthy folks who don’t require expensive care, or any care at all. If health plans leave the door open year-round, they’re likely to attract people who are very sick, newly diagnosed and in need of immediate care. And under the health reform law, health insurers cannot turn these sickest patients away.

Insurers react to new rules

Many uninsured Americans will pay a federal tax penalty during next year’s tax season, and people who procrastinated may have to wait until the next open enrollment period, starting Nov. 15, to enroll in coverage that takes effect in 2015.

So why cut off enrollment now? Experts say insurers are simply reacting to the health law’s incentives.

The Affordable Care Act prohibits most health insurers from denying coverage to people with pre-existing medical conditions. The exception is for so-called grandfathered plans that were in place before the law took effect.

To discourage folks from waiting until they’re sick to buy coverage, health plans offered on the federal and state marketplaces, or exchanges, are available only during open enrollment and under special circumstances — say, a move, divorce or birth of a child.

Healthy young adults for the most part are not the ones scrambling to sign up. They’ve already weighed the cost versus the benefit and decided to hold onto their premium dollars, brokers said.

Limiting open enrollment minimizes the risk of attracting mostly sick people in dire need, which would make health insurance unaffordable for everyone.

“What they should have done is said, ‘Look, you can always enroll in a health insurance plan any time of the year. However, it doesn’t cover any pre-existing conditions if you enroll outside of the open enrollment period,’ ” said Robert Slayton, an independent broker in Naperville, Ill.

Exchange plans don’t have a choice, but off-exchange health insurers can decide when to offer coverage, said Carrie McLean, director of customer care for the online insurance broker eHealthInsurance. They can limit enrollment to a designated period mirroring the Obamacare sign-up and special enrollment periods. Or, they can sell insurance year-round, she explained.

Few are choosing to leave the door wide open, insurance brokers said.

“I think the biggest misconception was that [consumers] would just get the tax penalty” if they missed the March 31 open enrollment deadline, McLean noted. “People really did not understand that you couldn’t get insurance at all,” she said.

Of the more than 180 insurance carriers its works with across the United States, eHealthInsurance has identified just 14 states where at least one insurer has agreed to accept new applications off-exchange, mostly through April 15 or April 30.

‘People did not understand that you couldn’t get insurance at all’

There are a few exceptions.

Meritus, a Tempe, Ariz.-based nonprofit health insurer, said it intends to sell coverage outside of open enrollment. The consumer-owned and -operated health insurer is currently confirming its plan with the Arizona Department of Insurance.

“Due to the large number of people who did not enroll during open enrollment, we feel that providing an opportunity for people to still secure coverage is important to the community,” Meritus CEO Kathleen Oestreich told HealthDay.

“We understand there may be additional risk, but we are prepared to manage that risk,” she added.

Nevada Health Co-op, a nonprofit health insurer in Las Vegas, is also extending enrollment beyond April.

“They ought to put a kiosk in the emergency rooms, because who’s going to be signing up? It’s going to be people who desperately need insurance right now,” said Larry Harrison, an independent broker in Las Vegas.

The rollout of Obamacare was marred by extensive computer glitches that hampered many Americans trying to sign up for coverage. The recent resignation of U.S. Health and Human Services Secretary Kathleen Sebelius may have been partly due to the fallout from that botched launch.

Consumers in most states had until April 15 to complete the enrollment process. People who submitted paper applications to the federal marketplace by April 7 have until the end of the month to select a plan.

More information

Visit HealthCare.gov to find out how to complete an insurance application.

Categories: Health & Fitness

5 Upgrades to Your Favorite Body Weight Moves

Thu, 2014-04-17 16:19

Body weight workouts are a convenient, inexpensive way to burn calories and build muscle fast. If you’re no longer getting your desired results, however, chances are your routine has become a bit too easy. Luckily, body weight exercises are easy to modify if you’re looking for more of a challenge. Try these 5 variations on basic body weight moves next time you work out. Your muscles will thank you!

Instead of tricep dips…try tricep push-ups
Get into push-up position, but instead of placing your hands directly under your shoulders, put them next to each other so they meet beneath the middle of your chest. Your fingertips and thumbs should touch to form a diamond shape. From here, lower into a push-up keeping your body in a straight line. Press back up and repeat. Tricep pushups are difficult, so if you’re looking to make it slightly easier, do the pushups on your knees instead of toes.

Instead of regular lunges…try Bulgarian split lunges
Bulgarian split lunges will test your balance (which helps engage your core) in addition to working your leg muscles. Standing with your feet shoulder-width apart, rest one leg back behind you on a platform like a chair or bench so that you’re in an elevated lunge position. With your back leg on the platform, bend into a lunge on your front leg. Push up from the lunge until your front leg is straight, and repeat. Repeat on the other side.

Instead of crunches…try a plank with leg extension
Planks work all four layers of your abdominal muscles, a.k.a. your entire core. They definitely give you more bang for your buck than the average crunch, but you can still make them harder. Get into push-up position, then take one of your legs off the ground and extend it straight back. Hold this position for a count of 15, and then switch to your other leg. After holding your plank for a minute, take a 30 second break before repeating again.

Instead of regular squats…try one-legged squats
The single-leg squat tests your lower body strength while also adding the element of balance. It helps to expose imbalances in the body, as most people have a stronger side that overcompensates for their weaker side while doing regular squats. Single-leg squats use the same technique as a regular squat, but instead of standing on both feet, lift one foot up and extend your leg straight out in front of your body at a 45-degree angle. Do as many one-legged squats on the left leg as you can in 1 minute, then switch to your right leg for another minute.

Instead of regular pushups…try staggered pushups
Once you’re in push-up position, scoot one hand a few inches up and the other a few inches down. Do half of your reps this way, and then switch your hands for the remaining reps. Staggered pushups engage your abs more, while also working your obliques harder than normal pushups.

Looking for more bodyweight workout tips? Check out 4 Things You Need To Know About Planks!

Jennifer Cohen is a leading fitness authority, TV personality, best-selling author, and entrepreneur. With her signature, straight-talking approach to wellness, Jennifer was the featured trainer on The CW’s Shedding for the Wedding, mentoring the contestants’ to lose hundreds of pounds before their big day, and she appears regularly on NBC’s Today Show, Extra, The Doctors and Good Morning America. Connect with Jennifer on Facebook, Twitter, G+ and on Pinterest.

Categories: Health & Fitness

6 Fascinating Things a Food Journal Can Teach You About Your Eating Habits

Thu, 2014-04-17 14:55

If you tried to recall everything you ate and drank yesterday, chances are you’d forget a thing or two (or five), and that’s completely normal. Unless you consciously set out to think through everything you put in your mouth, it’s easy to forget about a free sample at the market, a few nibbles while cooking, or a taste from your partner’s plate. Trouble is, those unacknowledged extras can add up quick, and get in the way of weight loss and health results. What’s more, you may be engaging in unhealthy patterns you’re not even remotely aware of. The solution: start keeping a diary.

A Kaiser Permanente study involving more than 1,600 people found that those who kept a daily food journal lost twice as much weight over six months (18 pounds versus 9) compared to those who weren’t regular recorders. Another recent study, published in the Journal of the Academy of Nutrition and Dietetics, found that overweight and obese women in diet only or diet plus exercise weight loss groups all lost weight. But those who kept food journals shed six extra pounds.

Here are six key insights you may gain from tracking your intake, plus how each one can affect your ability to slim down.

Why you eat when you’re not hungry

I ask my clients to record not just what and how much they eat, but also how they feel emotionally at mealtimes, as well as their hunger and fullness ratings before and after eating. Many realize they’re triggered to eat not by physical hunger, but because they’re bored, sad, angry, or worried. Others notice that they eat to pass time when procrastinating, or out of habit, such as always having a snack while watching TV. This kind of insight is invaluable, because triggers and patterns are often unconscious, and you can’t change something you don’t even realize you’re doing. Keeping a journal changes that, because it allows you to identify the “whys” of your choices, systematically work on forming new habits, and find non-food ways to cope with emotions (for more, please see my previous post 5 Ways to Shut Down Emotional Eating).

How your dining companions affect your habits

After starting a diary, one of my clients was shocked to learn just how much more she ate with her hubby compared to dining solo or with friends. Not only were the two “partners in crime” who enjoyed indulging in things like ice cream together, but they often split pizzas and ate similar portions, even though his needs were far greater than hers. It took making this connection for her to realize that gaining 15 pounds since they moved in together wasn’t just about getting older, and she felt empowered to make changes that led to weight loss. If you’re in the same boat, check out my previous post Is Your Partner Making You Fat?

How much you’re really eating

In a fascinating study, Cornell University researchers used a hidden camera to spy on patrons at an Italian restaurant. Just five minutes after the meal was over, they asked diners how much bread they had consumed. Most people ate about 30% more than they thought, and 12% of people who were seen eating bread on camera denied having any at all. The results aren’t shocking, because eating is often mindless. When you’re chewing food and distracted at the same time—whether by carrying on a conversation, checking e-mail, or watching TV—it’s easy to lose track of what or how much you downed. Recording your intake forces you to pay attention and offers a real time reality check. Even texting can help. A Duke University study of obese women who participated in a six-month weight-loss intervention found that those who tracked their intake via text lost weight, while those who didn’t gained pounds.

How fast you chow down

Journaling often triggers major light-bulb moments among my clients about just how quickly they eat. When one began tracking, he noticed that he was always the first one to finish his food when dining with others, and even alone he wolfed down sandwiches and snacks at lightning speed. As a result, he often experienced heartburn and felt unsatisfied, even when uncomfortably full. Just slowing his pace led to eating less over a longer stretch (but enjoying food more), sipping more water, ending meals without digestive upset, and, before long, tightening his belt a notch—pretty huge payoffs for one small change.

How you feel after eating certain foods

In my opinion, one of most important insights gained from food journaling is connecting what and how you eat to how your body feels. When I ask my clients to track things like energy, mood, mental clarity, and digestive happiness in their food diaries, they’re often blown away but what the find. Recently one client realized that having a veggie-packed salad topped with quinoa, lean protein, and avocado for lunch left her feeling like a million bucks all afternoon, while heating up a frozen processed “diet” meal left her feeling sluggish, grumpy, and unmotivated. As a result, she began bringing lunches to work, eating clean in order to feel better, and losing weight despite eating more calories (check out my previous post Why Calorie Counts Are Wrong).

If your perceptions match reality

My clients frequently make comments like, “I eat tons of fruits and vegetables” or “I don’t drink that much,” but when they begin to track, they realize just how far off their perceptions are from reality. It’s essentially human nature—we like to recall our successes and perhaps even exaggerate them. But telling yourself nutritional white lies can hold you back from reaching your goals, or even cause you to abandon them altogether. The point of a food journal isn’t to judge or police yourself, or even to grade yourself; it’s to learn about yourself, which is the first step toward adopting healthy changes that stick!

What are your thoughts on this topic? Chat with us on Twitter by mentioning @goodhealth and @CynthiaSass.

Cynthia Sass is a nutritionist and registered dietitian with master’s degrees in both nutrition science and public health. Frequently seen on national TV, she’s Health’s contributing nutrition editor, and privately counsels clients in New York, Los Angeles, and long distance. Cynthia is currently the sports nutrition consultant to the New York Rangers NHL team and the Tampa Bay Rays MLB team, and is board certified as a specialist in sports dietetics. Her latest New York Times best seller is S.A.S.S! Yourself Slim: Conquer Cravings, Drop Pounds and Lose Inches. Connect with Cynthia on FacebookTwitter and Pinterest.

Categories: Health & Fitness

White House: 8 Million People Signed Up for Health Insurance

Thu, 2014-04-17 14:37

By Karen Pallarito
HealthDay Reporter

THURSDAY, April 17, 2014 (HealthDay News) — Eight million Americans signed up for private health insurance during the just-concluded first enrollment period under the Affordable Care Act, the White House announced Thursday afternoon.

An estimated 35 percent of those who signed up are younger than 35, and 28 percent are between 18 and 34 years of age. Those numbers are very close to the first-year enrollment numbers Massachusetts saw when it introduced its health reform legislation in 2006, the White House said in a news release.

Younger adults’ participation in the Affordable Care Act, sometimes called Obamacare, is considered crucial because they tend to be healthy and their insurance premiums are designed to offset the costs of medical treatment of older, sicker people.

The rising cost of health care also has slowed to the lowest rate on record, Obama administration officials said Thursday. Since the Affordable Care Act became law in 2010, per capita health care spending is “estimated to have grown at the lowest rate on record for any three-year period and less than one-third the long-term historical average stretching back to 1960,” the news release said.

“This thing [the Affordable Care Act] is working,” President Barack Obama said Thursday afternoon during a press briefing at the White House.

The first sign-up period for insurance under the Affordable Care Act ended March 31, when an 11-hour surge of consumers pushed initial enrollment estimates to 7.1 million participants.

The prospect of 7 million Americans signing up seemed unlikely as recently as mid-March, when federal officials were saying approximately 6 million people had registered for coverage.

According to the White House, one of the main objectives of the Affordable Care Act is to expand access to affordable health care options for uninsured Americans, estimated last year to be 45 million people. The law led to the creation of the online marketplaces, or exchanges, where people in each state and the District of Columbia could compare health plans and sign up for coverage.

But the law remains controversial. Numerous polls show Americans are sharply divided over it, and Republicans are almost universally opposed to it.

The enrollment process got off to a terrible start back in October with the botched unveiling of the HealthCare.gov federal registration website. Computer glitches and software problems made the website virtually unusable for long periods of time.

The problems with HealthCare.gov, which serves 36 states that don’t operate their own registration websites, were eventually solved. But it was widely assumed that the registration earlier this month of Health and Human Services Secretary Kathleen Sebelius was due to the early registration problems.

Now that the first enrollment deadline has passed, most Americans won’t have another chance to sign up for coverage until the next open enrollment period, which begins Nov. 15. Coverage purchased during that time won’t take effect until 2015.

With some exceptions, people who are uninsured for most of 2014 may have to pay a penalty during next year’s tax season under provisions of the Affordable Care Act. The maximum penalty for 2014 is $95 per adult and half of that for children (up to $285 for a family of three or more) — or up to 1 percent of household income, whichever is greater.

More information

To learn more, visit HealthCare.gov.

Categories: Health & Fitness

Scientists Map DNA of Deadly Fungus

Thu, 2014-04-17 14:37

THURSDAY, April 17, 2014 (HealthDay News) — Researchers who sequenced the genome of a deadly fungus say their achievement offers a genetic map for finding weaknesses in the fungus in order to fight it.

Cryptococcus neoformans causes millions of cases of pneumonia and meningitis every year, says a team of scientists that spent 10 years decoding the DNA of one highly dangerous strain, called H99.

The mapping of the fungus’ entire genetic code, or genome, can be used to learn more about how the fungus causes illness and to find ways to prevent it from developing into even deadlier strains, the scientists said.

“We are beginning to get a grasp on what makes this organism tick,” study co-author Dr. John Perfect, a professor of medicine at Duke University, said in a university news release. “By having a carefully annotated genome of H99, we can investigate how this and similar organisms can change and mutate and begin to understand why they aren’t easily killed by antifungal medications.”

The study is published April 17 in the journal PLoS Genetics.

Perfect said he first isolated H99 from a patient with cryptococcal meningitis 36 years ago.

Cryptococcus neoformans primarily infects people with a weakened immune system, such as transplant recipients and patients with HIV/AIDs. The researchers found that the H99 strain became less virulent as they grew it in the laboratory.

“Virulence, or the ability of this organism to cause disease in mice or humans, is not very stable. It changes, and can rapidly be lost or gained. When the organism is in the host it is in one state. But when we take it out of the host and begin growing it in the laboratory it begins mutating,” senior study author Fred Dietrich, an associate professor of molecular genetics and microbiology at Duke University School of Medicine, said in the news release.

The next step is to mutate all of H99′s genes one by one to determine which ones cause disease, the researchers said.

They added that having a map of H99′s genome also provides them with a starting point for studying other strains of Cryptococcus neoformans.

More information

The U.S. Centers for Disease Control and Prevention has more about fungal diseases.

Categories: Health & Fitness

Doctors’ Free Drug Samples Can Mean Pricier Prescriptions for You

Thu, 2014-04-17 13:37

WEDNESDAY, April 16, 2014 (HealthDay News) — Dermatologists who receive free drug samples are more likely to give their patients prescriptions for expensive medicines, a new study says.

Researchers looked at data on prescriptions for adult acne medications written in 2010 by dermatologists across the United States.

For a single visit, the average retail cost of prescriptions for patients whose doctors received free samples from drug makers was about $465, compared with about $200 for patients whose doctors did not receive free samples, the study found.

Brand name drugs and “branded generics” — off-patent drugs that have different dosages or new formulations and are sold under a new name — accounted for 79 percent of prescriptions written by dermatologists nationwide, the study showed.

In contrast, such drugs only accounted for 17 percent of prescriptions written by doctors at an academic medical center that doesn’t allow its doctors to accept free drug samples, researchers found.

Brand name drugs and branded generics have similar retail prices, while generic drugs are cheaper, noted the authors of the study published April 16 in the journal JAMA Dermatology.

Among other medical specialties, the percentage of prescriptions written with a free drug sample decreased from 7 percent in 2001 to 4 percent in 2010, according to study background information. But the percentage increased among dermatologists during that time, from 12 percent to 18 percent, the new study found.

“Physicians may not be aware of the cost difference between brand-name and generic drugs, and patients may not realize that, by accepting samples, they could be unintentionally channeled into subsequently receiving a prescription for a more expensive medication,” study senior author Dr. Alfred Lane, emeritus professor of dermatology and of pediatrics at Stanford University, said in a university news release.

He and his colleagues said their findings contribute to the debate about whether free drug samples are helpful or cause doctors to favor more expensive brand name drugs instead of generic drugs, thereby increasing costs for patients and health insurers.

Previous research has found that drug companies give about $16 billion in free drug samples to doctors every year, the news release noted.

“Many physicians believe that free samples have both benefits and drawbacks,” study first author Michael Hurley, a Stanford medical student, said in the news release.

“Primarily, they feel that the samples give them more freedom and flexibility to help people who are uninsured, or with less financial means,” Hurley said. “But the national data don’t really support that. Those people are not the ones who are typically getting these samples.”

More information

The U.S. Food and Drug Administration has more about generic medications.

Categories: Health & Fitness

Salmonella Cases Dip in U.S., But Food Poisoning Rates Remain High

Thu, 2014-04-17 13:37

By Steven Reinberg
HealthDay Reporter

THURSDAY, April 17, 2014 (HealthDay News) — While the United States has seen a decline in the number of Salmonella illnesses in recent years, there’s been little progress overall in reducing food poisoning outbreaks, health officials say.

“The news is mixed,” Dr. Robert Tauxe, deputy director of the U.S. Centers for Disease Control and Prevention’s Division of Foodborne, Waterborne and Environmental Diseases, said during a noon press briefing. “Some improvements were made, but substantial more work is needed.”

Rates of illnesses due to Vibrio, a bacterial toxin found in shellfish, have actually spiked recently, the CDC noted.

The new report tracked patterns of foodborne illness outbreaks for 10 states. In 2013, the CDC’s food poisoning reporting system identified 19,000 related infections, 4,200 hospitalizations, and 80 deaths among the 48 million residents of these states.

Salmonella remains the most frequent cause of food poisoning, accounting for 38 percent of all cases, Tauxe said. Second was the Campylobacter bacterium, which accounted for 35 percent of foodborne infections. Both Salmonella and Campylobacter can contaminate meat, chicken and vegetables, Tauxe said.

But there was some good news: In 2013, the rate of Salmonella infections fell by 9 percent, compared with the rate in 2010-2012, the CDC report found. “This drop brings Salmonella down to the rate we saw back in 2006-2008,” Tauxe noted.

But the current rate of Salmonella infections of 15 cases per 100,000 people is still below the goal of 11.4 per 100,000, which the CDC hopes to reach by 2020, he said.

Tauxe believes that some of the decline in Salmonella cases is the result of stopping a large outbreak of the bacteria in eggs in 2010, and subsequent U.S. Food and Drug Administration (FDA) regulation mandating continuous refrigeration of eggs from farm to store.

On the other hand, however, Campylobacter infections have risen 13 percent since 2006-2008 and have remained stable over the past five years, Tauxe said.

Cases of illness from the Vibrio bacteria, found in raw shellfish, still account for only 1 percent of food poisoning cases but have been on the rise. “Vibrio infections have continued to increase as they have in the past,” Tauxe said. “We are at the highest level observed since our tracking began in 1996.”

Since 1996, Vibrio infections have climbed 168 percent, and cases rose by one-third in just the last three years, he said.

In addition, food poisoning from another bacteria, E. coli, have also been creeping up again after a period of decline. “The progress that has been noted since 2006-2008 [against E. coli] has stalled,” he said. “Still, E. coli infections are 30 percent lower than they were in 1996.”

Those most affected by food poisoning were children under 5 and adults 65 and older, according to Tauxe.

Dr. Marc Siegel, an associate professor of medicine at NYU Langone Medical Center in New York City, said the only way to curb food poisoning is with more and stricter regulation.

“We overtreat animals and people with antibiotics, which breeds strains of these bacteria that are resistant to drugs,” he believes. “That’s the problem right there.”

Siegel also contends that the ways animals are raised — in overcrowded conditions, often living in their own waste — is a breeding ground for harmful bacteria.

“More oversight and testing for these bacteria is needed,” he said.

To help reduce the threat of food poisoning, the FDA and the U.S. Department of Agriculture say they are coming up with new plans and regulations, including new standards for cut-up poultry parts and ground chicken and turkey.

Consumers and the food industry also have a role to play, the CDC noted. Companies can use safer ingredients and can institute controls to prevent shipping contaminated food.

In addition, restaurants and consumers can follow safe practices in their kitchens. These include cooking meat to proper temperatures, washing produce, and preparing meat and fresh vegetables on different surfaces.

Consumers should also know there are risks to eating unpasteurized milk, soft cheeses made with unpasteurized milk and raw oysters, the agency added.

The report was published April 18 in the CDC’s Morbidity and Mortality Weekly Report.

More information

For more information on avoiding food poisoning, visit Foodsafety.gov.

Categories: Health & Fitness

FDA Warns Against Procedure for Uterine Fibroids

Thu, 2014-04-17 13:37

By Dennis Thompson
HealthDay Reporter

THURSDAY, April 17, 2014 (HealthDay News) — A surgical technique used to grind up uterine growths and remove them through tiny incisions could increase a woman’s risk of cancer, the U.S. Food and Drug Administration warned Thursday.

The FDA said that the procedure, known as “laparoscopic power morcellation,” can inadvertently spread cancerous tissue beyond a woman’s uterus and into other parts of her body.

Surgeons frequently use laparoscopic power morcellation when they perform a hysterectomy or remove uterine fibroids, which are noncancerous growths on the smooth muscle tissue on the wall of the uterus.

The minimally invasive procedure uses a power tool to chop up the tissue of the fibroids or, in the case of a hysterectomy, the uterus itself. These tissue fragments are then removed through tiny incisions, according to background information from the agency.

The FDA estimates that about one in 350 women undergoing a hysterectomy or fibroid removal has an unsuspected type of cancer called uterine sarcoma.

If a surgeon performs power morcellation on these women, there’s a risk the procedure will spread the cancerous tissue within the patient’s abdomen and pelvis.

About 60,000 of these procedures are performed every year, estimated Dr. William Maisel, deputy director for science and chief scientist at the FDA’s Center for Devices and Radiological Health.

The FDA stopped short of banning the power morcellation device from the market, but is urging physicians and patients to weigh the risk prior to its use.

“Women should ask their health care provider if power morcellation will be used during the procedure, and explain why it’s the best option,” Maisel said at a Thursday news conference.

Women who already have undergone power morcellation don’t need to get a cancer screening, because some of the tissue removed during the procedure would have been sent for pathologic analysis, Maisel said. If cancer had been detected, they would have been informed, he added.

“We think that most women who have undergone these procedures require routine care,” he said. “If they don’t have any ongoing or recurrent symptoms, they should be fine.”

Most women will develop uterine fibroids at some point in their lives, according to the U.S. National Institutes of Health. These fibroids can cause symptoms such as heavy or prolonged menstrual bleeding, pelvic pain or frequent urination.

Women who need a hysterectomy or fibroid removal can still undergo traditional or laparoscopic surgery, just without the use of a power morcellator, Maisel said.

The agency has instructed manufacturers of power morcellators to review their current product labeling for accurate risk information for patients and health care professionals.

The FDA also will convene a public meeting this summer of its obstetrics and gynecological medical devices panel to discuss the matter and weigh whether further measures are required.

The FDA approved the first power morcellator for use in 1995, Maisel said. A non-power version of the morcellator received FDA approval in 1991.

The medical community has been aware of the risk of cancer spread during power morcellation since the device came onto the market, but “the magnitude of the risk appears to be higher than what was appreciated in the clinical community,” Maisel said.

Brigham and Women’s Hospital in Boston and the Cleveland Clinic both recently strengthened their informed consent for the procedure, warning women of the potential cancer risk, according to recent news reports.

In particular, specialists at Brigham and Women’s tell patients about their own in-house research, which found a ninefold higher rate of unexpected uterine sarcoma during a review of the medical records of more than 1,000 women who received morcellation for fibroids, according to The New York Times.

More information

For more about uterine sarcoma, visit the U.S. National Cancer Institute.

Categories: Health & Fitness

Tonsillectomy May Spur Weight Gain in Kids, But Won’t Cause Obesity: Study

Thu, 2014-04-17 13:37

THURSDAY, April 17, 2014 (HealthDay News) — Some children gain weight after having their tonsils removed, but this weight gain is typically confined to younger, underweight children and doesn’t seem to add to obesity rates, a new study finds.

Each year in the United States, about 500,000 children have their tonsils removed. In the new study, a team from Stanford University School of Medicine tracked outcomes for 815 children who underwent tonsillectomy.

Overall, the children’s weight rose by an average of just over 6 percent within 18 months of their surgery and their body mass index (an estimate of body fat based on height and weight) rose an average of 8 percent.

The largest weight increases occurred in children who were smaller and younger than age 4 at the time of surgery. Children older than age 8 gained the least weight, and children who were already heavier before their surgery did not gain weight, according to the researchers.

One expert not connected to the study said the findings make sense.

“One possible interpretation of this clinical observation has been that some children with significant nighttime breathing issues — like sleep apnea — actually are underweight due to the increased work of breathing, or due to obstructive food aversions related to the size of the tonsils,” said Dr. Michael Rothschild, clinical professor of otolaryngology and pediatrics at the Icahn School of Medicine at Mount Sinai in New York City.

“These children may move to a more appropriate weight for their age and height following the surgery with improved eating and sleeping, while children who are overweight might not have the same degree of weight gain,” he said.

The study findings seem to bear that out — even though many children gained weight after tonsil removal, there was only a small increase in the number of children who were obese: 14.5 percent before versus 16.3 percent after. This suggests that tonsil removal is not associated with higher obesity rates, the researchers concluded.

Two other experts not involved in the study said the findings may be useful for parents and physicians.

“This study provides helpful information to parents trying to weigh the risks and benefits of surgery for their child,” said Dr. Aaron Bernard, clinical skills director at the Quinnipiac University School of Medicine in Hamden, Conn.

Dr. Lisa Liberatore, an ear, nose and throat specialist at Lenox Hill Hospital in New York City, agreed. She noted that the study “found that there is an increase in weight in some children after this surgery but it was in those children who were underweight and, in some cases, not thriving — this would be a good thing in those children.”

On the other hand, “in children who were obese before surgery, there was no gain in weight or no worsening of their obesity,” Liberatore said. She believes that “parents and physicians should not avoid indicated reasons for removal of the tonsils and adenoids for fear of causing obesity.”

The study was published online April 17 in JAMA Otolaryngology–Head & Neck Surgery.

More information

The U.S. National Library of Medicine has more about tonsil removal.

Categories: Health & Fitness

5 Yoga Mistakes Even Non-Newbies Make

Thu, 2014-04-17 12:02

Once you’re no longer a beginner making rookie yoga mistakes, it doesn’t mean yoga gets easier, necessarily. After practicing yoga for 20 years, I’ve learned that it’s sometimes challenging to stay committed to the practice and to keep improving. The beautiful thing about yoga is there is no end goal—it’s a process. Remember to stay in your own practice and really pay attention to all of the little gains you make daily, on and off the mat.

That said, if you feel like you’re really not making any progress lately, one of these 5 things could be holding you back.

Trying to show off
It’s all too common to think that yoga is about flying arm balances, crazy split poses, and contortionist stretches, but the exact opposite is true. Sometimes the simplest postures are the ones that require the most concentration and skill. When I see a student trying too hard to master all of the show-off poses, it makes me laugh a little. Remember that you’re not trying to perform for anyone. If you think of yoga as performance based, chances are you’ll injure yourself or push too hard to try a complicated pose without getting the correct foundation.

Skipping savasana
It always makes me so sad when my students leave class early before taking final relaxation. Corpse pose, savasana in Sanskrit, is truly one of the most important poses in yoga. I know that we all have busy schedule and things to do, but you must give yourself time to reap the rewards of your practice. Lie still for a minute and let it all soak in. If you have to leave class early, stop a few minutes beforehand and do your own relaxation. In savasana, your body absorbs everything you’ve done in your practice and can improve, grow, and repair itself.

Moving too fast
Many flow-style classes like Ashtanga can go at a very rapid pace. I think it’s fun to flow freely and move through the sun salutations; but not at the expense of improper form. If you find that you can’t keep your shoulders from rounding forward in chaturanga or your knee from rolling inward during warrior 2, you may be going to fast or doing too much. You need to be able to link your breath to the movement and stay connected to your breathing throughout the practice. If you can’t keep up with your breath, slow down and find a pace that works for you. Move mindfully and use your practice to work on the posture—and do your cardio elsewhere.

Checking your cell phone
I know you’re thinking “who on earth would check their phone during yoga?” But I’ve seen it time and again. Yoga is when you put everything else aside and focus on your mind, body, and breath. Try to truly leave the gadgets at the front door. Imagine you’re at the theater: You would never disrupt an amazing play or movie to check your phone. Do yourself the same kind of favor and respect your time in your yoga practice by making it distraction-free. I even prefer not to use any music in my classes and just be with the breath.

Not listening to your body
Even the most advanced practitioners often try to ignore that nagging hamstring or inflamed shoulder. It’s so important to listen to what your body is telling you and adjust your practice accordingly. Pay attention to when you’re overly tired or when you have a lot of energy to expend and tailor your practice to fit your needs. And just because a teacher is telling you to do something doesn’t mean you have to do it. It’s always your own practice, and you should speak up if you’re getting an adjustment that feels too intense. The longer you practice the more in touch you’ll be with yourself and you’ll build the confidence to make it all about you!

Don’t judge yourself or compare yourself to anyone and know that you will continue to make progress daily, yearly, and throughout your life. Yoga isn’t a sprint it’s more of a marathon and you will reap the most rewards if you stay connected to yourself and take it day by day.

Kristin McGee is a leading yoga and Pilates instructor and healthy lifestyle expert based in New York City. She is an ACE certified personal trainer who regularly trains celebrity clients in New York and Los Angeles. She serves as Health’s contributing fitness editor and is frequently seen on national TV. Her latest in a large collection of fitness DVDs is YogaSlim. Follow her on Twitter @KristinMcGee and like her page on Facebook.


Categories: Health & Fitness

Off Season May Not Be Long Enough to Recover From Football ‘Hits’

Thu, 2014-04-17 09:37

By Kathleen Doheny
HealthDay Reporter

THURSDAY, April 17, 2014 (HealthDay News) — New research shows that the brains of some football players who had the usual head hits associated with the sport, but no concussions, still had signs of mild brain injury six months after the season ended.

“We followed athletes at the beginning of football season, after and for six months later,” said Dr. Jeffrey Bazarian, an associate professor of emergency medicine at the University of Rochester School of Medicine and Dentistry, in Rochester, N.Y.

Bazarian found white matter changes consistent with mild brain injury generally persisted for six months. “When we looked at players individually, there were a few that looked like they did resolve,” he said, but half of the players still showed changes at the six-month mark.

“We didn’t see these changes in those who don’t play football,” he said. “And these are the kinds of changes that are being found in retired NFL players.”

The latest study is published in the April 16 online issue of PLOS ONE.

For the research, Bazarian evaluated 10 Division III college football players and five college students who did not play sports during the 2011-2012 season. All 15 underwent brain imaging in addition to balance, cognitive (thinking) skills and other testing before the season, at the end of the season and after six months of rest. The athletes were told not to play during the six months, he said, although the researchers can’t be sure everyone followed that instruction.

During the football season, accelerometers mounted to the helmets measured head impacts. The total head impacts for the season ranged from 431 to 1,850, but no one got a diagnosis of concussion.

A concussion is a brain injury that disrupts normal functioning. In recent years, experts have told coaches, players and parents that athletes should not return to play until a doctor evaluates them if a concussion is suspected.

In the new study, the athletes had more changes in white matter from the first measurement to the second, and most of these differences remained at the final measure, six months after play had stopped.

The lack of recovery could contribute to the white matter changes that accumulate over the years with repetitive head impacts, the researchers noted.

“We are obviously trying to understand, are these changes the beginning of this process?” Bazarian said. They also need to find out why some brains recover more quickly, he added.

“Inflammation may be at play,” Bazarian said. “If that’s the case, maybe it’s a case of preventing inflammation. Maybe more than six months of rest is needed.”

The researchers can’t say if the changes are “clinically meaningful,” Bazarian said. “We found no changes in balance or cognition.”

One expert noted there were some limitations to the study.

The findings are “very preliminary,” said Dr. John Kuluz, director of traumatic brain injury and neurorehabilitation at Miami Children’s Hospital. “It’s only a small number of athletes.”

Kuluz added that comparing football players to nonathletes was also not ideal. “It would have been much better having swimmers or track and field athletes, some sport where they are not hit on the head.”

The white matter changes, as the researchers noted, could have been due to physical exertion, not just the impacts to the head.

However, Bazarian said the findings raise questions about whether hits that fall short of concussions can still lead to neurological problems.

If the research bears out in future studies, one solution may be to take football players out of play when head impacts reach a certain number, to protect their brains.

Until more is known, athletes should pay attention to symptoms suggesting a concussion and get medical help if one is suspected. Headaches, trouble with concentration, sensitivity to light or sound and dizziness are common symptoms of a concussion.

Bazarian reports a pending patent on a method of diagnosing concussion.

The study was funded by the National Football League Charities.

More information

To learn more about concussions, visit the American Academy of Pediatrics.

Categories: Health & Fitness

Quarter of Prostate Cancer Patients May Abandon ‘Watchful Waiting’ Approach

Thu, 2014-04-17 09:37

By Dennis Thompson
HealthDay Reporter

THURSDAY, April 17, 2014 (HealthDay News) — Doctors often recommend no treatment at all when a man is diagnosed with prostate cancer, opting instead to keep a close eye on the slow-growing tumor and acting only when it becomes aggressive.

But a new, long-term European study says this strategy, called “active surveillance,” has a major flaw — if men don’t come back for regular checkups, doctors won’t be able to tell if their prostate cancer becomes life-threatening.

A quarter of prostate cancer patients participating in a Swiss active surveillance study didn’t bother showing up for their recommended appointments, lead researcher Dr. Lukas Hefermehl reported to the annual meeting of the European Association of Urology, held this month in Stockholm.

“These findings leave us with a practical and ethical dilemma,” Hefermehl, a urologist at Kantonsspital Baden, in Switzerland, said in an association news release. “We often recommend that men go onto an active surveillance program, but these results indicate that more than a quarter of men will disappear from the system.”

Active surveillance — also known as “watchful waiting” — is a pragmatic treatment strategy derived from two known facts about prostate cancer.

First, prostate cancer grows so slowly in most men that they are likely to die from other causes. Second, the surgery and radiation therapy used to treat prostate cancer often cause impotence, incontinence and other side effects that affect the man’s quality of life.

Prostate cancer is the most common cancer in American men other than skin cancer, according to the American Cancer Society, but the 15-year survival rate for prostate cancer is an impressive 94 percent.

As a result, many doctors have concluded it’s better to leave the prostate cancer alone and only act if it accelerates.

This new study followed 157 men during 13 years of active surveillance.

Researchers found that after 13 years, about 28 percent of all patients required treatment because their prostate cancer flared up. Nearly all the men were cured of their prostate cancer, with an overall group survival rate of 94 percent.

However, another 27 percent of the men in the study didn’t bother coming back for check-ups after being placed on active surveillance, leaving themselves potentially vulnerable to a prostate cancer flare-up.

Researchers also found that about 19 percent of the men refused to undergo a second biopsy three months after their diagnosis, to confirm the results of their first prostate cancer biopsy.

“We don’t know exactly what the reasons are,” Hefermehl said. “It may be that once the patient was told that this cancer is probably ‘not immediately threatening,’ he might downplay the importance of another test.

“On the other hand, some men might have real concerns about the risk of there being a more severe cancer,” he said. “Or it may be to do with the risk of incontinence or impotence after treatment, the idea of having cancer, a sense that nothing will really happen to them or it may be due to another reason which we just don’t know about.”

The study highlights the need for doctors to impress upon prostate cancer patients the importance of checkups, said Dr. David Samadi, chairman of urology at Lenox Hill Hospital, in New York City.

“The patient must be willing to have regular follow-ups that will consist of regular PSAs [blood tests for prostate-specific antigen], physicals and ultrasounds to closely watch if the cancer is progressing, resulting in long-term follow-ups with close surveillance,” Samadi said. “Compliance from the patient throughout the whole process is a must, as watchful waiting can lead to metastasis and spread to other organs.”

Dropout rates are probably even worse in the United States than in Switzerland, said Dr. Otis Brawley, chief medical officer for the American Cancer Society.

Men in the United States face more difficulty finding transportation to the doctor, may not be able to afford the co-pays required for each visit or might lose their insurance during active surveillance, Brawley said.

Prostate cancer patients also might put their condition on the back burner because they are facing other, more critical medical issues, or just don’t want to hassle with invasive probes on a regular basis, he said.

On the other hand, Brawley said, the new study actually is a success story for active surveillance, in that three-fourths of the men who kept their appointments never needed treatment.

“It’s a glass-half-full, glass-half-empty situation,” he said. “I look at the same data and say aha, there were a large proportion of men who stayed in follow-up and never got treated, and that’s good.”

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

For more about active surveillance of prostate cancer, visit the American Cancer Society.

Categories: Health & Fitness

Obesity Linked to Increased Odds of Losing Baby, Study Finds

Thu, 2014-04-17 08:15


By Steven Reinberg
HealthDay Reporter

THURSDAY, April 17, 2014 (HealthDay News) — Women who are overweight or obese when they get pregnant may be at increased risk for miscarriage, stillbirth or infant death, researchers say.

The danger is greatest for severely obese women, who appear to have about double or triple the risk of losing their baby, although that risk is still small, the study authors noted.

The findings, based on a review of previously published studies, underscore the need for women who plan pregnancy to try to maintain a healthy weight, the researchers suggested.

“As for women who are already pregnant, they should follow existing guidelines for weight gain during pregnancy,” said lead author Dagfinn Aune, from the department of epidemiology and biostatistics in the School of Public Health at Imperial College London in England.

“This analysis gives a better picture of the strength of the risks,” said Aune. “Although fetal and infant deaths are relatively rare in high-income countries, affecting about 0.5 percent of pregnancies, they are devastating for the parents that are affected.”

Moreover, overwhelming data shows that being overweight or obese increases the risk for type 2 diabetes, gestational diabetes, preeclampsia, high blood pressure and birth defects, Aune said.

“All of these conditions have been linked to increased stillbirth risk. Although we don’t know all the details of the molecular mechanisms, I think it’s likely that there is a biological effect of excess weight on these outcomes,” he said.

The report, published April 16 in the Journal of the American Medical Association, adds to existing concerns about the U.S. obesity epidemic.

Twenty years ago it was rare to see a woman who weighed 200 pounds, said Dr. Paul Cook, an obstetrician/gynecologist at Scott & White Specialty Clinic in Marble Falls, Texas.

“Flash forward to today and now it’s very common to see women at 250 pounds,” he said. “Right now, 85 percent of pregnant women in the U.S. are overweight or obese.”

Cook agrees overweight women need to get their weight down before conceiving.

“Sometimes these women aren’t counseled very frankly about their weight,” he said. “It can truly jeopardize both their health and the health of their baby.”

But if women don’t come for counseling before pregnancy, the opportunity to improve their health and their babies’ health is lost, Cook said.

For the study, Aune’s team analyzed 38 previously published studies that looked at the association between weight before and during early pregnancy, and death of the fetus or infant.

These studies included more than 10,000 miscarriages, over 16,200 stillbirths and more than 4,300 deaths near the time of birth. Nearly 11,300 deaths during the first month of life and just under 5,000 infant deaths later were also covered.

Overweight and obesity is determined by body mass index (BMI), a calculation based on height and weight. A woman 5 feet 2 inches tall who weighs 220 pounds has a BMI of 40, which is considered severely obese.

A woman of the same height who weighs 105 to 130 pounds would have a BMI between 19 and 24, which is considered normal weight. At 130 to 160 pounds, her BMI would be 25 to 29, which is considered overweight.

Even modest increases in the mother’s weight was linked to an increased risk of infant death, the researchers found. However, the link does not prove a cause-and-effect relationship.

And Aune added, the absolute risks are relatively low. The absolute risk for fetal death, which is the most common outcome, is 1 percent for obese women, he said. That risk rises with increasing weight, reaching 2.7 percent for severe obesity versus 0.76 percent for a BMI of 20, the study found.

“Still, we have to remember that overweight and obesity increase the risk of a number of other more common pregnancy complications and many other diseases as well,” he said.

Much is still unknown about weight and pregnancy, Aune added. “We need more data regarding the optimal gestational weight gain in relation to stillbirths,” he said.

More information

For more information on pregnancy complications, visit the U.S. Centers for Disease Control and Prevention.

Categories: Health & Fitness

Sleep Apnea May Be Linked to Poor Bone Health

Thu, 2014-04-17 08:00


THURSDAY, April 17, 2014 (HealthDay News) — People with sleep apnea, a common sleep disorder, may be at increased risk for the bone-thinning disease osteoporosis, especially women and older people, a new study suggests.

Sleep apnea causes repeated, brief interruptions in breathing during sleep. Untreated sleep apnea can increase a person’s risk of heart disease, heart attack and stroke.

“Ongoing sleep disruptions caused by obstructive sleep apnea can harm many of the body’s systems, including the skeletal system,” said study co-author Dr. Kai-Jen Tien, of Chi Mei Medical Center in Tainan, Taiwan.

“When sleep apnea periodically deprives the body of oxygen, it can weaken bones and raise the risk of osteoporosis,” Tien said. “The progressive condition can lead to bone fractures, increased medical costs, reduced quality of life and even death.”

For the study, published April 15 in the Journal of Clinical Endocrinology & Metabolism, researchers analyzed the medical records of nearly 1,400 people in Taiwan diagnosed with obstructive sleep apnea between 2000 and 2008. They compared them with more than 20,600 people who did not have the sleep disorder.

Over six years of follow-up, people with sleep apnea were 2.7 times more likely to be diagnosed with osteoporosis. The risk for the bone-thinning disease was highest among women and older people with sleep apnea, according to the study.

“As more and more people are diagnosed with obstructive sleep apnea worldwide, both patients and health care providers need to be aware of the heightened risk of developing other conditions,” Tien said in a journal news release. “We need to pay more attention to the relationship between sleep apnea and bone health so we can identify strategies to prevent osteoporosis.”

However, the study only noted an association between sleep apnea and osteoporosis. It does not prove that one causes the other.

More information

The U.S. National Heart, Lung, and Blood Institute has more about sleep apnea.

Categories: Health & Fitness

School Bans on Chocolate Milk May Backfire

Thu, 2014-04-17 06:37

THURSDAY, April 17, 2014 (HealthDay News) — Banning chocolate milk from schools may sound like a good move for kids’ health, but efforts to do so haven’t turned out that way, a small study found.

Bans on chocolate milk in 11 Oregon elementary schools were linked to a big drop in the amount of healthy, fat-free white milk students drank, a team of Cornell University researchers reports.

Nicole Zammit, former assistant director of nutrition services at the Eugene School District in Oregon, wasn’t surprised by the findings.

“Given that the role of the federal school meal program is to provide nutritious meals to students who may otherwise have no access to healthy foods, I wouldn’t recommend banning flavored milk unless you have a comprehensive plan in place to compensate for the lost nutrients when kids stop drinking milk altogether,” she said in a Cornell news release.

In the study, researchers analyzed data from 11 Oregon elementary schools that outlawed chocolate milk and replaced it with skim milk. While the bans meant children could no longer get the added sugar found in chocolate milk, there were unexpected consequences.

Total milk sales at the schools fell by 10 percent, the study showed, and students ended up wasting 29 percent more milk than before. And while the students consumed less sugar and fewer calories, their intake of calcium and protein also fell.

After the chocolate milk bans took effect, there was a also 7 percent decrease in the number of students taking part in the Eugene School District’s lunch program, according to the researchers at Cornell University’s Center for Behavioral Economics in Child Nutrition Programs.

“There are other ways to encourage kids to select white milk without banning the chocolate,” study co-author Brian Wansink, director of the Cornell Food and Brand Lab, said in the news release.

“Make white milk appear more convenient and more normal to select,” he said. “Two quick and easy solutions are: Put the white milk in the front of the cooler and make sure that at least 1/3 to 1/2 of all the milk is white.”

More information

The U.S. National Library of Medicine has more about child nutrition.

Categories: Health & Fitness

Mouse Study Reveals New Secrets of Fertilization

Thu, 2014-04-17 06:37

By Maureen Salamon
HealthDay Reporter

THURSDAY, April 17, 2014 (HealthDay News) — Scientists report they have demystified how a sperm and egg couple, with new research in mice indicating that egg cells carry a special receptor that allows sperm to attach to and fertilize eggs.

The British study, published online April 16 in the journal Nature, may offer new ways to improve both fertility treatments and contraceptives in people, with experts saying that human eggs also have protein receptors crucial to the meeting of sperm and egg.

A similar protein receptor was found on sperm in 2005 by Japanese researchers, who dubbed it Izumo1 after a Japanese marriage shrine. The newly discovered egg receptor has been named Juno after the Roman goddess of fertility and marriage.

“The finding that the interaction between Izumo and Juno is essential for fertilization was, in a way, surprising,” said study author Gavin Wright, group leader of the Cell Surface Signalling Laboratory at the Wellcome Trust Sanger Institute, a genome research institute in the United Kingdom.

“One might have expected that something as fundamental as fertilization would not rely on a single critical interaction; if there’s anything wrong with Izumo in males, or Juno in females, then infertility results,” Wright added.

About one in eight American couples suffers from infertility, defined as being unable to conceive after one year of unprotected sex, according to the infertility association RESOLVE. The problem may be due to male or female factors such as low sperm count or ovulation disorders, among other issues.

But even when infertility is treated with measures such as in vitro fertilization, where a couple’s sperm and eggs are mixed in a petri dish, fertilization will still sometimes fail to take place unless a sperm cell is injected into the egg in a procedure known as intracytoplasmic sperm injection (ICSI).

Wright said this problem may be due to a faulty or absent receptor on egg or sperm cells, as evidenced by his new research.

“Our results would suggest that by using a simple and noninvasive genetic screening test, infertile women could be tested to see if they have a correct Juno gene,” he said. “If they don’t, their fertility treatment can be guided by proceeding directly to ICSI, saving them expense and trouble.”

Wright and his team built on the Japanese Izumo1 research, creating an artificial version of the Izumo protein and using it to identify binding partners on the surface of mice eggs. Using this method, they learned that Izumo1 on the sperm paired with Juno on the egg to induce fertilization.

The researchers also developed mice that lacked the Juno protein on their egg surface, finding these mice to be infertile and incapable of fusing with normal sperm. Similarly, male mice lacking the Izumo sperm protein are also infertile, highlighting the vital roles of the receptors to fertility.

An interesting feature of the Juno egg receptor, Wright said, is that it disappears within about 40 minutes after an egg is fertilized.

“We believe this is one of the ways in which eggs ensure that they fuse with one and only one sperm,” he said. “That is, once the first sperm has fertilized the egg, the egg shuts down its ability to recognize additional sperm, ensuring that the fertilized egg doesn’t contain too many chromosomes, which would result in a non-viable embryo.”

Dr. Michael Heard, a reproductive endocrinologist at Houston Methodist Hospital in Texas, lauded the new research as “very interesting” and said the findings hold promise for future fertility treatments and contraceptives.

“A male contraceptive is still on the back burner. If they could inhibit those [Izumo1 sperm] receptors so they wouldn’t fertilize the eggs at all, with a high percentage of reliability, that would be great,” said Heard, who wasn’t involved in the study.

Scientists note that research involving animals often fails to provide similar results in humans.

More information

The American Society for Reproductive Medicine has more about infertility.

Categories: Health & Fitness