If you thought the details of Joan Rivers’ death from complications during a routine endoscopy couldn’t get any more shocking, you’re wrong: Rumors surfaced today that Dr. Lawrence Cohen, the gastroenterologist who performed the procedure, allegedly snapped a selfie of himself and the unconscious comedian just moments before the procedure.
Outrageous? Absolutely. Infuriating? For sure. But this kind of—questionable would be the kind way to put it—behavior isn’t as uncommon as you might think. Get a gander at some other examples of physicians, nurses, and even a couple of clueless medical students gone wild over the past several years. (Trust us: The plotlines of Grey’s Anatomy have nothing on these.)
*In 1999, a New York City surgeon carved his initials (a large A Z, if you’re interested) into the belly of a patient after he performed a Caesarean section.
Adding insult to injury: The District Attorney’s office had received complaints about complaints about “Dr. Zorro” (as he came to be known) for at least seven years before the incident—with two dozen patients and fellow practitioners citing incidents they described as “dangerous” and “weird.”
*In 2010, a nurse injected herself with a painkiller meant for a patient who was prepped for kidney stone surgery.
Adding insult to injury: While filling herself full of meds, she advised the distraught guy to “man up” and “go to your beach…go to your happy place.”
*In 2000, a surgeon left in the middle of surgery to run to the bank and cash his paycheck.
Adding insult to injury: He told his stunned OR team that he’d be back in about five minutes; he returned 35 minutes later.
*A married doctor attacked his pregnant lover in 2000 with a syringe—reportedly shouting, “I am going to give you an abortion!”.
Adding insult to injury: After his dastardly deed, the MD still had the presence of mind to deposit the empty syringe into a medical waste container at a nearby hospital.
*In 2002, a New Jersey medical student presented his girlfriend with the hand of a cadaver that was scheduled to be cremated.
Adding insult to injury: The severed appendage was later found sitting in a jar in the apartment of the aforementioned lover, a local exotic dancer.
*An Ann Arbor pediatrician was charged in 2011 with looking out of the window of his home and watching his neighbor, a 12-year-old girl, change her clothes.
Adding insult to injury: The girl was a patient of the doctor since birth.
*In 2010, a medical student posted a photo on Facebook of a classmate posing next to a dead body during an anatomy class, smiling and giving a thumbs-up sign.
Adding insult to injury: Did we mention that the student was smiling and giving a thumbs-up sign?
*Two Wisconsin nurses were fired in 2009 after taking snaps of an X-ray—showing an object lodged in a patient’s rectum—and posting them to Facebook.
Adding insult to injury: According to the police, the nurses took the photos after learning that said object was a sexual device.
*After being handed a device that wasn’t working properly during a complicated operation, a surgeon lost her cool—big time.
Adding insult to injury: During her 2011 tirade, the doc slammed the device down, accidentally breaking a technician’s finger.
*In 2009, a Texas doctor persuaded a county sheriff to go after two nurses who had accused him of unethical practices.
Adding insult to injury: Those unethical practices included using his office to run an herbal remedies business.
You’re so over your job: the endless stream of emails, catty coworkers, unpaid overtime—the reasons go on and on. But a new study published in the journal Social Psychiatry and Psychiatric Epidemiology found it’s not only office problems that wear you down (though on-the-job factors can definitely affect you, too). Here, three other things that may be causing your work burnout:You’re not getting enough support at home
Feel like you can’t vent to your partner about your day? Turns out having an understanding significant other is just as important as having a supportive boss in preventing work burnout, the Canadian researchers found. If you feel like your partner doesn’t get where you’re coming from, be it at work or at home, have a sit-down with them and talk about how a little listening can go a long way.
And we’re not talking about Facebook. People who had the support of a social network outside the office had fewer mental health issues associated with job burnout, the study also found. So take the time to meet with your friends for coffee or a drink after work, even if you’re not in the mood after long day. And if most of your friends are your officemates, consider joining a social group that syncs with a hobby or pastime (think hiking or reading) that’s well-removed from your work social circle.You’re not taking a lunch break
Well, at least not away from your desk. A separate study from the University of Toronto found that skipping your lunch break can make you less motivated and less productive. Researchers say this habit can drain your psychological energy by lunchtime and doesn’t give you time to recharge. So while you may think you’re being an office star by eating your salad at your desk, you may actually feel more sluggish and get less done (potentially leading to later nights on the job). A survey by tech company the Draugiem Group takes it one step further: They found the most productive people got up once every 52 minutes (for 17-minute breaks, but that seems like a bit much). Try starting with an actual lunch break, and go from there.
WEDNESDAY, Sept. 17, 2014 (HealthDay News) — Social networking sites can help people lose weight, according to a new study.
For people who are obese, sites like Twitter and Facebook can be an inexpensive and convenient source of support from doctors as well as peers, researchers found.
“One advantage of using social media over other methods is that it offers the potential to be much more cost effective and practical for day-to-day use when compared to traditional approaches,” the study’s lead author, Dr. Hutan Ashrafian, a health policy researcher at Imperial College London, said in a university news release.
“The feeling of being part of a community allows patients to draw on the support of their peers as well as clinicians. They can get advice from their doctor without the inconvenience or cost of having to travel, and clinicians can provide advice to many patients simultaneously,” Ashrafian, who is also a surgeon at the college, said.
The study’s authors examined the results of 12 previous studies involving almost 1,900 people in the United States, Europe, east Asia and Australia. They found that the people who used social networking sites to lose weight had a modest but significant decrease in body mass index.
“The use of social media to treat obesity encourages patients to be more pro-active and empowers them to contribute towards their own treatment. It’s not the only solution to the obesity epidemic, but it should be introduced as an element of every country’s obesity strategy.” Ashrafian noted.
The study, written for the World Innovation Summit for Health and published in the Sept. 8 issue of Health Affairs, pointed out that social networking may not be a good option for all overweight people trying to lose weight.
“There are also possible downsides, such as potential privacy issues and a need for the patient to be Internet savvy, so it may not be right for everyone,” Ashrafian explained.
“The studies we looked at were the first to investigate social media approaches to obesity. There needs to be more research into this area to see what approaches work best for which patients in light of the dramatic global adoption of social media tools and content,” said Ashrafian.
Obesity is a global health issue, contributing to other chronic conditions such as diabetes, heart disease, cancer and mental health issues.
The U.S. National Heart, Lung and Blood Institute has more on treatments for obesity.
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My dad used to heat a sauté pan so hot that I thought the handle would fall right off. He would put it on the burner and leave it there, over low heat, for about 15–20 minutes. While a completely silent process, I remember feeling as if the pan was “screaming” hot. He would calmly season the steak with salt and black pepper on both sides, shut off the heat under the pan and gently drop it in.
We would have a ribeye every once in a while, but my dad is a London broil and hanger steak guy. Those cuts, while not the most tender, are so delicious when seared over high heat and sliced against their “grain” to increase tenderness. And, while all beef is expensive, hanger and London broil are more affordable.
To go with my steak, I love a simple little sauce—made right in the same pan—with any drippings from the cooking stirred together and poured over the steak. These are the kinds of recipes that don’t require a lot of ingredients but really resonate with people.
It’s also a “one pan” meal, which I like. It’s amazing how spoiled I get having a dishwasher at the restaurant. When cooking at home for my hungry daughter, I try my best to make tasty food and keep the dish washing to a minimum. My dad once told me that his parents would have guests over for dinner and his mother would spend the whole night cooking and cleaning. By the time she came out of the kitchen, her guests would be ready to leave!
I’d rather cook something great and then spend my time eating it with my daughter or friends. I’d imagine you feel the same way. You want that kind of dish where someone takes a bite and stops for a minute to look down at the food and then up at you. Because it tastes so good.Check out the recipe for Alex Guarnaschelli’s Perfect Steak at PEOPLE Great Ideas. PEOPLE Great Ideas is the ultimate source for the latest entertainment food news, plus exclusive recipes, decorating ideas, travel tips, videos and more from your favorite stars and celebrity chefs. Get more information at PEOPLE Great Ideas.
Get off your butt: Sitting less can help slow your body’s aging process, finds a new study in the British Journal of Sports Medicine. I read about it during my train commute. I hadn’t gotten a seat—but suddenly, that was a good thing.
Researchers have long known sitting isn’t good for your health—but now they’ve figured out why, reports The New York Times. Swedish scientists found that in a group of study subjects, those who sat for the least amount of time had longer telomeres—itty-bitty caps on the ends of DNA strands that shorten as cells age. Obesity and illness can speed up their shrinkage, while healthier lifestyles may help maintain their length.
At work, I can happily remain glued to a computer screen for hours on end. Forget my poor telomeres; this has wreaked havoc on my neck, my lower back, and my waistline. Over the years, I’ve come up with strategies to help me be less sedentary when I’m at my desk:
• I set an alarm on my Stand App to go off every hour and remind me to get moving. The app also includes a bunch of desk exercises that I never bother to do but, hey, at least I’m getting up.
• When I read something really interesting, or want to tell a colleague something about a work project, I’ll jump up to discuss it with them in person instead of emailing. Bonus points for face time!
• If I head to the bathroom, I do a loop around the entire office.
• At lunchtime, I force myself to head outside instead of just hitting the cafeteria.
• Every once in a while, I turn on my Pandora Katy Perry Radio station, jump on my desk and dance!
Well, OK, not that. My tactics may not be exciting, but they work. You’re welcome, telomeres.
Want some crowd-sourced inspiration to get moving? Commit to doing a quickie exercise every day, take a picture or video and post it to Instagram, Facebook, or Twitter with the hashtag #StandUpforHealth. Follow us at instagram.com/healthmagazine.
WEDNESDAY, Sept. 17, 2014 (HealthDay News) — A blood test that measures DNA from a prostate cancer tumor could provide doctors with a better assessment of the state of a man’s disease, a new study suggests.
If used routinely, this blood test could reveal when treatment for advanced prostate cancer stops working and actually begins promoting tumor growth, the researchers suggested.
“Our study showed that a steroid treatment given to patients with advanced prostate cancer and often initially very effective started to activate harmful mutations and coincided with the cancer starting to grow again,” study leader Dr. Gerhardt Attard, from the Institute of Cancer Research (ICR) in London, explained in an ICR news release.
“In the future, we hope to routinely monitor genetic mutations in patients with advanced disease using just a blood test — enabling us to stop treatments when they become disease drivers and select the next best treatment option. We need to confirm these findings in larger numbers of patients, but using these types of blood tests could allow true personalization of treatment for prostate cancer patients, based on the cancer mutations we detect,” he explained.
Using a blood test to measure circulating tumor DNA levels is less expensive and less invasive than needle biopsies. This test could be an effective way to monitor the emergence of treatment-resistant prostate cancer, the study published on Sept. 17 in Science Translational Medicine suggested.
“Drug resistance is the single biggest challenge we face in cancer research and treatment, and we are just beginning to understand how its development is driven by evolutionary pressures on tumors,” Paul Workman, interim chief executive at the ICR, said in the news release.
This discovery “reveals how some cancer treatments can actually favor the survival of the nastiest cancer cells, and sets out the rationale for repeated monitoring of patients using blood tests, in order to track and intervene in the evolution of their cancers,” Workman said.
“There are currently too few treatment options for men living with advanced stage prostate cancer. Not only do we desperately need to find more treatments for this group of men, we also need to understand more about when those that are available stop working and why,” Dr. Matthew Hobbs, deputy director of research at Prostate Cancer UK, said in the news release.
“This research is important as it shows that there might be a new way to monitor how a man’s cancer is changing during treatment, and that could help us to pinpoint the stage at which some drugs stop being effective. In the future, this could arm doctors with the knowledge they need to ensure that no time is wasted between a drug that stops working for a man and him moving on to another effective treatment,” Hobbs said.
But, Hobbs also noted that this is preliminary research and that the study size was small — just 16 men. He agreed with Attard that the findings need to be confirmed in a larger study.
The researchers cautioned that any patients currently taking medication for advanced prostate cancer should continue to take their medications as prescribed and discuss any concerns about their treatment with their doctor.
The U.S. National Cancer Institute provides more information on prostate cancer.
By Randy Dotinga
WEDNESDAY, Sept. 17, 2014 (HealthDay News) — Women who have the largest number of post-traumatic stress disorder symptoms are almost three times more likely to develop an addiction to food, a new study suggests.
The findings don’t prove a direct link between PTSD and women overeating or becoming addicted to food. And it’s also possible that certain women are prone to food addiction and experiencing trauma, PTSD, or both.
Still, the research seems to add to existing evidence connecting PTSD to overeating and obesity, although the overall risk is fairly low, the researchers from the University of Minnesota said.
The findings can be helpful, said the study’s lead author, Susan Mason, an assistant professor with the university’s division of epidemiology and community health. “If clinicians providing mental health care are aware that PTSD is sometimes accompanied by problematic eating behaviors, then they may be able to offer better and more tailored care to their patients,” she said.
PTSD is an anxiety disorder that develops in some people after they experience a horrific event, like a natural disaster, violence or warfare. Those with PTSD may become endlessly vigilant, have a difficult-to- impossible time relaxing, and can develop flashbacks, nightmares and severe anxiety.
Previous research has linked PTSD to higher rates of obesity and being underweight, Mason said, along with addiction problems. It’s difficult for researchers to figure out exactly what’s going on, however, because they can’t use the gold standard of research, a clinical trial, to examine a possible connection. It would be unethical — and probably impossible — to randomly assign some people to develop PTSD and then compare them to healthy people.
In the new study, researchers tried to get a handle on possible connections between PTSD and food addiction.
Food addiction is defined as a kind of psychological dependence on food, with symptoms like other kinds of addictions. For instance, physical withdrawal if those with the disorder stop eating certain foods, using food to make them feel better and eating when they don’t need to.
Mason said she wasn’t aware of research pinpointing how many people suffer from food addiction.
The researchers examined the results of Nurses’ Health Study II surveys of more than 49,400 female nurses in the United States in 2008 and 2009. The women joined the study in 1989 when they were 25 to 42 years old.
According to Mason, the researchers found that 6 percent of the one-third of women who had no signs of PTSD showed signs of food addiction. Of the 10 percent of women who had the most symptoms — 6 to 7 on a 7-symptom PTSD screening questionnaire — nearly 18 percent had a food addiction.
The researchers noted two things: Nurses reported their most common trauma experience was treating individuals with traumatic injuries, and early onset of symptoms predicted a higher prevalence of food addiction.
Why do these numbers matter? “It is a big deal if a substantial proportion of women are feeling highly distressed or feel that their functioning is being undermined by their relationship with food,” Mason said.
Still, she said it’s not clear how all this is connected to obesity. The nurses in the study who seem to be addicted to food “are substantially heavier than women who do not meet those criteria, but we don’t yet know whether the food addiction causes obesity, or the other way around, or if the two things are both caused by some underlying factor we don’t know about.”
Dr. Timothy Brewerton, executive medical director with The Hearth Center for Eating Disorders in Columbia, S.C., praised the research. “This study represents a major advance in validating the concept of food addiction, and in linking food addiction with trauma and PTSD,” he said.
He noted that the study adds support for the idea that food addiction is real — “there are a lot of naysayers in the eating disorders community in regard to the existence of food addiction”– and suggests that trauma and PTSD could be a cause. “The greater the number of PTSD symptoms, the greater the probability of food addiction,” he said.
As for future research, Mason said researchers want to look at larger groups of people to see if the connection holds up.
The study appears in the Sept. 17 issue of JAMA Psychiatry.
For more about PTSD, visit the National Center for PTSD.
By Maureen Salamon
WEDNESDAY, Sept. 17, 2014 (HealthDay News) — Migraines in midlife may be associated with increased odds of developing Parkinson’s disease or other movement disorders in later years, new research suggests.
The study, which did not prove a cause-and-effect link between the two brain-based conditions, also suggested that the migraine-Parkinson’s association was stronger in women with migraines preceded by aura. An aura is a warning sign of a pending attack that includes flashes of light and skin tingling.
“We should emphasize that while the risk is increased for Parkinson’s disease and these [similar] symptoms, they’re still uncommon among those with migraine,” said study author Ann Scher, a professor of epidemiology at Uniformed Services University in Bethesda, Md. “I don’t think people should necessarily worry that if they have migraines, Parkinson’s disease is [in their future].”
The research is published in the Sept. 17 online edition of the journal Neurology.
Throbbing, chronic headaches that impact about 28 million Americans aged 12 and up, migraines affect three times as many women as men, according to the American Headache Society.
Meanwhile, about 1 million people in the United States have Parkinson’s disease and up to 60,000 more are diagnosed each year, according to the National Parkinson Foundation. The incurable neurological condition causes tremors, stiffness, slow movement, and impaired balance and coordination.
Scher and her colleagues reviewed records of more than 5,600 Icelandic people aged 33 to 65 who were tracked for 25 years. At the study’s start, about 4,000 participants had no headaches, with 1,028 suffering non-migraine headaches, 238 migraine with no aura and 430 migraine with aura.
In later life, participants were asked whether they’d been diagnosed with Parkinson’s or experienced symptoms; had a family history of Parkinson’s; or had symptoms of restless legs syndrome, a movement disorder characterized by uncomfortable leg sensations and an irresistible urge to move the legs.
The findings showed that those with migraine with aura at midlife were more than twice as likely to have been later diagnosed with Parkinson’s than people with no headaches. Those with migraine with aura were 3.6 times as likely to report four of six parkinsonian symptoms, while those with migraine with no aura were 2.3 times more likely. Overall, the study found nearly 20 percent of those with migraine with aura had symptoms, compared to 12.6 percent of those with migraine with no aura and 7.5 percent of those with no headaches.
Both Parkinson’s disease and restless legs syndrome involve a dysfunction in the brain chemical dopamine, Scher said, and migraine development is also thought to be associated with dopamine abnormalities. Future research should examine whether Parkinson’s and migraine share genetic risk factors, she added.
“Previous studies noted that migraine, particularly migraine with aura, was linked to cardiovascular disease and stroke, so there’s increasing interest in whether these linkages might manifest in other neurological symptoms later in life,” Scher said.
Dr. Michael Okun, national medical director of the National Parkinson Foundation, called the new research “interesting.” But he said it had several notable weaknesses, including that its participants were only from the Icelandic region and that some patients reporting Parkinson’s symptoms had not been formally diagnosed with the disorder.
“The idea that a history of migraine headaches has something to do with Parkinson’s is intriguing, but there’s not a lot of scientific data right now that would support that notion,” said Okun, also co-director of the Movement Disorders Center at the University of Florida. “I’d be extremely cautious to conclude that migraine is associated with Parkinson’s.”
The U.S. National Library of Medicine has more about Parkinson’s disease.
WEDNESDAY, Sept. 17, 2014 (HealthDay News) — Positive messages about the health benefits of quitting smoking may help some people kick the habit, a new study suggests.
Although smokers who think quitting will be difficult responded better to “loss-framed” messages about the harmful effects of smoking, researchers found smokers who believe they can quit whenever they want benefit more from “gain-framed,” or positive, messages about how quitting will improve their health.
The researchers concluded that using a mix of both types of messages might get more people to stop smoking.
“This study shows us that leveraging both gain- and loss-framed messaging may prompt more smokers to quit,” lead investigator Darren Mays, a population scientist at Georgetown Lombardi Comprehensive Cancer Center, said in a university news release.
Most tobacco warnings on cigarette packages in the United States and around the world are “loss-framed” messages. The researchers cautioned that these statements may not convince many smokers to quit.
The 2009 Family Smoking Prevention and Tobacco Control Act authorized the U.S. Food and Drug Administration to regulate tobacco products. The law also required new picture labels to be posted on the labels of cigarette packs.
However, implementation of this legislation has been delayed by lawsuits from the tobacco industry. Because its nine proposed graphic label warnings were struck down in court in 2012, the FDA is pursuing more research to support these graphic warning label requirements.
The study, published Sept. 15 in Nicotine & Tobacco Research, involved 740 participants. The researchers examined the effects of four images: a man using a device to help him breathe; a healthy lung next to a diseased lung; a man lying on a white sheet with stitches on his chest, and a mouth ravaged by cancer. These images had either “loss-framed” or “gain-framed” messages.
“Gain-framed” messages stressed the health benefits of quitting, such as a reduced risk of death from tobacco. Meanwhile, “loss-framed” messages emphasized negative outcomes from smoking, such as increased risk of death.
The American Cancer Society-supported study found each image was effective. The researchers said their findings could provide additional evidence for new graphic warnings proposed for U.S. cigarette packages.
“Leveraging policies such as graphic warnings for cigarette packs to help smokers quit is critical to improve public health outcomes,” concluded Mays. “Our study shows that framing messages to address smokers’ pre-existing attitudes and beliefs may help achieve this goal.”
The U.S. Centers for Disease Control and Prevention provides more information on ways to quit smoking.
Americans are losing the battle with belly fat. The average waist circumference of U.S. adults increased by more than an inch (from 37.6 inches to 38.8 inches) since 2000, according to a new study in the Journal of the American Medical Association. And, sadly, when researchers looked at certain groups, researchers found that young women saw especially big gains, according to the Los Angeles Times: African American women in their 30s saw their average waist size grow by nearly 4.6 inches, and white women in their 40s added an average of 2.6 inches to their waists. Overall, women’s waistlines grew twice as much as men’s.
So what’s the big deal? Sadly, belly fat isn’t just bad news when it comes to fitting into your clothes, it’s a big issue for your long-term health. Here, 3 reasons to work on shedding it.It’s worse than other types of fat
Whereas fat stored in say, your thighs, just sits there, the fat stored in your midsection (called visceral fat) is “biologically active,” according to Harvard Medical School. In fact, experts think of it more like an extra organ or gland because it produces hormones that can affect your health, especially those related to appetite and metabolism, like adiponectin and leptin. Visceral fat also increases your risk for type 2 diabetes (excess fat interferes with blood sugar-regulating insulin) and lung problems (less room in the chest means decreased lung function).It hurts your heart
Visceral fat also pumps out cytokines, proteins normally associated with the immune system, which can up your risk for heart disease by promoting constant low-level inflammation and insulin resistance. Fatty acids released by belly fat are also linked to higher LDL or “bad” cholesterol and lower HDL or “good” cholesterol. Worth repeating: heart disease remains the number one killer of American women.It ups your breast cancer risk
Being obese or overweight in general can up your risk for breast cancer because body fat produces the hormone estrogen, which feeds breast cancer cells. But abdominal fat in particular has its own risks: Pre-menopausal women with a large waist are more likely to develop breast cancer that is estrogen receptor (ER)-negative, according to a study in the Journal of the National Cancer Institute. (ER-negative means that estrogen doesn’t stimulate growth of the cancer.)
Ready to tackle your waistline? Check out these tips:
By Steven Reinberg
WEDNESDAY, Sept. 17, 2014 (HealthDay News) — Scientists have uncovered a key factor to explain why antibiotic-resistant bacteria can thrive in a hospital setting.
Tiny circles of DNA called plasmids appear to be the culprit. They can easily enter bacteria and move from one bacteria to another, and some carry a gene that makes bacteria drug-resistant, a new study finds.
“The plasmids we are talking about carry an antibiotic-resistant gene to a class of antibiotic called carbapenems,” said the study’s co-author, Dr. Tara Palmore, an infection control specialist at the U.S. National Institutes of Health.
Carbapenems are antibiotics of last resort, and carbapenem-resistant Enterobacteriaceae (CRE) are bacterial pathogens that pose a “formidable” threat to hospitalized patients, according to the research.
The incidence of CRE has quadrupled in the last decade in the United States, according to background information in the report. CRE has been detected in nearly 4 percent of hospitals and about 18 percent of long-term acute care facilities. In addition, the researchers noted, CRE are resistant to most, if not all, antibiotics. Investigations have reported a death rate of 40 percent to 80 percent from infection.
Given ongoing concerns that even bacteria like Klebsiella and Enterobacter — which are found in the environment and in healthy stomachs — are becoming increasingly resistant to last-resort antibiotics, the researchers set out to find some answers. Their report, published Sept. 17 in Science Translational Medicine, showed that plasmid transfer in hospitals is likely contributing to the increase in antibiotic-resistant bacteria.
Using advanced DNA sequencing of samples from more than 1,000 patients, the researchers were able to see the complete genome of bacteria samples and identify the antibiotic-resistant genes — plasmids — located in those samples.
Plasmids can multiply independently and integrate their DNA with the DNA of the bacteria. And plasmids that have the gene that inactivates certain antibiotics can be transferred to bacteria of various types, the scientists found.
Over the course of two years, the researchers identified 10 patients seen at the U.S. National Institutes of Health Clinical Center who had resistance to carbapenems.
The investigators also found antibiotic-resistant genes in tiny collections of organisms called biofilms living in hospital sink drains in patient rooms.
This finding did not show that bacteria from the sink drain were passed to any patient, the study authors said.
But even though patients who carry this bacteria may not be sick themselves, they can pass this drug-resistant bacteria to others, they added.
Study co-author Julie Segre, chief and senior investigator at the U.S. National Human Genome Research Institute, noted, “We are trying to reinforce the message that these drug-resistant bacteria can’t become so prevalent that we can no longer control them.”
And she emphasized, “We are still at the point where we can make a difference in terms of controlling the bacteria.”
However, Palmore said, knowing how bacteria become drug-resistant doesn’t change how preventing its spread is carried out.
“It informs us of how bacteria can pick up the resistance,” Palmore said. “Efforts to control these bacteria need to focus on containing them by isolating patients who are carriers of the bacteria and also by disinfecting the hospital environment where the bacteria might live.”
Victoria Richards, an associate professor of medical sciences at the Frank H. Netter MD School of Medicine at Quinnipiac University in North Haven, Conn., was not involved with the study but was familiar with the findings. She said, “Bacteria don’t want to be killed. When we try to kill them with antibiotics, they are going to fight back. It’s an ongoing battle.”
Dr. Marc Siegel, an associate professor of medicine at NYU Langone Medical Center in New York City, another expert who was not involved in the study, said, “Carbapenems are the best we have. So if you’ve got carbapenem-resistance, there is nowhere else for us to go. We don’t have a secret treatment up our sleeves.”
Siegel thinks that drug companies need to create new antibiotics, which doctors would then need to use more cautiously. In addition, he added, hospitals need to be doing a better job with disinfectants.
For more on antibiotic resistance, visit the U.S. Centers for Disease Control and Prevention.
WEDNESDAY, Sept. 17, 2014 (HealthDay News) — Managing diabetes, quitting smoking, controlling high blood pressure, exercising and maintaining a healthy weight can reduce the risk for dementia — even late in life, according to new research.
The World Alzheimer Report 2014, commissioned by Alzheimer’s Disease International, revealed that diabetes can increase the risk of dementia by 50 percent. The study noted that obesity and an inactive lifestyle are key risk factors for diabetes as well as high blood pressure.
The researchers suggested that dementia should be included in national public health prevention and detection programs along with other major non-communicable diseases, such as cancer and heart disease. They pointed out that it’s never too late in life to make healthy lifestyle changes.
“While age and genetics are part of the disease’s risk factors, not smoking, eating more healthily, getting some exercise, and having a good education, coupled with challenging your brain to ensure it is kept active, can all play a part in minimizing your chances of developing dementia,” Graham Stokes, global director of dementia care at the international health care group Bupa, said in a news release from King’s College London in England.
“People who already have dementia, or signs of it, can also do these things, which may help to slow the progression of the disease,” Stokes added.
A team of researchers, led by Martin Prince, a professor at King’s College London’s Institute of Psychiatry, Psychology and Neuroscience, found that quitting smoking had a strong link with a reduced risk for developing dementia.
The report, published on the Alzheimer’s Disease International website in advance of World Alzheimer’s Day on Sept. 21, found that among people aged 65 and older, former smokers have a dementia risk that is similar to never-smokers. In contrast, current smokers are at much higher risk for this mental decline.
People with more education are also at lower risk for dementia. Although education doesn’t affect the brain changes that lead to dementia, it can reduce their impact on brain function, the researchers explained.
Changes in the brain can begin long before symptoms develop. The investigators concluded that growing older with a stimulated and healthy brain can help people live longer, more independent lives.
Although survey data from Bupa has shown that many people are worried about developing dementia, few know about some specific steps that can help reduce their risk, including being socially active with friends and family, losing weight and exercising.
“There is already evidence from several studies that the incidence of dementia may be falling in high-income countries, linked to improvements in education and cardiovascular health,” Prince said in the news release. “We need to do all we can to accentuate these trends. With a global cost of over $600 billion, the stakes could hardly be higher.”
And, added Marc Wortmann, executive director of Alzheimer’s Disease International, “From a public health perspective, it is important to note that most of the risk factors for dementia overlap with those for the other major non-communicable diseases.”
Wortmann explained in the news release that “in high-income countries, there is an increased focus on healthier lifestyles, but this is not always the case with lower- and middle-income countries. By 2050, we estimate that 71 percent of people living with dementia will live in these regions, so implementing effective public health campaigns may help to reduce the global risk.”
The U.S. National Library of Medicine has more about dementia.
By Dennis Thompson
WEDNESDAY, Sept. 17, 2014 (HealthDay News) — Diabetics and dieters who turn to artificial sweeteners to soothe their sweet tooth may not be doing themselves any favors, a new Israeli study suggests.
Artificial sweeteners can potentially make blood sugar levels rise despite containing no calories, researchers found in human and mouse studies.
That’s because saccharine and its counterparts appear to alter the bacteria residing in the intestines in ways that can impair some people’s ability to process glucose, the researchers report in the Sept. 17 issue of Nature. That means rather than helping the current epidemics of obesity and type 2 diabetes in the United States, artificial sweeteners could potentially be contributing to the problem, according to the study.
The researchers found that mice fed artificial sweeteners developed higher blood sugar levels compared to mice drinking plain water or even water laced with sugar.
They further found that they could bring the mice’s blood sugar levels back to normal by treating them with antibiotics. And, they could induce higher blood sugar levels in healthy mice never exposed to artificial sweeteners by transplanting gut bacteria from mice who had been fed saccharine.
Turning to a group of nearly 400 people, the researchers found that long-term users of artificial sweeteners were more likely to have higher fasting blood sugar levels. They were also more likely to have signs of impaired glucose processing, compared with people who don’t normally use such sweeteners.
In a small follow-up experiment, the researchers tested blood sugar levels of seven people who don’t normally consume artificial sweeteners. The researchers found that four of these people had higher blood sugar levels after consuming the U.S Food and Drug Administration’s maximum recommended daily amount of saccharine for six days straight.
“We were surprised, given the massive consumption and use of artificial sweeteners and their general regard as being safe,” said the study’s co-author Eran Segal, a professor of computer science and applied mathematics at the Weizmann Institute of Science in Rehovot, Israel.
Even though the human and mouse studies mainly focused on saccharine, the first set of mouse experiments also included sucralose and aspartame, Segal said. All three appeared to have the same effect on blood sugar levels in mice.
The researchers said that no one should make immediate dietary choices based on these findings.
“We must stress that by no means are we saying sugary drinks are healthy and should be brought back as a healthy part of our nutrition,” said lead author Dr. Eran Elinav of the Weizmann Institute’s Immunology Department.
But the team found evidence that some people may be more susceptible than others to blood sugar increases caused by artificial sweeteners.
By profiling the bacterial content of a person’s gut, “we could cluster them in a way that would show who would respond and not respond to artificial sweeteners,” Segal said.
Elinav believes that in the guts of those people who developed elevated blood sugar, certain bacteria reacted to the chemical sweeteners by secreting substances that then provoked an inflammatory response similar to sugar overdose, promoting changes in the body’s ability to utilize sugar.
These findings bolster the American Diabetes Association’s position that “using non-nutritive sweeteners is not a panacea,” said Judy Wylie-Rosette, an ADA spokesperson and professor of epidemiology at the Albert Einstein College of Medicine in New York City.
“If you don’t have a carefully planned approach to your diet, artificial sweeteners are not going to provide you much benefit,” Wylie-Rosette said. “If you’re thinking about what you’re eating, it may help some.”
However, artificially sweetened sodas are clearly better than sugary sodas, Wylie-Rosette added, noting that a person drinking a single 20-ounce regular soda is getting close to 20 extra teaspoons of sugar in their daily diet.
“Water is the best alternative, and non-nutritive sweeteners are somewhere in between,” she said. “When you’re thirsty, you need to drink water. Water is the best thirst-quenching beverage.”
For more information on artificial sweeteners, visit the Harvard School of Public Health.
WEDNESDAY, Sept. 17, 2014 (HealthDay News) — Present-day Europeans are the descendants of at least three groups of ancient humans, according to a new study.
Previous research suggested that Europeans descended from indigenous hunter-gatherers and early European farmers. But, a new genetic analysis involving ancient bone samples revealed they are also the descendants of Ancient North Eurasians. Nearly all present-day Europeans have genetic material from this third ancestral group, researchers from Harvard Medical School said.
In conducting its investigation into Europeans’ heritage, the team of researchers collected and sequenced the DNA of more than 2,300 people currently living around the world. They also examined DNA from nine ancient humans from Germany, Luxembourg and Sweden.
The ancient samples were taken from the bones of eight hunter-gatherers who lived about 8,000 years ago, and one farmer who lived about 7,000 years ago.
“Ancient DNA has emerged as a powerful technology that makes it possible to go back in time to understand how people in the past relate to people today,” study co-senior author, David Reich, professor of genetics at Harvard Medical School, said in a university news release.
About 7,500 years ago in Europe, agriculture from the Near East brought early farmers into contact with hunter-gatherers who had been living in Europe for tens of thousands of years. Nearly all Europeans are the result of the mixing of these two ancient populations.
“There was a sharp genetic transition between the hunter-gatherers and the farmers, reflecting a major movement of new people into Europe from the Near East,” noted Reich.
The study’s authors found, however, Ancient North Eurasians also contributed DNA to present-day Europeans. Ancient North Eurasians also likely contributed DNA to people who crossed the Bering Strait into the Americas more than 15,000 years ago, according to the researchers.
“Nearly all Europeans have ancestry from all three ancestral groups,” explained the study’s first author, Iosif Lazaridis, a research fellow in genetics in Reich’s lab.
“Differences between them are due to the relative proportions of ancestry. Northern Europeans have more hunter-gatherer ancestry — up to about 50 percent in Lithuanians — and Southern Europeans have more farmer ancestry,” Lazaridis said in the news release.
Before this paper was published, Reich said, “the models we had for European ancestry were two-way mixtures. We show that there are three groups.”
Lazaridis pointed out that “the Ancient North Eurasian ancestry is proportionally the smallest component everywhere in Europe, never more than 20 percent, but we find it in nearly every European group we’ve studied and also in populations from the Caucasus and Near East. A profound transformation must have taken place in West Eurasia” after farming arrived, he added.
The research published online Sept. 17 in Nature found that Ancient North Eurasians also contributed DNA to Native Americans. “This also explains the recently discovered genetic connection between Europeans and Native Americans,” Reich said.
Meanwhile, ancient Near Eastern farmers and their European descendants can trace much of their ancestry back even further to an older lineage called the Basal Eurasians, the study authors pointed out in the news release.
“This deep lineage of non-African ancestry branched off before all the other non-Africans branched off from one another,” Reich said. “Before Australian Aborigines and New Guineans and South Indians and Native Americans and other indigenous hunter-gatherers split, they split from Basal Eurasians. This reconciled some contradictory pieces of information for us.”
Looking ahead, the researchers plan to investigate when the Ancient North Eurasians arrived in Europe. They also want to find ancient DNA from the Basal Eurasians.
“There are important open questions about how the present-day people of the world got to where they are,” said Reich. “The traditional way geneticists study this is by analyzing present-day people, but this is very hard because present-day people reflect many layers of mixture and migration.”
The U.S. National Library of Medicine has more about genetic ancestry testing.
WEDNESDAY, Sept. 17, 2014 (HealthDay News) — Scientists have developed a blood-cleansing device, called the “biospleen,” that they say could potentially change the way the blood infection sepsis is treated.
Researchers at Harvard’s Wyss Institute for Biologically Inspired Engineering said their device works outside the body like a dialysis machine, and can quickly filter bacteria, fungi and toxins out of patients’ blood.
“Even with the best current treatments, sepsis patients are dying in intensive care units at least 30 percent of the time,” Mike Super, a senior staff scientist at the Wyss Institute, said in an institute news release. “We need a new approach.”
Sepsis, a life-threatening condition in which bacteria or fungi multiply in the blood, claims at least 8 million lives around the world each year. It’s also the leading cause of hospital deaths.
Sepsis is currently treated with antibiotics, but it often progresses too quickly for this approach to work. The increasing prevalence of drug-resistant bacteria makes treating sepsis more difficult.
The researchers modeled their design after the human spleen, which removes pathogens (germs) and dead cells from the blood through a series of tiny interwoven blood channels.
The biospleen they created consists of two adjoining hollow channels connected by a series of slits. While one channel contains flowing blood, the other has a saline solution that removes the germs that pass through the slits.
The biospleen was first tested with infected human blood in a lab before being tested on rats. In just hours the biospleen filtered live and dead germs and the deadly toxins they release, the researchers reported Sept. 14 in Nature Medicine. The device also increased the survival of the rats with sepsis, the researchers said.
The human blood was filtered at a rate of about half a liter to one liter per hour, the study authors noted in the news release.
The rats involved in the study were infected with E. coli and other bacteria and toxins that are similar to human bloodstream infections. The researchers found that roughly 90 percent of the bacteria and toxins were removed from the rats’ blood after five hours of filtering. While 90 percent of the treated rats survived, 14 percent of those in an untreated “control” group did not.
“We didn’t have to kill the pathogens. We just captured and removed them,” Super said in the news release.
Dr. Don Ingber, founding director of the Wyss Institute, said sepsis is a major medical threat, which is increasing because of antibiotic resistance. “We’re excited by the biospleen because it potentially provides a way to treat patients quickly without having to wait days to identify the source of infection, and it works equally well with antibiotic-resistant organisms,” Ingber said.
“We hope to move this towards human testing to advancing to large animal studies as quickly as possible,” he added.
The U.S. Centers for Disease Control and Prevention has more about sepsis.
Congratulations are in order for Eva Mendes and Ryan Gosling on their new bundle of joy. The couple of three years welcomed a healthy—and most likely ridiculously good looking—baby girl on Friday.
Eva is a first-time mom at 40 years old, which is no longer that uncommon as more women delay childbirth. Since 2000, the number of first births among women aged 35-39 rose 24% and increased 35% for women 40-44, according to a 2012 Centers for Disease Control and Prevention survey. This baby boom persisted even as total births declined during that same period.
RELATED: Is It Too Late For A Baby?
Experts caution that trying to conceive after 35 comes with its own set of challenges and health risks including infertility as well as increased risk of miscarriage, gestational diabetes, high blood pressure, premature birth, and chromosomal abnormalities in the baby. But, new treatments and better understanding about the causes of infertility can help make relatively older couples’ dreams of having children come true. (If you fall into that group, check out our guide to getting pregnant later in life.)
We wish Eva and Ryan the best of luck with their newest adventure: parenting.
By Dennis Thompson
WEDNESDAY, Sept. 17, 2014 (HealthDay News) — Twelve states now have confirmed cases of Enterovirus D68, the severe respiratory illnesses that may have sickened hundreds of children, U.S. health officials report.
Alabama, Colorado, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Missouri, New York, Oklahoma and Pennsylvania collectively have 130 laboratory-confirmed cases of Enterovirus D68, according to the U.S. Centers for Disease Control and Prevention.
The virus, part of the family of viruses that includes the common cold, can sometimes require hospitalization, especially for children with asthma.
More cases will be confirmed in the coming weeks because the testing for Enterovirus D68 is complex and can only be done by the CDC and a small number of state-run laboratories, the CDC said.
The first cases were diagnosed last month in Midwestern and Western states and have now spread to the Northeast and Louisiana.
Enteroviruses are common in September as kids head back to school, with an estimated 10 million to 15 million people infected each year. But doctors believe this particular type of enterovirus is causing more severe cases than in the past, and can be troublesome for kids with asthma.
The virus is also hard to track because it causes symptoms similar to many other infections, including the common cold, experts have said.
“It is important that we follow common sense rules to prevent the spread of this virus, as we do for flu and other contagious illnesses,” New York state acting Health Commissioner Dr. Howard Zucker said in a statement. “Because there is no specific treatment or vaccination against this virus, our best defense is to prevent it by practicing proper hygiene.”
Illness associated with the Enterovirus D68 infection typically lasts about a week. Children will appear to have a severe cold, with runny nose, sneezing and cough. But the illness can escalate quickly in some cases, and the child may start to have trouble breathing. It’s typically transmitted through close contact with an infected person, or by touching objects or surfaces contaminated with the virus and then touching the mouth, nose or eyes, according to health officials.
Antibiotics won’t work against a virus, and there is no antiviral treatment available for Enterovirus D68, public health officials said.
The CDC is asking doctors and public health officials to consider Enterovirus D68 as a potential suspect if widespread respiratory illnesses start occurring in their communities.
Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City, agreed that good hygiene is the best defense against a child catching Enterovirus D68.
“Hand washing is paramount, and teaching kids not to touch their faces with unwashed hands is the point,” Horovitz said. “Any child or adult with flu-like symptoms or common cold symptoms should be seen, evaluated and followed by doctors for any respiratory complications.”
Children and adults should wash their hands with soap and water for at least 20 seconds on a regular basis. They also should avoid contact with people who are sick, and stay home if they themselves fall ill. Kids with asthma need to stay on top of their symptoms and take their medication, public health officials said.
The virus tends to “produce severe shortness of breath in children who may not have asthma. Therefore, children with asthma must be watched closely by doctors if they contract the virus,” Horovitz said.
Enteroviruses are very common, according to the CDC. There are more than 100 types of enteroviruses. People who come down with a bad summer cold often have been laid low by an enterovirus, the federal agency said.
To learn more about enteroviruses, visit the U.S. Centers for Disease Control and Prevention.
TUESDAY, Sept. 16, 2014 (HealthDay News) — Modern forensic techniques are shedding light on a 500-year-old mystery: Which battlefield injuries might have killed King Richard III, the last English monarch to die in battle?
A new analysis of the king’s skeletal remains, using whole-body CT scans and micro-CT imaging of injured bones, provides a detailed account of the 11 injuries he suffered at the Battle of Bosworth Field, where he died on Aug. 22, 1485.
The modern forensics revealed that two skull injuries could have killed the king in a short amount of time, according to a new report published Sept. 16 in The Lancet.
The skeletal remains of the king were discovered under a Leicester parking lot in 2012 by archaeologists from the University of Leicester. Since then, the university’s forensic imaging team, in collaboration with the forensic pathology unit and department of engineering, has analyzed his wounds. They also examined tool marks on his bones to identify the medieval weapons that may have caused his injuries.
The team, led by Dr. Jo Appleby of the university’s School of Archaeology and Ancient History, was able to determine which of the king’s wounds might have been fatal.
The study showed of the 11 injuries he sustained at or near the time of his death, nine were wounds to his skull. The researchers noted this head trauma occurred during battle, suggesting Richard either removed or lost his helmet.
“Richard’s injuries represent a sustained attack or an attack by several assailants with weapons from the later medieval period,” study author Sarah Hainsworth, a professor of materials engineering at the university, said in a journal news release. “The wounds to the skull suggest that he was not wearing a helmet, and the absence of defensive wounds on his arms and hands indicate that he was otherwise still armored at the time of his death.”
The researchers concluded that some of the king’s injuries, including a wound to his pelvis, may have been inflicted after his death. If he were alive, they explained, he would have been wearing a specific type of armor that would have protected him from such wounds.
“The most likely injuries to have caused the King’s death are the two to the inferior aspect of the skull — a large sharp force trauma possibly from a sword or staff weapon, such as a halberd or bill, and a penetrating injury from the tip of an edged weapon,” study co-author Guy Rutty, from the East Midlands Pathology Unit at the university, said in the news release.
The study itself noted, “If inflicted in life, either of the injuries on the inferior aspect of the cranium could result in subarachnoid hemorrhage, injury to the brain, or an air embolus. Any . . . would be potentially fatal within a short time. The injuries are highly consistent with the body having been in a prone position or on its knees with the head pointing downwards.”
Rutty added, “Richard’s head injuries are consistent with some near-contemporary accounts of the battle, which suggest that Richard abandoned his horse after it became stuck in a mire and was killed while fighting his enemies.”
In the study, the researchers added this end-note: “The fact that the face is not more completely destroyed might relate to the need to display Richard’s corpse after the battle, which was done to reduce the chances of future pretenders claiming the throne in Richard’s name.”
The U.S. National Library of Medicine has more about modern forensic science.
By Kathleen Doheny
TUESDAY, Sept. 16, 2014 (HealthDay News) — A simple urine test can routinely spot human papillomavirus (HPV), which is linked to the risk of cervical cancer, a new analysis found.
“Our study shows that testing urine for HPV has good accuracy when compared to testing samples taken from the cervix for HPV,” said lead researcher Dr. Neha Pathak. She is a resident in obstetrics and gynecology and research fellow at Queen Mary University of London, England.
The test could be done at home, and then interpreted by medical professionals, Pathak added.
With her colleagues, Pathak reviewed 16 published articles reporting on 14 studies that looked at the HPV urine test.
While the test is not yet widely available or included in any screening guidelines, Pathak said it has potential, but more research is needed. Right now, women only receive this test in the context of research, she explained.
HPV is one of the most common sexually transmitted infections. Up to 80 percent of sexually active women are infected at some point in their lives, according to background information in the study.
Often, the infection will clear up on its own, but up to 20 percent of women have persistent infections. Specific strains of HPV have been linked with the development of cervical cancer.
About 12,300 new cases of cervical cancer will be diagnosed this year, according to American Cancer Society estimates, and about 4,000 women will die of the disease in 2014.
For early detection of cervical cancer, women can undergo a Pap test. At the same time, a cervical HPV test can be done to check for the presence of the virus.
However, the study authors noted, there has been a decline in screening, so they wanted to see if a more convenient test would be as accurate.
Compared with cervical samples, the HPV urine test correctly identified positive results 87 percent of the time. The urine tests correctly identified negative results 94 percent of the time. When it came to the high-risk strains of the virus — HPV 16 and 18 — the urine test correctly identified positive results 73 percent of the time and negative results 98 percent of the time.
Although more research on the test is needed, the concept has potential, said Fred Wyand, a spokesman for the American Sexual Health Association and the National Cervical Cancer Coalition.
“Were such a test ever approved for clinical use, it would be a unique addition to the options health care providers currently have to screen women for cervical cancer,” Wyand said. “The uniqueness of the urine specimen would be in comparison to current offerings of screening tests that involve taking a physical sample of cells from the cervix.
“A urine assay for the virus might be helpful in large research studies, for example,” he added. “It could also be a boon in settings where more traditional means of screening for cervical cancer are difficult due to cultural resistance to gynecologic exams.”
The new study findings appear in the Sept. 16 online issue of thebmj.com.
To learn more about HPV testing, visit U.S. Centers for Disease Control and Prevention.
In the new Vanity Fair cover story, Robert Downey Jr. talks about his struggles with drugs and his concern that he may have passed on an addictive personality to his son (his oldest child, Indio, was arrested for cocaine possession this summer and this past Friday entered a guilty plea). The actor’s remarks raise the question: Is addiction actually genetic? To find out if you can, in fact, inherit a drug or alcohol problem, we talked to Akikur Mohamad, MD, a nationally-recognized addiction expert and founder of Inspire Malibu, a Los Angeles treatment center (which has not treated either Downey).
Robert Downey Jr. is correct: Genes play a role in addiction.
Most studies show that 50% of your risk of becoming an addict is linked to your genes, says Dr. Mohamad: “Alcohol and drug addition is a chronic brain disease and just like most chronic diseases (asthma, diabetes, etc.), there is a strong genetic component.”
A child of an addict or alcoholic is more likely to get hooked.
“Pick a dysfunction and and it’s a family problem,” the Iron Man star told Vanity Fair. It’s not a far-fetched statement. “Sons of alcoholic fathers are up to nine times as likely to develop drinking problems as the general population,” Dr. Mohamad notes. “Babies of alcoholics adopted into non-drinking homes have almost the same odds of alcoholism as they would if they’d stayed with their birth parents.”
Partying as a teen can set you up for future drug problems.
Robert Downey Jr. has spoken openly about his father (director Robert Downey) introducing him to drugs at an early age, once telling People: “When my dad and I would do drugs together, it was like him trying to express his love for me in the only way he knew how.” Bad idea, say the experts. “Young people (from birth to their college years) have a much higher chance of incurring permanent brain damage from using alcohol or drugs, because their brains are still developing,” Dr. Mohamad explains. Not to mention, partying with the kids sends a powerful message that getting drunk or high is a smart idea.
Nurture also matters—in a surprising way.
Nature and nurture play a role in drug abuse: “Your environment can trigger the genetic component,” explains Dr. Mohamad. For an alcoholic, simply passing a bar is enough to stimulate the brain receptors that turn on a craving for alcohol. And it can be a lifelong vulnerability. “Look at Philip Seymour Hoffman,” Dr. Mohamad points out. “After 20-plus years of being clean and sober, he reportedly snorted heroin several months before his death, and his addiction returned full-blown.”
These two steps help prevent the problem.
“The vast majority of people who take a drink or even shoot heroin will not become addicts,” says Dr. Mohamad. (Only 10% of the population have a true addiction.) But if you have a family history, it’s key to make lifestyle tweaks. Two smart moves: Avoid friends who party hard and get counseling for any mental health issue that could cause you to “self medicate” with booze and pills. The encouraging news for the Downeys of the world: the cycle of addition can be broken, stresses Dr. Mohamad says: “Their fate isn’t sealed.”