Aetna Latest Healthy Living News http://www.planforyourhealth.com/ Latest Healthy Living News from Aetna en Aetna Latest Healthy Living News http://www.planforyourhealth.com/ http://www.planforyourhealth.com/ Latest Healthy Living News from Aetna TYPO3 - get.content.right http://blogs.law.harvard.edu/tech/rss Wed, 22 Feb 2012 13:47:00 -0500 Simple Injection May Stop Long Seizures http://www.planforyourhealth.com/living-healthy/health-news/healthy-living/healthy-living-details/newsarticle/simple-injection-may-stop-long-seizures/ A pre-loaded injector may deliver drugs to halt long seizures more easily than the intravenous... What Is the Doctor's Reaction? A generalized, or grand mal, seizure is a frightening event for all concerned. First, the person loses consciousness and collapses to the ground. Next comes a series of strong muscle contractions that produce twitching and shaking movements. Breathing becomes difficult and may even stop briefly. Jaw-clenching may produce a bitten tongue and bleeding from the mouth. The person may lose bowel or bladder control. Fortunately, most seizures stop by themselves within 2 to 5 minutes. After a generalized seizure, most people will not be able to talk right away. They can remain confused for a few hours afterward. In rare instances, someone may get injured from falling during a seizure. Otherwise, seizures that end quickly are not dangerous. They do not cause brain damage. A seizure that lasts for more than 5 to 10 minutes is a medical emergency. Doctors call this status epilepticus. Each year, an estimated 100,000 to 200,000 status epilepticus seizures occur in the United States. Unlike seizures that stop sooner than 5 minutes, status epilepticus can cause permanent damage and disability. There is also a 15% to 22% risk of death. The longer a seizure goes on past 10 minutes, the more likely it is that the seizure will not stop on its own. The drugs used to stop a seizure also become less effective as the seizure lasts longer. So the sooner an anti-seizure medicine can reach the brain, the better the outcome. The fastest way to get medicine to the brain is by injecting through a vein into the bloodstream. However, it takes time to set up an IV, find a "good" vein and make a successful stick. This is especially challenging when someone is having a seizure. Researchers have been testing if other ways of delivering anti-seizure medicine could work as quickly as an IV and be easier to use. This week's New England Journal of Medicine includes research on one such approach. The study was designed to see if injecting a benzodiazepine drug into a muscle would stop status epilepticus as well as giving the drug into a vein. Benzodiazepines are the drugs of choice for status epilepticus. These drugs include lorazepam (Ativan) and midazolam (Versed). In the study, the injections were given by a preloaded syringe. The syringe automatically pushed the drug into the muscle after going through the skin. The researchers were hoping that the muscle injection would work as well as the IV injection. It actually worked faster and better. The muscle injection stopped the seizure in 73.4% of the patients. The IV route stopped the seizure in 63.4%. What Changes Can I Make Now? Here's what to do if you witness a seizure. Stay calm and do your best to keep everyone else calm. If no one knows the person, call 911 or have someone else do it. Time the seizure. If the person is known to have a seizure disorder (epilepsy), call 911 anyway if the seizure does not stop within 2 to 3 minutes. Try to remember as many details as you can to tell the paramedics and doctor later. Don't try to hold the person down or force anything into his or her mouth, even if the tongue is bleeding. To prevent head injury, gently place a soft, flat object under the head. For example, use a folded jacket. Loosen the collar or tie, but only if you can do so gently. Remove any nearby hard or sharp objects. When the jerking stops, gently roll the person onto his or her side. When he or she wakes up, be reassuring and provide a ride or other help that may be needed. What Can I Expect Looking to the Future? Once these auto-injectors become more widely available, they will become part of standard equipment in ambulances. Further in the future, people with a history of status epilepticus will likely be provided with a home treatment. Besides auto-injectors to deliver the anti-seizure medicine into a muscle, researchers are also testing a nasal spray.]]> Fri, 17 Feb 2012 12:24:00 -0500 Study: Antibiotics Don't Help Most Sinusitis http://www.planforyourhealth.com/living-healthy/health-news/healthy-living/healthy-living-details/newsarticle/study-antibiotics-dont-help-most-sinusitis/ Antibiotics don't help people feel better faster with a short-term sinus infection, a new study... What Is the Doctor's Reaction? If you've ever had sinus trouble, you may have wondered how you could get relief quickly. The congestion, pressure and pain can make life truly miserable. And it can go on for weeks. Do antibiotics help to cure sinusitis? In many (perhaps even most) cases, the answer is no. But treating sinusitis with antibiotics seems so logical. A bacterial infection often causes the symptoms. And antibiotics kill bacteria. So why aren't these drugs clearly helpful? The reason is that sinusitis usually gets better just as quickly without antibiotics as with them. Viral infections, allergies and poor sinus drainage may trigger sinus symptoms. These conditions will not improve any faster with antibiotics than without them. Even when bacteria cause the symptoms, it's not clear that antibiotics are needed. These infections often get better quickly without these drugs. A new study provides some of the best evidence to date on the role of antibiotics in the treatment of sinusitis. The full name for this condition is acute rhinosinusitis. It means sudden inflammation of the sinuses and nasal passages. The new study included 166 people with sinus inflammation. Doctors thought that the cause was a bacterial infection. All received treatment for symptoms. For example, they took decongestants for a stuffy head or acetaminophen for pain. Half also received a 10-day course of amoxicillin. This is an antibiotic that's commonly prescribed for sinus infections. The other half took a placebo for 10 days. During and after treatment, each person was asked in detail about symptoms. Both groups had similar answers related to:
  • Improvement in sinus symptoms after 3 days and after 10 days of treatment
  • Whether they had to miss work
  • How well they could perform their usual activities
  • Relapse (return of symptoms) and recurrence (development of a new infection)
  • Overall satisfaction with treatment
These findings are important because sinusitis:
  • Is common
  • Is a frequent cause of missed work
  • Accounts for major health care costs
  • Is commonly treated with antibiotics
Doctors are trying more to avoid treating people with antibiotics that they don't need. Excess use of these drugs gives bacteria more chances to become resistant to them. Then the drugs don't work when they are needed. Antibiotics also can sometimes cause serious side effects. For example, some people are allergic. Some antibiotics can have dangerous interactions with other drugs. Do the results of this study mean that people should never take antibiotics for sinus symptoms? Not at all. This study did not include chronic sinusitis. This is sinus inflammation that lasts for weeks. It also did not include sinus infections that lead to further problems, such as an infection that spreads outside the sinuses. Antibiotics may be particularly helpful and important for these situations. What Changes Can I Make Now? There is no magic to weight loss. Eat less. Exercise more. One of the main reasons that doctors prescribe antibiotics for sinusitis is that their patients expect it. Sometimes patients even demand antibiotics. This needs to change. Patients and their doctors should consider studies, like this one, that show antibiotic treatment is often not needed. If you have sinus symptoms, several treatments can help you feel better without antibiotics. They include:
  • Decongestants, such as pseudoephedrine (Sudafed) or oxymetazoline (Afrin, Mucinex and others)
  • Antihistamines, including diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton), loratadine (Claritin), fexofenadine (Allegra) and cetirizine (Zyrtec)
  • Nasal sprays that contain salt water (saline) or steroids, including mometasone (Nasonex) and fluticasone (Flonase)
  • Pain relievers, such as acetaminophen (Tylenol) or ibuprofen (Advil and others)
If you want to use an antihistamine, check with your doctor first. These medicines may reduce allergic symptoms, such as an itchy nose. But they may also dry out the nasal passages, which can hinder drainage. Contact your doctor if your symptoms won't go away or get worse. Also call if you develop a fever. Your illness may be worse than what the people in this latest study had. And that means antibiotics (and other treatments) may be warranted. What Can I Expect Looking to the Future? This new study may discourage doctors from prescribing antibiotics for acute sinusitis in the future. But doctors will need to explain why, including the results of this new study. Over time, patients should become less likely to expect antibiotics for sinusitis. In an age of increasing bacterial resistance, we need to use antibiotics only when needed. Look for more research that better defines when antibiotics are and are not helpful for people with sinus trouble. ]]> Wed, 15 Feb 2012 13:47:00 -0500 Experts: Cheap Seats Don't Raise Clot Risk http://www.planforyourhealth.com/living-healthy/health-news/healthy-living/healthy-living-details/newsarticle/experts-cheap-seats-dont-raise-clot-risk/ Sitting in coach class doesn't increase your risk of a blood clot after a long flight, an expert... What Is the Doctor's Reaction? The professionals who put together these detailed guidelines deserve a huge "thank you" from all of us. Doctors face difficult questions every day about how best to prevent and treat blood clots in their patients. The journal Chest has just published new guidelines to help them. The authors of the guidelines challenged themselves to be as brief as possible. Despite this great effort, the guidelines are still 40 pages long. They provide condensed suggestions for the hundreds of different situations that require blood clot prevention and treatment decisions. These guidelines address blood clots in:
  • Large veins, called deep vein thrombosis (DVT)
  • Lungs, called pulmonary emboli
  • The heart
  • The coronary arteries on the outside of the heart, where blockages cause chest pain (angina) and heart attacks
  • Arteries to the brain and inside the brain, where blockages cause strokes
The Associated Press (AP) article concentrates on just one aspect of the guidelines. AP focuses on the risk of a DVT when you sit for a long time, such as a long plane ride. Before the recent publicity about "economy class syndrome," most people sailed through life without ever worrying about getting a DVT. In fact, whether you sit in first class or the more cramped economy class, you have the same risk of one of these deep vein clots. Unless you have an above-average risk, the chance of a DVT is extremely low. This is especially true if you have no risk factors and your flight is under four hours. Factors that increase the risk of developing a DVT include:
  • Injury to a vein from a broken bone or severe trauma
  • Recent major surgery, especially on the abdomen, pelvis, hip or leg
  • Slow blood flow caused by a long bed rest or being unable to move much because of a cast
  • Use of hormones such as testosterone or estrogen (including birth control pills or hormone therapy after menopause)
  • Pregnancy
  • Severe obesity
  • Some medical conditions, such as:
    • An inherited clotting disorder
    • A strong family history of DVT
    • Active cancer
    • Inflammatory bowel disease (ulcerative colitis and Crohn's disease)
    • Lupus
What Changes Can I Make Now? If you have any of these risk factors, or if you have had a DVT before, your risk of a future DVT is higher than average. The experts suggest that you take these prevention measures on long plane rides:
  1. Get up and move around often. Stand up and stretch your arms and legs at least once an hour. Walk up and down the aisle.
  2. Book an aisle seat when possible. You are more likely to get out of your seat if you're not disturbing anyone.
  3. Move your leg and foot muscles while sitting. Do simple exercises such as straightening your knee and stretching your leg. Point your toes up, then down. Give yourself more room to move by storing as little as possible under the seat in front of you.
  4. Wear properly fitted below-the-knee compression stockings.
This advice makes sense whenever you need to sit for several hours at a time -- in the car, on a train, at work or even at home. Long distance travelers without any risk factors can also benefit from the first three prevention measures. But the experts say compression stockings are not needed. Two more tips for everyone to help prevent a DVT during long flights:
  • Drink plenty of liquids. Bring extra bottles of water on board. Drink enough water to make you get up and use the restroom several times.
  • Avoid alcohol. Alcohol can dry you out. It can also make you so drowsy that you don't move much.
What Can I Expect Looking to the Future? The guidelines contain many more excellent recommendations. They will help doctors and their patients decide on what clot treatment or prevention to choose. But these guidelines, like all guidelines, rely in many cases on the doctor determining if the benefit is worth the risk. This is often a very close call. So the choice of therapy to prevent or treat blood clots will often remain challenging. ]]> Wed, 08 Feb 2012 09:07:00 -0500 Pill May Help Control Fibroids in Uterus http://www.planforyourhealth.com/living-healthy/health-news/healthy-living/healthy-living-details/newsarticle/pill-may-help-control-fibroids-in-uterus/ A smaller dose of the "morning after" birth control pill may help to control fibroids... A smaller dose of the "morning after" birth control pill may help to control fibroids in the uterus as well. That's the conclusion of two new studies. They were done in Europe, where the pill is awaiting approval. Fibroids are growths that can cause heavy bleeding, pain and fertility problems. Fibroids are not cancerous, but treatments often don't work well. Esmya is a lower dose of the drugs in Ella, an emergency birth control pill. The new studies included a total of 550 women with fibroids. All had such severe symptoms that they were planning surgery. In one study, women were randomly assigned to take Esmya or placebo (fake) pills for 3 months. The other study compared Esmya with a monthly hormone-blocking shot. It controls fibroids, but can thin bones after long use. Women received either Esmya and a fake shot, or a real shot and a fake pill. Esmya stopped bleeding and shrank fibroids in most women. The second study showed it worked as well as the shot, but with fewer side effects. The New England Journal of Medicine published the studies. The Associated Press wrote about them February 2.
What Is the Doctor's Reaction? When a medical condition has several treatment options, with none being the best, it's welcome news to hear about a treatment with fewer side effects. That may be the case for a drug called ulipristal acetate. It's a new treatment for fibroid symptoms. Fibroids in the uterus are very common. They occur in up to 75% of women. They are rubbery growths in the wall of the uterus. Fibroids are not cancerous. The hormones estrogen and progesterone stimulate the growth of fibroids. Therefore, they tend to enlarge during a woman's child-bearing years, when the ovaries are still producing female hormones. When hormone levels fall after menopause, fibroids shrink. Most women have no symptoms from fibroids. They might never know that they had them if they are small. Or a doctor could feel them during a pelvic exam or see them on an ultrasound done for some other reason. About 25% of women have symptoms. The most common symptoms are discomfort in the pelvic area and irregular or heavy menstrual bleeding. The pain sometimes can be quite severe. And the heavy periods can lead to iron-deficiency anemia (a low red blood cell count). Large fibroids can push on the bladder, causing a frequent urge to urinate. During pregnancy, very high levels of estrogen and progesterone can stimulate quicker growth of fibroids. This is linked with a greater than average risk of miscarriage. African-American women are three times more likely to develop symptom-causing fibroids than women of other ethnic groups. Also, they typically do so at an earlier age. No one knows exactly why fibroids form. Genes that speed up the growth of muscle cells in the uterus may play a role. Abnormal blood vessels in the uterus may also be involved. Clearly estrogen and progesterone play a major role in their growth, but that doesn't mean they cause fibroids to form. What Changes Can I Make Now? If you have fibroids and no symptoms, no treatment is needed. If you do have symptoms, your doctor will consider your age and how severe your symptoms are. He or she will also want to know if you are planning future pregnancies. Fibroids can grow rapidly during pregnancy. There are many ways to treat fibroids. You and your doctor will make the choice between medical and surgical options or one of the newer approaches. If you're in your 40s and symptoms aren't severe, you may simply wait out your fibroids. They will likely shrink after menopause, and symptoms should go away. Meanwhile, you can use over-the-counter painkillers. These include:
  • Acetaminophen (such as Tylenol)
  • Nonsteroidal anti-inflammatory drugs
    • Ibuprofen (such as Motrin, Advil)
    • Naproxen (such as Aleve)
To treat the anemia caused by heavy bleeding, increase your iron intake through diet and an iron supplement. No medicine can prevent fibroids or guarantee that they won't return. Right now, the primary medical option is injection with gonadotropin-releasing hormone (GnRH) agonists. An example is leuprolide (Lupron), which was used in one of the new studies. These drugs are given as a monthly shot. They suppress estrogen production by the ovaries. Without estrogen, fibroids shrink. But they usually grow back once the drug is stopped. Side effects, similar to those of menopause, are common. Surgery to remove the uterus (hysterectomy) is the ultimate cure for fibroid symptoms. Your decision will depend largely on whether you might want more children or you are willing to wait for menopause. Other options include:
  • Myomectomy -- This operation removes only the fibroids. It preserves the uterus.


  • Uterine artery embolization (also known as uterine fibroid embolization) -- A radiologist inserts a thin tube called a catheter through the skin into an artery in the groin. The catheter is pushed into the artery that feeds blood to the uterus. Sand-sized particles are injected into the uterine artery. The particles come together and cut off blood supply to the fibroids.


  • Magnetic resonance-guided intensity ultrasound -- This treatment works by heating and shrinking the fibroid with high-intensity ultrasound waves. MRI is used to see the fibroid and keep track of temperature changes in the uterus during the procedure. This is not widely available. It may not be covered by insurance.
What Can I Expect Looking to the Future? This new drug ulipristal acetate sounds very promising as an alternative to hormone-blocking shots. It appears to work at least as well at shrinking fibroids and perhaps better. We don't know yet whether ulipristal can be used long-term as an alternative to surgery or other procedures. It is not approved by the U.S. Food and Drug Administration. It probably won't be approved for at least two more years. ]]> Fri, 03 Feb 2012 07:10:00 -0500 Tracking How Red Wine Chemical Works http://www.planforyourhealth.com/living-healthy/health-news/diet-fitness/diet-fitness-details/newsarticle/tracking-how-red-wine-chemical-works/ U.S. government researchers think they may have found out how a chemical in red wine appears to... What Is the Doctor's Reaction? If you're a social drinker, you are not alone. About two-thirds of Americans report drinking alcohol on occasion. Many have a habit of drinking every day. Some even claim their drinking is "medicinal." Could this be true? Perhaps. There's substantial evidence that people who drink in moderation have lower rates of death from heart and blood vessel disease than those who don't drink at all. What does "moderate" drinking mean? The evidence suggests this is up to one drink a day for women or one to two drinks a day for men. Naturally, there is enormous interest in how drinking alcohol might provide health benefits. Understanding this connection could lead to new preventive treatments for people at risk of heart and blood vessel disease. It could also lead to new treatments for those who already have heart problems. A new study explores a substance called resveratrol. This is an ingredient in red wine thought to be responsible for at least some of its health benefits. You may have heard about resveratrol.
  • Past studies have linked it with a reduced risk of heart and blood vessel disease, diabetes and other health benefits.
  • Advertisements for pills containing resveratrol have become widespread.
  • A resveratrol researcher recently became the target of a scientific fraud investigation.
In this latest research, scientists showed that resveratrol interferes with a protein in muscle called PDE4. This action led to biochemical changes linked with health benefits. These included improved blood sugar, less obesity and improved physical stamina in mice. This research could lead to important medical progress. For one, it could shift the focus from resveratrol to other chemicals that interfere with PDE4. That could lead to safer and more effective treatments for heart disease and other diseases. While this story is exciting, it’s unlikely to be the final word on resveratrol. This new study looked at changes in how cells function and in how mice react to the supplement. This doesn't mean the same is true in humans. We also don't know whether long-term use causes unacceptable side effects. The study's lead author says that past research linking resveratrol to health benefits in humans used very high doses. They were far higher than the amount found in wine. If that's true, it suggests that if moderate drinking is truly good for you, it's not because of resveratrol. It's important to note that too much alcohol comes with an array of health risks. These include:
  • Alcoholism
  • Liver disease
  • Depression
  • Some cancers
  • Injuries that occur after people drink too much
It's difficult to talk about the potential health benefits of moderate drinking without mentioning the downsides of drinking up. What Changes Can I Make Now? You can make many changes now to reduce your risk of heart and blood vessel disease. Increasing your red wine intake is not one that most doctors will recommend. Part of this may simply be a concern that moderate drinking could become excessive. But a more compelling argument is that we simply don't know whether someone who drinks little or no alcohol actually gains health benefits by drinking more. All we know is that people who drink have certain health benefits compared with nondrinkers. This does not mean that alcohol causes the improved health. That's a common misunderstanding in medical research. There also have not been any convincing, large-scale human studies proving that resveratrol (in wine or in some other form) leads to better health. So if you're interested in improving your heart and blood vessel health -- as we all should be -- here are a few steps you can take:
  • Don't smoke. Avoid secondhand smoke as well.
  • Exercise regularly.
  • Get your blood pressure, blood sugar and cholesterol checked. If one or more of these is not in an ideal range, talk to your doctor. Diet, exercise and medicines often can help.
  • Improve your diet. Eat less saturated fat and trans fat.
  • Maintain a healthy weight. Take in fewer calories if you need to lose weight.
  • If you already have heart or blood vessel disease (such as heart attack or stroke), take your medicines as recommended. Let your doctor know about your symptoms or any side effects from your medicines.
Should you take resveratrol? Ask your doctor. My own view is that we don't know enough about the effects on human health to recommend it. And at least some of the data on this substance may have been exaggerated or even faked. What Can I Expect Looking to the Future? You can expect continued interest in resveratrol and other substances that interfere with PDE4. In fact, just last year the U.S. Food and Drug Administration approved one such medicine. This drug, roflumilast, was approved for certain types of lung disease. It's worth keeping an eye on the resveratrol story. We may learn that resveratrol does provide important health benefits. But I think it's at least as likely that other components in alcohol and other supplements will be just as good or better. ]]> Thu, 02 Feb 2012 06:00:00 -0500 Fast Heartbeat May Raise Stroke Risk http://www.planforyourhealth.com/living-healthy/health-news/healthy-living/healthy-living-details/newsarticle/fast-heartbeat-may-raise-stroke-risk/ People with a very fast heartbeat that is not causing symptoms may still have a higher risk of... What Is the Doctor's Reaction? During a stroke, a part of the brain dies. Strokes can cause major disability. It's not rare to lose your ability to walk, speak or live independently. And strokes can kill. That's why we need better ways to prevent strokes from occurring in the first place. We have seen advances in the understanding and treatment of strokes. But still nearly 800,000 are diagnosed in the United States each year. About 140,000 people die each year from complications of strokes. High blood pressure and diabetes are strongly linked with a higher risk of stroke. We do have good ways to prevent and treat those conditions. But the cause of up to 25% of strokes is unknown. A new study suggests a potential explanation for many of these. Researchers took advantage of a "side benefit" of having a device, such as a pacemaker or a defibrillator, implanted in the heart. These devices record the rhythm of the heart. That way they can take control of the heart rhythm when necessary. For example, a pacemaker may start firing when the heart slows down to a dangerously low rate. A defibrillator will "reset" the heart with an electrical shock if it detects a dangerous and unstable heart rhythm. These heart devices can also record fast heart rhythms. One abnormal rhythm, called atrial fibrillation, is known to increase the risk of stroke. During atrial fibrillation, the top part of the heart does not beat in a regular rhythm. Instead, it quivers in a chaotic way. This allows blood clots to form. They can travel to the brain, causing a stroke. This new study included more than 2.500 people over age 65. All of them had recently implanted heart devices. Researchers used data from these devices to explore the relationship between fast heart rhythms and stroke risk. The study lasted 2½ years. In that time:
  • About 10% of study subjects had lengthy episodes of a rapid heart rate
  • These rapid rhythms (which caused no symptoms) were often followed by atrial fibrillation
  • A rapid heart rate that lasted for a while was linked with an increased risk of stroke even if no atrial fibrillation occurred
But this isn't the end of the story. Several questions remain:
  • Did the implanted heart devices contribute to the rapid heart rates?
  • Do the findings of this study apply to people who do not have heart disease bad enough to require an implanted heart device?
  • Do the findings of this study apply to younger patients?
These findings suggest that a rapid heart rate might account for many strokes in people without other clear risk factors. And that could lead to new preventive treatments. What Changes Can I Make Now? You may be able to reduce your risk of developing atrial fibrillation or other rapid heart rhythms that increase the risk of stroke. Here's what you can do:
  • Avoid heavy drinking of alcohol.
  • Don't smoke.
  • Lose excess weight.
  • Exercise regularly.
  • Get your blood pressure checked. Get treatment if it's high.
  • Have tests of your thyroid gland if you're taking thyroid medicine.
If you already have atrial fibrillation, your doctor may recommend treatments such as:
  • Medicines to slow the heart
  • Medicines to encourage the heart to remain in a normal, regular rhythm
  • Blood thinners, to prevent clots
  • A minor heart procedure to interrupt signals traveling between the chambers of the heart (though this may require an artificial pacemaker)
Besides an abnormal heart rhythm, several other factors increase the risk of stroke. Many of them can be reversed. The most important of these and ways to address them include:
  • Lack of exercise -- Try to get regular exercise for at least 45 minutes most days of the week.
  • Smoking -- Make quitting a priority.
  • High blood pressure (hypertension) -- Have your blood pressure checked. If it's high, limit your salt intake and lose excess weight. If necessary, take medicines that your doctor recommends.
  • Diabetes -- Try to maintain tight control of your blood sugar. This may lower your risk of further health problems, including stroke.
  • High cholesterol -- If your HDL, LDL and total cholesterol are not in ideal ranges, talk to your doctor about how to improve them.
  • Carotid artery narrowing -- These arteries are in the neck and supply blood to the brain. Sometimes they become narrowed by a buildup of fatty deposits inside. A surgical procedure can open up the artery, reducing stroke risk.
What Can I Expect Looking to the Future? It's hard to prevent something when you don't know its cause. This latest research suggests that an abnormally fast heart rate may increase the risk of stroke. Expect to hear about more research that examines ways to detect and treat rapid heart rhythms. It's quite possible that this approach will reduce new cases of stroke. ]]> Thu, 12 Jan 2012 13:44:00 -0500 Nicotine Patch May Aid Memory Problems http://www.planforyourhealth.com/living-healthy/health-news/conditions/health-conditions-details/newsarticle/nicotine-patch-may-aid-memory-problems/ Wearing a nicotine patch may provide a small boost for older adults with mild losses in attention... What Is the Doctor's Reaction? We know smoking is bad for your health. But could nicotine be good for your brain? The answer is "maybe," according to a new study. The medical journal Neurology published it. Previous research has shown improved measures of brain function among people using nicotine treatments. For example, when they chewed nicotine gum, they were better able to pay attention to a complex task. A study of people with Alzheimer's disease also found that nicotine infused into a vein seemed to improve memory and attention. This latest research looked at people whose brain function was not entirely normal, but not as abnormal as in people with dementia. This is known as "mild cognitive impairment." People with this condition have difficulty with memory or thinking. However, they are not disabled by it. They do have a high risk of developing Alzheimer's disease or another form of dementia. In this study, 74 elderly men and women with mild cognitive impairment were randomly divided into two groups. One group wore patches containing nicotine. The other wore placebo patches. The dose was similar to what someone who smokes 10 cigarettes or fewer per day might use while trying to quit. After six months of treatment, long-term memory improved significantly among those wearing the nicotine patch. Meanwhile, memory test scores got worse for those wearing placebo patches. No major side effects were reported. These results were surprising. But there is a potential scientific explanation. One of the ways the brain responds to nicotine is by releasing a chemical messenger called glutamate. This chemical is involved in memory and learning. Interesting? Yes! But does this study mean that smoking might not be so bad for you? Does it mean that you should use nicotine to improve your memory? Not yet! It's too early to embrace nicotine as a way to ward off Alzheimer's disease or reverse cognitive impairment. Here's why:
  • The study was quite small. A larger study would provide a more reliable measure of whether nicotine helps people with mild cognitive impairment.
  • Doctors evaluating people in the study did not detect overall improvement among those receiving nicotine treatment. The changes were shown only in test scores.
  • This study provides no information about the ideal dose or how long treatment should last. Cognitive impairment and dementia usually can't be reversed. So long-term treatment would likely be needed.
  • The safety of long-term use of nicotine among the elderly is not known. A small study lasting only 6 months cannot assure us that this approach is safe.
  • Smoking is linked with many serious health problems. Even if other studies confirm a benefit for nicotine, the risks of smoking would still far outweigh the benefits. Nicotine treatment might be recommended in the future for its effects on the brain. But this would take the form of nicotine gum or patches. Smoking would never be recommended.
What Changes Can I Make Now? You can make changes now that may reduce your risk of cognitive impairment or dementia. But it's too soon to say that the use of nicotine should be one of them. Here's what you can do now.
  • Exercise regularly.
  • Improve your diet. Make sure it includes more fruits, vegetables, fiber and omega-3 fatty acids (such as those found in fish).
  • Keep your blood pressure in a normal range.
  • Keep your blood lipids (such as cholesterol) in a healthy range.
  • Maintain a healthy weight.
  • Don't smoke (despite the findings of this study).
  • "Exercise" your mind. It's not clearly proven, but a busy social life, hobbies and activities that challenge your brain (such as crossword puzzles) may be linked with a lower risk of dementia.
For those already diagnosed with Alzheimer's disease, medicines intended to slow the decline in mental function are available. If you're worried that your memory or thinking abilities are declining, see your doctor. He or she can evaluate you or refer you to a doctor who focuses on brain function (such as a neurologist or a neuropsychologist). The good news is that many people who are concerned about their memory as they age discover that their memory is actually normal. What Can I Expect Looking to the Future? It's not yet clear that nicotine will ever be used to prevent or treat dementia. But this new study should promote more research. We'll need more studies to find out whether a substance with such a bad reputation could actually provide hope for those at risk of developing dementia. ]]> Tue, 10 Jan 2012 14:53:00 -0500 Rare Genes May Allow Super-Long Lives http://www.planforyourhealth.com/living-healthy/health-news/healthy-living/healthy-living-details/newsarticle/rare-genes-may-allow-super-long-lives/ People who live to be at least 110 may be protected from disease by rare differences in some... What Is the Doctor's Reaction? Today, life expectancy at birth is close to 80 years in the United States. This is a great leap forward from 1900. At that time, the average newborn couldn't expect to reach age 50. If you live to celebrate certain milestones of age, your life expectancy stretches. The longer you live, the longer you're likely to live. In fact, if you make it to 90, there is a reasonable chance you can reach 100. And a few will reach 110. These are the supercentenarians. What allows some people to live so long? First, they need to lead healthy lifestyles. They also need to be fortunate to live in a nontoxic environment that has a low level of infectious diseases. During the first 85 years of life, genetics plays a smaller role. The genes you inherit from your parents account for only 20% to 25% of the reasons that you make it to that age. Not smoking, limiting alcohol, eating healthfully and getting plenty of exercise matter the most. Once you hit your mid-80s, your genes matter more and more. And once your reach your 90s, how much longer you are likely to live was determined the day your father's sperm fertilized your mother's egg. Thomas Perls, M.D., has led many studies helping us understand why some people can live well past 100. Now he and his colleagues provide more exciting new information. It is based on a complete sequencing of the genome of two people who lived past their 114th birthdays. Results appear in the most recent issue of the journal Frontiers in Genetics. The two supercentenarians had:
  • DNA that appeared to be very similar to people who did not have long lives
  • The same number of known disease-linked genes as most other human genomes sequenced so far
  • A small number of genes that were unexpected and not seen before -- perhaps these new genes might be life-extenders
The research results suggest that some common and rare genes linked with long life may offset the disease-linked genes. This might then allow an extended lifespan. What Changes Can I Make Now? No need to get your genome analyzed yet. It won't change what you need to do now. You have the power to change many thinks that influence your health and how long you live. Here are 10 steps to take:
  1. Don't smoke.
  2. Build physical and mental activities into every day.
  3. Eat a healthy diet rich in whole grains, vegetables and fruits. Reduce or avoid unhealthy saturated fats and trans fats. Instead, use healthier monounsaturated and polyunsaturated fats.
  4. If you worry that your diet does not provide enough vitamins and minerals, take a daily multivitamin. Also be sure to get enough calcium and vitamin D.
  5. Maintain a healthy weight and body shape.
  6. Challenge your mind.
  7. Build a strong social network.
  8. Protect your sight, hearing and general health by following preventive care guidelines.
  9. Floss, brush and see a dentist regularly. Poor oral health may have many effects. It can lead to poor nutrition, pain and possibly even a higher risk of heart disease and stroke.
  10. Discuss with your doctor whether you need any medicine to help you stay healthy. These might include medicines to control high blood pressure, treat osteoporosis or lower cholesterol, for example.
What Can I Expect Looking to the Future? Researchers will sequence and analyze the genomes of more people who survive to extremely old age. This will provide new insight into what allows us to maintain health after we reach 80. But to reach a healthy 80, lifestyle choices and environment will always be the more important issues. ]]> Mon, 09 Jan 2012 13:23:00 -0500 FDA Limits Some Antibiotics for Animals http://www.planforyourhealth.com/living-healthy/health-news/healthy-living/healthy-living-details/newsarticle/fda-limits-some-antibiotics-for-animals/ The U.S. Food and Drug Administration (FDA) has taken a first step to limit use of antibiotics in... What Is the Doctor's Reaction? The U.S. Food and Drug Administration (FDA) has introduced its first rule that will limit the use of antibiotics in livestock and poultry farming. This is welcome news to me, a primary care doctor. Doctors need to limit their antibiotic use to times when it is most needed -- and so do farmers. Otherwise, antibiotics lose their power. Bacteria strains become drug-resistant. When I diagnose a new infection in one of my patients today, I hesitate as I pick out what antibiotic to use. We are seeing more and more drug-resistant bacteria. This makes me worry each time I treat an infection. I tell them to call me so I can hear that they are doing better. If they don't get better, I may have to put them into the hospital for a while. In that case, I'll pull out the "big gun" antibiotics. The worrisome thing is, we don't have too many "big guns" left. We run into drug-resistant bacteria in medical care really often. How much of the problem comes from use of antibiotics on farms? We can't say. But it definitely contributes. Many commercial farms crowd animals into a small living and feeding area. These farms routinely use antibiotics in healthy animals. They are used to prevent infection and to help the animals grow. The amount of antibiotics used in agriculture is huge. The FDA says 24.6 million pounds of antibiotics are used each year in swine, poultry and cattle purely for the sake of prevention. Antibiotics in feed allow our meat animals to grow larger, and to cost less. But the other result is more antibiotic resistance. From my vantage point, the trade-off is not worth it. Antibiotics kill bacteria that are not resistant. This leaves behind any bacteria that are protected from antibiotics by a special gene. These "resistant" bacteria can then multiply. They become "the new normal." After antibiotic use in animals, drug-resistant strains of bacteria end up on the skin of animals. Farmers, butchers and consumers touch the skin. The drug-resistant bacteria also end up in the dirt and water. This allows them to contaminate vegetables, too. Several years ago, researchers looked at 200 chicken, beef, turkey and pork samples from groceries in Washington, D.C. They found that 1 out of 5 samples contained salmonella bacteria. About 84% of the salmonella found was resistant to at least 1 antibiotic. About 53% was resistant to at least 3 antibiotics. In a separate study, scientists took samples from 136 packages of meat and poultry. The samples came from 4 states and the District of Columbia. They found Staphylococcus aureus bacteria in 47% of the samples. Many of these bacteria samples were drug-resistant, too. A study from the Netherlands examined dirt samples taken at different times in farming history. Genes that resist some types of antibiotics were 15 times more abundant in today's dirt than dirt from several decades ago. What Changes Can I Make Now? Keep an eye out for further news about antibiotics for farm use. In the meantime, use antibiotics for your own infections only when necessary. You don't need antibiotics for acute bronchitis or for the common cold, acne or sinus symptoms that last fewer than seven days. When you prepare food at home, take care to handle it properly.
  • Wash your hands before and after food preparation.
  • Rinse fruits and vegetables well. Keep them away from surfaces that you have been using to prepare meats.
  • Keep raw and cooked meats refrigerated.
  • Respect expiration dates.
  • Cook meats thoroughly. This is especially important for ground meats and for poultry.
  • Avoid eating raw meat, fish or eggs.
What Can I Expect Looking to the Future? The U.S. government set up a system to keep track of drug-resistant bacteria way back in 1996. This system regularly checks our food supply for disease-causing bacteria. It also checks these bacteria for drug resistance. Later, the Interagency Task Force on Antimicrobial Resistance was created. It includes 10 U.S. agencies involved in health. In 2001, the task force published a plan to fight drug resistance in bacteria and other microbes. It is now writing an updated draft. The government has monitored industry practice for 15 years. Yet this week's announcement is the FDA's first rule that restricts antibiotic use on farms. It limits only antibiotics used for prevention. It does not affect drugs used for treatment of infections. It also applies to only one class of antibiotic. We can expect to see the FDA expand this program. We receive much of our food through large-scale produce distribution and imports. For example, food imports have almost doubled during the last 10 years. About 25% of all of the fruits and vegetables we eat in the United States are imported. This makes it challenging to monitor quality and to inspect food. It is a good reason to buy foods that are produced locally. ]]> Fri, 06 Jan 2012 07:08:00 -0500 Other Neck-Pain Treatments Beat Drugs http://www.planforyourhealth.com/living-healthy/health-news/healthy-living/healthy-living-details/newsarticle/other-neck-pain-treatments-beat-drugs/ Spinal manipulation and home exercise may relieve neck pain better than medicines, new research... What Is the Doctor's Reaction? Neck pain is a common and bothersome symptom. It's estimated that 75% of adults will suffer with major neck pain at some point. Muscle spasm and arthritis are among the most common causes of neck pain. For many people, though, there is no clear cause. Unfortunately, no single treatment works well for everyone. People often take nonsteroidal anti-inflammatory drugs (such as ibuprofen) or acetaminophen for neck pain. However, heat or massage may work as well. Some people swear by spinal manipulation to treat their neck pain. In this treatment, a chiropractor or other health professional person presses carefully on part of the spine. Scientists have looked at how well this works compared with other common treatments. But these studies have reached different conclusions. That why this new study is important. It included 272 adults with neck pain that had lasted from 2 to 12 weeks. They were randomly divided into 3 groups. Each group received one of these treatments for 3 months:
  • Spinal manipulation -- This treatment also included "limited light soft-tissue massage."
  • Medicine -- People took anti-inflammatory drugs. They included ibuprofen, narcotics and muscle relaxants.
  • Home exercise with advice -- People in this group met one-on-one with a health care professional for an hour on two occasions. They reviewed gentle exercises that could be done at home. They also learned about neck anatomy and proper techniques for lifting and other common activities.
Up to a year later, people in the spinal manipulation and exercise groups reported equal pain relief. Both of these groups reported more pain relief than those assigned to take medicines. Those who had spinal manipulation were more satisfied with their care than those in the other treatment groups. This research raises several questions.
  • Why did people who had spinal manipulation improve as much as or more than the others? Could it have been the result of frequent contact with a health provider? People in this group had an average of 15 visits during the 12 weeks of the study. On average, the exercise group had only 2 visits. People in the medicine group met 5 times with their doctors.


  • Why were people more satisfied with spinal manipulation than with exercise even though pain relief was similar?


  • Would similar results be seen in people whose neck pain had lasted longer (more than 3 months) or those with nerve compression from a damaged disc?


  • What are the risks of spinal manipulation of the neck? How can they be eliminated? No problems were reported in this study. But there were too few people in the study to detect rare problems. Rare cases of spinal cord and major artery injury after neck manipulation have been reported in the past. These injuries can have serious effects.
More research is needed to answer these questions. What Changes Can I Make Now? You may be able to prevent neck pain with some simple measures.
  • Change your work environment. For example, you could arrange the position of your computer and chair to reduce stress on your neck.
  • Keep active. If you work long hours at a computer, get up and move around. Stretching regularly can be helpful.
  • Use a headset or speaker phone if you are on the phone often. Avoid holding the phone wedged between your ear and shoulder.
  • Keep your purse or briefcase light.
If your neck pain that isn't getting better on its own, talk to your doctor. He or she can look into the cause and make sure it's nothing serious. A serious cause may be more likely if you have:
  • Fever
  • Headache
  • A very stiff neck
  • Pain that moves down an arm or leg, particularly if the limb also feels weak, numb or tingly
  • Difficulty controlling your bowel or bladder
  • Swelling of the lymph nodes ("glands") in the neck
  • A history of major trauma or cancer
Once any serious causes have been ruled out, you and your doctor can decide on a treatment plan. Besides the treatments used in this study, options include:
  • Heat
  • Physical therapy
  • Injections of medicines near the source of pain (such as a disc that is squeezing a nerve)
  • Massage
  • Acupuncture
Surgery is another option, but it is generally a last resort. It helps only certain causes of neck pain, such as disc disease. If further research confirms this new study, spinal manipulation may be an effective first treatment for neck pain. But it also may cost more and take longer than other options that are just as effective or nearly so. For many people, using more than one treatment may work best. What Can I Expect Looking to the Future? Neck pain is one of the most common reasons that people visit a doctor. Therefore, you can expect to hear about other treatments that work better than current options. We will need more research on spinal manipulation in the treatment of neck pain. This should include studies on which people are most likely to improve and which types of manipulation are safest and most effective. ]]> Tue, 03 Jan 2012 14:14:00 -0500