Depression during pregnancy: You're not alone

From: http://www.mayoclinic.org/depression-during-pregnancy/art-20237875

Elder abuse often missed in the ER

Many American seniors suffer elder abuse, but most pass through emergency departments without the problem being identified, according to new research

From: http://www.cbsnews.com/news/elder-abuse-often-missed-in-the-emergency-room/

Depression during pregnancy: You're not alone

From: http://www.mayoclinic.com/depression-during-pregnancy/art-20237875

For firefighters, emotional stress often the deadliest enemy

Though most often associated with soldiers, PTSD leaves many firefighters psychologically and emotionally damaged

From: http://www.cbsnews.com/news/firefighters-emotional-stress-ptsd/

Now hear this, men: Hearing aids can be a life changer

Chalk one up for exasperated women everywhere. Odds are the older men in their lives actually don’t hear them and need a hearing aid. Some estimates suggest that by age 65, about one-third of men need hearing aids. However, only half of this group wears them.

Why men tend to resist hearing aids

“Men tend to avoid hearing aids because of their negative imagery,” says Dr. Steven Rauch, an otologist with Harvard-affiliated Massachusetts Eye and Ear. “To them, hearing aids symbolize declining age and health and that their best years are behind them.”

While some men can get by without a hearing aid, they need to consider the potential impact hearing loss has on their life, relationships, and even cognitive health. “Left untreated, hearing loss is associated with higher risks for social isolation, depression, dementia, and reduced physical activity,” says Dr. Rauch.

If you think you might need a hearing aid, get tested

The first step to knowing whether you need a hearing aid is to get your hearing checked by a certified audiologist. (Ask your doctor for a recommendation.) Hearing tests measure loudness and clarity of sound — how loud the sound needs to be for you to hear it and how clear the sound is.

People with normal hearing can hear sounds with a loudness between zero and 25 decibels (dB). When the softest sounds you can hear are louder than 30 dB, you may be missing a significant amount of speech and are probably a candidate for a hearing aid.

It is important to note that hearing aids are amplifiers — they make sounds louder, but not clearer. If you have trouble understanding speech in a noisy environment (a clarity problem), there are ways to improve communication without a hearing aid. For example, when speaking with someone, sit face-to-face and reduce background noise, like the TV, or distractions, like reading the paper. Be fully focused and engaged. “Ask the person not to shout, but to speak more slowly and more clearly in order to hyper-enunciate words,” says Dr. Rauch.

If you do have a hearing problem…

Age-related hearing loss and noise-induced hearing loss tend to affect both ears equally. If hearing loss occurs in one ear but not the other, it could be a result of a stroke, infection, or tumor, and requires a medical evaluation, says Dr. Rauch.

People with single-sided hearing loss, or hearing loss that is different in each ear, are less likely to benefit from a hearing aid in the bad ear. “These people seem to have trouble fusing the electronic sound of a hearing aid with the normal sound in the opposite ear,” says Dr. Rauch.

Hearing aids also have a learning curve. “If you’ve had a gradual, progressive hearing loss over a period of years, your brain is out of practice processing and filtering the full spectrum of normal sounds, so it needs time to adjust,” says Dr. Rauch. Wear your hearing aids for about an hour daily and then gradually increase your time over a few weeks. You don’t have to wear them all the time either. Put them in only when you need to, but the more you use them, the quicker you will adjust.

Also, be aware that not everyone finds hearing aids pleasurable. “They make everything louder — voices, noises, sounds — and some may find it overwhelming in places with a lot of stimulus like restaurants and crowds,” says Dr. Rauch. “They are usually more helpful in quieter environments.”

Factors to consider when hearing aid shopping

• A hearing aid center offers a better range of features, options, and prices than a franchise, which often has limited choices.
• A single aid can cost from $3,000 to $4,000, although most vendors offer a discount for the second one.
• Medicare and most other insurance plans don’t cover hearing aids, but the Veterans Administration might.
• Check the consumer protection laws regarding hearing aids for your state.
• The average hearing aid lasts about five years.

The post Now hear this, men: Hearing aids can be a life changer appeared first on Harvard Health Blog.

From: Matthew Solan http://www.health.harvard.edu/blog/now-hear-men-hearing-aids-can-life-changer-2016112510674

Depression during pregnancy: You're not alone

From: http://www.mayoclinic.org/depression-during-pregnancy/art-20237875

Anti-inflammatory medications and the risk for cardiovascular disease: A new study, a new perspective

Follow me on Twitter  @RobShmerling

News last week about celecoxib shows how challenging it can be to understand the risks and benefits of newly developed drugs. This is particularly true when the findings of one study contradict those of past studies. And that’s exactly what has happened with celecoxib.

Anti-inflammatory medications: pros and cons

The FDA approved celecoxib (Celebrex) in 1999. This anti-inflammatory medication can be a highly effective treatment for arthritis and other painful conditions. It was developed with the hope that it would be at least as effective as other anti-inflammatory medications (such as ibuprofen or naproxen) but cause less stomach irritation. Developing a safer anti-inflammatory medication is a worthy goal, since stomach irritation can not only cause annoying pain or nausea, but it can also lead to ulcers, bleeding, or perforation. These medications can also increase blood pressure and cause kidney problems.

Celecoxib is known as a COX-2 inhibitor — that’s because it targets an enzyme (COX-2) involved in inflammation. Ibuprofen and naproxen (and many other anti-inflammatories) target COX-1 and COX-2. They’re called “non-selective” anti-inflammatory drugs. Because of where these enzymes are found in the body, the COX-2 selective medications seemed capable of dampening down inflammation while going easier on the stomach.

And that was true. Celecoxib — and other COX-2 inhibitors, such as rofecoxib (Vioxx) — did cause less stomach trouble. But soon after its approval, studies suggested other concerns: an increased risk of heart attack and stroke. Rofecoxib was removed from the market in 2004. And while the FDA allowed celecoxib to remain on the market, it required the manufacturer to issue additional warnings to patients. It also required additional study. And that’s why celecoxib is back in the news this week. The results of the PRECISION (Prospective Randomized Evaluation of Celecoxib Integrated Safety versus Ibuprofen or Naproxen) trial were released. And the news is good for celecoxib.

Results suggests lower cardiovascular disease risk — and fewer side effects — than expected

The PRECISION trial is a carefully designed and powerful study that analyzed the impact of celecoxib on cardiovascular disease. The study spanned 926 medical centers in 13 countries and enrolled more than 24,000 patients with two of the most common types of arthritis (osteoarthritis and rheumatoid arthritis). Each study subject had a higher than average risk for cardiovascular disease due to a history of high blood pressure or high cholesterol.

Study subjects were divided into three groups who took anti-inflammatory medications every day: one group took celecoxib, one group took ibuprofen, and the last group took naproxen.

Study subjects taking celecoxib in moderate doses were

• no more likely than those taking ibuprofen or naproxen to have a fatal or non-fatal heart attack or stroke
• less likely than those taking ibuprofen or naproxen to have significant gastrointestinal problems, such as serious bleeding
• less likely than those taking ibuprofen to have kidney problems or hospital admission for high blood pressure.

What does this mean for you?

It’s rare that a single study provides a definitive answer or changes practice overnight. But this was a large, well-designed, and expensive study that is unlikely to be repeated any time soon. And, another study of lower-risk people came to a similar conclusion just last year.

Still, questions may yet come up regarding:

• The lack of a placebo group. As suggested by some prior research, it is possible that all three of the drugs used in this study increase the risk of cardiovascular problems; without a control group, it’s impossible to say.
• Dosing. Study subjects were allowed to take up to 400 mg/day of celecoxib if they had rheumatoid arthritis but only 200 mg/day if they had osteoarthritis. In real life doctors may prescribe a wider range of doses.
• Reason for treatment. This study only included people with rheumatoid arthritis or osteoarthritis. The results might be different if people with other conditions had been included.
• Other medical problems. The risks and benefits of celecoxib in people with other medical problems (such as significant kidney disease) are uncertain because this study excluded them.
• Other medical treatments. All patients in this study took a medication to protect the stomach; outside of studies, that’s not always the case.

While these issues are valid, I think this study does provide a significant measure of reassurance regarding the cardiovascular risks of celecoxib. And it may encourage doctors who thought the drug was too risky to prescribe it more often.

This new research shows in a dramatic way why “more research is needed” is not just a tagline at the end of so many medical news stories. And in the case of celecoxib, the result of the additional research is good news indeed.

The post Anti-inflammatory medications and the risk for cardiovascular disease: A new study, a new perspective appeared first on Harvard Health Blog.

From: Robert H. Shmerling, MD http://www.health.harvard.edu/blog/anti-inflammatory-medications-and-the-risk-for-cardiovascular-disease-a-new-study-a-new-perspective-2016112310725

For many, LASIK eye surgery creates new problems

An FDA study delves into the common side effects that sprout up after corrective eye surgery

From: http://www.cbsnews.com/news/lasik-eye-surgery-side-effects/

Sweat it out! Skin patch aims to test sweat for health

Researchers are creating a skin patch that can test droplets of sweat while people exercise as a possible new way to track health and fitness

From: http://www.cbsnews.com/news/sweat-it-out-skin-patch-aims-to-test-sweat-for-health/

Leukemia drug study halted after more patient deaths

In the second setback for the closely watched study, Juno Therapeutics halted mid-stage testing of the promising, but still unproven, treatment

From: http://www.cbsnews.com/news/juno-therapeutics-halts-study-after-more-patient-deaths/

Boy disfigured by chimp in Africa thrives after U.S. surgery

Doctors are marveling at Dunia Sibomana's resiliency a year after undergoing reconstructive surgery​ in New York

From: http://www.cbsnews.com/news/boy-dunia-sibomana-disfigured-by-chimp-in-africa-thrives-after-u-s-surgery/

OMS: Fortalecer la función del sistema de salud para abordar la violencia contra las mujeres

From: World Health Organization http://www.youtube.com/watch?v=NAlY-1KI6ts

WHO - Violence against women: Strengthening the health system response

From: World Health Organization http://www.youtube.com/watch?v=Qc_GHITvTmI

Depression during pregnancy: You're not alone

From: http://www.mayoclinic.com/depression-during-pregnancy/art-20237875

High blood pressure dangers: Hypertension's effects on your body

High blood pressure is a risk factor for more than heart disease. Discover what complications high blood pressure can cause.

From: http://www.mayoclinic.com/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20045868

Depression during pregnancy: You're not alone

From: http://www.mayoclinic.org/depression-during-pregnancy/art-20237875

Anti-inflammatory medications and the risk for cardiovascular disease: A new study, a new perspective

Follow me on Twitter  @RobShmerling

News last week about celecoxib shows how challenging it can be to understand the risks and benefits of newly developed drugs. This is particularly true when the findings of one study contradict those of past studies. And that’s exactly what has happened with celecoxib.

Anti-inflammatory medications: pros and cons

The FDA approved celecoxib (Celebrex) in 1999. This anti-inflammatory medication can be a highly effective treatment for arthritis and other painful conditions. It was developed with the hope that it would be at least as effective as other anti-inflammatory medications (such as ibuprofen or naproxen) but cause less stomach irritation. Developing a safer anti-inflammatory medication is a worthy goal, since stomach irritation can not only cause annoying pain or nausea, but it can also lead to ulcers, bleeding, or perforation. These medications can also increase blood pressure and cause kidney problems.

Celecoxib is known as a COX-2 inhibitor — that’s because it targets an enzyme (COX-2) involved in inflammation. Ibuprofen and naproxen (and many other anti-inflammatories) target COX-1 and COX-2. They’re called “non-selective” anti-inflammatory drugs. Because of where these enzymes are found in the body, the COX-2 selective medications seemed capable of dampening down inflammation while going easier on the stomach.

And that was true. Celecoxib — and other COX-2 inhibitors, such as rofecoxib (Vioxx) — did cause less stomach trouble. But soon after its approval, studies suggested other concerns: an increased risk of heart attack and stroke. Rofecoxib was removed from the market in 2004. And while the FDA allowed celecoxib to remain on the market, it required the manufacturer to issue additional warnings to patients. It also required additional study. And that’s why celecoxib is back in the news this week. The results of the PRECISION (Prospective Randomized Evaluation of Celecoxib Integrated Safety versus Ibuprofen or Naproxen) trial were released. And the news is good for celecoxib.

Results suggests lower cardiovascular disease risk — and fewer side effects — than expected

The PRECISION trial is a carefully designed and powerful study that analyzed the impact of celecoxib on cardiovascular disease. The study spanned 926 medical centers in 13 countries and enrolled more than 24,000 patients with two of the most common types of arthritis (osteoarthritis and rheumatoid arthritis). Each study subject had a higher than average risk for cardiovascular disease due to a history of high blood pressure or high cholesterol.

Study subjects were divided into three groups who took anti-inflammatory medications every day: one group took celecoxib, one group took ibuprofen, and the last group took naproxen.

Study subjects taking celecoxib in moderate doses were

• no more likely than those taking ibuprofen or naproxen to have a fatal or non-fatal heart attack or stroke
• less likely than those taking ibuprofen or naproxen to have significant gastrointestinal problems, such as serious bleeding
• less likely than those taking ibuprofen to have kidney problems or hospital admission for high blood pressure.

What does this mean for you?

It’s rare that a single study provides a definitive answer or changes practice overnight. But this was a large, well-designed, and expensive study that is unlikely to be repeated any time soon. And, another study of lower-risk people came to a similar conclusion just last year.

Still, questions may yet come up regarding:

• The lack of a placebo group. As suggested by some prior research, it is possible that all three of the drugs used in this study increase the risk of cardiovascular problems; without a control group, it’s impossible to say.
• Dosing. Study subjects were allowed to take up to 400 mg/day of celecoxib if they had rheumatoid arthritis but only 200 mg/day if they had osteoarthritis. In real life doctors may prescribe a wider range of doses.
• Reason for treatment. This study only included people with rheumatoid arthritis or osteoarthritis. The results might be different if people with other conditions had been included.
• Other medical problems. The risks and benefits of celecoxib in people with other medical problems (such as significant kidney disease) are uncertain because this study excluded them.
• Other medical treatments. All patients in this study took a medication to protect the stomach; outside of studies, that’s not always the case.

While these issues are valid, I think this study does provide a significant measure of reassurance regarding the cardiovascular risks of celecoxib. And it may encourage doctors who thought the drug was too risky to prescribe it more often.

This new research shows in a dramatic way why “more research is needed” is not just a tagline at the end of so many medical news stories. And in the case of celecoxib, the result of the additional research is good news indeed.

The post Anti-inflammatory medications and the risk for cardiovascular disease: A new study, a new perspective appeared first on Harvard Health Blog.

From: Robert H. Shmerling, MD http://www.health.harvard.edu/blog/anti-inflammatory-medications-and-the-risk-for-cardiovascular-disease-a-new-study-a-new-perspective-2016112310725

High blood pressure dangers: Hypertension's effects on your body

High blood pressure is a risk factor for more than heart disease. Discover what complications high blood pressure can cause.

From: http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20045868