Scientists have struggled to develop an Ebola vaccine over the years, and this is the first one proven to work
From: http://www.cbsnews.com/news/ebola-vaccine-highly-effective-who-says/
Thursday, December 22, 2016
A Christmas Gift for Thyroid Patients - Mayo Clinic
From: Mayo Clinic http://www.youtube.com/watch?v=BSyPmZdORD8
Is aspirin a wonder drug?
Follow me on Twitter @RobShmerling
Imagine that after years of painstaking research, scientists announced the development of a breakthrough treatment that costs pennies a pill, saves lives, and could reduce healthcare spending by nearly $700 billion in the coming years. And you wouldn’t even need a prescription to get it. Perhaps this all sounds too good to be true. But, according to a new study, we already have such a drug: it’s called aspirin.
An analysis of aspirin use
Based on current recommendations, only about 40% of people who should be taking aspirin are doing so. In this new report, researchers asked: what might happen to population health, longevity, and healthcare costs if aspirin use were more widespread? To answer this, they analyzed reams of health data from thousands of patients and estimated the impact of more widespread aspirin use on their health and survival.
Their findings were striking. For people in the U.S. ages 51 to 79, routine aspirin use could, over a 20-year period:
- prevent 11 cases of heart disease for every 1,000 persons
- prevent four cases of cancer for every 1,000 persons
- lengthen national life expectancy by about four months, allowing an extra 900,000 people to be alive in 2036
- save $692 billion.
Is there a downside to aspirin?
As is true for all medications, aspirin has its downsides. Among other side effects, allergic reactions may occur. And, aspirin is a blood thinner and can irritate the stomach. Episodes of bleeding and stomach ulcers can be serious. So, the researchers took these into account; the estimates above include these side effects of taking aspirin.
It’s important to emphasize that this study assessed the impact of low-dose aspirin, such as the 85 mg daily dose often found in baby aspirin; higher doses may be recommended for other conditions (and come with added risk). In addition, aspirin can interact with other medications. For example, if you take low-dose aspirin for your heart and ibuprofen for arthritis, it’s important that the ibuprofen be taken at least 30 minutes after or more than eight hours before the aspirin; otherwise, the benefit of the aspirin may be lost.
Who should take aspirin?
For those at highest risk of future cardiovascular problems, including those who have had a prior heart attack or stroke, aspirin is routinely recommended to reduce recurrence.
For everyone else, recommendations vary. Some experts recommend low-dose aspirin for everyone over age 50. Other guidelines make a more conservative recommendation based on age (e.g., 50–79 years old) and cardiovascular risk factors that predict a heart attack or stroke occurring in the next 10 years. Well-studied risk calculators, such as the one developed by the Framingham Heart Study, are available to estimate 10-year risk.
In addition, aspirin is routinely recommended to lower cancer risk in people with certain genetic conditions, including hereditary nonpolyposis colorectal cancer.
Why don’t more people take aspirin?
It’s not entirely clear why many people forego aspirin use. My guess is that it’s a combination of factors, including:
- a lack of awareness that aspirin is recommended
- it wasn’t specifically recommended by their doctor
- a greater concern about side effects from aspirin than its potential benefits
- a previous bad experience with aspirin use, such as an allergic reaction
- an aversion to medications in general.
It’s worth emphasizing that when it comes to any treatment — and especially preventive treatments — individual preferences matter a lot. As a result, many reasonable people who would be good candidates to benefit from aspirin will choose not to take it.
What does this mean for you?
For all the effort to identify new and better drugs, it’s remarkable that we aren’t taking full advantage of what we already have. This new study suggests that large health benefits are not being realized simply because not enough people are taking aspirin. But each person has his or her own set of circumstances that can affect the both the risks and the benefits of aspirin treatment, as well as his or her own preferences. The decision to take or forego aspirin is a big one — so add this to your list of things to discuss at your next appointment with your doctor.
The post Is aspirin a wonder drug? appeared first on Harvard Health Blog.
From: Robert H. Shmerling, MD http://www.health.harvard.edu/blog/aspirin-wonder-drug-2016122210916
How loud is too loud when listening to music?
One pediatric audiologist said there are "pockets of young people who have worse hearing than you would expect"
From: http://www.cbsnews.com/news/when-using-headphones-to-listen-to-music-how-loud-it-too-loud-for-kids/
From: http://www.cbsnews.com/news/when-using-headphones-to-listen-to-music-how-loud-it-too-loud-for-kids/
Exercise May Be Real Medicine for Parkinson's
Physical activity helps improve gait and balance, research review finds
From: http://www.webmd.com/parkinsons-disease/news/20161222/exercise-may-be-real-medicine-for-parkinsons-disease?src=RSS_PUBLIC
Who's at risk for missing "silent" heart attack signs?
Doctors should be on the lookout for less-obvious heart attack symptoms, especially in women, study suggests
From: http://www.cbsnews.com/news/high-pain-tolerance-silent-heart-attack-may-be-linked/
From: http://www.cbsnews.com/news/high-pain-tolerance-silent-heart-attack-may-be-linked/
A novel approach: Fighting painkiller addiction at home
While waiting to get into a treatment program, people hooked on opioids can use a drug at home to curb cravings, new research suggests
From: http://www.cbsnews.com/news/fighting-painkiller-addiction-at-home-buprenorphine-suboxone/
From: http://www.cbsnews.com/news/fighting-painkiller-addiction-at-home-buprenorphine-suboxone/
Choking on grapes can kill young children, doctors warn
A new report cites the deaths of a 5-year-old and toddler, highlighting the risks
From: http://www.cbsnews.com/news/choking-on-grapes-can-kill-children-doctors-report/
From: http://www.cbsnews.com/news/choking-on-grapes-can-kill-children-doctors-report/
Drug Shows 'Breakthrough' Promise for Advanced MS
Specialist hopes ocrelizumab will be available by spring
From: http://www.webmd.com/multiple-sclerosis/news/20161222/new-ms-drug-shows-breakthrough-promise-for-advanced-disease?src=RSS_PUBLIC
Serious yoga injuries, though rare, are on the rise
New research shows yoga-related sprains, muscle strains, and fractures have increased in recent years, especially among older adults
From: http://www.cbsnews.com/news/serious-yoga-injuries-on-the-rise/
From: http://www.cbsnews.com/news/serious-yoga-injuries-on-the-rise/
People with dyslexia have other brain differences, study finds
Brain scans reveal that people with dyslexia respond differently to sensory and visual info, not just written words
From: http://www.cbsnews.com/news/dyslexia-brain-differences-imaging-study-suggests/
From: http://www.cbsnews.com/news/dyslexia-brain-differences-imaging-study-suggests/
Mayo Clinic - Session 8: Start Now: Mark Burrell, Ph.D.
From: Mayo Clinic http://www.youtube.com/watch?v=Xn_zfb-K8sw
Mayo Clinic - Session 5: Case Study 2: Challenges of Change
From: Mayo Clinic http://www.youtube.com/watch?v=14_nDsT101I
Mayo Clinic - Session 7: Thriving in an Ecosystem for Health: Dave Isay
From: Mayo Clinic http://www.youtube.com/watch?v=EC9KsI5be44
Mayo Clinic - The Theater of Public Policy
From: Mayo Clinic http://www.youtube.com/watch?v=NRrmrXsbXRM
Making Mayo's Recipes: Almond Crusted Chicken
From: Mayo Clinic http://www.youtube.com/watch?v=IHIy6nZCvII
Is aspirin a wonder drug?
Follow me on Twitter @RobShmerling
Imagine that after years of painstaking research, scientists announced the development of a breakthrough treatment that costs pennies a pill, saves lives, and could reduce healthcare spending by nearly $700 billion in the coming years. And you wouldn’t even need a prescription to get it. Perhaps this all sounds too good to be true. But, according to a new study, we already have such a drug: it’s called aspirin.
An analysis of aspirin use
Based on current recommendations, only about 40% of people who should be taking aspirin are doing so. In this new report, researchers asked: what might happen to population health, longevity, and healthcare costs if aspirin use were more widespread? To answer this, they analyzed reams of health data from thousands of patients and estimated the impact of more widespread aspirin use on their health and survival.
Their findings were striking. For people in the U.S. ages 51 to 79, routine aspirin use could, over a 20-year period:
- prevent 11 cases of heart disease for every 1,000 persons
- prevent four cases of cancer for every 1,000 persons
- lengthen national life expectancy by about four months, allowing an extra 900,000 people to be alive in 2036
- save $692 billion.
Is there a downside to aspirin?
As is true for all medications, aspirin has its downsides. Among other side effects, allergic reactions may occur. And, aspirin is a blood thinner and can irritate the stomach. Episodes of bleeding and stomach ulcers can be serious. So, the researchers took these into account; the estimates above include these side effects of taking aspirin.
It’s important to emphasize that this study assessed the impact of low-dose aspirin, such as the 85 mg daily dose often found in baby aspirin; higher doses may be recommended for other conditions (and come with added risk). In addition, aspirin can interact with other medications. For example, if you take low-dose aspirin for your heart and ibuprofen for arthritis, it’s important that the ibuprofen be taken at least 30 minutes after or more than eight hours before the aspirin; otherwise, the benefit of the aspirin may be lost.
Who should take aspirin?
For those at highest risk of future cardiovascular problems, including those who have had a prior heart attack or stroke, aspirin is routinely recommended to reduce recurrence.
For everyone else, recommendations vary. Some experts recommend low-dose aspirin for everyone over age 50. Other guidelines make a more conservative recommendation based on age (e.g., 50–79 years old) and cardiovascular risk factors that predict a heart attack or stroke occurring in the next 10 years. Well-studied risk calculators, such as the one developed by the Framingham Heart Study, are available to estimate 10-year risk.
In addition, aspirin is routinely recommended to lower cancer risk in people with certain genetic conditions, including hereditary nonpolyposis colorectal cancer.
Why don’t more people take aspirin?
It’s not entirely clear why many people forego aspirin use. My guess is that it’s a combination of factors, including:
- a lack of awareness that aspirin is recommended
- it wasn’t specifically recommended by their doctor
- a greater concern about side effects from aspirin than its potential benefits
- a previous bad experience with aspirin use, such as an allergic reaction
- an aversion to medications in general.
It’s worth emphasizing that when it comes to any treatment — and especially preventive treatments — individual preferences matter a lot. As a result, many reasonable people who would be good candidates to benefit from aspirin will choose not to take it.
What does this mean for you?
For all the effort to identify new and better drugs, it’s remarkable that we aren’t taking full advantage of what we already have. This new study suggests that large health benefits are not being realized simply because not enough people are taking aspirin. But each person has his or her own set of circumstances that can affect the both the risks and the benefits of aspirin treatment, as well as his or her own preferences. The decision to take or forego aspirin is a big one — so add this to your list of things to discuss at your next appointment with your doctor.
The post Is aspirin a wonder drug? appeared first on Harvard Health Blog.
From: Robert H. Shmerling, MD http://www.health.harvard.edu/blog/aspirin-wonder-drug-2016122210916
Republican says son's broken arm was poor health care point
Rep. Bill Huizenga of Michigan said he skipped an emergency room visit after his son broke his arm to avoid the costly treatment
From: http://www.cbsnews.com/news/republican-says-sons-broken-arm-was-poor-political-point-on-health-care/
From: http://www.cbsnews.com/news/republican-says-sons-broken-arm-was-poor-political-point-on-health-care/
Live. Work. Play: Molly’s Diabetes Story
Working for the American Diabetes Association® means making a difference for millions of people and working toward a future free of diabetes and all its burdens.
We all have a story to share. Some of us live with type 1 or type 2 diabetes, gestational diabetes or prediabetes. Others have loved ones with the disease or have lost someone to the fight.
The following are personal stories from the Association’s staff about why we are so committed to the mission to prevent and cure diabetes and to improve the lives of all people affected by diabetes.
Molly with her sons at a Step Out Walk.
Molly Duerr
Corporate Development Officer
Edina, Minnesota
“The sky is the wrong color blue!”
This is one phrase I use a lot to describe life with type 1 diabetes. It is a phrase I learned after I was diagnosed in 1995 and had the opportunity to attend Camp Needlepoint in Hudson, Wisconsin. The experience I had at this diabetes camp was incredible, and I believe it really shaped the person I am today.
When I arrived at camp at age 16, I had been diagnosed with diabetes only three months earlier. This was my first time getting to meet other kids with diabetes. It was the most amazing experience to be surrounded by others who made me feel, for the first time in months, “normal.” While I was at camp I learned so much, from carbohydrate counting to how to use an insulin pump, as well as how other people my age lived with diabetes every day.
After camp, I decided that I wanted to go on an insulin pump. At that time (1995), it was very uncommon for someone under the age of 18 to use one. After I proved my diabetes knowledge base over several months, my doctor allowed me to go on the pump.
Since Camp Needlepoint had been such an incredible experience for me, I started to volunteer my time, first as a camp counselor and then on the medical staff as a Certified Insulin Pump Trainer. Knowing what the American Diabetes Association had given to me through my experience at Camp Needlepoint, I decided that I wanted to work for the organization and make an impact for others living with diabetes.
After finishing graduate school, I took a job in New Jersey working on the Tour de Cure®, the Association’s premier cycling event. After a year in the New Jersey office, I transferred to Minnesota to work on the American Diabetes Association Minnesota Gala and the Diabetes EXPO. I quickly found that my passion for serving those with diabetes came through my ability to work with companies who funded our mission, whether by supporting an event, program or awareness campaign. Now I’m proud to serve as the Corporate Development Officer for the Midwest region, working with companies to find the best way they can support our mission and those affected by diabetes.
What keeps me motivated to live well with diabetes are my greatest accomplishments, my children—Alex, age 8, and Zach, age 4. Having diabetes while pregnant was challenging, not only because I needed to keep my blood sugar between 70 and 140, but also because I had what felt like a million doctor appointments. This taught me that diabetes is like a marathon: You can’t focus too much on one number or the next; it’s about the entire race.
After living with diabetes for 21 years, one thing I’ve learned is that it is unpredictable. You can do the same things, eat the same things and still end up with a different result. My answer to this blood sugar uncertainty is what I learned at camp many years ago: Sometimes, the only answer is “the sky is the wrong color blue” that day.
I work hard every day to raise funds not only to help everyone live well with diabetes, but also to help find a cure—and not just for myself, but for everyone. Alex often asks me about what is happening in diabetes research and when we will have a cure, because he can see the daily struggles and the family team effort it takes to make sure I am as healthy as possible.
Some days, living with diabetes and working in the diabetes field can be difficult. But I can truly say that I believe everything happens for a reason, and my reason for having diabetes is to help others. I am fortunate that many of the friends I made at Camp Needlepoint, right after I was diagnosed, are still very close to me. They are an important support system for me today—and I am proud to give back.
To learn more about nationwide employment opportunities and life at the Association, please visit diabetes.org/careers.
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From: American Diabetes Association http://diabetesstopshere.org/2016/12/22/live-work-play-molly/
Ablation: Treatment for Ventricular Tachycardia - Part 2
From: Mayo Clinic http://www.youtube.com/watch?v=jK54aWqNrXY
Ablation: Treatment for Ventricular Tachycardia - Part 1
From: Mayo Clinic http://www.youtube.com/watch?v=8Pe_OoB7vok
New Approach to Concussion Diagnosis
Ability to process sound provides clues about brain injury, researchers say
From: http://www.webmd.com/brain/news/20161222/new-approach-to-concussion-diagnosis?src=RSS_PUBLIC
Serious Yoga Injuries Are Rare, But on the Rise
Problems requiring ER care up about 70 percent, even more in older people, study finds
From: http://www.webmd.com/balance/news/20161222/serious-yoga-injuries-though-rare-are-on-the-rise?src=RSS_PUBLIC
Advocacy highlights of a busy 2016
2016 was a busy year for the Association’s Washington office.
From: http://www.ada.org/en/publications/ada-news/2016-archive/december/advocacy-highlights-of-a-busy-2016
From: http://www.ada.org/en/publications/ada-news/2016-archive/december/advocacy-highlights-of-a-busy-2016
Natural movement: Going back to basics
From: http://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/natural-movement-going-back-to-basics/art-20267226
Delay in Clamping Umbilical Cord Benefits Babies
New guideline follows research showing that waiting 30 to 60 seconds boosts iron levels throughout 1st year
From: http://www.webmd.com/baby/news/20161221/delay-in-clamping-umbilical-cord-benefits-babies-doctors-say?src=RSS_PUBLIC
Innovative Programs Help Addicts Get Off Opioids
Long waitlists for drug rehab led to two promising efforts in New England
From: http://www.webmd.com/mental-health/addiction/news/20161221/innovative-programs-help-addicts-get-off-opioids?src=RSS_PUBLIC
Antibiotics Duration and Kids' Ear Infections
10 days of the medication was twice as effective, study finds
From: http://www.webmd.com/cold-and-flu/ear-infection/news/20161221/short-course-of-antibiotics-not-best-for-kids-ear-infections?src=RSS_PUBLIC
Ex-pharma execs accused of scheme to prescribe opioid drugs
A new criminal case raises questions about how some in the medical community are pushing the use of addictive painkillers. Six former executives and managers from Arizona-based drugmaker Insys Therapeutics face conspiracy charges over what a federal prosecutor calls a racketeering scheme. Jim Axelrod reports.
From: http://www.cbsnews.com/videos/ex-pharma-execs-accused-of-scheme-to-prescribe-opioid-drugs/
From: http://www.cbsnews.com/videos/ex-pharma-execs-accused-of-scheme-to-prescribe-opioid-drugs/
Former drugmaker execs accused of bribing doctors to push pain meds
Six former employees of Insys Therapeutics face conspiracy charges over allegedly rewarding doctors for prescribing their spray version of fentanyl -- even when it wasn't necessary
From: http://www.cbsnews.com/news/insys-therapeutics-conspiracy-charges-bribing-doctors-fentanyl-subsys-opioid-addiction-painkillers/
From: http://www.cbsnews.com/news/insys-therapeutics-conspiracy-charges-bribing-doctors-fentanyl-subsys-opioid-addiction-painkillers/
Making health decisions in the face of uncertainty: Let your values be your guide
Follow me on Twitter @DavidAScales
My sister texted me recently about my nine-year-old niece. She’d been experiencing joint pain so saw her pediatrician for a check-up. They did some blood tests, which were all normal except one.
“Should we be worried?” my sister asked.
“I’m no pediatrician, but I’d let it go,” I said. “It’s like seeing a cloud in the sky and asking me if I’m concerned about a hurricane.” Should we worry about and investigate every cloud when most don’t end up being a passing storm, let alone a hurricane?
Many patients are like my sister, looking for certainty that everything is normal, and if not, a concrete diagnosis. “Part of the reason why the culture of medicine prizes [certainty] is people come to expect it in us,” Steven Hatch, the author of Snowball in a Blizzard: A Physician’s Notes on Uncertainty in Medicine, said in an interview.
Most doctors, and many patients, have a low tolerance for uncertainty
Yet while most doctors agree that medical uncertainty is ubiquitous and inevitable, it might not initially seem that way when you go to the doctor. Physicians are often happy to oblige a patient’s quest for certainty. Some negative tests might reassure them, and sometimes they might reassure us. We’ve all heard stories about the doctor who didn’t test for something and cancer was later discovered.
That’s because physicians don’t tolerate uncertainty well. “The culture of medicine evinces a deep-rooted unwillingness to acknowledge and embrace it,” according to authors of a recent opinion piece in the New England Journal of Medicine. Our tests and teaching from medical school and beyond push us to think a right answer exists for every clinical conundrum, says Hatch.
Medical uncertainty is frustrating for patients and doctors; it’s also challenging to try and understand it. For any decision we make — to do more tests, or not to test —we have to weigh two risks against each other: the risks of being harmed by the side effects of the test itself versus the risk of missing a serious diagnosis by not testing. It’s the preoccupation of monitoring every cloud to ensure not missing a hurricane.
Those risks are never certain, but abstract numbers based on statistics and probabilities help us weigh decisions. The closest we get to medical certainty is when a probability approaches 100%.
Making decisions about your health in the face of uncertainty
But that rarely happens. For most real-world scenarios, every doctor and every patient has their own threshold for uncertainty versus the risks of further tests. Some lean toward testing, minimizing the potential harms of further testing; others assume everything will be okay and that multiple doctor visits and testing pose the greater inconvenience. You have to know yourself and your values to guide which risks you’d prefer to tolerate to get closer to certainty.
I take that approach with my patients. As a patient, it’s important to understand that your doctor doesn’t have all the answers and that medical textbooks often don’t either. There. When I don’t know something, I try to be clear about what I know versus what is not known, by anyone. I explain the limits of medicine, that most of our studies shed light on things that kill you, so, in a backwards way, the fact that we don’t know very much about your illness is reassuring. It means it is very unlikely to kill you.
That’s not always the most reassuring statement. Patients suffering from pilonidal cysts, irritable bowel syndrome, or lactose intolerance, to name just a few examples, can be debilitated by painful and even dangerous conditions. In those cases, we have a discussion about values —which feels riskier to you: getting hurt by the side effects of more testing to rule out the most dangerous diagnoses, or missing a diagnosis like that because we didn’t test for it?
One patient I know has been devastated by the countless numbers of her relatives who died from cancer. When I asked what risks she might be willing to take to screen for cancer, she told me she would accept all of them. Whatever mammograms, breast biopsies, Pap smears, colonoscopies, or blood tests were necessary, she wanted them. When it came to cancer, her threshold for uncertainty was very low.
Another patient of mine was an elderly man who took no medications. Based on his age, blood pressure, and cholesterol level, we used an online calculator to estimate that he had about a 15% chance of having a heart attack in the next decade. This is a clear indication to start a medication that helps reduce the risk of heart attacks — the chance that the benefits outweigh the risk is very high. We were approaching certainty in our medical recommendation, but he didn’t want to follow it. He likes living without medications, telling me unless the risk of a heart attack in ten years was 50% he wouldn’t consider changing. We were dealing with hypothetical situations based on statistics, but it gave us a mechanism to figure out where his thresholds rested.
My sister texted me her concerns that the blood test might be a harbinger of an obscure diagnosis — the worst-case scenario, the hurricane. She was worried. I said the most important thing was communicating with her doctor just how much the uncertainty worried her. Only then could they partner on a way to balance the need to reduce the uncertainty without exposing my niece to an array of risky tests.
The post Making health decisions in the face of uncertainty: Let your values be your guide appeared first on Harvard Health Blog.
From: David Scales, MPhil, MD, PhD http://www.health.harvard.edu/blog/uncertainty-in-medicine-and-making-health-decisions-let-your-values-be-your-guide-2016122110874
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