U.S. Customs and Border Patrol seize record amount of fentanyl and other opioids

U.S. Customs and Border patrol officials seized a record amount of fentanyl and other synthetic opioids in the fiscal year that ends tonight. Most of the illegal packages were found in the mailroom at New York's JFK Airport. Tony Dokoupil reports.

From: http://www.cbsnews.com/videos/u-s-customs-and-border-patrol-seize-record-amount-of-fentanyl-and-other-opioids/

Mayo Clinic Minute: 'HALT' before you grab a snack

From: Mayo Clinic https://www.youtube.com/watch?v=5DFp4MgycWs

Time to rethink the debate on PSA testing

For most of us, whether to screen for cancer is a no-brainer. Who wouldn’t want a simple test to prevent cancer or identify it at an earlier, more treatable stage? However, as with many things, the screening decision is more complex than it may appear. For example, the test may not be particularly “simple,” such as undergoing screening colonoscopy. For prostate cancer, even after 30-plus years of using a screening blood test called the prostate specific antigen, or PSA, it still isn’t clear how well it prevents prostate cancer deaths. This has led to conflicting and changing recommendations about whether to screen or not. Earlier this year, I commented on revised recommendations from the US Preventive Services Task Force (USPSTF) — a group that advises primary care physician such as myself about a wide range of topics including cancer screening.

A new look at old studies

The PSA test was used for many years without any clear evidence for or against it, and without the USPSTF providing a specific recommendation. This changed in 2009 after the publication of two large trials, one from the US and the other from Europe. Unfortunately, they showed conflicting results — no benefit in the US trial versus a small benefit in the European one. This led the USPSTF to recommend against PSA screening based on the negative results from the US trial, as well as evidence of potential harms of PSA testing from overdiagnosis and treatment of small, benign-appearing cancers unlikely to spread or lead to death. Earlier this year, the USPSTF proposed changing its recommendations to say that health care providers should now discuss the pros and cons of the test with eligible male patients to help them decide whether to have the test or not, using a process called shared decision making.

If all this wasn’t confusing enough, a new study recently re-examined these two (now old) trials and concluded that they really aren’t as different as we thought. The authors of the new study did new analyses showing that PSA testing decreased prostate cancer deaths similarly in these trials. So, what’s going on, and will the USPSTF again change its recommendation?

In brief, the new study used original data from these two trials and computer modeling to control for important differences. These differences included lower rates of prostate cancer overall and more control patients getting a PSA test done (who shouldn’t have) in the US trial. The European trial performed PSA screening less frequently but called the test result abnormal at a lower value than the US trial. After accounting for all these differences, the new study reported that men in both trials who underwent screening as recommended had lower rates of death due to prostate cancer.

What now?

Though this new study may explain why these two trial results differed, I don’t expect the USPSTF will change its recommendation. Personally, I have long favored shared decision making with my patients, and think the USPSTF finally got it right. Why? First, despite all the fancy modeling in this study, it sought to examine the benefit of the PSA test under ideal circumstances, rather than what actually took place. Moreover, the benefit of PSA testing seems large in relative terms (20-30%), but is small in absolute terms. I’d have to screen over 1,000 men with the PSA test to prevent one prostate cancer death. Moreover, decades of using the test have also uncovered real harms — many men are being diagnosed and treated for prostate cancers that otherwise never would have been detected or caused harm. Finally, prostate cancer therapies for those with serious disease needing treatment have improved a great deal since these trials were done, lowering the value of earlier detection.

I support calls to move on from the overly simplistic debate of PSA test: yes or no. Rather, it is time to figure out how to better inform all eligible men about the benefits and harms of PSA testing. For those who elect to have the test, we need to do a better job figuring out who needs treatment when prostate cancer is found, and how to make sure we avoid harming those without such disease — harm that can be both psychologic in terms of worry and physical in terms of side effects from treatment.

The post Time to rethink the debate on PSA testing appeared first on Harvard Health Blog.

From: Steven J. Atlas, MD, MPH https://www.health.harvard.edu/blog/time-to-rethink-the-psa-to-test-or-not-to-test-debate-2017092912463

Members of Congress ask HHS to remove burdensome regulations to help providers, patients

Washington — Members of Congress are asking the U.S. Department of Health and Human Services to remove regulations that “specifically and adversely impact dentists and their patients.”

From: http://www.ada.org/en/publications/ada-news/2017-archive/september/members-of-congress-ask-hhs-to-remove-burdensome-regulations-to-help-providers-patients

Nurses Believe (Trailer) - Healthy Nurse, Healthy Nation Grand Challenge

From: Mayo Clinic https://www.youtube.com/watch?v=G8uOazJAAiE

Nurses Believe - Healthy Nurse, Healthy Nation Grand Challenge

From: Mayo Clinic https://www.youtube.com/watch?v=Z6YqHBQsAXE

Mayo Clinic Minute: Sleep and Alzheimer's disease connection

From: Mayo Clinic https://www.youtube.com/watch?v=-gfEepYk92I

Diabetes: Adding lifestyle changes to medication can deliver a knockout punch

Plenty of research supports the common-sense notion that a healthy lifestyle can prevent or treat many diseases. A diet high in fruits, veggies, whole grains, and plant protein and low in processed carbs, added sugars, saturated fats; regular physical activity; and emotional well-being are the potent treatments that can prevent the need for or even replace many prescription medications.

Yet lifestyle interventions are still not “mainstreamed” into primary care.

The power of lifestyle changes for diabetes

Here is yet another study supporting intensive lifestyle intervention, this time for diabetes. The study authors seem to downplay their findings, which, frankly, baffled me. I’m happy to enthusiastically report that this study strongly confirms what I’ve often observed over the past 15 years in medicine: the way we live and what we put in our mouths can be way more powerful than many of the pills we’re prescribed.

Basically, the study authors recruited 98 people with type 2 (adult-onset) diabetes who were all pretty similar. They had had diabetes for less than 10 years and their blood sugars were not completely out of control (HbA1c* less than 9%); they were not on insulin; they all had a body mass index between 25 and 40 (that is, they were overweight).

They divided people into two groups for a year. Both groups stayed on their regular medications. The standard care group (34 people) received basic counseling and education in type 2 diabetes, including lifestyle advice by a nurse at the start of the study and again every three months.

The other group (64 people) also received a pretty intensive lifestyle intervention:

• five to six exercise sessions per week, consisting of 30 to 60 minutes of supervised aerobic activity, along with two to three sessions of weight training
• an individualized nutrition plan with dietary counseling, including calorie restriction for the first four months
• a smart watch/step counter and encouragement to be physically active in their leisure time (with a goal of at least 10,000 steps per day).

The lifestyle group did have slightly better overall blood sugar control after a year, but the real kicker was this: 73% of the lifestyle participants were able to decrease the dosage of their diabetes medications, compared to only 26% of the standard care group. And, over half of the lifestyle participants could safely discontinue their medications! As a matter of fact, 44% of the standard care group had to have their medications increased during the study, compared to only 11% in the lifestyle group.

*HbA1C is the abbreviation for hemoglobin A1c, the product formed by the attachment of glucose (blood sugar) to hemoglobin (a protein in red blood cells). A test for HbA1c is a useful measure of blood sugar control over time. An HbA1C level between 4% and 5.6% means that blood sugar has been in a good range over the past few months.

Other improvements in measure of health

In addition, the lifestyle group enjoyed significant improvements in pretty much all their measurements: weight (13.2 lbs. lost, compared to 4.4 lbs.), BMI (31 to 29, compared to 32.5 to 32), and abdominal fat (2 lbs. lost, as compared to 0.2 lbs.), with a gain in lean body mass (i.e. muscle). Over a third of the lifestyle group lost over 10% of their body weight, compared with 3% of the standard care group. And the lifestyle folks also experienced a significant improvement in their physical fitness, as measured by a fancy machine measuring oxygen uptake by the body during intense exercise.

The study authors seemed to emphasize that lifestyle improved blood sugar only modestly better than standard care at 12 months. What was incredibly striking, though, was the trend in the blood sugars over the entire year. At six months, the lifestyle group’s HbA1c levels decreased very significantly, from 6.6% to 6.2%, while the standard care group’s HbA1c increased from 6.7% to 6.9%. At 12 months, both groups drifted closer to where they had started, with the lifestyle group still a bit better than the standard care group at 6.3% as compared to 6.6%.

Why is this?

There are two possible reasons. One was that the lifestyle group had fully supervised exercise and dietary counseling sessions (including calorie restriction) for only the first four months, and after that, supervision was progressively decreased, and as a result people were less likely to stick with the program. In fact, the article shows that participation in the exercise and dietary counseling sessions dropped off over the year.

Another factor is that the participants’ diabetes medication was being adjusted throughout the study for health and safety reasons. If the HbA1c dropped below 6.5%, then their medication was decreased, and if it stayed that low or went lower, the medication was discontinued. Likewise, if the HbA1c went above 7.5%, then the medication was increased. The lifestyle group did have more episodes of low blood sugar than the standard care side, and while that can be dangerous, it also signals that the lifestyle participants needed less medication as time went on.

So, it’s reasonable to speculate that if the exercise and dietary session supervision was continuous throughout the study, and if the medications were not continually adjusted, then the results would have shown even greater improvements for the people in the lifestyle group.

And that jibes with previous studies looking at lifestyle intervention for the prevention and treatment of heart disease. There’s so much accumulated evidence supporting lifestyle intervention as a very effective treatment, that major insurance carriers will now cover such programs.

I do hope that patients will realize that lifestyle changes are as good as, and sometimes better than, prescription medications. Primary care doctors need to help them do just that.

Resources

Lifestyle medicine potential for reversing a world of chronic disease epidemics: from cell to community. International Journal of Clinical Practice, October 2014.

Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association. Circulation, August 2012.

Head-to-head comparison of intensive lifestyle intervention (U-TURN) versus conventional multifactorial care in patients with type 2 diabetes: protocol and rationale for an assessor-blinded, parallel group and randomised trial. BMJ, December 2015.

Effect of an Intensive Lifestyle Intervention on Glycemic Control in Patients With Type 2 Diabetes: A Randomized Clinical Trial. JAMA, August 2017.

Effects of Lifestyle Modification Programs on Cardiac Risk Factors. PLoS One, December 2014.

The post Diabetes: Adding lifestyle changes to medication can deliver a knockout punch appeared first on Harvard Health Blog.

From: Monique Tello, MD, MPH https://www.health.harvard.edu/blog/diabetes-adding-lifestyle-changes-medication-can-deliver-knockout-punch-2017092812468

Time to rethink the debate on PSA testing

For most of us, whether to screen for cancer is a no-brainer. Who wouldn’t want a simple test to prevent cancer or identify it at an earlier, more treatable stage? However, as with many things, the screening decision is more complex than it may appear. For example, the test may not be particularly “simple,” such as undergoing screening colonoscopy. For prostate cancer, even after 30-plus years of using a screening blood test called the prostate specific antigen, or PSA, it still isn’t clear how well it prevents prostate cancer deaths. This has led to conflicting and changing recommendations about whether to screen or not. Earlier this year, I commented on revised recommendations from the US Preventive Services Task Force (USPSTF) — a group that advises primary care physician such as myself about a wide range of topics including cancer screening.

A new look at old studies

The PSA test was used for many years without any clear evidence for or against it, and without the USPSTF providing a specific recommendation. This changed in 2009 after the publication of two large trials, one from the US and the other from Europe. Unfortunately, they showed conflicting results — no benefit in the US trial versus a small benefit in the European one. This led the USPSTF to recommend against PSA screening based on the negative results from the US trial, as well as evidence of potential harms of PSA testing from overdiagnosis and treatment of small, benign-appearing cancers unlikely to spread or lead to death. Earlier this year, the USPSTF proposed changing its recommendations to say that health care providers should now discuss the pros and cons of the test with eligible male patients to help them decide whether to have the test or not, using a process called shared decision making.

If all this wasn’t confusing enough, a new study recently re-examined these two (now old) trials and concluded that they really aren’t as different as we thought. The authors of the new study did new analyses showing that PSA testing decreased prostate cancer deaths similarly in these trials. So, what’s going on, and will the USPSTF again change its recommendation?

In brief, the new study used original data from these two trials and computer modeling to control for important differences. These differences included lower rates of prostate cancer overall and more control patients getting a PSA test done (who shouldn’t have) in the US trial. The European trial performed PSA screening less frequently but called the test result abnormal at a lower value than the US trial. After accounting for all these differences, the new study reported that men in both trials who underwent screening as recommended had lower rates of death due to prostate cancer.

What now?

Though this new study may explain why these two trial results differed, I don’t expect the USPSTF will change its recommendation. Personally, I have long favored shared decision making with my patients, and think the USPSTF finally got it right. Why? First, despite all the fancy modeling in this study, it sought to examine the benefit of the PSA test under ideal circumstances, rather than what actually took place. Moreover, the benefit of PSA testing seems large in relative terms (20-30%), but is small in absolute terms. I’d have to screen over 1,000 men with the PSA test to prevent one prostate cancer death. Moreover, decades of using the test have also uncovered real harms — many men are being diagnosed and treated for prostate cancers that otherwise never would have been detected or caused harm. Finally, prostate cancer therapies for those with serious disease needing treatment have improved a great deal since these trials were done, lowering the value of earlier detection.

I support calls to move on from the overly simplistic debate of PSA test: yes or no. Rather, it is time to figure out how to better inform all eligible men about the benefits and harms of PSA testing. For those who elect to have the test, we need to do a better job figuring out who needs treatment when prostate cancer is found, and how to make sure we avoid harming those without such disease — harm that can be both psychologic in terms of worry and physical in terms of side effects from treatment.

The post Time to rethink the debate on PSA testing appeared first on Harvard Health Blog.

From: Steven J. Atlas, MD, MPH https://www.health.harvard.edu/blog/time-to-rethink-the-psa-to-test-or-not-to-test-debate-2017092912463

Diabetes: Adding lifestyle changes to medication can deliver a knockout punch

Plenty of research supports the common-sense notion that a healthy lifestyle can prevent or treat many diseases. A diet high in fruits, veggies, whole grains, and plant protein and low in processed carbs, added sugars, saturated fats; regular physical activity; and emotional well-being are the potent treatments that can prevent the need for or even replace many prescription medications.

Yet lifestyle interventions are still not “mainstreamed” into primary care.

The power of lifestyle changes for diabetes

Here is yet another study supporting intensive lifestyle intervention, this time for diabetes. The study authors seem to downplay their findings, which, frankly, baffled me. I’m happy to enthusiastically report that this study strongly confirms what I’ve often observed over the past 15 years in medicine: the way we live and what we put in our mouths can be way more powerful than many of the pills we’re prescribed.

Basically, the study authors recruited 98 people with type 2 (adult-onset) diabetes who were all pretty similar. They had had diabetes for less than 10 years and their blood sugars were not completely out of control (HbA1c* less than 9%); they were not on insulin; they all had a body mass index between 25 and 40 (that is, they were overweight).

They divided people into two groups for a year. Both groups stayed on their regular medications. The standard care group (34 people) received basic counseling and education in type 2 diabetes, including lifestyle advice by a nurse at the start of the study and again every three months.

The other group (64 people) also received a pretty intensive lifestyle intervention:

• five to six exercise sessions per week, consisting of 30 to 60 minutes of supervised aerobic activity, along with two to three sessions of weight training
• an individualized nutrition plan with dietary counseling, including calorie restriction for the first four months
• a smart watch/step counter and encouragement to be physically active in their leisure time (with a goal of at least 10,000 steps per day).

The lifestyle group did have slightly better overall blood sugar control after a year, but the real kicker was this: 73% of the lifestyle participants were able to decrease the dosage of their diabetes medications, compared to only 26% of the standard care group. And, over half of the lifestyle participants could safely discontinue their medications! As a matter of fact, 44% of the standard care group had to have their medications increased during the study, compared to only 11% in the lifestyle group.

*HbA1C is the abbreviation for hemoglobin A1c, the product formed by the attachment of glucose (blood sugar) to hemoglobin (a protein in red blood cells). A test for HbA1c is a useful measure of blood sugar control over time. An HbA1C level between 4% and 5.6% means that blood sugar has been in a good range over the past few months.

Other improvements in measure of health

In addition, the lifestyle group enjoyed significant improvements in pretty much all their measurements: weight (13.2 lbs. lost, compared to 4.4 lbs.), BMI (31 to 29, compared to 32.5 to 32), and abdominal fat (2 lbs. lost, as compared to 0.2 lbs.), with a gain in lean body mass (i.e. muscle). Over a third of the lifestyle group lost over 10% of their body weight, compared with 3% of the standard care group. And the lifestyle folks also experienced a significant improvement in their physical fitness, as measured by a fancy machine measuring oxygen uptake by the body during intense exercise.

The study authors seemed to emphasize that lifestyle improved blood sugar only modestly better than standard care at 12 months. What was incredibly striking, though, was the trend in the blood sugars over the entire year. At six months, the lifestyle group’s HbA1c levels decreased very significantly, from 6.6% to 6.2%, while the standard care group’s HbA1c increased from 6.7% to 6.9%. At 12 months, both groups drifted closer to where they had started, with the lifestyle group still a bit better than the standard care group at 6.3% as compared to 6.6%.

Why is this?

There are two possible reasons. One was that the lifestyle group had fully supervised exercise and dietary counseling sessions (including calorie restriction) for only the first four months, and after that, supervision was progressively decreased, and as a result people were less likely to stick with the program. In fact, the article shows that participation in the exercise and dietary counseling sessions dropped off over the year.

Another factor is that the participants’ diabetes medication was being adjusted throughout the study for health and safety reasons. If the HbA1c dropped below 6.5%, then their medication was decreased, and if it stayed that low or went lower, the medication was discontinued. Likewise, if the HbA1c went above 7.5%, then the medication was increased. The lifestyle group did have more episodes of low blood sugar than the standard care side, and while that can be dangerous, it also signals that the lifestyle participants needed less medication as time went on.

So, it’s reasonable to speculate that if the exercise and dietary session supervision was continuous throughout the study, and if the medications were not continually adjusted, then the results would have shown even greater improvements for the people in the lifestyle group.

And that jibes with previous studies looking at lifestyle intervention for the prevention and treatment of heart disease. There’s so much accumulated evidence supporting lifestyle intervention as a very effective treatment, that major insurance carriers will now cover such programs.

I do hope that patients will realize that lifestyle changes are as good as, and sometimes better than, prescription medications. Primary care doctors need to help them do just that.

Resources

Lifestyle medicine potential for reversing a world of chronic disease epidemics: from cell to community. International Journal of Clinical Practice, October 2014.

Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association. Circulation, August 2012.

Head-to-head comparison of intensive lifestyle intervention (U-TURN) versus conventional multifactorial care in patients with type 2 diabetes: protocol and rationale for an assessor-blinded, parallel group and randomised trial. BMJ, December 2015.

Effect of an Intensive Lifestyle Intervention on Glycemic Control in Patients With Type 2 Diabetes: A Randomized Clinical Trial. JAMA, August 2017.

Effects of Lifestyle Modification Programs on Cardiac Risk Factors. PLoS One, December 2014.

The post Diabetes: Adding lifestyle changes to medication can deliver a knockout punch appeared first on Harvard Health Blog.

From: Monique Tello, MD, MPH https://www.health.harvard.edu/blog/diabetes-adding-lifestyle-changes-medication-can-deliver-knockout-punch-2017092812468

Pharmacist in San Juan working to get medication to people in shelters

For Hurricane Maria's victims in Puerto Rico, medicine is in short supply, in addition to food and water. CBS News chief medical correspondent Dr. Jon LaPook reports on the work to aid the medical crisis in San Juan.

From: http://www.cbsnews.com/videos/pharmacist-in-san-juan-working-to-get-medication-to-people-in-shelters/

Mayo Clinic Minute: 'HALT' before you grab a snack

From: Mayo Clinic https://www.youtube.com/watch?v=5DFp4MgycWs

HHS Secretary Tom Price Resigns

Actress Julia Louis-Dreyfus Has Breast Cancer Hugh Hefner Dead at 91

From: http://www.webmd.com/health-insurance/news/20170929/health-highlights-sept-29-2017?src=RSS_PUBLIC

Ways to boost bone health as you age

Dr. Joshua Grahlman shares strategies to help build bone strength and prevent fractures

From: http://www.cbsnews.com/news/bones-healthy-retirement-gsk/

Members of Congress ask HHS to remove burdensome regulations to help providers, patients

Washington — Members of Congress are asking the U.S. Department of Health and Human Services to remove regulations that “specifically and adversely impact dentists and their patients.”

From: http://www.ada.org/en/publications/ada-news/2017-archive/september/members-of-congress-ask-hhs-to-remove-burdensome-regulations-to-help-providers-patients

Women Lack 'High Quality' Guidance Post-Mastectomy

Fewer than half of patients made decisions that were best for their own preferred outcome.

From: http://www.webmd.com/breast-cancer/news/20170929/women-lack-high-quality-guidance-post-mastectomy?src=RSS_PUBLIC

Flu Season: Vaccine Crucial to Avoiding Illness

Officials won't predict severity of the flu season, but say the best way to protect yourself and others is to get a flu shot.

From: http://www.webmd.com/cold-and-flu/news/20170929/flu-season-vaccine-crucial-to-avoiding-illness?src=RSS_PUBLIC

Health services must stop leaving older people behind

Health services must stop leaving older people behind

From: http://www.who.int/entity/mediacentre/news/releases/2017/health-older-people/en/index.html

FDA approves first blood sugar monitor without finger prick

The device, approved for adults with Type 1 or Type 2 diabetes​, should be available in pharmacies within months

From: http://www.cbsnews.com/news/fda-approves-first-blood-sugar-monitor-without-finger-prick/

After eye tattoo goes wrong, model issues warning on social media

Model warns others after botched eye tattoo may leave her completely blind in one eye

From: http://www.cbsnews.com/news/sclera-tattoo-gone-wrong-warning-model-catt-gallinger/

Study Questions Practice of Placenta Eating

It may be potentially dangerous, researchers say

From: http://www.webmd.com/parenting/baby/news/20170929/study-questions-practice-of-placenta?src=RSS_PUBLIC

Researchers Find Gender Has Role in Autism Risk

When oldest female child has the disorder, risk is raised for younger siblings, especially boys: study

From: http://www.webmd.com/brain/autism/news/20170929/researchers-find-gender-has-role-in-autism-risk?src=RSS_PUBLIC

Respiratory Disease Death Rates Have Soared

More than 3.9 million Americans died from COPD over last 35 years, new data shows

From: http://www.webmd.com/lung/copd/news/20170929/respiratory-disease-death-rates-have-soared?src=RSS_PUBLIC

Study Questions Practice of Placenta Eating

It may be potentially dangerous, researchers say

From: http://www.webmd.com/parenting/baby/news/20170929/study-questions-practice-of-placenta?src=RSS_PUBLIC

Respiratory Disease Death Rates Have Soared

More than 3.9 million Americans died from COPD over last 35 years, new data shows

From: http://www.webmd.com/lung/copd/news/20170929/respiratory-disease-death-rates-have-soared?src=RSS_PUBLIC

After eye tattoo goes wrong, model issues warning on social media

Model warns others after botched eye tattoo may leave her completely blind in one eye

From: http://www.cbsnews.com/news/sclera-tattoo-gone-wrong-warning-model-catt-gallinger/

Time to rethink the debate on PSA testing

For most of us, whether to screen for cancer is a no-brainer. Who wouldn’t want a simple test to prevent cancer or identify it at an earlier, more treatable stage? However, as with many things, the screening decision is more complex than it may appear. For example, the test may not be particularly “simple,” such as undergoing screening colonoscopy. For prostate cancer, even after 30-plus years of using a screening blood test called the prostate specific antigen, or PSA, it still isn’t clear how well it prevents prostate cancer deaths. This has led to conflicting and changing recommendations about whether to screen or not. Earlier this year, I commented on revised recommendations from the US Preventive Services Task Force (USPSTF) — a group that advises primary care physician such as myself about a wide range of topics including cancer screening.

A new look at old studies

The PSA test was used for many years without any clear evidence for or against it, and without the USPSTF providing a specific recommendation. This changed in 2009 after the publication of two large trials, one from the US and the other from Europe. Unfortunately, they showed conflicting results — no benefit in the US trial versus a small benefit in the European one. This led the USPSTF to recommend against PSA screening based on the negative results from the US trial, as well as evidence of potential harms of PSA testing from overdiagnosis and treatment of small, benign-appearing cancers unlikely to spread or lead to death. Earlier this year, the USPSTF proposed changing its recommendations to say that health care providers should now discuss the pros and cons of the test with eligible male patients to help them decide whether to have the test or not, using a process called shared decision making.

If all this wasn’t confusing enough, a new study recently re-examined these two (now old) trials and concluded that they really aren’t as different as we thought. The authors of the new study did new analyses showing that PSA testing decreased prostate cancer deaths similarly in these trials. So, what’s going on, and will the USPSTF again change its recommendation?

In brief, the new study used original data from these two trials and computer modeling to control for important differences. These differences included lower rates of prostate cancer overall and more control patients getting a PSA test done (who shouldn’t have) in the US trial. The European trial performed PSA screening less frequently but called the test result abnormal at a lower value than the US trial. After accounting for all these differences, the new study reported that men in both trials who underwent screening as recommended had lower rates of death due to prostate cancer.

What now?

Though this new study may explain why these two trial results differed, I don’t expect the USPSTF will change its recommendation. Personally, I have long favored shared decision making with my patients, and think the USPSTF finally got it right. Why? First, despite all the fancy modeling in this study, it sought to examine the benefit of the PSA test under ideal circumstances, rather than what actually took place. Moreover, the benefit of PSA testing seems large in relative terms (20-30%), but is small in absolute terms. I’d have to screen over 1,000 men with the PSA test to prevent one prostate cancer death. Moreover, decades of using the test have also uncovered real harms — many men are being diagnosed and treated for prostate cancers that otherwise never would have been detected or caused harm. Finally, prostate cancer therapies for those with serious disease needing treatment have improved a great deal since these trials were done, lowering the value of earlier detection.

I support calls to move on from the overly simplistic debate of PSA test: yes or no. Rather, it is time to figure out how to better inform all eligible men about the benefits and harms of PSA testing. For those who elect to have the test, we need to do a better job figuring out who needs treatment when prostate cancer is found, and how to make sure we avoid harming those without such disease — harm that can be both psychologic in terms of worry and physical in terms of side effects from treatment.

The post Time to rethink the debate on PSA testing appeared first on Harvard Health Blog.

From: Steven J. Atlas, MD, MPH https://www.health.harvard.edu/blog/time-to-rethink-the-psa-to-test-or-not-to-test-debate-2017092912463

WHO recommends large-scale deworming to improve children’s health and nutrition

Four species of intestinal worms affect almost a quarter of the world’s poorest and mostly marginalized people. They disrupt people’s ability to absorb nutrients, and impede the growth and physical development of millions of children. Periodic deworming programmes with a single-tablet treatment can drastically reduce the suffering of those infected and protect the 1.5 billion people currently estimated to be at risk.

From: http://www.who.int/entity/mediacentre/news/releases/2017/large-scale-deworming/en/index.html

Why this flu season could be a bad one

Flu hit the Southern Hemisphere particularly hard over the past few months, which could mean a miserable fall and winter for the U.S.

From: http://www.cbsnews.com/news/flu-season-could-be-bad/

Nurses Believe (Trailer) - Healthy Nurse, Healthy Nation Grand Challenge

From: Mayo Clinic https://www.youtube.com/watch?v=G8uOazJAAiE

Nurses Believe - Healthy Nurse, Healthy Nation Grand Challenge

From: Mayo Clinic https://www.youtube.com/watch?v=Z6YqHBQsAXE

Julia Louis-Dreyfus Reveals Breast Cancer

The multiple-Emmy winner revealed her diagnosis on Instagram.

From: http://www.webmd.com/breast-cancer/news/20170928/julia-louis-dreyfus-reveals-breast-cancer?src=RSS_PUBLIC

How Zika Virus Went From Mild to Devastating

Mouse study suggests one genetic mutation in 2013 unleashed its ability to attack developing fetal brains

From: http://www.webmd.com/a-to-z-guides/news/20170928/how-zika-virus-went-from-mild-to-devastating?src=RSS_PUBLIC

FDA OKs Device With No Finger-Prick For Diabetes

Device eliminates need to prick finger to measure blood sugar levels

From: http://www.webmd.com/diabetes/news/20170928/fda-oks-device-with-no-finger-prick-for-diabetes?src=RSS_PUBLIC

Nearly Half of the World's Abortions Are Unsafe

Worst conditions found in Africa, Asia and Latin America, WHO researchers say

From: http://www.webmd.com/infertility-and-reproduction/news/20170928/nearly-half-of-the-worlds-abortions-are-unsafe?src=RSS_PUBLIC

WHO Statement on Philip Morris funded Foundation for a Smoke-Free World

WHO Statement on Philip Morris funded Foundation for a Smoke-Free World

From: http://www.who.int/entity/mediacentre/news/statements/2017/philip-morris-foundation/en/index.html

FDA expands opioids efforts to include guidance on managing acute pain

The Food and Drug Administration announced Sept. 28 that immediate release opioids medications will now be subject to a "more stringent set of requirements" as part of the agency's efforts to address the nation's opioids crisis.

From: By Jennifer Garvin http://www.ada.org/en/publications/ada-news/2017-archive/september/fda-expands-opioids-efforts-to-include-guidance-on-managing-acute-pain

Last chance to register for webinar that addresses third-party payer contracts

Third-Party Payer Contract: The Most Important Decision is a free webinar from the ADA that will stream Oct. 5 from noon-1 p.m. Central Daylight Time.

From: http://www.ada.org/en/publications/ada-news/2017-archive/september/last-chance-to-register-for-webinar-that-addresses-third-party-payer-contracts

Mayo Clinic Minute: Sleep and Alzheimer's disease connection

From: Mayo Clinic https://www.youtube.com/watch?v=-gfEepYk92I

Delays in Diagnosis Hurt Women With Heart Disease

Study found they were less likely to receive surgeries involving multiple artery grafts

From: http://www.webmd.com/heart-disease/news/20170928/delays-in-diagnosis-hurt-women-with-heart-disease?src=RSS_PUBLIC

Brain Scan May Explain Parkinson's Hallucinations

Scans showed areas with decreased connectivity

From: http://www.webmd.com/parkinsons-disease/news/20170928/brain-scan-may-explain-parkinsons-hallucinations?src=RSS_PUBLIC

Coffee Doesn't Help Parkinson's Motor Disorders

Caffeine has no impact, says long-term trial that reverses earlier findings

From: http://www.webmd.com/parkinsons-disease/news/20170928/coffee-doesnt-help-parkinsons-motor-disorders?src=RSS_PUBLIC

Diabetes: Adding lifestyle changes to medication can deliver a knockout punch

Plenty of research supports the common-sense notion that a healthy lifestyle can prevent or treat many diseases. A diet high in fruits, veggies, whole grains, and plant protein and low in processed carbs, added sugars, saturated fats; regular physical activity; and emotional well-being are the potent treatments that can prevent the need for or even replace many prescription medications.

Yet lifestyle interventions are still not “mainstreamed” into primary care.

The power of lifestyle changes for diabetes

Here is yet another study supporting intensive lifestyle intervention, this time for diabetes. The study authors seem to downplay their findings, which, frankly, baffled me. I’m happy to enthusiastically report that this study strongly confirms what I’ve often observed over the past 15 years in medicine: the way we live and what we put in our mouths can be way more powerful than many of the pills we’re prescribed.

Basically, the study authors recruited 98 people with type 2 (adult-onset) diabetes who were all pretty similar. They had had diabetes for less than 10 years and their blood sugars were not completely out of control (HbA1c* less than 9%); they were not on insulin; they all had a body mass index between 25 and 40 (that is, they were overweight).

They divided people into two groups for a year. Both groups stayed on their regular medications. The standard care group (34 people) received basic counseling and education in type 2 diabetes, including lifestyle advice by a nurse at the start of the study and again every three months.

The other group (64 people) also received a pretty intensive lifestyle intervention:

• five to six exercise sessions per week, consisting of 30 to 60 minutes of supervised aerobic activity, along with two to three sessions of weight training
• an individualized nutrition plan with dietary counseling, including calorie restriction for the first four months
• a smart watch/step counter and encouragement to be physically active in their leisure time (with a goal of at least 10,000 steps per day).

The lifestyle group did have slightly better overall blood sugar control after a year, but the real kicker was this: 73% of the lifestyle participants were able to decrease the dosage of their diabetes medications, compared to only 26% of the standard care group. And, over half of the lifestyle participants could safely discontinue their medications! As a matter of fact, 44% of the standard care group had to have their medications increased during the study, compared to only 11% in the lifestyle group.

*HbA1C is the abbreviation for hemoglobin A1c, the product formed by the attachment of glucose (blood sugar) to hemoglobin (a protein in red blood cells). A test for HbA1c is a useful measure of blood sugar control over time. An HbA1C level between 4% and 5.6% means that blood sugar has been in a good range over the past few months.

Other improvements in measure of health

In addition, the lifestyle group enjoyed significant improvements in pretty much all their measurements: weight (13.2 lbs. lost, compared to 4.4 lbs.), BMI (31 to 29, compared to 32.5 to 32), and abdominal fat (2 lbs. lost, as compared to 0.2 lbs.), with a gain in lean body mass (i.e. muscle). Over a third of the lifestyle group lost over 10% of their body weight, compared with 3% of the standard care group. And the lifestyle folks also experienced a significant improvement in their physical fitness, as measured by a fancy machine measuring oxygen uptake by the body during intense exercise.

The study authors seemed to emphasize that lifestyle improved blood sugar only modestly better than standard care at 12 months. What was incredibly striking, though, was the trend in the blood sugars over the entire year. At six months, the lifestyle group’s HbA1c levels decreased very significantly, from 6.6% to 6.2%, while the standard care group’s HbA1c increased from 6.7% to 6.9%. At 12 months, both groups drifted closer to where they had started, with the lifestyle group still a bit better than the standard care group at 6.3% as compared to 6.6%.

Why is this?

There are two possible reasons. One was that the lifestyle group had fully supervised exercise and dietary counseling sessions (including calorie restriction) for only the first four months, and after that, supervision was progressively decreased, and as a result people were less likely to stick with the program. In fact, the article shows that participation in the exercise and dietary counseling sessions dropped off over the year.

Another factor is that the participants’ diabetes medication was being adjusted throughout the study for health and safety reasons. If the HbA1c dropped below 6.5%, then their medication was decreased, and if it stayed that low or went lower, the medication was discontinued. Likewise, if the HbA1c went above 7.5%, then the medication was increased. The lifestyle group did have more episodes of low blood sugar than the standard care side, and while that can be dangerous, it also signals that the lifestyle participants needed less medication as time went on.

So, it’s reasonable to speculate that if the exercise and dietary session supervision was continuous throughout the study, and if the medications were not continually adjusted, then the results would have shown even greater improvements for the people in the lifestyle group.

And that jibes with previous studies looking at lifestyle intervention for the prevention and treatment of heart disease. There’s so much accumulated evidence supporting lifestyle intervention as a very effective treatment, that major insurance carriers will now cover such programs.

I do hope that patients will realize that lifestyle changes are as good as, and sometimes better than, prescription medications. Primary care doctors need to help them do just that.

Resources

Lifestyle medicine potential for reversing a world of chronic disease epidemics: from cell to community. International Journal of Clinical Practice, October 2014.

Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association. Circulation, August 2012.

Head-to-head comparison of intensive lifestyle intervention (U-TURN) versus conventional multifactorial care in patients with type 2 diabetes: protocol and rationale for an assessor-blinded, parallel group and randomised trial. BMJ, December 2015.

Effect of an Intensive Lifestyle Intervention on Glycemic Control in Patients With Type 2 Diabetes: A Randomized Clinical Trial. JAMA, August 2017.

Effects of Lifestyle Modification Programs on Cardiac Risk Factors. PLoS One, December 2014.

The post Diabetes: Adding lifestyle changes to medication can deliver a knockout punch appeared first on Harvard Health Blog.

From: Monique Tello, MD, MPH https://www.health.harvard.edu/blog/diabetes-adding-lifestyle-changes-medication-can-deliver-knockout-punch-2017092812468

Diabetes: Changing the Conversation, Reaping the Rewards

We’re proud to launch our new initiative, In It Together, in conjunction with John Hancock Life Insurance, to celebrate people living with type 2 diabetes and the actions they take to lead healthy and fulfilling lives.

In It Together features a new podcast series, giving a voice to the stories of people living with type 2 diabetes—their challenges and complications, their breakthroughs and triumphs—to inspire and encourage others and bring a sense of urgency to the prevalence of this disease.

New episodes of the podcast will be posted here on the last Thursday of the month.

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In It Together: From Denial to Awareness and Life-Changing Action

Our first podcast features Ina Mendoza-Wilson, a woman who’s committed to managing diabetes and living healthier—for herself and her family.

Ina offers a first-hand account of the important decisions she makes due to her diabetes and how diabetes self-management is the key to helping her take steps toward living a healthy lifestyle.

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People living with type 2 diabetes encounter daily challenges—from managing medications, deciding what to eat and facing common misconceptions about the disease—and they don’t often talk about it. Through In It Together, we strive to change the conversation about people living with diabetes. Please join us!

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John Hancock life insurance shares our goal of supporting people by changing the conversation about diabetes. To learn more about “In It Together” and John Hancock and its wellness-based life insurance program, John Hancock Vitality, visit http://www.diabetes.org/inittogether.

From: American Diabetes Association http://diabetesstopshere.org/2017/09/28/diabetes-changing-the-conversation-reaping-the-rewards/

Health insurer Anthem is leaving Maine's health insurance exchange in 2018

Anthem this year rolled back its presence in Nevada, California, Ohio, Wisconsin, Georgia and its home state of Indiana

From: http://www.cbsnews.com/news/health-insurer-anthem-is-leaving-maines-health-insurance-exchange-in-2018/

Puerto Rico facing "unparalleled" health crisis, doctor says

Hurricane Maria left Puerto Rico's hospitals in critical condition. Fifty-nine of the island's 69 hospitals are open in some capacity. But some are worried they won't have enough fuel or supplies to keep going. Dr. Jon LaPook reports from San Juan where he spoke with patients and doctors.

From: http://www.cbsnews.com/videos/puerto-rico-facing-unparalleled-health-crisis-doctor-says/

Hunt for illegal opioids in the U.S. starts inside JFK airport

At a time when your mailman may be an unwitting drug dealer, the John F. Kennedy International Airport is also the front lines in the opioid crisis

From: http://www.cbsnews.com/news/opioid-crisis-illegal-shipments-from-china-jfk-airport-mail-room/

The hunt for illegal opioids at JFK airport

John F. Kennedy International Airport processes more than a million inbound packages every day. As fentanyl and other potent synthetic opioids pour into the U.S., it has also become the front lines in the opioid crisis. Tony Dokoupil reports.

From: http://www.cbsnews.com/videos/the-hunt-for-illegal-opioids-at-jfk-airport/

Worldwide, an estimated 25 million unsafe abortions occur each year

Worldwide, an estimated 25 million unsafe abortions occur each year

From: http://www.who.int/entity/mediacentre/news/releases/2017/unsafe-abortions-worldwide/en/index.html

Can Babies Help Heart Patients?

Umbilical cord stem cells could be a treatment for heart failure, small study suggests

From: http://www.webmd.com/heart-disease/heart-failure/news/20170927/can-babies-help-heart-patients?src=RSS_PUBLIC

Report: Nearly half of abortions worldwide are unsafe

New research shows that countries with better safety rates were also more likely to have less restrictive abortion laws

From: http://www.cbsnews.com/news/report-finds-nearly-half-of-all-abortions-worldwide-are-unsafe/

Swine flu found in 5 people after contact with pigs

Those infected were in close contact with pigs at the Anne Arundel County Fair or the Great Frederick Fair​ in Maryland

From: http://www.cbsnews.com/news/swine-flu-maryland-county-fairs-h3n2-virus-strain/

Mayo Clinic Minute: Why whole grains are the healthier choice

From: Mayo Clinic https://www.youtube.com/watch?v=sNCQJWIFvRw

Rapid, Easy Zika Test Developed

Dipstick strip can diagnose the difference between Zika and dengue fever in a critical time frame

From: http://www.webmd.com/a-to-z-guides/news/20170927/rapid-easy-zika-test-developed?src=RSS_PUBLIC

Mayo Clinic: #AsktheMayoMom about Fetal Surgery and Birth Defects

From: Mayo Clinic https://www.youtube.com/watch?v=QsA7kLCjh98

Doctors remove toy man inhaled 40 years ago

Instead of signs of lung cancer, doctors found a tiny plastic toy traffic cone the man had received on his seventh birthday

From: http://www.cbsnews.com/news/suspected-cancer-tumor-turns-out-to-be-toy-man-inhaled-40-years-ago/

Opioid commission unveils new partnerships, drug supply limits to stop epidemic

PhRMA CEO says the company supports limiting opioid's to a 7-day supply instead of the traditional 30 days to curb abuse

From: http://www.cbsnews.com/news/opioid-commission-unveils-new-partnerships-drug-supply-limits-to-stop-epidemic/

Is Older Blood OK to Use in a Transfusion?

Ability to use less fresh blood could help ease shortages

From: http://www.webmd.com/a-to-z-guides/news/20170927/is-older-blood-ok-to-use-in-a-transfusion?src=RSS_PUBLIC

20 Percent of U.S. Teens May Have Had a Concussion

Contact sports is a leading reason why, study contends

From: http://www.webmd.com/brain/news/20170926/20-percent-of-us-teens-may-have-had-a-concussion?src=RSS_PUBLIC

Woman dies of infection from Harvey floodwaters

The 77-year-old Texas woman died from flesh-eating bacteria she contracted after falling into floodwaters from Hurricane Harvey

From: http://www.cbsnews.com/news/texas-woman-dies-infection-flesh-eating-bacteria-harvey-floodwaters/

Woman awarded $57M in Johnson & Johnson lawsuit speaks out

Ella Ebaugh says she is in "excruciating pain" from complications with the pelvic mesh meant to help control urinary incontinence

From: http://www.cbsnews.com/news/woman-awarded-57m-verdict-in-johnson-johnson-lawsuit/

Flu shots during pregnancy

Is your head already spinning from all of the confusing information about the safety of routine vaccinations? Well, news of the latest findings regarding the flu vaccine during pregnancy certainly won’t help things.

A group of researchers recently reported an association between a pregnant woman getting the flu vaccine and having a miscarriage.

The authors were clear that the study could not establish that flu shots cause miscarriage. It could only report the observation that, in this small group of women, miscarriage was slightly more common within 28 days of getting the flu shot — but only in women who had also gotten a specific formulation of the flu shot the previous year. More research would be needed to draw conclusions beyond that.

But before you panic or march off to your next prenatal appointment to emphatically refuse this season’s flu vaccine, let’s take a step back and look at this situation a little more carefully.

As with any treatment or medication, it is essential to balance its potential benefits with potential harms. The flu and the flu vaccine are no exceptions. We need to compare the potential benefits and harms of getting the flu shot with the potential harms of the flu. (There is obviously no benefit to getting the flu!)

What’s the big deal about getting the flu when I’m pregnant?

The pregnant you is not the same as the non-pregnant you, especially when it comes to your immune system.

In general, your immune system is dialed down a bit in pregnancy. But interestingly enough, your pregnant immune system may actually respond more intensely in certain situations. And how you respond to the influenza virus is one of those situations. It is thought that this altered immune response, along with changes in how your heart and lungs work, are why pregnant women who get the flu often have much more severe symptoms, serious complications, and can even die from the infection.

There is also some evidence that having the flu in the first several weeks of pregnancy might be associated with an increased risk of your baby being born with certain birth defects.

Here’s why we recommend that pregnant women get a flu shot

Put this risk of severe complications from the flu together with the relative low risk of the flu vaccine, and it’s easy to understand why getting the flu shot during pregnancy is so strongly recommended.

Getting vaccinated against the flu during pregnancy has benefits for your baby as well. Newborns, like pregnant women, are more likely to get seriously ill or even die if they get the flu. Your baby can’t get a flu shot until 6 months of age. However, if you get the flu vaccine during pregnancy you will pass antibodies to your baby that will protect him or her from the flu in the first few months of life. This is especially important for babies that will be born during flu season (between October and May).

So, what about the research linking flu shots and miscarriage?

Many studies over several years have shown the relative safety of the flu vaccine in pregnancy. Although studies involving women in the first trimester of pregnancy are limited, those studies that did include women vaccinated in the first trimester of pregnancy did not show an association with miscarriage.

In a recent study, the data suggest an association between getting a flu shot and having a miscarriage within 28 days of the vaccine, especially in those women who were also vaccinated against the H1N1 strain in the prior year.

These results are surprising. One potential explanation is the specific inflammatory response triggered by the H1N1 vaccine, with a repeat vaccination causing an even more significant response to occur. As noted by the authors of a commentary published with the original article, “One important takeaway message from this study is that seasonal vaccine formulations are not all the same.”

Expert panels including the American Congress of Obstetricians and Gynecologists have not changed their opinion based on these study results, noting that the study included only a small number of women, and those results are not outweighed by the significant amount of existing data supporting flu vaccine safety. The current guidelines that the flu vaccine is strongly recommended in pregnancy, and is safe to be given in any trimester, remain unchanged.

The post Flu shots during pregnancy appeared first on Harvard Health Blog.

From: Andrea Chisholm, MD https://www.health.harvard.edu/blog/flu-shots-during-pregnancy-2017092712458

1 in 3 Seniors Take Sleep Aids, Despite Dangers

But national guidelines generally recommend against these products for those over 65

From: http://www.webmd.com/healthy-aging/news/20170927/1-in-3-seniors-take-sleep-aids-despite-dangers?src=RSS_PUBLIC

Republicans Abandon Health Reform Bill

Senate Majority Leader Mitch McConnell pulls latest version due to lack of votes

From: http://www.webmd.com/health-insurance/news/20170926/republicans-abandon-health-reform-bill?src=RSS_PUBLIC

Radiation, Chemo Mix Boosting Lung Cancer Survival

About one-third of stage 3 patients alive after 5 years, a development called promising by oncologists

From: http://www.webmd.com/lung-cancer/news/20170926/radiation-chemo-mix-boosting-lung-cancer-survival?src=RSS_PUBLIC

STDs Hit All-Time High in U.S.

Annual report shows more than 2 million cases of chlamydia, gonorrhea and syphilis reported in 2016

From: http://www.webmd.com/sexual-conditions/news/20170926/stds-hit-all-time-high-in-us?src=RSS_PUBLIC

Senate GOP Pulls Plug On Latest ACA Repeal Effort

Republicans could not muster the 50 votes necessarily to move forward with Graham-Cassidy measure.

From: http://www.webmd.com/health-insurance/news/20170926/senate-gop-pulls-plug-on-latest-aca-repeal-effort?src=RSS_PUBLIC

CTE Marker Seen in Living Football Players

Brain disease caused by repeated concussions can only be diagnosed after death at this point

From: http://www.webmd.com/brain/news/20170926/cte-marker-seen-in-living-football-players?src=RSS_PUBLIC

Postpartum Depression Likely to Recur

Mood disorder seen in 1 in 200 new moms with no psychiatric history

From: http://www.webmd.com/depression/postpartum-depression/news/20170926/postpartum-depression-likely-to-recur?src=RSS_PUBLIC

STD cases hit record high in the U.S.

Annual CDC report on sexually transmitted diseases shows more than 2 million cases of chlamydia, gonorrhea and syphilis in 2016

From: http://www.cbsnews.com/news/std-cases-hit-record-high-in-us/

'Every year the numbers go up'

As a person with Type 1 diabetes, Dr. Gary Hack wears an insulin pump and a continuous glucose monitor at all times to manage the condition he's had for 30 years.

From: By Michelle Manchir http://www.ada.org/en/publications/ada-news/2017-archive/september/every-year-the-numbers-go-up

Florida dentist gets bird's-eye view of Irma's devastation on the Keys

Dr. Charles Llano has flown over areas hit by hurricanes before, but what Hurricane Irma left behind still seemed unbelievable.

From: By Kimber Solana http://www.ada.org/en/publications/ada-news/2017-archive/september/florida-dentist-gets-birds-eye-view-of-irmas-devastation-on-the-keys

Technology Experience is no virtual reality at ADA 2017 — it is real reality

Whether you are a tech geek or not, there is a lot to check out at The Technology Experience area at the ADA annual meeting.

From: http://www.ada.org/en/publications/ada-news/2017-archive/september/technology-experience-is-no-virtual-reality-at-ada-2017-it-is-real-reality

Mayo Clinic Minute: Best shoes for healthy feet

From: Mayo Clinic https://www.youtube.com/watch?v=mpdMkK8qBgc

These infections are a hidden risk in kids' sports

MRSA, herpes, and athlete's foot can all be spread through close contact sports, but there are steps you can take to prevent it

From: http://www.cbsnews.com/news/infectious-disease-a-hidden-risk-in-kids-sports/

Genetics a Cause of Autism in Most Cases: Study

Re-analysis of stats from earlier study shows new estimate of DNA impact

From: http://www.webmd.com/brain/autism/news/20170926/genetics-a-cause-of-autism-in-most-cases-study?src=RSS_PUBLIC

FDA targets "rogue" online pharmacies

Crackdown targets hundreds of websites the FDA said were illegally selling opioids and other potentially dangerous, unapproved drugs

From: http://www.cbsnews.com/news/opioids-online-fda-targets-rogue-pharmacies/

Council Theater selections include convenient CE

Dentists, students and team members can learn about subjects ranging from the CDT Code to nutrition at ADA council-sponsored courses in the ADA Council Theater during ADA 2017 – America's Dental Meeting.

From: http://www.ada.org/en/publications/ada-news/2017-archive/september/council-theater-offers-fruit-from-ada-councils

'The science mattered'

With input from the dental community, water officials here voted 5-2 on Sept. 20 to resume water fluoridation for the utility's 606,000 water users.

From: http://www.ada.org/en/publications/ada-news/2017-archive/september/the-science-mattered

Exhibit Hall to offer hands-on experiences

The Exhibit Hall is where attendees of ADA 2017–America's Dental Meeting can test and buy new products, interact with vendors and attend free continuing education.

From: http://www.ada.org/en/publications/ada-news/2017-archive/september/touch-feel-and-compare-at-exhibit-hall-at-annual-meeting

Dra. M. Fernanda Bellolio habla acerca del estudio sobre los opioides en Departamento de Emergencia

From: Mayo Clinic https://www.youtube.com/watch?v=mcvmimyqiHY

Dr. Molly Jeffery discusses study on opioids in the Emergency Department

From: Mayo Clinic https://www.youtube.com/watch?v=ES2QYCz6QaA

Treating more than the disease: Giving kids with cancer Brighter Tomorrows

From: Mayo Clinic https://www.youtube.com/watch?v=yTvNR3Gqsgs

Mayo Clinic Minute: Symptoms, solutions for carpal tunnel syndrome

From: Mayo Clinic https://www.youtube.com/watch?v=Nzh081c8v6Y

U.S. pays high price for obesity

Lifetime costs from medical care and lost wages add up to a high price tag, according to new research

From: http://www.cbsnews.com/news/us-pays-high-price-for-obesity/

Sleep Deprivation a Serious Threat: Expert

Getting proper rest can impact all areas of life.

From: http://www.webmd.com/sleep-disorders/news/20170926/sleep-deprivation-a-serious-threat-expert?src=RSS_PUBLIC

Major U.S. Study Will Examine Precision Medicine

NIH study to examine correlation between genes, environment, health, personal traits.

From: http://www.webmd.com/a-to-z-guides/news/20170926/major-us-study-will-examine-precision-medicine?src=RSS_PUBLIC

4 ways to help your child get enough sleep

Follow me on Twitter @drClaire

Children need sleep, plain and simple. We all do. Without enough sleep, we get cranky and, with time, unhealthy. But for children, it’s especially important because the effects of sleep deprivation can lead to lifelong problems.

Studies have shown that not getting enough sleep can contribute to obesity. But even more troubling, studies show that children who don’t get enough sleep can end up with behavioral and learning problems that persist for years and affect a child’s life forever. Teens who don’t get enough sleep are at higher risk for depression and learning problems, and are more likely to get into car accidents and other accidents.

The prevalence of devices such as cell phones and tablets also has implications for sleep. More and more, children are staying up, or being woken up, by these devices. Add to that our achievement culture; between homework and extracurricular activities, many teens simply have less time for sleep.

How much sleep does your child need? Here are the recommended amounts:

• Infants: 12 to 16 hours (including naps)
• Toddlers: 11 to 14 hours (including naps)
• Preschoolers: 10 to 13 hours (including naps)
• Grade school-aged children: 9 to 12 hours
• Teens: 8 to 10 hours

Ultimately, though, it’s up to your child. The bottom number is the absolute minimum; some children need closer to the maximum in order to function well. These days, I am finding that many children, especially teens and tweens, aren’t getting enough sleep. It’s common for a teen to tell me that they get 6 to 7 hours a night, which just isn’t enough.

Here are four ways you can help your child get enough sleep

1.  Make sleep a priority. Just like you schedule time for homework, sports, and other activities, schedule time for sleep. Literally. Start from when your child needs to get up in the morning, and then count back the number of hours your child needs to sleep… and set a non-negotiable bedtime. For tweens and teens, this may lead to some tough conversations and decisions about schedules and activities, and may mean cutting back on some activities, finding ways to get homework done earlier, and pushing some leisure activities (like video games) to weekends. If you are going to make it work you will also need to…

2.  Start the bedtime routine earlier. None of us can go right from a physically or mentally intense activity right to sleep. If bedtime is 9:00 pm, that means that your child needs to start winding down between 8 and 8:30 so that they are ready to actually fall asleep at 9. A big part of winding down is to…

3.  Shut off the screens. The blue light emitted from screens can wake up the brain and make it harder to fall asleep. This is particularly true for “small screens” such as phones or tablets that are held closer to the face. Shut them off an hour before you want your child to be asleep. Phones should be charged outside of the bedroom — or at the very least, put in Do Not Disturb mode. If your child tries to tell you they need their phone to wake them up in the morning, buy them an alarm clock.

Another important way to be sure your child gets enough sleep is to…

4.  Keep the same sleep routines on weekends and vacations. A little leeway is okay, like staying up an hour or so later if your child can and will sleep later in the morning (if you have one of those kids who is up at dawn no matter what, staying up later may not work out so well). It throws our bodies off when our sleep schedules change; we do much better when they stay the same.

Remember, too, that children pay more attention to what we do than what we say. If you make your own sleep a priority, you will set a good example for your child — and feel better yourself.

The post 4 ways to help your child get enough sleep appeared first on Harvard Health Blog.

From: Claire McCarthy, MD https://www.health.harvard.edu/blog/four-ways-to-help-your-child-get-enough-sleep-2017092612472

U.S. Pays a Hefty Price for Obesity

Lifetime costs add up for diseases, lost productivity, study finds

From: http://www.webmd.com/diet/obesity/news/20170926/us-pays-a-hefty-price-for-obesity?src=RSS_PUBLIC

USDA-ARS RESEARCHERS ARE CONTROLLING MOSQUITOES NATURALLY

From: USDA https://www.youtube.com/watch?v=jiyjize0jmA

ADA 2017 advance registration deadline extended to Sept. 29

The ADA extended the advance registration date for ADA 2017 – America's Dental Meeting to 5 p.m. Central Daylight Time Friday, Sept. 29.

From: http://www.ada.org/en/publications/ada-news/2017-archive/september/ada-2017-advance-registration-deadline-extended-to-sept-29

Blacks, Elderly Missing From U.S. Cancer Trials

Women are also underrepresented, researchers find

From: http://www.webmd.com/cancer/news/20170925/blacks-elderly-missing-from-us-cancer-trials?src=RSS_PUBLIC

Stopping Aspirin Tied to Spike in Health Risks

Swedish study finds those who quit the daily low-dose pill face a more rapid risk of cardio woes

From: http://www.webmd.com/heart/news/20170925/stopping-aspirin-tied-to-spike-in-health-risks?src=RSS_PUBLIC

Dim prospects for GOP Graham-Cassidy health bill

Senate Republicans' last-ditch effort to dismantle Obamacare appears to be dead. Sen. Susan Collins of Maine said Monday she opposes the legislation. She joins fellow Republicans John McCain, Rand Paul and Ted Cruz, who already said they're against it. Nancy Cordes reports.

From: http://www.cbsnews.com/videos/dim-prospects-for-gop-graham-cassidy-health-bill/

Nerve 'Zap' Pulls Patient From Vegetative State

But patient is only 'minimally conscious,' study author says

From: http://www.webmd.com/brain/news/20170925/nerve-zap-pulls-patient-from-vegetative-state?src=RSS_PUBLIC

Mayo Clinic Minute: What men need to know about planning a family

From: Mayo Clinic https://www.youtube.com/watch?v=bH20aA5Qk_c

How technology can impact long-term health

Wired magazine editor-in-chief Nick Thompson looks at some of the ways technology can help hack the aging process

From: http://www.cbsnews.com/news/technology-healthy-retirement-gsk/

Americans disapprove of Trump's handling of North Korea, health care

Americans see North Korea as a threat, but they're also concerned U.S. would take military action too quickly

From: http://www.cbsnews.com/news/most-americans-disapprove-of-trumps-handling-of-north-korea-health-care/

Gun Violence in Movies a Trigger for Teens?

Parents need to keep weapons locked up, limit exposure to media violence, experts say

From: http://www.webmd.com/children/news/20170925/gun-violence-in-movies-a-trigger-for-teens?src=RSS_PUBLIC

Diagnosis, Education and Planning: Karrie’s Type 2 Diabetes Story

When Karrie was diagnosed with type 2 diabetes in 2004, she was not only afraid, but also unsure of how her life was going to be affected despite having a family history of diabetes. She committed to learning more about the disease, finding a doctor and working with him to come up with an individualized diabetes management plan that would work for her.

However, she quickly learned that sticking to a treatment plan can be very challenging, especially when life gets busy. Work, family and daily responsibilities made it difficult for Karrie to stay motivated to keep track of the different aspects of her treatment plan like diet, exercise and taking the medicine her doctor prescribed.

While it’s been a difficult journey, Karrie refuses to give up, and she’s taking the next step with America’s Diabetes Challenge by facing her challenges head on. She’s learned that small tips like being consistent and forming healthy habits can help make things a little easier, and being proactive about her health has helped her stick to her plan and reach her goals.

Karrie is not alone dealing with this challenge—type 2 diabetes management isn’t always easy, and many people are looking for helpful ways to stay on track. Check out this video and visit AmericasDiabetesChallenge.com for tips to help people living with and affected by type 2 diabetes tackle their challenges.

From: American Diabetes Association http://diabetesstopshere.org/2017/09/25/diagnosis-education-and-planning-karries-type-2-diabetes-story/

USDA Responds to Farmers and Ranchers Impacted by Storms

From: USDA https://www.youtube.com/watch?v=Zm2RhpGM1iM

Breast Cancer Radiation 'Less Scary' Than Thought

Majority of patients report more tolerable experience than they expected

From: http://www.webmd.com/breast-cancer/news/20170925/breast-cancer-radiation-less-scary-than-thought?src=RSS_PUBLIC

ADA develops guideline for evaluating potentially malignant disorders in the oral cavity

All adult dental patients should receive an intraoral and extraoral conventional visual and tactile examination when visiting their dentists, according to ADA-developed recommendations published in the October issue of The Journal of the American Dental Association.

From: By Michelle Manchir http://www.ada.org/en/publications/ada-news/2017-archive/september/ada-develops-guideline-for-evaluating-potentially-malignant-disorders-in-the-oral-cavity

Oct. 26 webinar will focus on exceeding patients' expectations

Some dentists find certain non-clinical aspects of dentistry less rewarding than delivering actual patient care. Given the choice, they might prefer performing even the most basic procedures instead of completing paperwork, booking appointments and collecting payments.

From: By David Burger http://www.ada.org/en/publications/ada-news/2017-archive/september/oct-26-webinar-will-focus-on-exceeding-patients-expectations

GOP Sweetens Health Care Bill to Woo Key Votes

Revisions would give states more decision-making authority on how to allocate health care dollars

From: http://www.webmd.com/health-insurance/news/20170925/gop-sweetens-health-care-bill-to-woo-key-votes?src=RSS_PUBLIC

Treatment restores signs of awareness in brain-injured man

Researchers tested an experimental treatment in man who'd spent 15 years in a vegetative state

From: http://www.cbsnews.com/news/nerve-stimulation-restores-signs-of-awareness-in-brain-injured-man/

Where Legal, 25% of Cancer Patients Use Marijuana

But patients in Washington state say doctors provide little information about the drug

From: http://www.webmd.com/cancer/news/20170925/where_legal_25_of_cancer_patients_use_marijuana?src=RSS_PUBLIC

The latest scoop on the health benefits of coffee

Follow me on Twitter @RobShmerling

What a difference a few years can make. Not long ago, I was learning about the dangers of coffee — how it could raise your blood pressure, make your heart race, impair sleep, and maybe even cause cancer.

Now, the World Health Organization (WHO) is taking coffee off the possible carcinogen list. And there’s increasing evidence that coffee might actually be good for you. So good that doctors might begin recommending it.

What’s changed? It’s all about the evidence.

Possible health benefits of coffee

Over the last several decades, coffee has been among the most heavily studied dietary components. And the news is mostly good. Moderate coffee consumption (three to four cups per day) has been linked with longer lifespan. In fact, a November 2015 study in Circulation found that coffee consumption was associated with an 8% to 15% reduction in the risk of death (with larger reductions among those with higher coffee consumption). Other studies have found that coffee drinkers may have a reduced risk of

• cardiovascular disease (including heart attack, heart failure, and stroke)
• type 2 diabetes
• Parkinson’s disease
• uterine and liver cancer
• cirrhosis
• gout.

The reason that coffee drinking might be beneficial is unknown. One factor, of course, could be the caffeine, but that can be hard to sort out from the research because many studies do not distinguish whether the coffee is caffeinated or decaffeinated.

Possible health risks of coffee

A number of studies have linked coffee consumption to health problems, including:

• Bladder and pancreatic cancer. Studies performed more than 30 years ago suggested a potential link between coffee consumption and cancers of the bladder, pancreas, and possibly others. Since then, better research has largely refuted these concerns. In fact, some of the older studies raising red flags about a cancer link have since been used as examples of “fishing expeditions” and weak research methodology.
• Esophageal cancer. In its recently released report, the WHO has raised concerns that drinking coffee (or other beverages) at temperatures higher than 149° F may increase the risk of esophageal cancer. However, this is not unique to coffee. And drinking coffee at such high temperatures is unusual among most coffee drinkers in the US.
• Cardiovascular disease. Studies linking coffee consumption to cardiovascular disease have mostly observed it with higher consumption (well above four cups per day), and some of these studies did not account for smoking, which often accompanies coffee consumption and is, of course, an important cardiovascular disease risk factor on its own. Other concerns include modest and temporary elevations in blood pressure, and fast or abnormal heart rhythms.
• Bothersome, but mostly minor, side effects. The caffeine in coffee can impair sleep, cause a “speedy” or jittery feeling, and even cause anxiety. Heartburn, frequent urination (because caffeine is a diuretic), and palpitations are problematic for some coffee drinkers.

A new move by the WHO… and others

In a June 2016 report, the WHO officially lifted coffee from the list of potentially carcinogenic foods. It went on to designate coffee as potentially protective against cancer of the uterus and liver.

And the WHO is not the only organization to include coffee in its list of foods that are probably harmless and possibly healthy. The 2015 Dietary Guidelines Advisory Committee (commissioned by the secretaries of the US Department of Health and Human Services and the US Department of Agriculture) thoroughly reviewed the evidence and declared that “moderate coffee consumption (three to five cups per day) can be incorporated into a healthy dietary pattern…” And the World Cancer Research Fund International concluded that coffee consumption was linked with a lower risk of several types of cancer.

Should you drink coffee?

Considering all of this good news about coffee consumption, you might feel tempted to increase your intake or to start drinking it if you don’t already.

Here’s my take:

• If you don’t like coffee, there is no current recommendation to drink it anyway. However, if we can figure out why coffee might have health benefits, it’s possible that a medication can be developed that provides those benefits without the side effects (or taste) of coffee or caffeine. Or, faced with a choice of a new medication or coffee, one might choose the latter.
• If you are already a coffee drinker, it should be reassuring that after decades of research, no strong link can be found between coffee intake and cancer and, to the contrary, a number of health benefits seem to accompany coffee consumption. But, I’m not sure the evidence is powerful enough to recommend an increase in your daily habit. One reason is that we don’t know for sure that coffee consumption actually caused the health benefits observed in these studies. Some other, unmeasured factor could be responsible. Another reason is that the overall effect was small. And, it’s worth noting that some people are quite sensitive to the side effects of coffee.
• Moderate your coffee intake. Although we don’t have proof that drinking six or more cups of coffee is dangerous, the risk of side effects is lower with moderation.
• Don’t drink beverages at very high temperatures (i.e., over 149° F). In addition to the potential risk of esophageal cancer, there is a risk of burning yourself.

In conclusion…

It’s unusual that a food on the “cancer risk list” comes off of it — and it’s even more unusual that such foods then become considered a healthy choice. But, as the millions of people drinking coffee every day will tell you, when it comes to coffee, there’s nothing like it.

The post The latest scoop on the health benefits of coffee appeared first on Harvard Health Blog.

From: Robert H. Shmerling, MD https://www.health.harvard.edu/blog/the-latest-scoop-on-the-health-benefits-of-coffee-2017092512429

Mastectomy Study Confirms 'Angelina Jolie Effect'

Preventive breast cancer surgeries rose after the actress publicized her decision

From: http://www.webmd.com/breast-cancer/news/20170925/mastectomy-study-confirms-angelina-jolie-effect?src=RSS_PUBLIC

Greater Houston Dental Society creates diversity committee, shares lessons learned

Considering that Houston is one of the most diverse cities in the country, it caught Dr. Victor Rodriguez by surprise to learn that the Greater Houston Dental Society did not have its own diversity committee.

From: By Kimber Solana http://www.ada.org/en/publications/ada-news/2017-archive/september/greater-houston-dental-society-creates-diversity-committee-shares-lessons-learned

Republicans face resistance in last-ditch effort to repeal and replace Obamacare

A new CBS News poll finds most Americans do not support the latest GOP-led effort to overhaul Obamacare. This comes as more top Republicans are backing away from the Graham-Cassidy bill. CBS News chief congressional correspondent Nancy Cordes takes us through the latest developments on Capitol Hill.

From: http://www.cbsnews.com/videos/republicans-face-resistance-in-last-ditch-effort-to-repeal-and-replace-obamacare/

Drugs & Genes: Pharmacogenomics for the Modern Health Care Team

From: Mayo Clinic https://www.youtube.com/watch?v=BJysrUg3MdE

Team-Based Thoracic Surgery

From: Mayo Clinic https://www.youtube.com/watch?v=v4icJcvkVd0

Mark Allen, M.D.: Thoracic Surgeon

From: Mayo Clinic https://www.youtube.com/watch?v=8xfBbcXDLCo

New version of Graham-Cassidy health care bill amid GOP divide

A CBS News poll finds most Americans do not support the last-ditch Republican effort to repeal and replace Obamacare. Just 20 percent approve of the bill written by Sens. Lindsey Graham and Bill Cassidy, while 52 percent disapprove. Nancy Cordes reports.

From: http://www.cbsnews.com/videos/new-version-of-graham-cassidy-health-care-bill-amid-gop-divide/

New Graham-Cassidy health care bill has more funding for some states

CBS News' Nancy Cordes reports that the new version has more funding for Arizona, Alaska and Maine

From: http://www.cbsnews.com/news/new-graham-cassidy-health-care-bill-has-more-funding-for-some-states/

Poll reveals Americans' attitudes on GOP health care bill

Four in 10 say Republicans trying to push Obamacare replacement bill through Congress too fast, and fewer than one in 10 believe it would help them

From: http://www.cbsnews.com/news/poll-graham-cassidy-republican-health-care-bill-repeal-replace-obamacare-aca/

1 in 3 families have trouble affording diapers, survey finds

"Some months it would be between paying for the electric bill or paying for diapers"

From: http://www.cbsnews.com/news/1-in-3-families-trouble-affording-diapers-survey/

Leaky gut: What is it, and what does it mean for you?

Before the medical community had better understanding of the mechanisms that cause disease, doctors believed certain ailments could originate from imbalances in the stomach. This was called hypochondriasis. (In Ancient Greek, hypochondrium refers to the upper part of the abdomen, the region between the breastbone and the navel.) This concept was rejected as science evolved and, for example, we could look under a microscope and see bacteria, parasites, and viruses. The meaning of the term changed, and for many years doctors used the word “hypochondriac” to describe a person who has a persistent, often inexplicable fear of having a serious medical illness.

But what if this ancient concept of illnesses originating in the gut actually holds some truth? Could some of the chronic diseases our society faces today actually be associated with a dysfunctional gastrointestinal system?

The expression “leaky gut” is getting a lot of attention in medical blogs and social media lately, but don’t be surprised if your doctor does not recognize this term. Leaky gut, also called increased intestinal permeability, is somewhat new and most of the research occurs in basic sciences. However, there is growing interest to develop medications that may be used in patients to combat the effects of this problem.

What exactly is leaky gut?

Inside our bellies, we have an extensive intestinal lining covering more than 4,000 square feet of surface area. When working properly, it forms a tight barrier that controls what gets absorbed into the bloodstream. An unhealthy gut lining may have large cracks or holes, allowing partially digested food, toxins, and bugs to penetrate the tissues beneath it. This may trigger inflammation and changes in the gut flora (normal bacteria) that could lead to problems within the digestive tract and beyond. The research world is booming today with studies showing that modifications in the intestinal bacteria and inflammation may play a role in the development of several common chronic diseases.

Who gets a leaky gut (and why)?

We all have some degree of leaky gut, as this barrier is not completely impenetrable (and isn’t supposed to be!). Some of us may have a genetic predisposition and may be more sensitive to changes in the digestive system, but our DNA is not the only one to blame. Modern life may actually be the main driver of gut inflammation. There is emerging evidence that the standard American diet, which is low in fiber and high in sugar and saturated fats, may initiate this process. Heavy alcohol use and stress also seem to disrupt this balance.

We already know that increased intestinal permeability plays a role in certain gastrointestinal conditions such as celiac disease, Crohn’s disease, and irritable bowel syndrome. The biggest question is whether or not a leaky gut may cause problems elsewhere in the body. Some studies show that leaky gut may be associated with other autoimmune diseases (lupus, type 1 diabetes, multiple sclerosis), chronic fatigue syndrome, fibromyalgia, arthritis, allergies, asthma, acne, obesity, and even mental illness. However, we do not yet have clinical studies in humans showing such a cause and effect.

A path toward a healthier gut

Although it is unusual to hear the term “increased intestinal permeability” in most doctors’ offices, alternative and integrative medicine practitioners have worked on gut healing as an initial step to treat chronic diseases for decades. Other cultures around the world often recommend specific diets to make people feel better. Even in the United States, it is common to see people changing their diets after getting sick. A common initial step some practitioners take is to remove foods that can be inflammatory and could promote changes in the gut flora. Among the most common are alcohol, processed foods, certain medications, and any foods that may cause allergies or sensitivities. In my practice, I often see patients improve significantly when they start eating a healthier diet.

Controversy still exists on whether leaky gut causes the development of diseases outside the gastrointestinal tract in humans. However, it is always a good idea to eat a nutritious, unprocessed diet that includes foods that help quell inflammation (and avoids foods known to trigger inflammation), which may, at least in theory, help to rebuild the gut lining and bring more balance to the gut flora. This recipe could make you feel better, without any side effects. It is definitely worth a try.

Resources

Leaky Gut As a Danger Signal for Autoimmune Diseases. Frontiers in Immunology, May 2017.

The intestinal epithelial barrier: a therapeutic target? Nature Reviews Gastroenterology & Hepatology, November 2016.

The post Leaky gut: What is it, and what does it mean for you? appeared first on Harvard Health Blog.

From: Marcelo Campos, MD https://www.health.harvard.edu/blog/leaky-gut-what-is-it-and-what-does-it-mean-for-you-2017092212451

Marc Short claims health care bill guarantees pre-existing conditions coverage

Short claims the proposed Graham-Cassidy bill "does not change" coverage of pre-existing conditions

From: http://www.cbsnews.com/news/whs-marc-short-claims-graham-cassidy-guarantees-coverage-for-pre-existing-conditions/

Sen. Collins says it's hard to envision getting to "yes" on latest health care bill

"It is hard for me to envision getting to yes on this bill, because my concerns are so fundamental," Sen. Collins said on CBS News' "Face the Nation" Sunday

From: http://www.cbsnews.com/news/sen-collins-says-its-hard-to-envision-getting-to-yes-on-graham-cassidy-bill/

Morning Rounds: New tattoo guidelines, over-treating patients

CBS News medical contributor Dr. Tara Narula joins "CBS This Morning: Saturday" to discuss a new report that offers guidance on the potential health issues surrounding body modifications like tattoos, a telling survey on the over-treatment of patients and a new patch that could help diabetics accurately measure glucose levels after exercise.

From: http://www.cbsnews.com/videos/morning-rounds-new-tattoo-guidelines-over-treating-patients/

U.S. denies visa to Vietnamese donor who's perfect for leukemia patient

A California family is trying desperately to bring a relative to the United States from Vietnam for a life-saving transplant. But they're being tangled up in red tape. Carter Evans has more.

From: http://www.cbsnews.com/videos/u-s-denies-visa-to-vietnamese-donor-whos-perfect-for-leukemia-patient/

Results announced in largest study of benefits of exercise

What's said to be the largest study ever on the benefits of exercise was published this week. Researchers tracked the physical activity of 130,000 people in 17 countries. Dr. Jon LaPook has the results.

From: http://www.cbsnews.com/videos/results-announced-in-largest-study-of-benefits-of-exercise/

John McCain opposes health care bill

The latest Republican plan to replace Obamacare is in danger of flatlining. And once again, the fatal blow may be a "no" vote from Sen. John McCain. Nancy Cordes reports.

From: http://www.cbsnews.com/videos/john-mccain-opposes-health-care-bill/

Egg Freezing Gives You Options but Has Risks

Doctors say more women are interested in egg freezing, a procedure that may help preserve their fertility but comes with risks.

From: http://www.webmd.com/infertility-and-reproduction/news/20170922/egg-freezing-gives-you-options-but-has-risks?src=RSS_PUBLIC

Mayo Clinic Minute: Symptoms, solutions for carpal tunnel syndrome

From: Mayo Clinic https://www.youtube.com/watch?v=IBAg5Jl4c5w

'Invaluable' symposium gives dentists a look at their role in cancer prevention

To help other dental professionals understand how they fit in with oncologists, head and neck surgeons and other health professionals when it comes to helping patients with oropharyngeal cancer, experts from the ADA, the University of Texas MD Anderson Cancer Center, University of Chicago Medicine and the Centers for Disease Control and Prevention will speak at a symposium preceding ADA 2017 – America's Dental Meeting.

From: By Michelle Manchir http://www.ada.org/en/publications/ada-news/2017-archive/september/invaluable-symposium-gives-dentists-a-look-at-their-role-in-cancer-prevention

CVS to Limit Opioid Prescription Amounts

First national pharmacy chain to limit prescriptions to seven days.

From: http://www.webmd.com/mental-health/addiction/news/20170922/cvs-to-limit-opioid-prescription-amounts?src=RSS_PUBLIC

Infectious Diseases A-Z: Hepatitis A outbreak

From: Mayo Clinic https://www.youtube.com/watch?v=Mk6pavaXwJQ

How to get more out of your workout in less time

When it comes to exercise, quality trumps quantity, new research suggests

From: http://www.cbsnews.com/news/get-the-most-out-of-your-workout-in-the-least-amount-of-time/

Treating more than the disease: Giving kids with cancer Brighter Tomorrows

From: Mayo Clinic https://www.youtube.com/watch?v=sPXwMwEw8to

NYU dental research on cavity prevention, children’s quality of life receives $13.3M

New York University College of Dentistry announced Sept. 20 it received a $13.3 million funding award from the Patient-Centered Outcomes Research Institute to study caries prevention and its impact on students' quality of life and school performance.

From: http://www.ada.org/en/publications/ada-news/2017-archive/september/nyu-dental-research-receives-13-3m-to-study-cavity-prevention-childrens-quality-of-life

Babies try harder when they see you sweat

Research suggests there may be value in letting children know sometimes you have to struggle to succeed

From: http://www.cbsnews.com/news/research-shows-babies-try-harder-when-they-see-you-sweat/

Even a Little More Activity Could Save Millions

Think of walking to work or cleaning as low-cost preventive medicine

From: http://www.webmd.com/fitness-exercise/news/20170922/even-a-little-more-activity-could-save-millions?src=RSS_PUBLIC

Coming Soon: Glaucoma Self-Care, From Home?

Study finds many patients can manage self-testing, but one doctor questions its value

From: http://www.webmd.com/eye-health/news/20170922/coming-soon-glaucoma-self-care-from-home?src=RSS_PUBLIC