03/06/17

Monday, March 6, 2017

Trump offers to maintain Planned Parenthood funding if it halts abortions

Its president spurned the proposal and noted that federal money already is not allowed to be used for abortion

From: http://www.cbsnews.com/news/trump-offers-to-maintain-planned-parenthood-funding-if-it-halts-abortions/

Bone and joint problems associated with diabetes

From: http://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/diabetes/art-20049314

Germs: Understand and protect against bacteria, viruses and infection

From: http://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/germs/art-20045289

Bone and joint problems associated with diabetes

From: http://www.mayoclinic.com/diseases-conditions/diabetes/in-depth/diabetes/art-20049314

House GOP unveils plan for health care overhaul

Committees plan to vote on the legislation on Wednesday, in what's expected to be perhaps Congress' biggest policy battle of the year

From: http://www.cbsnews.com/news/house-republicans-unveil-plan-for-health-care-overhaul/

Germs: Understand and protect against bacteria, viruses and infection

From: http://www.mayoclinic.com/diseases-conditions/infectious-diseases/in-depth/germs/art-20045289

Internal Medicine Board Review 2017: Course Overview

From: Mayo Clinic http://www.youtube.com/watch?v=vNqOgtEulJ0

Moyamoya Disease

From: Mayo Clinic http://www.youtube.com/watch?v=ZEm_1bNsd5o

Obesity May Raise Girls' Risk of Asthma, Allergies

But same was not true for boys, study found

From: http://www.webmd.com/children/news/20170306/obesity-may-raise-girls-risk-of-asthma-allergies?src=RSS_PUBLIC

Bone and joint problems associated with diabetes

From: http://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/diabetes/art-20049314

Chrissy Teigen reveals postpartum depression

The former Sports Illustrated swimsuit cover model shares her experience with depression and anxiety after baby was born

From: http://www.cbsnews.com/news/chrissy-teigen-reveals-postpartum-depression/

Germs: Understand and protect against bacteria, viruses and infection

From: http://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/germs/art-20045289

Bone and joint problems associated with diabetes

From: http://www.mayoclinic.com/diseases-conditions/diabetes/in-depth/diabetes/art-20049314

WHO: Pollution kills more than 1.7 million children a year

Many health problems from poor sanitation and drinking water, industrial pollution, chemicals and smoke are preventable, say experts

From: http://www.cbsnews.com/news/pollution-kills-more-than-1-7-million-children-a-year-who-reports/

Push for healthier nail salons in California finding success

Officials and community organizers are working reduce the hazardous chemical exposures of nail-salon workers

From: http://www.cbsnews.com/news/push-for-healthier-nail-salons-in-california-findings-success/

Germs: Understand and protect against bacteria, viruses and infection

From: http://www.mayoclinic.com/diseases-conditions/infectious-diseases/in-depth/germs/art-20045289

In a first, gene therapy lets teen dodge sickle cell disease

Teen who was given gene therapy for sickle cell disease now has enough properly working red blood cells to dodge the effects of the disorder, researchers say

From: http://www.cbsnews.com/news/gene-therapy-lets-a-french-teen-dodge-sickle-cell-disease/

Can Social Media Leave You Socially Isolated?

More time using apps and sites like Twitter, Instagram, Facebook linked to greater sense of isolation, study suggests

From: http://www.webmd.com/balance/news/20170306/can-social-media-sites-leave-you-socially-isolated?src=RSS_PUBLIC

Patients Often Reject Drug-Only Psych Treatment

Compliance more likely when doctors prescribe talk therapy, study finds

From: http://www.webmd.com/mental-health/news/20170306/patients-often-reject-drug-only-psychiatric-treatment?src=RSS_PUBLIC

Secondhand Smoke Linked to Food Allergies in Kids

Passive exposure tied to more egg and peanut sensitivity in study

From: http://www.webmd.com/allergies/news/20170306/secondhand-smoke-linked-to-food-allergies-in-kids?src=RSS_PUBLIC

Polluted Environments Kill 1.7M Kids Yearly: WHO

The deaths stem from indoor and outdoor air pollution, secondhand smoke, unsafe water, lack of sanitation, and poor hygiene

From: http://www.webmd.com/children/news/20170306/pollution-children-deaths-who?src=RSS_PUBLIC

Council counters confusion, misinformation on revised sedation, anesthesia guidelines

The Council on Dental Education and Licensure reminded state dental societies and dental boards on March 3 that state dental boards and legislatures ultimately make policies regarding sedation and anesthesia.

From: http://www.ada.org/en/publications/ada-news/2017-archive/march/council-counters-confusion-misinformation-on-revised-sedation-anesthesia-guidelines

Bone and joint problems associated with diabetes

From: http://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/diabetes/art-20049314

Germs: Understand and protect against bacteria, viruses and infection

From: http://www.mayoclinic.org/diseases-conditions/infectious-diseases/in-depth/germs/art-20045289

Feeling lonely? Social media may have surprising role

More time using apps and sites like Twitter, Instagram, and Facebook were linked to greater sense of isolation in a new study

From: http://www.cbsnews.com/news/feeling-lonely-social-media-may-have-something-to-do-with-it/

Will high heels get the boot in British offices?

One woman's protest against wearing high heels sparks a national debate over whether workplace dress codes are sexist

From: http://www.cbsnews.com/news/high-heels-british-lawmakers-workplace-dress-codes-sexist/

Enfriamiento Activo: Paleta de Enfriamiento (Chill Stick)

From: USDA http://www.youtube.com/watch?v=-gB-jZg7d6s

Calibrando el Termómetro: El Método de Agua Hirviendo

From: USDA http://www.youtube.com/watch?v=IZkoKoZalTQ

Calibrando el Termómetro: El Método de Agua Helada

From: USDA http://www.youtube.com/watch?v=tcRsRNlvGwo

Lavado de Manos: Cómo Lavarse las Manos

From: USDA http://www.youtube.com/watch?v=bwAUskwJgyI

El Lavado de Manos: El Por Qué Lavarse las Manos

From: USDA http://www.youtube.com/watch?v=LtiLFu04fSE

Sugar consumption tackled in health literacy essay contest

Ms. Gorshteyn, a student at the University of California Los Angeles School of Dentistry, was named earlier this year the winner of the ADA Health Literacy in Dentistry Essay Contest for her writing, “The Truth About Sugary Drinks and Your Smile.”

From: http://www.ada.org/en/publications/ada-news/2017-archive/march/sugar-consumption-tackled-in-health-literacy-essay-contest

'Like-minded' dentists meet, join forces at Mission of Mercy event

Having participated in 29 Mission of Mercy events since 2001, Dr. Mark Humenik said he can't count the number of underserved patients to whom he's donated dental care.

From: http://www.ada.org/en/publications/ada-news/2017-archive/march/like-minded-dentists-meet-join-forces-at-mission-of-mercy-event

Nasal 'Nerve Block' May Help Ease Kids' Migraines

But one headache expert says procedure not without risks, pain relief not significantly better than meds

From: http://www.webmd.com/migraines-headaches/news/20170305/nasal-nerve-block-may-help-ease-kids-migraines?src=RSS_PUBLIC

Can Mom's Vitamin E Head Off Child's Asthma Risk?

Association only significant with type of nutrient found in highest amounts of safflower, sunflower oils

From: http://www.webmd.com/baby/news/20170304/can-moms-vitamin-e-head-off-childs-asthma-risk?src=RSS_PUBLIC

Asthma Much More Lethal for Black Children

This group has 6 times the odds of dying from the illness compared to whites, Hispanics

From: http://www.webmd.com/asthma/news/20170304/asthma-much-more-lethal-for-black-children-study-finds?src=RSS_PUBLIC

Infectious Diseases A-Z: Zika and spring break

From: Mayo Clinic http://www.youtube.com/watch?v=qci88GI5w6U

Mayo Clinic Minute: Fit versus fat

From: Mayo Clinic http://www.youtube.com/watch?v=uk561liO0sw

The tricky thing about asthma

In mid-January, health headlines announced that nearly one-third of adults diagnosed with asthma don’t actually have this respiratory condition at all. This announcement appeared everywhere from Fox News Health to the Chicago Tribune.

As a primary care doc, a medical writer, and an asthma sufferer, I was very skeptical of these dramatic announcements, and with good reason. An editorial that accompanied this study provides important perspective that suggests the news headlines were exaggerated and misleading.

Taking a closer look at the study

Let’s talk about the study, which is a good one, and has merit. Canadian researchers recruited 615 random people who had been given a diagnosis of asthma, and performed formal testing to see if they still had it. And in fact, 33% of those tested did not meet criteria for the diagnosis of asthma at the time of testing. The lead author of this study is then quoted as suggesting that doctors diagnosed these patients with asthma without doing the necessary tests.

Okay. As a physician who diagnoses and treats asthma (and its many variants), a medical writer and researcher who dissects these articles, and someone who is currently experiencing an awful asthma flare (or exacerbation), I take major issue with these headlines and the lead author’s press statements.

Looking a little deeper

The data tell the story. Of the one-third of patients who tested negative for asthma in the study, 24 (or 12% of them) actually did have appropriate testing (that confirmed asthma) when they were first diagnosed. What’s more, 22 of the participants who tested negative for asthma at the time of the study, tested positive months later (again using appropriate testing).

What this really tells us is that asthma has many forms and, like many chronic disease, symptoms may come and go. This is consistent with what I know from professional — and personal — experience.

The study authors themselves recognize at the start of the study how tricky asthma can be, pointing out that there are many types of asthma that can look a little different, and have different triggers. They go on to say (as mentioned in the editorial) that symptoms of asthma can relapse (come back) and remit (go away).

Let’s get real about asthma

When I see a patient with wheezing and/or coughing spasms, and especially whose symptoms improve after a breathing (nebulizer or neb) treatment in the office, I will tell them that they at the very least have reactive airways syndrome. This is not exactly asthma. It just means that something triggered them to wheeze — maybe an allergic reaction, or a virus. They may never wheeze again. But in my office, right then, because they are wheezing at that moment, they will probably benefit from an inhaler. If an inhaler has been helpful in the past or the neb provided immediate relief, I’m not going to say, oh wait, we need to have formal testing first, before we treat you. Nope.

But, if symptoms continue and we are worried that this is more than a one-time or occasional thing, then we may want to pursue a formal, official diagnosis of asthma.

How do you know for sure if it’s asthma?

A diagnosis of asthma requires two things: a history of respiratory symptoms consistent with asthma (chest tightness, wheezing, coughing spasms, particularly nighttime cough), along with proof of “variable expiratory airflow obstruction.” What the heck is that?

Lung function tests can show whether inflammation and narrowing of the airways is impeding your ability to breathe out. A key piece of equipment for doing this is called a spirometer, and it’s not something that you will generally find in any primary care office (it is not the same as a peak flow meter you can buy at the drug store). We refer patients to a pulmonary function lab for this sort of testing. The person breathes into the spirometer while the machine measures total lung capacity, as well as various measures of exhalation speed. They may also receive inhaled medications that can help to make the diagnosis of asthma. Sometimes medications (bronchodilators like albuterol) may be used to see if they relieve symptoms (or a different medication called methacholine can be used to carefully provoke an asthma attack). If the albuterol helps or the methacholine triggers an asthma attack — diagnosis made.

For some patients, the formal testing may be too expensive. Or maybe they can’t get it scheduled in a timely manner. If their history is as clear as mine, it may make sense to simply give them the asthma diagnosis, so that things like a nebulizer machine can be covered by insurance. Even if formal testing confirms asthma, it can resolve on its own, and repeat testing may be negative later on. Was this a misdiagnosis? No, this was just asthma.

Asthma in real life

Me? I was in my doctor’s office today with wheezing. I had the flu last week (more on that in another post) which triggered a prolonged wheezing/coughing episode. My doctor saw that I was struggling to breathe, measured my oxygen levels, which were low, and heard wheezing when listening to my lungs. She also tested my peak flow, which improved with a nebulized albuterol treatment in her office. This all supports a diagnosis of asthma, but for now, I’m labeled as having reactive airways, because I haven’t had any formal evaluation with a pulmonologist and I have never had spirometry.

Yet.

Because this is now the, oh, fifth time I’ve had similar symptoms, my doctor feels we need to pursue the more formal diagnosis, and guess what? I’ve got a referral for my pulmonary function testing sometime in the future. Right now, however, I’m sick, and so she’s simply treating me.

Sources

Asthma may be misdiagnosed in many adults. Fox News Health, January 18, 2017.

1 in 3 adults diagnosed with asthma may not have it, study suggests. Chicago Tribune, January 18, 2017.

Hollingsworth, H., O’Connor, G. Asthma — Here Today, Gone Tomorrow? JAMA, January 17, 2017.

Aaron, S., Vandemheen, K., FitzGerald, J., et. al., Reevaluation of Diagnosis in Adults With Physician-Diagnosed Asthma. JAMA, January 17, 2017.

One-Third of Adults Diagnosed With Asthma Don’t Actually Have It, Study Finds. Science Alert, January 20, 2017.

Study finds 33 percent of adults recently diagnosed with asthma do not have it. Medical Xpress, January 17, 2017.

Study: 33 percent of adults are misdiagnosed with asthma. Infowars, January 18, 2017.

1 in 3 Adults Diagnosed With Asthma May Not Have It: Study. tucson.com, January 17, 2017.

Weinberger, S., Silvestri, R. Treatment of subacute and chronic cough in adults. UpToDate, March 29, 2016.

Fanta, C., An overview of asthma management. UpToDate, May 31, 2016.

McCormack, M., Office spirometry. UpToDate, June 6, 2016.

Gerald, L., Carr, T. Peak expiratory flow rate monitoring in asthma. UpToDate, December 22, 2016.

The post The tricky thing about asthma appeared first on Harvard Health Blog.

From: Monique Tello, MD, MPH http://www.health.harvard.edu/blog/tricky-thing-asthma-2017030611293

#MayoClinicNeuroChat about Brain Aneurysms

From: Mayo Clinic http://www.youtube.com/watch?v=8VwV8qmed5s

Samuel D. Harris grant deadline April 14

The application deadline for the 2017 ADA Foundation's Samuel D. Harris Fund for Children's Dental Health grant program is April 14.

From: http://www.ada.org/en/publications/ada-news/2017-archive/march/samuel-d-harris-grant-deadline-april-14

Peyton Manning to speak at ADA 2017

The ADA Distinguished Speaker Series will feature legendary quarterback Peyton Manning at ADA 2017 – America's Dental Meeting in Atlanta.

From: http://www.ada.org/en/publications/ada-news/2017-archive/march/peyton-manning-to-speak-at-ada-2017

Mardi Gras grins

Given the sparkly green, purple and yellow Mardi Gras decorations adorning the halls and clinic at the Louisiana State University School of Dentistry, the little girl's question was a fair one.

From: http://www.ada.org/en/publications/ada-news/2017-archive/march/mardi-gras-grins

Just the Facts — March 6, 2017

Average number of patient visits by gender

From: http://www.ada.org/en/publications/ada-news/2017-archive/march/just-the-facts-march-6-2017

Microneedling: The beauty treatment craze now available at home

A procedure once only available at dermatologist offices or high-end spas is now being sold for at-home use, despite concerns from the FDA

From: http://www.cbsnews.com/news/microneedling-the-beauty-treatment-craze-now-available-at-home/

The cost of a polluted environment: 1.7 million child deaths a year, says WHO

More than 1 in 4 deaths of children under 5 years of are attributable to unhealthy environments. Every year, environmental risks – such as indoor and outdoor air pollution, second-hand smoke, unsafe water, lack of sanitation, and inadequate hygiene – take the lives of 1.7 million children under 5 years, say two new WHO reports.

From: http://www.who.int/entity/mediacentre/news/releases/2017/pollution-child-death/en/index.html