In "landmark" study, breast cancer drug extends lives

The drug is already approved in the U.S., and may be a promising option for some women with hard-to-treat breast cancer

From: http://www.cbsnews.com/news/breast-cancer-drug-xeloda-can-extend-lives-landmark-study/

"The Bachelorette" and relationship therapy for one

"You are creating a new model of an intimate relationship in the therapy office," one counselor explains, "then take that kind of experience out into the world and repeat it"

From: http://www.cbsnews.com/news/the-bachelorette-rachel-lindsay-and-relationship-therapy-for-one/

Iowa's GOP senators say a full Obamacare repeal is unlikely

The comments by Sens. Chuck Grassley and Joni Ernst come as the GOP-controlled Senate moves forward on its plan to dismantle the health care law

From: http://www.cbsnews.com/news/iowas-gop-senators-say-a-full-obamacare-repeal-is-unlikely/

Drugmakers accused of fueling devastating opiate crisis

In filing lawsuit, Ohio Attorney General says pharmaceutical firms "knew they were wrong, but they did it anyway"

From: http://www.cbsnews.com/news/drugmakers-accused-of-fueling-devastating-opiate-crisis/

Breast surgeon who maimed patients gets 15 years

One victim described the doctor as a "monster" who performed unnecessary surgeries

From: http://www.cbsnews.com/news/british-breast-surgeon-who-maimed-patients-gets-15-years/

Olivia Newton-John's breast cancer return sparks questions

Recurrence "reinforces that breast cancer is potentially a systemic or whole body disease from the get-go," UCLA expert says

From: http://www.cbsnews.com/news/olivia-newton-john-breast-cancer-return-raises-questions-about-recurrence/

Reliving Communist past helps East German dementia patients

Reminders from bygone days​ can trigger memories once thought lost in patients with Alzheimer's

From: http://www.cbsnews.com/news/reliving-communist-past-helps-east-german-dementia-patients/

Eat only every other day and lose weight?

The alternate-day fasting thing is very popular right now. This gist of it is, basically, feast and famine. You starve one day, then feast the next. Proponents claim that this approach will lead to weight loss, as well as a number of other benefits.

As a physician researcher, this annoys and alarms me. I preach sensible intake of real foods as part of a lifelong approach to health. I also depend on scientific evidence to guide my counseling. So, I welcomed this yearlong study comparing alternate-day fasting with more common calorie restriction.

Some data on alternate-day fasting

Researchers divided 100 obese study volunteers (mostly African-American women, without other major medical issues) into three groups:

• one group followed an alternate fasting plan, which meant on the fasting day they would eat only 25% of their caloric needs and on the non-fasting day they’d eat a little bit more (125% of their caloric needs per day)
• a second group ate 75% of their caloric needs per day, every day
• a third group ate the way they typically did, for six months.

The two diet groups received counseling as well as all foods provided. This “weight loss” period was followed by another six months of “weight maintenance” and observations.

Both diet groups lost about 5.5% of their body weight (12 pounds) by month six, and both regained about 1.8% (four pounds) by month 12, and had significant improvements in blood pressure, blood sugar, insulin, and inflammatory proteins when compared to the people who ate their normal diets.

At the end of the 12 months, there was only one difference between the two diet groups: the alternate fasting day group had a significant elevation in low density lipoprotein (LDL), an increase of 11.5 mg/dl as compared to the daily calorie restriction group. LDL is known as a risk factor for heart attacks and strokes, so that’s not good.

And how would this work in real life?

This was a very small study to begin with, and, more importantly, there was a fairly significant dropout rate. Only 69% of subjects stayed to the end, which decreases the power of the findings. Twelve people quit the alternate-day fasting group, with almost half citing dissatisfaction with the diet. By comparison, 10 people quit the daily calorie restriction group, and none cited dissatisfaction with diet, only personal reasons and scheduling conflicts (eight quit the control group for the same reasons).

It’s not surprising that people disliked alternate-day fasting. Previous studies have reported that people felt uncomfortably hungry and irritable on fasting days, and that they didn’t get accustomed to these discomforts. Interestingly, in this study, over time people in the fasting group ate more on fasting days and less on feasting days. So basically by the end of the study they were eating similarly to the calorie restriction group.

The authors note more limitations. The control group did not receive food, counseling, or the same attention from the study personnel, potential factors that could affect their results, besides how they ate. And this study can’t tell us about the potential benefits for people who have high blood pressure, high cholesterol, or diabetes because the study didn’t include individuals with those conditions.

The bottom line

Usually at this point we say something like “more studies of this approach are needed,” but I won’t. There’s already plenty of evidence supporting a common-sense lifestyle approach to weight loss: ample intake of fruits and veggies, healthy fats, lean proteins, and plenty of exercise. From apples to zucchini, there are over a hundred “real” foods you can eat endlessly, enjoy, and yes, still lose weight.

I would advise against spending any more money on fad diet books. Or processed carbs, for that matter. Rather, hit the fresh or frozen produce aisle, or farmer’s market, and go crazy. Then go exercise. Do that, say, for the rest of your life, and you will be fine. No one got fat eating broccoli, folks. (That said, if you tend to binge or stress-eat sugary or starchy foods, and you feel like you can’t control your habit, talk to your doctor, because that is a separate issue to be addressed.)

Sources

Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection Among Metabolically Healthy Obese Adults: A Randomized Clinical Trial. JAMA Internal Medicine, Published online May 1, 2017.

Alternate-day fasting in nonobese subjects: effects on body weight, body composition, and energy metabolism. American Journal of Clinical Nutrition, January 2005.

The post Eat only every other day and lose weight? appeared first on Harvard Health Blog.

From: Monique Tello, MD, MPH http://www.health.harvard.edu/blog/eat-only-every-other-day-and-lose-weight-2017053111791

Premenstrual dysphoria disorder: It’s biology, not a behavior choice

Almost all women have some mild premenstrual symptoms that signal the imminent arrival of their period every month. These symptoms are typically just an annoyance and don’t cause any distress.

But for some women, these symptoms are much more significant. About 20% of menstruating women suffer from premenstrual syndrome, or PMS. Women with PMS have mostly physical symptoms and some minor mood disturbances caused by the changing hormone levels in the second half (or luteal phase) of the menstrual cycle. These hormone-induced symptoms can cause significant physical distress in the days leading up to menstruation.

PMDD: More than PMS

Sometimes — in about 5% to 8% of menstruating women — debilitating mood changes accompany these premenstrual physical symptoms. Globally this is often referred to as severe PMS, but in the United States this combination of physical symptoms and mood disturbances is called premenstrual dysphoria disorder, or PMDD.

Unfortunately, women with PMDD are often misdiagnosed. Sometimes they go undiagnosed, being told they are just hormonal and need to get over it. And sometimes they are overdiagnosed. Unfortunately, it is all too common for women with PMDD to be incorrectly diagnosed with bipolar disorder.

What causes PMDD?

Broadly speaking, if you have PMDD, you have an increased sensitivity to your reproductive hormones during the two weeks before your period starts. This sensitivity leads to alterations in the brain chemicals and neurologic pathways that control your mood and your general sense of well-being. Exactly what that sensitivity is and what causes it has not been well understood. And treatment options have been limited.

Fortunately, progress is being made with some exciting new discoveries. Researchers at the National Institutes of Health (NIH) have found that women with PMDD have an altered gene complex that processes the body’s response to hormones and stressors. This is a very important discovery, as it establishes a biological basis for the mood disturbances of PMDD. Not only is this validation for women who live with PMDD, but it also has tremendous implications for new and improved treatment options.

And more recently, Dr. Peter Schmidt, one of the lead researchers on the NIH study, published data that support the working theory that it is the changes in hormone levels, not just the hormones themselves, that trigger the symptoms of PMDD.

Getting the diagnosis right

There are no tests to diagnose PMDD. The diagnosis is made entirely on the type and timing of symptoms.

To make the diagnosis of PMDD, symptoms must be present only in the week or two before your period, and they must subside within a few days of starting your period as quickly as they come on. The type of symptoms are also important. Specifically, to meet the criteria for PMDD you must experience at least one of the following:

• feeling very irritable or angry
• feeling very down or depressed
• feeling very anxious, stressed, or tense
• avoiding your usual activities

In addition to these four core mood symptoms, any one of the following symptoms (to make a total of five) are needed to confirm PMDD:

• difficulty concentrating
• feeling tired and very low in energy level
• binge eating or having a really strong, specific food craving
• sleeping too much or having trouble falling asleep
• feeling overwhelmed or out of control
• unpleasant physical symptoms, especially breast tenderness, bloating, body aches, and weight gain

If you experience any of these symptoms apart from the two weeks before your period, you don’t have PMDD. Instead, it is likely that you have another underlying mood disorder. With the other mood disorders like major depression, bipolar disorder, and generalized anxiety disorder, you may have good days and bad days with your symptoms but they are not predictable. Your symptoms will occur randomly throughout the month, not just in the two weeks before your period. You may, however, notice an increase in symptoms before your period. This is known as a premenstrual exacerbation. It is very important to get the diagnosis right because the treatments are often very different for PMDD from the other mood disorders.

5 things you should do if you think you have PMDD

1. Track your symptoms. This is essential to getting the right diagnosis. You should record how you are feeling every day for at least two cycles, making note of the days you bleed. Try using a period tracker app like Clue to help you collect this information.
2. Educate yourself. It is important for you to understand as much as you can about PMDD. Unfortunately, much of the medical profession is undereducated about PMDD. You will need to be an advocate for your health. You can look to the Gia Allemand Foundation and the Center for Women’s Mental Health at Massachusetts General Hospital for information and guidance.
3. Reach out to peer support groups. Remember, you are not alone. It is important to connect with others who have PMDD. Hearing other women’s stories and struggles can help you cope with your diagnosis. Try PMDD Moms or PMDD Safehouse.
4. Start with lifestyle changes. The first step in managing the symptoms of PMDD starts with improving your overall health and wellness. Eating a well-balanced diet, getting regular exercise, and adequate sleep are essential. Consider introducing some mind-body practice like yoga or meditation to help manage stress.
5. Talk to your doctor. It is very important that you discuss your symptoms and concerns with your doctor. Consider tracking your symptoms before your visit. If you don’t feel that your doctor is taking your complaints seriously, you should not hesitate to get another opinion. Do not give up until you get the help you deserve.

The post Premenstrual dysphoria disorder: It’s biology, not a behavior choice appeared first on Harvard Health Blog.

From: Andrea Chisholm, MD http://www.health.harvard.edu/blog/premenstrual-dysphoria-disorder-its-biology-not-a-behavior-choice-2017053011768

Signs a child is drowning can be easy to miss

A water safety expert says drowning can happen quickly and without the telltale signs you might expect

From: http://www.cbsnews.com/news/how-to-spot-signs-of-a-child-drowning/

State of Mind Episode 5: Out of the depths

Vito Randazzo has been suffering from severe depression for 18 years, and after nothing else worked, he turned to deep brain stimulation for help

From: http://www.cbsnews.com/news/depression-neurosurgery-dbs-mental-health-uncharted-state-of-mind-episode-5/

Mayo Clinic Minute - Treatment for hair loss in women

From: Mayo Clinic https://www.youtube.com/watch?v=5qXhi7NZcrQ

Wellness Wednesday: Add a bridge to your march

From: Mayo Clinic https://www.youtube.com/watch?v=C2-9EptJeqw

The Whole Truth About Whole Fruits

Why it's often better to skip the smoothie

From: http://www.webmd.com/food-recipes/news/20170531/the-whole-truth-about-whole-fruits?src=RSS_PUBLIC

The danger for kids who know snack food brand names

When a preschooler recognizes popular cola, candy, fast food and chip brands and logos, a more serious issue may lurk

From: http://www.cbsnews.com/news/kids-who-know-snack-food-brands-overweight-obesity-risk/

Quitting Hormone Replacement Therapy for Menopause

WebMD looks at when, why, and how to quit hormone replacement therapy for menopause.

From: http://www.webmd.com/menopause/features/quitting-hormone-replacement-therapy?src=RSS_PUBLIC

Can You Change Your Gut Bacteria?

WebMD explores probiotics and prebiotics, and what they can and can't do for health.

From: http://www.webmd.com/digestive-disorders/news/20170531/can-you-change-your-gut-bacteria?src=RSS_PUBLIC

Popular skin cancer treatment not right for all patients

Even after decades of use, there are questions about the long-term effects of superficial radiation therapy (SRT)

From: http://www.cbsnews.com/news/skin-cancer-non-melanoma-srt-superficial-radiation-therapy/

1 in 4 Nursing Home Residents Has Antibiotic-Resistant Bacteria

More infection-prevention education and policies are needed, study findings suggest

From: http://www.webmd.com/healthy-aging/news/20170530/1-in-4-nursing-home-residents-has-antibiotic-resistant-bacteria?src=RSS_PUBLIC

Does Dad Time With Infants Boost Babies' IQ?

Positive interactions during first few months could enhance thinking skills at age 2, study suggests

From: http://www.webmd.com/parenting/baby/news/20170530/does-dad-time-with-infants-boost-babies-iq?src=RSS_PUBLIC

Can a Senior Have the Arteries of a 20-Year-Old?

It's possible, but hard work in today's 'Western' culture, study finds

From: http://www.webmd.com/heart-disease/news/20170530/can-a-70-year-old-have-the-arteries-of-a-20-year-old?src=RSS_PUBLIC

Seventieth World Health Assembly update, 30 May 2017

Delegates at the World Health Assembly today came to agreement on vector control, a number of issues related to noncommunicable diseases, as well as chemicals management and WHO reporting on the Sustainable Development Goals.

Delegates welcomed the strategic approach proposed in the Global Vector Control Response (GVCR) 2017-2030. The response aims to prevent epidemics of vector-borne diseases in all countries, reduce the incidence of these diseases by at least 60% and cut mortality rates by at least 75% by 2030.

From: http://www.who.int/entity/mediacentre/news/releases/2017/vector-control-ncds-cancer/en/index.html

Behind the prescription meds listed in Tiger Woods' police report

Dr. Tara Narula joins "CBS This Morning" to describe the four medications listed in the police report for Tiger Woods' arrest.

From: http://www.cbsnews.com/videos/behind-the-prescription-meds-listed-in-tiger-woods-police-report/

Premenstrual dysphoria disorder: It’s biology, not a behavior choice

Almost all women have some mild premenstrual symptoms that signal the imminent arrival of their period every month. These symptoms are typically just an annoyance and don’t cause any distress.

But for some women, these symptoms are much more significant. About 20% of menstruating women suffer from premenstrual syndrome, or PMS. Women with PMS have mostly physical symptoms and some minor mood disturbances caused by the changing hormone levels in the second half (or luteal phase) of the menstrual cycle. These hormone-induced symptoms can cause significant physical distress in the days leading up to menstruation.

PMDD: More than PMS

Sometimes — in about 5% to 8% of menstruating women — debilitating mood changes accompany these premenstrual physical symptoms. Globally this is often referred to as severe PMS, but in the United States this combination of physical symptoms and mood disturbances is called premenstrual dysphoria disorder, or PMDD.

Unfortunately, women with PMDD are often misdiagnosed. Sometimes they go undiagnosed, being told they are just hormonal and need to get over it. And sometimes they are overdiagnosed. Unfortunately, it is all too common for women with PMDD to be incorrectly diagnosed with bipolar disorder.

What causes PMDD?

Broadly speaking, if you have PMDD, you have an increased sensitivity to your reproductive hormones during the two weeks before your period starts. This sensitivity leads to alterations in the brain chemicals and neurologic pathways that control your mood and your general sense of well-being. Exactly what that sensitivity is and what causes it has not been well understood. And treatment options have been limited.

Fortunately, progress is being made with some exciting new discoveries. Researchers at the National Institutes of Health (NIH) have found that women with PMDD have an altered gene complex that processes the body’s response to hormones and stressors. This is a very important discovery, as it establishes a biological basis for the mood disturbances of PMDD. Not only is this validation for women who live with PMDD, but it also has tremendous implications for new and improved treatment options.

And more recently, Dr. Peter Schmidt, one of the lead researchers on the NIH study, published data that support the working theory that it is the changes in hormone levels, not just the hormones themselves, that trigger the symptoms of PMDD.

Getting the diagnosis right

There are no tests to diagnose PMDD. The diagnosis is made entirely on the type and timing of symptoms.

To make the diagnosis of PMDD, symptoms must be present only in the week or two before your period, and they must subside within a few days of starting your period as quickly as they come on. The type of symptoms are also important. Specifically, to meet the criteria for PMDD you must experience at least one of the following:

• feeling very irritable or angry
• feeling very down or depressed
• feeling very anxious, stressed, or tense
• avoiding your usual activities

In addition to these four core mood symptoms, any one of the following symptoms (to make a total of five) are needed to confirm PMDD:

• difficulty concentrating
• feeling tired and very low in energy level
• binge eating or having a really strong, specific food craving
• sleeping too much or having trouble falling asleep
• feeling overwhelmed or out of control
• unpleasant physical symptoms, especially breast tenderness, bloating, body aches, and weight gain

If you experience any of these symptoms apart from the two weeks before your period, you don’t have PMDD. Instead, it is likely that you have another underlying mood disorder. With the other mood disorders like major depression, bipolar disorder, and generalized anxiety disorder, you may have good days and bad days with your symptoms but they are not predictable. Your symptoms will occur randomly throughout the month, not just in the two weeks before your period. You may, however, notice an increase in symptoms before your period. This is known as a premenstrual exacerbation. It is very important to get the diagnosis right because the treatments are often very different for PMDD from the other mood disorders.

5 things you should do if you think you have PMDD

1. Track your symptoms. This is essential to getting the right diagnosis. You should record how you are feeling every day for at least two cycles, making note of the days you bleed. Try using a period tracker app like Clue to help you collect this information.
2. Educate yourself. It is important for you to understand as much as you can about PMDD. Unfortunately, much of the medical profession is undereducated about PMDD. You will need to be an advocate for your health. You can look to the Gia Allemand Foundation and the Center for Women’s Mental Health at Massachusetts General Hospital for information and guidance.
3. Reach out to peer support groups. Remember, you are not alone. It is important to connect with others who have PMDD. Hearing other women’s stories and struggles can help you cope with your diagnosis. Try PMDD Moms or PMDD Safehouse.
4. Start with lifestyle changes. The first step in managing the symptoms of PMDD starts with improving your overall health and wellness. Eating a well-balanced diet, getting regular exercise, and adequate sleep are essential. Consider introducing some mind-body practice like yoga or meditation to help manage stress.
5. Talk to your doctor. It is very important that you discuss your symptoms and concerns with your doctor. Consider tracking your symptoms before your visit. If you don’t feel that your doctor is taking your complaints seriously, you should not hesitate to get another opinion. Do not give up until you get the help you deserve.

The post Premenstrual dysphoria disorder: It’s biology, not a behavior choice appeared first on Harvard Health Blog.

From: Andrea Chisholm, MD http://www.health.harvard.edu/blog/premenstrual-dysphoria-disorder-its-biology-not-a-behavior-choice-2017053011768