California wildfires could leave behind toxic mess

Officials are urging people to stay inside, especially children and those with lung problems

From: http://www.cbsnews.com/news/california-wildfires-could-leave-behind-toxic-mess-health-official-warns/

Troubling trend of self-harm seen in teen girls

New research from the U.K. finds a sharp increase in the number of adolescent girls reporting self-harm in recent years

From: http://www.cbsnews.com/news/teen-girls-self-harm-study/

HPV Vaccine Safe for Adult Women: Study

Analysis of millions of recipients finds no link to 44 different illnesses

From: https://www.webmd.com/sexual-conditions/hpv-genital-warts/news/20171018/hpv-vaccine-safe-for-adult-women-study?src=RSS_PUBLIC

Avoiding Alcohol Helps the Heart Beat Better

Each decade of teetotaling lowers risk of atrial fibrillation, study finds

From: https://www.webmd.com/heart-disease/atrial-fibrillation/news/20171018/avoiding-alcohol-helps-the-heart-beat-better?src=RSS_PUBLIC

Infectious Diseases A-Z: Does your child have a sore throat?

From: Mayo Clinic https://www.youtube.com/watch?v=Ye5nO-z2UJs

Schizophrenia Affects Brain's Communication Path

Finding may help spur new research

From: https://www.webmd.com/brain/news/20171018/schizophrenia-affects-brains-communication-path?src=RSS_PUBLIC

Talcum Powder/Ovarian Cancer Lawsuit Award Tossed

Award in Missouri case set aside upon appeal. Does not affect larger California award in similar suit.

From: https://www.webmd.com/ovarian-cancer/news/20171018/talcum-powder-ovarian-cancer-lawsuit-award-tossed?src=RSS_PUBLIC

ADA weighs in on HHS strategic plan

Washington — As the U.S. Department of Health and Human Services develops its strategic plan for fiscal years 2018-22, the ADA is offering recommendations on how the agency can best enhance the oral health and well-being of Americans.

From:

By Jennifer Garvin

http://www.ada.org/en/publications/ada-news/2017-archive/october/ada-weighs-in-on-hhs-strategic-plan

Company Recalling Organic Tarragon After Salmonella Found in Leaves

Spicely Organics is recalling jars of organic tarragon after routine sampling found salmonella bacteria in the leaves.

From: https://www.webmd.com/food-recipes/food-poisoning/news/20171017/organic-tarragon-recall?src=RSS_PUBLIC

How hospitals guide ultra-personal cancer care

Special hospital panels work to match individual cancer treatments to genetic mutations that seem to drive the disease

From: http://www.cbsnews.com/news/ultra-personal-therapy-gene-tumor-boards-guide-cancer-care/

Is blood donated by mothers less safe?

New research suggests possible risks for men who receive the blood transfusions

From: http://www.cbsnews.com/news/is-blood-donated-by-mothers-less-safe-than-men/

OMS : Enfermedades No Transmisibles (ENT) - Video de la ceremonia de apertura - Conferencia Mundial

From: World Health Organization https://www.youtube.com/watch?v=DGs2y5kyONU

Urinary incontinence: Common and manageable

As a primary care doctor, I see a lot of women dealing with the inconvenience, discomfort, and embarrassment of urinary incontinence (unintended leaking of urine). Some are comfortable bringing this up right away. Others suffer needlessly because they feel too shy or awkward to mention it.

The truth is, an estimated 45% of women experience some form of urinary incontinence at some point in their lives. That’s almost half of all women! It’s a very big deal. Urinary incontinence can negatively affect physical and emotional well-being. For example, women may avoid going out because they’re worried about having an accident away from home. Other problems include sexual dysfunction and depression.

Types of urinary incontinence

We usually think of two main categories of incontinence:

• Stress incontinence: Leaking of urine with coughing, sneezing, sex, or impact exercise, like running and jumping. This is related to damaged and/or weak pelvic floor muscles, and is common in younger women who have given birth vaginally.
• Urge incontinence: Sudden and unpredictable overwhelming urge to urinate, with leaking of small to large amounts of urine. This sometimes also goes along with needing to go often that can occur day and night. It is more common in women who are overweight, or have diabetes or other neurological issues such as dementia or strokes. The problem is thought to be due to spasms of the bladder. A lot of things can worsen symptoms, such as caffeine, diuretics (“water pills” used for high blood pressure), drinking too much fluid, and bladder infections.

The most common form of incontinence, called “mixed,” has features of both these categories. But the kind of incontinence really doesn’t matter. What women need to know is that there are solutions.

Get your life back by taking charge of urinary incontinence — here’s how

First, talk to a healthcare provider: There are readily identifiable medical factors that can cause or worsen incontinence. Certain medications, uncontrolled diabetes, bladder infections, constipation, and menopausal changes to name a few. Your primary care doctor can help identify and treat many of these issues.

Then take care of the area: I have seen many patients who have skin rashes and infections in their genital area due to excessive moisture. Some are using menstrual pads, or even balled-up tissues or folded paper towels for their urinary leakage, or nothing at all. If moisture isn’t absorbed, it will damage the skin and cause problems. Sometimes the issue is reluctance to explore the world of incontinence pads (which are now available in a variety of brands and styles), but often, sadly, it’s the expense. Some insurances, including Medicaid, will cover incontinence pads; healthcare spending accounts are an option for some people as well. Barrier ointments, even plain old petroleum jelly, can help to protect skin from moisture. Daily bathing is also helpful.

Hold off on medication or surgery: Many women don’t realize that lifestyle changes, physical and behavioral therapies are the preferred first-line method of treatment.

Watch the fluid intake: Limit bladder-irritating beverages such as caffeinated or acidic drinks (alcohol, coffee, black tea, green tea, sodas and seltzers with citric acid added). For women who make nighttime trips to the bathroom, decreasing fluid intake in the evening (especially alcohol) can help.

Lose a few pounds: Extra abdominal fat can create pressure on the bladder. Losing just 5% of body weight can help a lot. But even losing a few pounds can improve symptoms.

Exercise: The more physically active a woman is, the less likely she is to suffer from urinary incontinence. This may be related to better core and pelvic floor muscle tone in women with increased fitness.

Pelvic floor exercises and physical therapy: Those Kegel squeezes can really work! They’re not difficult, but it’s important to do them correctly. Believe it or not, formal pelvic floor physical therapy with a trained provider can be hugely helpful. These therapists are usually women. They will take a careful history and then assess anatomy, muscle control, and strength, and then outline a guided exercise program. Once my patients get over their initial hesitation, they almost always see a benefit.

Bladder training: Scheduling bathroom visits can help women to “train” an overactive bladder. Sometimes bladder training is done along with pelvic floor physical therapy, and can be more successful that way.

And if all that doesn’t help…

Talk to a healthcare provider again. There are several medications that may help. For women with postmenopausal vaginal and vulvar changes (called atrophy), an estrogen cream or ring can help a great deal. It may take as long as four months to see an effect, and though topical estrogen is low-risk, hormone therapy is not for everyone. There are also medications specifically for urinary incontinence, though frankly none are likely to be a cure. In fact, all the pills we see advertised (such as anticholinergics, the most commonly prescribed) only result in one or two less incontinence episodes per day, at best. Plus, there are many side effects, such as sleepiness, confusion, dry eyes, dry mouth, and constipation. These medications are especially dangerous in the elderly. Even the newer medications aren’t much different in terms of efficacy and side effect profile.

The important takeaway messages about urinary incontinence

Here’s what women really need to know:

• If you suffer from incontinence, know that you are not alone.
• Talk to your healthcare provider about it. Make sure there’s nothing else going on that should be addressed.
• Try lifestyle changes, behavior and physical therapies first, and second, and third.
• Be cautious with all medications, and weigh risk, benefits, and side effects carefully with your doctor.

Resources

Evaluation of women with urinary incontinence. UpToDate, September 14, 2017.

Treatment of urinary incontinence in women. UpToDate, August 28, 2017.

Urinary Incontinence and Associated Female Sexual Dysfunction. Sexual Medicine Reviews, October 2017.

MGH Primary Care Office Insight chapter on Urinary Incontinence in Women (Mary Hohenhaus, MD and Shana Birnbaum, MD, Specialist Reviewer: May Wakamatsu, MD)

Nonsurgical Management of Urinary Incontinence in Women: A Clinical Practice Guide from the American College of Physicians. Annals of Internal Medicine, September 16, 2014.

Effectiveness of pelvic floor muscle training in treating urinary incontinence in women: A current review. Actas Urologicas Espanolas, June 2016.

The post Urinary incontinence: Common and manageable appeared first on Harvard Health Blog.

From: Monique Tello, MD, MPH https://www.health.harvard.edu/blog/urinary-incontinence-common-and-manageable-2017101812583

Newer Blood Thinners Don't Raise Bleeding Risk

Risk is similar to warfarin, study reports

From: https://www.webmd.com/dvt/news/20171018/newer-blood-thinners-may-not-bring-higher-bleeding-risk?src=RSS_PUBLIC

Opioid crisis: Pennsylvania's AG on holding drug companies accountable

As part of our ongoing series, Issues That Matter, we look at the opioid crisis. Following an investigation by "60 Minutes" and the Washington Post, 41 attorneys general around the country have subpoenaed drug manufacturers and distributors for information and documents. They want to know how opioid medications are made, marketed and distributed. Pennsylvania Attorney General Josh Shapiro joins "CBS This Morning" to discuss the focus of their investigation and why they're not waiting for Congress to go after pharmaceutical companies.

From: http://www.cbsnews.com/videos/opioid-crisis-pennsylvanias-ag-on-holding-drug-companies-accountable/

WHO: Noncommunicable diseases - Opening Video - Global Conference in October 2017

From: World Health Organization https://www.youtube.com/watch?v=MWk8XJWEiO4

Trump backs away from bipartisan Obamacare subsidies plan

The success or failure of a bipartisan fix for Obamacare insurance markets could hinge on the White House. The president seemed to endorse a temporary plan from Sens. Lamar Alexander and Patty Murray Tuesday, but he turned away from the deal hours later. Nancy Cordes reports.

From: http://www.cbsnews.com/videos/trump-backs-away-from-bipartisan-obamacare-subsidies-plan/

Suspected cases from Seychelles test negative for plague

Suspected cases from Seychelles test negative for plague

From: http://www.who.int/entity/mediacentre/news/releases/2017/seychelles-plague-negative/en/index.html

Patient Prejudice Survey Results

This article provides data from a WebMD/Medscape survey done in collaboration with STAT on the topic of bias in health care.

From: https://www.webmd.com/a-to-z-guides/news/20171018/patient-prejudice-survey-results?src=RSS_PUBLIC

Credentials Don’t Shield Doctors, Nurses from Bias

A majority of health care professionals – including doctors, nurses and physician assistants -- say patients have made offensive comments to them based on their age, gender, ethnic background, race, weight, or other personal traits. The findings are from a new WebMD/Medscape survey done in collaboration with STAT news.

From: https://www.webmd.com/a-to-z-guides/news/20171018/survey-patient-bias-toward-doctors-nurses?src=RSS_PUBLIC