Category Archives: Health
Spending time in nature can work wonders for human health, from lowering blood pressure and stress hormones to sparking feelings of awe. Growing research suggests it may also improve sleep by resetting our internal clocks to a natural sleep cycle. A new study released in the journal Current Biology adds to that evidence by showing the sleep-promoting benefits of the great outdoors.
Kenneth Wright, a researcher at the University of Colorado Boulder and author of the new study, embarked on his camping research back in 2013, when he sent people on a week-long summer camping trip to understand how their internal clocks changed without electronics and only natural light. Before and after the trip, he measured their levels of the hormone melatonin, which alerts the body when it’s time to prepare for bed and helps set a person’s internal clock. Wright found that people’s internal clocks were delayed by two hours in their modern environment—which isn’t a good thing, since an out-of-whack sleep cycle has been linked to health problems like sleepiness, mood problems and a higher risk of being overweight. But they were able to recalibrate after a week in nature.
Now, in the new study, Wright set out to better understand how long it takes for people to recalibrate their internal sleep cycles and whether it also works in winter.
In the first part of his study, Wright equipped five people with wearable devices that measured when they woke up, when they went to bed and how much light they were normally exposed to. Wright also measured their melatonin levels in a lab. After that, everyone went on a week-long camping trip—but this time, it was during the winter.
Wright found that people’s internal clocks were delayed during their normal schedules—this time by two hours and 36 minutes—compared to when they were exposed to only natural light on their camping trip. They also had higher melatonin levels, which signals that it’s a person’s biological night. “We don’t know what this means, but we do know some humans are sensitive to seasonal changes,” says Wright. “Some people get winter depression or may gain weight a bit more.”
In the second part of the study, Wright wanted to see what happened when some people went camping for just a weekend and others stayed home. Most who stayed home stayed up later than usual and slept in, and their internal clocks were pushed back even further. But on the two-day trip, campers’ internal clocks shifted earlier. “That says we can rapidly change the timing of our internal clock,” says Wright.
Fun as it may be, camping isn’t the only way to get similar results, Wright says: Exposing yourself to morning light, cutting down on electrical light from smartphones and screens in the evening and even dimming the lights at home can help.
As for Wright, he sets his internal clock by hiking in the morning, then waking up and going to sleep at the same time every day. It appears to be working: he doesn’t even need an alarm clock anymore.
If you often run with music, or podcasts, or while watching television on the treadmill, you might want to listen up—literally. New research supports the idea that auditory and visual distractions while running may raise your risk for leg injuries.
The findings aren’t terribly surprising. It makes sense that the more things we have on our minds while working out, the less careful we may be about our form, biomechanics, obstacles in the way, or how hard we’re really working. But this may be one of the first times researchers have compared distracted versus non-distracted running in a lab setting, and really quantified the results.
To test their hypothesis that distractions could interfere with safety, researchers from the University of Florida asked 14 experienced runners to run on a treadmill three separate times—once while watching a screen that flashed different letters and colors; once while listening to words spoken by different voices; and once with no background images or noise. For both distraction scenarios, they were asked to pay attention and identify certain letter-color or word-voice combinations.
The researchers noted that when the runners concentrated on those distractions, they applied force to their legs at a faster rate, compared to when they had a single focus. They also tended to breathe heavier and have higher heart rates while distracted. During the listening scenario, they also experienced an increased amount of force from the ground—meaning they came down harder with each foot fall.
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The results, presented at the annual meeting of the Association of Academic Physiatrists in Las Vegas, are preliminary and have not yet been published in a peer-reviewed scientific journal. The authors didn’t look specifically at whether these things really do lead to sports injuries. But they say it’s certainly possible—and runners who often train or race with with music, crowd noise, or lots of other people, may be particularly vulnerable, they say.
Sometimes this type of background noise can’t be helped, of course—and sometimes you just really need Spotify to get you though long training runs. But it may be smart not to pile too many new sights and sounds on at once, says lead author Daniel Herman, MD, PhD, assistant professor in the University of Florida’s Department of Orthopedics and Rehabilitation.
“For example, when running a new route in a chaotic environment such as during a destination marathon, you may want to skip listening to something which may require more attention—like a new song playlist or a podcast,” said Dr. Herman in a press release.
This isn’t the first research to suggest a downside to distracted running: A recent pair of studies found that texting or talking on the phone negatively impacted both balance and workout intensity. (Listening to music, however, did not.)
The bottom line? Be careful out there, and be sure you’re giving your workout the attention it needs.
Medical and public health groups are banding together to explain how global warming has taken a toll on human health and will continue to cause food-borne illnesses, respiratory problems, and deaths unless policy changes are enacted.
In a conference call with reporters, the heads of the American Medical Association (AMA) and the American Public Health Association (APHA) joined with a pediatrician and a scientist to lay out what they say is a major public health issue: climate change caused by global warming.
The Link Between Air Pollution and Asthma
The “evidence has only grown stronger” that climate change is responsible for an increasing number of health ills, including asthma, diarrheal disease, and even deaths from extreme weather such as heat waves, said Dr. Georges Benjamin, executive director of the APHA.
For one, rising temperatures can mean more smog, which makes children with asthma sicker, explained pediatrician Dr. Perry Sheffield, assistant professor in the Department of Pediatrics and the Department of Preventive Medicine at the Mount Sinai School of Medicine, in New York.
There is also evidence that pollen season is also getting longer, she said, which could lead to an increase in the number of people with asthma.
Climate change also is thought to lead to increased concentrations of ozone, a pollutant formed on clear, cloudless days. Ozone is a lung irritant which can affect asthmatics, those with chronic obstructive pulmonary disease, and those with heart disease, said Dr. Kristie Ebi, who is a member of the Intergovernmental Panel on Climate Change.
More ozone can mean more health problems and more hospital visits, she said.
Aside from air-related ailments and illnesses, extreme weather can have a devastating effect on health, Sheffield said.
“As a result of global warming, extreme storms including hurricanes, heavy rainfall, and even snowstorms are expected to increase,” Sheffield said. “And these events pose risk of injury and disruption of special medical services, which are particularly important to children with special medical needs.”
Extreme heat waves and droughts are responsible for more deaths than any other weather-related event, Sheffield said.
The 2006 heat wave that spread through most of the U.S. and Canada saw temperatures that topped 100 degrees. In all, 450 people died, 16,000 visited the emergency room, and 1,000 were hospitalized, said Dr. Cecil Wilson, president of the AMA.
Climate change has already caused temperatures to rise and precipitation to increase, which, in turn, can cause diseases carried by tics, mosquitoes, and other animals to spread past their normal geographical range, explained Ebi.
For instance, Lyme disease is increasing in some areas, she said, including in Canada, where scientists are tracking the spread of Lyme disease north.
Ebi also recounted the 2004 outbreak of the leading seafood-related cause of gastroenteritis, Vibrio parahaemolyticus, from Alaskan seafood, which was attributed to increased ocean temperatures causing infected sea creatures to travel 600 miles north. Visit Obat Pembesar Penis for men vitality
Salmonella outbreaks also increase when temperatures are very warm, Sheffield said.
A 2008 study also projected that global warming will lead to a possible increase in the prevalence of kidney stones due to increased dehydration, although the link hasn’t been proven.
Wilson said the AMA wants to make doctors aware of the projected rise in climate-related illnesses. To combat climate change, Wilson says physicians and public health groups can advocate for policies that improve public health, and should also serve as role models by adopting environmentally-friendly policies such as eliminating paper waste and using energy-efficient lighting in their practices.
“Climate instability threatens our health and life-supporting system, and the risk to our health and well-being will continue to mount unless we all do our part to stabilize the climate and protect the nation’s health,” said Wilson.
Benjamin added that doctors should pay attention to the Air Quality Index. For instance, if there’s a “Code Red” day, which indicates the air is unhealthy, physicians should advise patients (particularly those with cardiac or respiratory conditions) that it’s not the day to try and mow the grass.
“ER docs are quite aware of Code Red days because we know that when those occur, we’re going to see lots of patients in the emergency room,” Benjamin said. use Pembesar Penis for strong vitality
The conference call came as Congress is considering what role the Environmental Protection Agency (EPA) should have in updating its safeguards against carbon dioxide and other pollutants.
While the EPA has the authority to regulate levels of CO2, a budget bill passed by the House of Representatives last the weekend prohibited the EPA from exercising that authority. Meanwhile, other bills are pending in Congress that would significantly delay the agency’s ability to regulate air pollutants.
AMA has a number of policies on the books regarding climate change, including a resolution supporting the EPA’s authority to regulate the control of greenhouse gases, and a statement endorsing findings from the most recent Intergovernmental Panel on Climate Change report that concludes the Earth is undergoing adverse climate changes, and that humans are a significant contributor to the changing weather.
In that statement, the AMA said it supports educating the medical community about climate change and its health implications through medical education on topics such as “population displacement, heat waves and drought, flooding, infectious and vector-borne diseases, and potable water supplies.”
The statement also said the AMA supports physician involvement in policymaking to “search for novel, comprehensive, and economically sensitive approaches to mitigating climate change to protect the health of the public.”
When people say they want to get healthier, they often focus on just two things: eating better and exercising more. But sleeping well is also a vital part of any health routine. Here’s your all-day guide to getting the best sleep you’ve ever had.
Wake up at the same time every day: around 8 A.M.
One of the most important factors in getting quality sleep is the consistency of your sleep schedule. Some research has shown that teens naturally wake up later than older adults, but the exact time you wake up is not as important as keeping it regular. Waking up at roughly the same time each day keeps your circadian rhythm—the body’s internal clock—in sync, says Kenneth Wright Jr., director of University of Colorado Boulder’s sleep and chronobiology laboratory. That’s key, because your circadian rhythm is the natural process that regulates feelings of sleepiness throughout the day.
Unfortunately, that means it’s not ideal to sleep in on the weekends or stay up too late. Changing your sleep schedule just one or two days a week throws off your body’s internal clock to a similar degree that jet lag does.
Go toward the light: 8:30 A.M.
“After you get up, one of the things that we recommend is getting some exposure to sunlight,” Wright says. Getting sunlight in the morning by going outside not only helps you wake up, but it also helps juice your internal clock, so you’ll feel ready to sleep again by the time you want to go to bed in the evening. “Even if it’s a cloudy day, going outside is a strong signal to your body to prepare for the day.”
Drink coffee in the morning: 10 A.M.
Drink your day’s worth of coffee—three to five cups at most—before lunchtime. That’s because caffeine can take four to six hours to work its way through your body, says Jeanne Duffy, a neuroscientist and sleep researcher at Harvard Medical School. “If you’re using caffeine too late in the afternoon or evening, that is definitely going to impact your sleep,” she says.
Eat a big lunch: 12:30 P.M.
Make lunch your biggest meal. It’s important to fuel up early in the day because your body needs calories to help you keep going. You’ll want to avoid eating heavy meals late at night, Duffy says, so try to stock up on hearty foods at lunch, even if you want to watch your calories.
Nap (but only if you must): 2 P.M.
Daytime naps are always tempting if you feel sleepy, but they’re not a good idea for everyone. While short naps help some people feel refreshed and alert, research has shown that longer naps can leave people feeling groggy and make it harder to fall asleep at bedtime. If you feel the need to rest your head during the day, the Mayo Clinic recommends limiting naps to 10-30 minutes and planning them for after lunch, when your body is naturally less alert.
Exercise: between 4 and 6 P.M.
Regular physical activity is good for sleep. Some people like to start their day with a workout, but for those who can’t make an early gym appointment, an afternoon workout has serious benefits. Your body is slightly warmer and has increased hormone levels in the afternoon, meaning you’ll be at your peak strength and your muscles can work more efficiently during this time.
But, like eating, you should be wary of exercising too late. Try to finish working out at least two or three hours before bed, Duffy advises. “One of the things that naturally happens when we fall asleep is our body temperature cools,” she says. “Exercise tends to raise your body temperature and you don’t cool down quickly, it takes some time, so that process can impact your ability to fall asleep.”
Eat a small dinner: 6:30 P.M.
Eating large meals too close to bedtime gives your body too little time to digest before you lie down, which can disrupt your sleep, Duffy says. But it can also cause longer-term consequences, like high blood sugar and a higher risk of metabolic disorders and diabetes. Your circadian rhythm typically gets your body ready to respond to food and use the nutrients as fuel, but if you eat too late at night, your body won’t react in the usual way.
Have your last glass of wine: 7 P.M.
Many people claim alcohol helps put them to sleep, but research shows the opposite: it’s actually one of the biggest sleep destroyers. Not only does booze dehydrate you, but as your body metabolizes the alcohol during the night, it also creates more fragmented sleep, says Jamie Zeitzer, a Stanford neurobiologist and sleep expert. A glass of wine at dinner is probably fine, but if you indulge in a nightcap or regularly drink right before going to sleep, you may want to quit earlier in the night.
Take a shower: 9 P.M.
Many people like to shower in the morning, and that’s just fine, Zeitzer says. But if you shower at night, pay attention to the timing. A warm shower or a hot bath may seem relaxing right before bed, but it may raise your body temperature and disrupt sleep, Zeitzer explains. Instead, take it at least an hour and a half before you drift off to give your body time to cool down.
Power down electronics: 10 P.M.
Recent studies have shown that the blue light your phone emits suppresses melatonin, a hormone the body needs to maintain its circadian rhythm. This can keep you up at night if you’re looking at a screen right before bed, but fortunately Zeitzer says those effects can be mitigated by getting a normal amount of light exposure during the day.
The other problem with your phone or laptop is harder to fix. “If the content on your screen is causing you to be anxious or stressed, that’s not ideal,” Zeitzer says. The content doesn’t even have to be negative—only stimulating—to work against slumber. Reading an exciting book on a tablet, answering emails from your boss or scrolling through Facebook can all make it harder to sleep.
“It’s definitely not a one-size-fits-all thing,” Zeitzer says. “But if you’re having trouble sleeping, put a moratorium on it an hour before bed, and don’t do it when you’re in bed.”
Go to bed: 11 P.M.
Your genetic makeup likely dictates when you’ll feel most comfortable going to bed. Some people are night owls and naturally stay alert until late night hours, while “morning larks” have an earlier rhythm. But experts say that going to bed between 8 p.m. and midnight gives your body the best chance of getting all the different types of sleep it needs.
Holding a cell phone to your ear for a long period of time increases activity in parts of the brain close to the antenna, researchers have found.
Glucose metabolism — that’s a measurement of how the brain uses energy — in these areas increased significantly when the phone was turned on and muted, compared with when it was off, Dr. Nora Volkow, director of the National Institute on Drug Abuse, and colleagues reported in the Journal of the American Medical Association.
“Although we cannot determine the clinical significance, our results give evidence that the human brain is sensitive to the effects of radiofrequency-electromagnetic fields from acute cell phone exposures,” co-author Dr. Gene-Jack Wang of Brookhaven National Laboratory in Long Island, where the study was conducted, told MedPage Today.
What We Know About Cell Phones and Cancer
Although the study can’t draw conclusions about long-term implications, other researchers are calling the findings significant.
“Clearly there is an acute effect, and the important question is whether this acute effect is associated with events that may be damaging to the brain or predispose to the development of future problems such as cancer as suggested by recent epidemiological studies,” Dr. Santosh Kesari, director of neuro-oncology at the University of California San Diego, said in an e-mail to MedPage Today and ABC News.
There have been many population-based studies evaluating the potential links between brain cancer and cellphone use, and the results have often been inconsistent or inconclusive.
Most recently, the anticipated Interphone study was interpreted as “implausible” because some of its statistics revealed a significant protective effect for cell phone use. On the other hand, the most intense users had an increased risk of glioma — but the researchers called their level of use “unrealistic.”
But few researchers have looked at the actual physiological effects that radiofrequency and electromagnetic fields from the devices can have on brain tissue. Some have shown that blood flow can be increased in specific brain regions during cell phone use, but there’s been little work on effects at the level of the brain’s neurons.
So Dr. Volkow and colleagues conducted a crossover study at Brookhaven National Laboratory, enrolling 47 patients who had one cell phone placed on each ear while they lay in a PET scanner for 50 minutes.
The researchers scanned patients’ brain glucose metabolism twice — once with the right cell phone turned on but muted, and once with both phones turned off.
There was no difference in whole-brain metabolism whether the phone was on or off.
Are Cell Phones Dangerous for Kids?
But glucose metabolism in the regions closest to the antenna — the orbitofrontal cortex and the temporal pole — was significantly higher when the phone was turned on.
Further analyses confirmed that the regions expected to have the greatest absorption of radiofrequency and electromagnetic fields from cell phone use were indeed the ones that showed the larger increases in glucose metabolism.
“Even though the radio frequencies that are emitted from current cell phone technologies are very weak, they are able to activate the human brain to have an effect,” Dr. Volkow said in a JAMA video report.
The effects on neuronal activity could be due to changes in neurotransmitter release, cell membrane permeability, cell excitability, or calcium efflux.
It’s also been theorized that heat from cell phones can contribute to functional brain changes, but that is probably less likely to be the case, the researchers said.
Dr. Wang noted that the implications remain unclear — “further studies are needed to assess if the effects we observed could have potential long-term consequences,” he said — but the researchers have not yet devised a follow-up study.
“The take-home message,” Dr. Kesair said, “is that we still don’t know, more studies are needed, and in the meantime users should try to use headsets and reduce cell phone use if at all possible. Restricting cell phone use in young children certainly is not unreasonable.”
Imagine waking up in the morning, looking in the mirror and realizing that one side of your face is sagging, your eyelid is drooping, and you are drooling out the side of your mouth. If you have ever had this experience, you were probably experiencing Bell’s palsy.
Bell’s palsy is the most common cause of facial paralysis. Although Bell’s palsy duration is usually limited to a few months, the symptoms can certainly be disturbing.
What Causes Bell’s Palsy?
Bell’s palsy can occur at any age but is most common at around age 40. Men and women are affected equally. Every year about 15 to 30 people out of 100,000 get Bell’s palsy. The cause of Bell’s palsy is not completely understood but is believed to be caused by a viral infection that causes swelling of the facial nerve.
A Sneak Peek Inside the Human Body
The two facial nerves are large nerves that branch out across the face and carry electrical impulses to the facial muscles. Each nerve contains 7,000 nerve fibers. When the nerve swells in response to an infection, the electrical impulses get weak and the facial muscles lose their movement. Branches of the facial nerve are also important for tear and saliva production, and they transmit some taste sensations from the tongue.
Although the exact cause of Bell’s palsy is not always clear, certain risk factors are known to increase the chances of getting Bell’s palsy. Risk factors include:
Being exposed to herpes simplex virus type 1
Having had a previous episode of Bell’s palsy
Bell’s Palsy Symptoms
Bell’s palsy usually only affects one side of the face. Bell’s palsy symptoms usually start suddenly and reach their peak in 48 hours. Symptoms can range from partial to total paralysis. Common symptoms include:
Weakness of the facial muscles causing loss of facial expression
Twitching of the facial muscles
Drooping of the eyelid with inability to close the eye
Dryness of the eye and mouth
Loss of taste
Drooling from the corner of the mouth
Difficulty speaking clearly
Diagnosis and Treatment of Bell’s Palsy
The typical symptoms and sudden onset of one-sided facial weakness are sufficient to make a diagnosis of Bell’s palsy. Other types of diagnostic tests are not usually needed. If Bell’s palsy does not seem to be getting better over time, a referral to a neurologist or an ear, nose, and throat doctor may be needed to rule out other causes of facial paralysis such as tumors, Lyme disease, or multiple sclerosis.
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Even without treatment, more than 80 percent of people with Bell’s palsy start to get better within three weeks. An early sign of improvement is often the return of taste. Bell’s palsy duration is rarely longer than six months. Some studies show that treatment can shorten Bell’s palsy duration and improve symptoms. Bell’s palsy treatment includes:
Steroids. The anti-inflammatory drug prednisone may be used to reduce swelling of the facial nerve. Prednisone may be started as soon as the diagnosis is made and tapered off over 10 days.
Antiviral drugs. Oral acyclovir (Zovirax) or valacyclovir (Valtrex) may be started within three days of Bell’s palsy symptoms and continued for seven days.
Eye care. Taping the eye closed, using an eye patch, and using artificial tears are helpful treatments to prevent eye irritation from excessive dryness.
Physical therapy. Messaging the face, exercising facial muscles, and applying gentle heat may help recovery.
Bell’s palsy can be a frightening experience. The good news is that even without treatment, most Bell’s palsy symptoms go away completely in time. Your primary care doctor can help you manage Bell’s palsy. In cases where symptoms are not improving, an ear, nose, and throat or neurological specialist should be consulted to rule out other causes of facial paralysis.
Appendicitis is a painful medical condition in which the appendix becomes inflamed and filled with pus, a fluid made up of dead cells that often results from an infection.
Appendicitis is the leading cause of emergency abdominal operations in the United States, according to the National Institutes of Health (NIH).
The appendix is a small, finger-shaped pouch attached to your large intestine on the lower right side of your abdomen.
It’s not entirely clear what role the appendix plays in the body, but some research suggests that it isn’t the useless organ it was once thought to be.
Though people can live perfectly normal lives without their appendix, inflammation of this abdominal organ can be a serious, life-threatening condition.
If not treated promptly, appendicitis may cause the appendix to burst, spreading an infection throughout the abdomen.
When people discuss appendicitis, they’re typically referring to acute appendicitis, which is marked by a sharp abdominal pain that quickly spreads and worsens over a matter of hours.
In some cases, however, people may develop chronic appendicitis, which causes mild, recurrent abdominal pain that often subsides on its own — these patients usually don’t realize they have appendicitis until an acute episode strikes.
Prevalence and Risk Factors for Appendicitis
Acute appendicitis now affects about 9 in 10,000 people each year in the United States (roughly 300,000 people annually) — this prevalence is higher than it was just 20 years ago, according to a 2012 report from the Journal of Surgical Research.
People of any age can get the condition, though appendicitis is most common among children and teenagers between 10 and 19 years old, according to the 2012 report.
It affects males more often than females, but scientists have yet to identify why this is the case.
Appendicitis is more common in Western societies, and may be more common in urban industrialized areas, compared with rural communities.
The typical “Western diet” that’s low in fiber and high in carbohydrates is thought to be behind this pattern.
It also appears that having a family history of appendicitis increases the risk of getting the condition for both children and adults.
The NIH estimates that almost 400 people die in the United States each year from appendicitis.
Causes of Appendicitis
It’s not always clear what causes appendicitis, but the condition often arises from one of two issues: A gastrointestinal infection that has spread to the appendix, or an obstruction that blocks the opening of the appendix.
In the second case, there are several different sources of blockage. These include:
Lymph tissue in the wall of the appendix that has become enlarged
Hardened stool, parasites, or growths
Irritation and ulcers in the gastrointestinal tract
Abdominal injury or trauma
Foreign objects, such as pins or bullets
When a person’s appendix becomes infected or obstructed, bacteria inside the organ multiply rapidly. This bacterial takeover causes the appendix to become infected and swollen with pus.
Symptoms of Appendicitis
At the onset of appendicitis, people often feel an aching pain that begins around the belly button, and slowly creeps over to the lower right abdomen.
The pain sharpens over several hours, and can spike during movement, deep breaths, coughing, and sneezing. Other symptoms of appendicitis may follow, including:
Constipation or diarrhea
Inability to pass gas
Loss of appetite
Because the symptoms of appendicitis are very similar to other conditions, including Crohn’s disease, urinary tract infections (UTI), gynecologic disorders, and gastritis, diagnosing appendicitis is no simple matter.
After learning about a patient’s medical history and recent pattern of symptoms, doctors will use a number of tests to help them diagnose appendicitis.
Conduct an abdominal exam to assess pain and detect inflammation
Take a blood test to determine white blood cell counts, which could indicate an infection
Order a urine test to rule out urinary tract infection and kidney stones
Perform a bimanual (two-handed) gynecologic exam in women
Use imaging tests, including computerized tomography (CT) scans, abdominal X-rays, ultrasounds, or magnetic resonance imaging (MRI) scans to confirm the appendicitis diagnosis or find other causes of abdominal pain
In rare cases, doctors will treat appendicitis with antibiotics, but the infection needs to be very mild.
Most often, appendicitis is considered a medical emergency, and doctors treat the condition with an appendectomy, the surgical removal of the appendix.
Surgeons will remove the appendix using one of two methods: open or laparoscopic surgery.
An open appendectomy requires a single incision in the appendix region (the lower right area of the abdomen).
During laparoscopic surgery, on the other hand, surgeons feed special surgical tools into several smaller incisions — this option is believed to have fewer complications and a shorter recovery time.
If a person’s appendix isn’t treated in time, it may burst and spread the infection throughout the abdomen, leading to a life-threatening condition called peritonitis, an infection of the peritoneum (the lining of the gut).
In other cases, abscesses may form on the burst appendix.
In both these cases, surgeons will usually drain the abdomen or abscess of pus and treat the infection with antibiotics before removing the appendix.
Psychotic illness occurs significantly earlier among marijuana users, results of a meta-analysis suggest.
Data on more than 22,000 patients with psychosis showed an onset of symptoms almost three years earlier among users of cannabis compared with patients who had no history of substance use.
The age of onset also was earlier in cannabis users compared with patients in the more broadly characterized category of substance use, investigators reported online in Archives of General Psychiatry.
“The results of this study provide strong evidence that reducing cannabis use could delay or even prevent some cases of psychosis,” Dr. Matthew Large, of the University of New South Wales in Sydney, Australia, and co-authors wrote in conclusion.
“Reducing the use of cannabis could be one of the few ways of altering the outcome of the illness because earlier onset of schizophrenia is associated with a worse prognosis and because other factors associated with age at onset, such as family history and sex, cannot be changed.”
Psychosis has a strong association with substance use. Patients of mental health facilities have a high prevalence of substance use, which also is more common in patients with schizophrenia compared with the general population, the authors wrote.
Several birth cohort and population studies have suggested a potentially causal association between cannabis use and psychosis, and cannabis use has been linked to earlier onset of schizophrenia. However, researchers in the field remain divided over the issue of a causal association, the authors continued.
Attempts to confirm an earlier onset of psychosis among cannabis users have been complicated by individual studies’ variation in methods used to examine the association. The authors sought to resolve some of the uncertainty by means of meta-analysis.
A systematic search of multiple electronic databases yielded 443 potentially relevant publications. The authors whittled the list down to 83 that met their inclusion criteria: All the studies reported age at onset of psychosis among substance users and nonusers.
The studies comprised 8,167 substance-using patients and 14,352 patients who had no history of substance use. Although the studies had a wide range of definitions of substance use, the use was considered “clinically significant” in all 83 studies. None of the studies included tobacco in the definition of substance use.
The studies included a total of 131 patient samples.
Substance use included alcohol in 22 samples, cannabis in 41, and was simply defined as “substance use” in 68 samples.
Alcohol use was not significantly associated with earlier age at onset of psychosis.
On average, substance users were about 2 years younger than nonusers were. The effect of substance use on age at onset was greater in women than in men, but not significantly so. Heavy use was associated with earlier age at onset compared with light use and former use, but also not significantly different, the authors reported.
Substance users were two years younger at the onset of psychosis compared with nonusers. Age at onset was 2.7 years earlier among cannabis users compared with nonusers.
Acknowledging limitations of the study, the authors cited the lack of information on tobacco use and its association with earlier age at onset of psychosis, and the lack of data on individual patients inherent in all meta-analyses.
Despite the limitations, the authors said the findings have potentially major clinical and policy implications.
“This finding is an important breakthrough in our understanding of the relationship between cannabis use and psychosis,” they wrote in conclusion. “It raises the question of whether those substance users would still have gone on to develop psychosis a few years later.”
“The results of this study confirm the need for a renewed public health warning about the potential for cannabis use to bring on psychotic illness,” they added.
Regular aerobic exercise such as walking may protect the memory center in the brain, while stretching exercise may cause the center — called the hippocampus — to shrink, researchers reported.
In a randomized study involving men and women in their mid-60s, walking three times a week for a year led to increases in the volume of the hippocampus, which plays an important role in memory, according to Dr. Arthur Kramer, of the University of Illinois Urbana-Champaign in Urbana, Ill., and colleagues.
On the other hand, control participants who took stretching classes saw drops in the volume of the hippocampus, Kramer and colleagues reported online in the Proceedings of the National Academy of Sciences.
The findings suggest that it’s possible to overcome the age-related decline in hippocampal volume with only moderate exercise, Kramer told MedPage Today, leading to better fitness and perhaps to better spatial memory. “I don’t see a down side to it,” he said.
The volume of the hippocampus is known to fall with age by between 1 percent and 2 percent a year, the researchers noted, leading to impaired memory and increased risk for dementia.
But animal research suggests that exercise reduces the loss of volume and preserves memory, they added.
To test the effect on humans, they enrolled 120 men and women in their mid-sixties and randomly assigned 60 of them to a program of aerobic walking three times a week for a year. The remaining 60 were given stretch classes three times a week and served as a control group.
Their fitness and memory were tested before the intervention, again after six months, and for a last time after a year. Magnetic resonance images of their brains were taken at the same times in order to measure the effect on the hippocampal volume.
The study showed that overall the walkers had a 2 percent increase in the volume of the hippocampus, compared with an average loss of about 1.4% in the control participants.
The researchers also found, improvements in fitness, measured by exercise testing on a treadmill, were significantly associated with increases in the volume of the hippocampus.
On the other hand, the study fell short of demonstrating a group effect on memory – both groups showed significant improvements both in accuracy and speed on a standard test. The apparent lack of effect, Kramer told MedPage Today, is probably a statistical artifact that results from large individual differences within the groups.
Analyses showed that that higher aerobic fitness levels at baseline and after the one-year intervention were associated with better spatial memory performance, the researchers reported.
But change in aerobic fitness was not related to improvements in memory for either the entire sample or either group separately, they found.
On the other hand, larger hippocampi at baseline and after the intervention were associated with better memory performance, they reported.
The results “clearly indicate that aerobic exercise is neuroprotective and that starting an exercise regimen later in life is not futile for either enhancing cognition or augmenting brain volume,” the researchers argued.
The study was supported by the National Institute on Aging, the Pittsburgh Claude D. Pepper Older Americans Independence Center, and the University of Pittsburgh Alzheimer’s Disease Research Center. The authors said they had no conflicts.
What is medical identity theft? In this serious and growing problem, someone else uses your personal information to obtain medical goods or services. Medical identity theft affects consumers, health care providers, and insurance organization. According to the Federal Trade Commission (FTC), medical identity theft accounts for about 3 percent of all identity theft, and the World Privacy Forum claims it’s the most difficult form of identity theft to correct.
When you are the victim of medical identity theft, incorrect information about diagnoses and treatments may appear on your medical records, potentially affecting your health care providers’ decisions about your care and treatment. Also, in addition to paying for treatment you didn’t receive, in some cases you might be denied treatment or coverage because of fraudulent medical or insurance information.
But there is some good news: HIPAA (the Health Insurance Portability and Accountability Act) regulations and the Identity Theft Protection Act, already in place, give you many of the tools you need to get errors corrected at your doctor’s office and with your insurance provider. Of course, like any crime, you’re better off preventing it from happening in the first place.
Spotting Medical Identity Theft
Among other signs, the FTC states that you may be a target of a potential medical identity theft or fraud if you are charged for medical services you didn’t receive. Keep a calendar to track your appointments, treatment dates, and any hospital admission and discharge dates. If the explanation of benefits from your insurance provider or Medicare isn’t exactly right, clear up the error as soon as possible.
Medical receipts, prescription drug information, health insurance forms, and any documents bearing your health care providers’ names might be all a clever thief needs to begin off-loading other medical claims to you. If you don’t need to keep medical documents, shred or burn them, and peel off labels from your prescription medications before recycling the containers.
Legal Protection to Combat Medical Identity Theft
The Identity Theft Protection Act of 2005 requires any commercial, charitable, educational, or non-profit organization that acquires or uses sensitive personal data to provide significant administrative, technical, and physical safeguards to prevent that data from being mishandled.
The same act that allows consumers to place a freeze on their credit reports also requires any covered entity to investigate suspected misappropriation of personal medical data and to do everything possible to correct resulting inaccurate medical information and billing problems.
Tips to Prevent Medical Identity Theft
Take your photo ID to all doctor appointments. Bring an ID along with your insurance information and any other documents, such as a Medicare card, so you can provide it. An FTC law known as the “red flags rule” encourages doctors and other health care providers to require proof of identity before providing services. You can write “See ID” on the signature line of your Medicare card, just as you can on a credit card, so your health care provider will be prompted to verify your identity. Also, when you’re asked to sign any paper at your doctor’s office, review the document first and be sure any erroneous information is corrected immediately.
Don’t divulge medical or insurance information too freely. Sometimes you’re smart to be suspicious, especially of someone contacting you by phone. If you get a caller asking you to take a health care survey and requesting your health care provider’s name or your insurance information, hang up, and then call to alert your insurance provider. Also, be suspicious of health care providers and equipment suppliers who use telemarketing or door-to-door sales tactics, put the wrong diagnosis on a claim “so Medicare will pay,” or advertise free medical consultations for people with Medicare.
Report any ID card loss immediately. If you lose your Medicare card or suspect it may have been stolen, call Social Security to get a replacement. Likewise, if you lose your insurance card, let your provider know right away.
Review all of your insurance documents. Insurance information and statements of benefits can be confusing, and medical identity thieves know that many people don’t read them carefully. However, these documents are one of the first alerts that you may be a victim of medical identity theft. Read your statements and if they don’t seem right, call your insurer’s office. Before you call, verify that the phone number on the documents you have matches the one on your insurance card.
Monitor Your Privacy and Your Health
Most people realize that maintaining good health — managing weight and keeping the body strong and mind active — means making an effort every day. Avoiding medical identity theft doesn’t require daily vigilance, but in order to avoid problems, you should perform regular “check-ups” to be sure no one is posing as you. Be sure to monitor your insurance provider’s regular statements. Although you can also request a complete copy of your medical records from your health care provider, it can be expensive — ask about the cost before you formally request it.