DEPRESSION

Are you tired and irritable all the time? Have you lost interest in your work, family, or hobbies? Are you having trouble sleeping and feeling angry or aggressive, sad, or worthless? Have you been feeling like this for weeks or months? If so, you may have depression   

What is depression?

Everyone feels sad or irritable sometimes, or has trouble sleeping occasionally. But these feelings and troubles usually pass after a couple of days. When a man has depression, he has trouble with daily life and loses interest in anything for weeks at a time.
Both men and women get depression. But men can experience it differently than women. Men may be more likely to feel very tired and irritable, and lose interest in their work, family, or hobbies. They may be more likely to have difficulty sleeping than women who have depression. And although women with depression are more likely to attempt suicide, men are more likely to die by suicide.
Many men do not recognize, acknowledge, or seek help for their depression. They may be reluctant to talk about how they are feeling. But depression is a real and treatable illness. It can affect any man at any age. With the right treatment, most men with depression can get better and gain back their interest in work, family, and hobbies.

"My daily routine was shot. I didn't have the energy to do anything. I got up because the dog had to be walked and my wife needed to go to work. The day would go by and I didn't know where it went. I wanted to get back to normal. I just wanted to be myself again."
—Jimmy Brown, Firefighter

What are the different forms of depression?

The most common types of depression are:
Major depression—severe symptoms that interfere with a man's ability to work, sleep, study, eat, and enjoy most aspects of life. An episode of major depression may occur only once in a person's lifetime. But more often, a person can have several episodes.
Dysthymic disorder, or dysthymia—depressive symptoms that last a long time (2 years or longer) but are less severe than those of major depression.
Minor depression—similar to major depression and dysthymia, but symptoms are less severe and may not last as long.

What are the signs and symptoms of depression in men?

Different people have different symptoms. Some symptoms of depression include:

• Feeling sad or "empty"
• Feeling hopeless, irritable, anxious, or angry
• Loss of interest in work, family, or once-pleasurable activities, including sex
• Feeling very tired
• Not being able to concentrate or remember details
• Not being able to sleep, or sleeping too much
• Overeating, or not wanting to eat at all
• Thoughts of suicide, suicide attempts
• Aches or pains, headaches, cramps, or digestive problems
• Inability to meet the responsibilities of work, caring for family, or other important activities.

What causes depression in men?

Several factors may contribute to depression in men.
Genes—men with a family history of depression may be more likely to develop it than those whose family members do not have the illness.
Brain chemistry and hormones—the brains of people with depression look different on scans than those of people without the illness. Also, the hormones that control emotions and mood can affect brain chemistry.
Stress—loss of a loved one, a difficult relationship or any stressful situation may trigger depression in some men.
Most of the time, it is likely a combination of these factors.

How is depression treated?

The first step to getting the right treatment is to visit a doctor or mental health professional. He or she can do an exam or lab tests to rule out other conditions that may have the same symptoms as depression. He or she can also tell if certain medications you are taking may be affecting your mood.
The doctor needs to get a complete history of symptoms. Tell the doctor when the symptoms started, how long they have lasted, how bad they are, whether they have occurred before, and if so, how they were treated. Tell the doctor if there is a history of depression in your family.

Medication

Medications called antidepressants can work well to treat depression. But they can take several weeks to work. Antidepressants can have side effects including:

• Headache
• Nausea, feeling sick to your stomach
• Difficulty sleeping and nervousness
• Agitation or restlessness
• Sexual problems.

Most side effects lessen over time. Talk to your doctor about any side effects you may have.
It's important to know that although antidepressants can be safe and effective for many people, they may present serious risks to some, especially children, teens, and young adults. A "black box"—the most serious type of warning that a prescription drug can have—has been added to the labels of antidepressant medications. These labels warn people that antidepressants may cause some people to have suicidal thoughts or make suicide attempts, especially those who become agitated when they first start taking the medication and before it begins to work. Anyone taking antidepressants should be monitored closely, especially when they first start taking them.
For most people, though, the risks of untreated depression far outweigh those of antidepressant medications when they are used under a doctor's supervision. Careful monitoring by a professional will also minimize any potential risks.

Therapy

Several types of therapy can help treat depression. Some therapies are just as effective as medications for certain types of depression. Therapy helps by teaching new ways of thinking and behaving, and changing habits that may be contributing to the depression. Therapy can also help men understand and work through difficult situations or relationships that may be causing their depression or making it worse.

"I lost interest with the kids and doing things that we used to do. . . they'd ask their mother, ‘Why is Daddy not getting up and not wanting to do anything with us?' ‘Did we do anything?' They didn't do anything to me. I just didn't want to do anything."
                                                                                —Rene Ruballo, Police Officer

How can I help a loved one who is depressed?

If you know someone who has depression, first help him find a doctor or mental health professional and make an appointment.

• Offer him support, understanding, patience, and encouragement.
• Talk to him, and listen carefully.
• Never ignore comments about suicide, and report them to his therapist or doctor.
• Invite him out for walks, outings and other activities. If he says no, keep trying, but don't push him to take on too much too soon.
• Encourage him to report any concerns about medications to his health care provider.
• Ensure that he gets to his doctor's appointments.
• Remind him that with time and treatment, the depression will lift.

How can I help myself if I am depressed?

As you continue treatment, gradually you will start to feel better. Remember that if you are taking an antidepressant, it may take several weeks for it to start working. Try to do things that you used to enjoy before you had depression. Go easy on yourself. Other things that may help include:

• See a professional as soon as possible. Research shows that getting treatment sooner rather than later can relieve symptoms quicker and reduce the length of time treatment is needed.
• Break up large tasks into small ones, and do what you can as you can. Don't try to do too many things at once.
• Spend time with other people and talk to a friend or relative about your feelings.
• Do not make important decisions until you feel better. Discuss decisions with others who know you well.

Where can I go for help?

If you are unsure where to go for help, ask your family doctor. You can also check the phone book for mental health professionals or check with your insurance carrier to find someone who participates in your plan. Hospital doctors can help in an emergency.

UV light disinfection significantly reduces Clostridium difficile incidence Automated UV light device curbs CDI by 25 percent.

Ultraviolet C light disinfection to clean unoccupied patient rooms significantly reduced C. difficile infections (CDI) in high-risk patients who later occupied those rooms, according to a study published today in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America. The no-touch device, used after patients with CDI were discharged from the hospital, also resulted in substantial healthcare savings, estimated between $350,000 and $1.5 million annually.

"UV light disinfection is a fast, safe, and effective technology to reduce the risk of C. difficile infection associated with the hospital environment," said David Pegues, MD, lead author of the study and a professor of Medicine in the Perelman School of Medicine at the University of Pennsylvania. "The success of this technology is dependent on Environmental Services employees as a critical partner in our ongoing efforts to eliminate hospital-acquired infections such as C. difficile and to improve patient safety."
The study was conducted in three hematology-oncology units at the Hospital of the University of Pennsylvania during a one-year period (February 2014-January 2015). Results showed that adding UV disinfection to typical disinfection protocols reduced the incidence of CDI by 25 percent among new patients in these units, compared to the prior year. At the same time, CDI rates increased 16 percent in the non-study units during this period. The team found that using the ultraviolet robot after a room cleaning by members of the Environmental Services team not only reduced the number of infections, but did so without adversely impacting room turnaround time. According to this study, room cleaning took only five minutes longer on average compared to non-study units.
"These findings have real implications for both health systems and patients. The effectiveness and efficiency of UV-C robots make it a practical and cost effective technology that will benefit hospitals around the country and save people's lives," said Pegues.
The technique, known as ultraviolet wavelength C germicidal irradiation, uses short-wavelength ultraviolet light to kill microorganisms. CDI is one of the most common healthcare-acquired infections in the United States and is associated with serious complications. It is resistant to many surface disinfectants and can persist on surfaces, making it an ongoing risk for transmission to patients.
While the UV disinfection device proved to be effective at reducing CDI incidence, it showed no effect on other healthcare-associated infections, such as methicillin-resistant Staphylococcus aureus (MRSA).

HPV Vaccine More Effective Than Thought: Study Prevents lesions that could cause cervical cancer by 50 percent,

THURSDAY, Sept. 29, 2016 (HealthDay News) -- The vaccine against human papillomavirus (HPV) infection, which doctors believe causes most cases of cervical cancer, appears even more effective than believed, a new study finds.
"After eight years of vaccination, the reduction in the incidence of cervical neoplasia [abnormal growth of cells], including pre-cancers, have been reduced approximately 50 percent. This is greater than what was expected -- that's pretty exciting," said lead researcher Cosette Wheeler. She is a professor of pathology and obstetrics and gynecology at the University of New Mexico, in Albuquerque.
The study also showed that the protection appears to occur even when only one or two of the recommended doses of the vaccine are given.
"Right now, the recommendation is three doses for girls and boys before the 13th birthday, so that you are protected before you become exposed," Wheeler explained.
"People thought that three doses of vaccine were necessary, but there's a lot of people who are getting one and two doses, and people are getting protection from one or two doses," she said.
On average, 40 percent of girls aged 13 to 17 in New Mexico had received all three doses in 2014, the researchers found. But, Wheeler said, "It may be that two doses are sufficient."
Protection from HPV is also coming from what's called herd immunity, which increases as more people are vaccinated and reduces the spread of HPV, Wheeler said. "Herd immunity means that the probability of getting infected decreases for everybody, even the people who aren't vaccinated," she explained.
Moreover, the vaccines protect against more types of HPV than they were designed to do, she added.
Although this is not the first report to show the effectiveness of the vaccine, it's the first to show declines in precancerous lesions across a large population, Wheeler said. The researchers also found that the reductions in the number of precancerous lesions were greater than anticipated.
This study even took into account changes in Pap test screening over the last 10 years.
In 2009, the American College of Obstetrics and Gynecology said most women under 21 do not need Pap test screening and recommended longer times between screening. In 2012, the U.S. Preventive Services Task Force said women, regardless of age, do not need to get screened more than every three years, Wheeler said.

If these changes were not taken into account, the effect of the vaccine would appear even greater than it already is, because it would assume that more women were being screened than actually were, she said.
"Parents and doctors should pay attention. These vaccines are highly efficacious," Wheeler said.
It's up to doctors to be sure kids are vaccinated, she said. "It's their job, just like other vaccines, to provide them to their patients. They are the key to get this done," Wheeler added.
In addition to cervical cancer, HPV can cause genital warts in men and women, and some head and neck cancers.
Although cervical cancer can take decades to develop, it's important to protect children before they become sexually active and risk getting infected with HPV, which is why Wheeler strongly recommends: "Get your kids vaccinated -- both your boys and your girls -- before their 13th birthday."
For the study, Wheeler and colleagues collected data on young women tested for cervical cancer with Pap tests from 2007 to 2014, who were part of the New Mexico HPV Pap Registry. New Mexico should be considered representative of the whole country, Wheeler said.
One expert said the findings make the case for HPV vaccination even stronger.
"These data highlight and provide even more evidence as to the efficacy of the vaccine in preventing HPV infections and related diseases," said Fred Wyand, a spokesman for the American Sexual Health Association/National Cervical Cancer Coalition.
Increasing HPV vaccination rates "goes back to the importance of health care provider's recommending the vaccine to parents and patients," he said. "Provider recommendation carries much weight, and parents are far more likely to have their child vaccinated if the provider encourages it."
Another approach to increasing vaccination rates is to "normalize" HPV vaccines, he said. "Rather than treat it as something exotic, it should just be offered as part of the routine adolescent vaccine program," Wyand said.
Dr. Metee Comkornruecha, an adolescent medicine specialist at Nicklaus Children's Hospital in Miami, agrees that the vaccine "is effective, and parents should have their sons and daughters vaccinated."
The report was published online Sept. 29 in the journal JAMA Oncology.
SOURCES: Cosette Wheeler, Ph.D., professor, pathology and obstetrics and gynecology, University of New Mexico, Albuquerque; Fred Wyand, spokesman, American Sexual Health Association/National Cervical Cancer Coalition, Research Triangle Park, N.C.; Metee Comkornruecha, M.D., adolescent medicine specialist, Nicklaus Children's Hospital, Miami; Sept. 29, 2016, JAMA Oncology, online

FDA Approves Kyleena Contraceptive Device Bayer news release;

  

 

The FDA has approved Kyleena (levonorgestrel-releasing intrauterine system) 19.5 mg, a progestin-containing intrauterine system (IUS) for the prevention of pregnancy for up to 5 years.
Indications:  Kyleena is a progestin-containing intrauterine system (IUS) indicated for prevention of pregnancy for up to 5 years.
Dosage and administration:
• Release rate of levonorgestrel (LNG) is 17.5 mcg/day after 24 days and declines to 7.4 mcg/day after 5 years; Kyleena must be removed or replaced after 5 years.
• To be inserted by a trained healthcare provider using strict aseptic technique. Follow insertion instructions exactly as described.
• Patient should be re-examined and evaluated 4 to 6 weeks after insertion; then yearly or more often if clinically indicated.
Safety and efficacy: The contraceptive efficacy of Kyleena was evaluated in a clinical trial that enrolled generally healthy women aged 18 to 35, of whom 1,452 received Kyleena. About 71% of 163 women who desired pregnancy after study discontinuation and provided follow-up information, conceived within 12 months after removal of Kyleena.
Adverse reactions: The most common adverse reactions reported (≥5% users) were vulvovaginitis, ovarian cysts, abdominal pain/pelvic pain, headache/migraine, acne/seborrhea, dysmenorrhea/uterine spasm, breast pain/breast discomfort, and increased bleeding.


Kyleena delivers a lower dose of hormones per day (17.5 micrograms per day) compared to Mirena (20 micrograms per day), explains Yesmean Wahdan, MD associate medical director, Bayer Women’s Healthcare. "[Also,] Kyleena can be used whether or not a woman has given birth to a child," says Dr. Wahdan. "Mirena...is recommended for women who have given birth, and is also indicated for heavy menstrual bleeding in women who choose an IUD."

Along with the implant, IUDs fall into the category of long-acting reversible contraception (LARCs). These are considered to be some of the most effective birth control options largely because, unlike taking the pill, you don't really have to do anything for them to work (other than the initial insertion, of course). Other options include the three-year Liletta and the non-hormonal copper ParaGard IUDs.