Sunday, November 29, 2015

This 8-Year-Old Girl Is the Youngest Person Ever to Be Diagnosed with Breast Cancer



A cancer diagnosis is always devastating, but the story of Chrissy Turner is especially distressing: The 8-year-old was diagnosed with secretory breast carcinoma earlier this month after discovering a lump in her breast.
“She came to us on a Sunday afternoon. She said, ‘Mommy I have been scared and I have this lump,'" Chrissy’s mom, Annette Turner, tells ABC News. “It had been there for a while.”
Secretory breast carcinoma is extremely rare (it affects just one in one million people), although it has occurred in children in the past, according to research published in the Archives of Pathology & Laboratory Medicine journal. It also typically has a “favorable prognosis.”
Chrissy is the youngest known patient with this type of breast cancer, says Annette.
Chrissy’s doctors are confident that they can remove the tumor via a mastectomy. However, Chrissy will lose all of her breast tissue to prevent the cancer from coming back. It's unclear whether Chrissy will be able to develop breasts after her surgery, but according to the research published in the Archives of Pathology & Laboratory Medicine, "preservation of prepubertal breast tissue is important to ensure proper breast development; however, that is not always possible because of the location of the tumor."
Unfortunately, health battles aren’t new for the Turner family: Annette is a cervical cancer survivor, and her husband has non-Hodgkin's lymphoma.
"We're just going to keep fighting," Annette tells ABC4 Utah News. "Doing everything we can to smile every day and laugh every day and carry our head high and do our best to overcome this."

http://www.womenshealthmag.com/health/secretory-breast-carcinoma




Friday, November 27, 2015

Progesterone Does Not Improve Outcomes for Women With History of Recurrent Miscarriages

BIRMINGHAM, United Kingdom -- November 25, 2015 -- New research published in the New England Journal of Medicine shows that progesterone supplements in the first trimester of pregnancy do not improve outcomes in women with a history of unexplained recurrent miscarriages.
The findings mark the end of a 5-year trial and provide a definitive answer to 60 years of uncertainty on the use of progesterone treatment for women with unexplained recurrent losses.
The study of 826 women with previously unexplained recurrent miscarriage showed that those who received progesterone treatment in early pregnancy were no less likely to miscarry than those who received a placebo. This was true whatever their age, ethnicity, medical history, and pregnancy history.
Nearly two thirds of the women in the trial had their baby, whether they had progesterone or the placebo. The live birth rate was 65.8% in the treatment group, and 63.3% in the placebo group.
Though the results of the Progesterone in Miscarriage Treatment (PROMISE) trial will be disappointing to many, it will allow researchers to direct their efforts towards exploring other treatments that can reduce the risk.
“We had hoped, like many people, that this research would confirm progesterone as an effective treatment,” said Arri Coomarasamy, MD, University of Birmingham, Birmingham, United Kingdom. “Though disappointing, it does address a question that has remained unanswered since progesterone was first proposed as a treatment back in 1953. Fortunately, there are a number of other positives that we can take from the trial as a whole.”
The trial results also showed that there were no significant negative effects of progesterone treatment for women or for their babies. This is important information for women taking progesterone for other reasons, such as fertility treatment, or for those taking part in other trials.
“It may well be that progesterone supplements have other uses, such as preventing miscarriage in women with early pregnancy bleeding, so it’s not the end of the road,” said Dr. Coomarasamy. “Furthermore, the PROMISE trial created a solid network of doctors, nurses and midwives across the UK and beyond, all committed to miscarriage research. That wealth of expertise and information will be invaluable as we continue to explore and test other treatments that really can reduce the risk of miscarriage.”
SOURCE: University of Birmingham

Thursday, November 26, 2015

Teasing Girls About Weight May Cause Lasting Harm






FRIDAY, Nov. 20, 2015 (Health Day News) -- Teasing overweight girls about their weight can cause lasting harm to their self-image and might increase their risk of eating disorders, a new study suggests.

 Weight status may be a more sensitive issue for children who are overweight or obese, and being teased about it may elicit a stronger response from them as opposed to children who are not overweight or obese," Norma Olvera, a professor and health educator at the University of Houston, said in a university news release.
The research included 135 black and Hispanic girls about age 11 who were overweight or obese. Eighty-one percent of the girls were obese. All of them said they were unhappy about their body weight and wished they were thinner, the researchers said.
"The study focused on black and Hispanic girls because they are at a higher risk of obesity, which may increase their desire to be thinner and lead them to engage in unhealthy eating behaviors," Olvera said. "Secondly, there is not a lot of research that explores these issues in minority girls."
Fifty-two percent of the girls said they had been teased about their weight by other girls. Sixty percent said they had been teased by boys, and some said they had been teased by siblings, the research revealed.
The teasing seemed to trigger unhealthy eating behaviors in the girls, the researchers found. But, it's important to note that this type of study isn't designed to prove a cause-and-effect relationship; it can only show an association between teasing and the girls' eating behaviors.
Seventy percent of those who were teased started to cut back on or skip meals, diet or starve themselves to lose weight, the study showed. The researchers also found that 12 percent engaged in binge eating followed by forcing themselves to throw up, and 33 percent reported eating because they were upset or bored (emotional eating).
"Results from this study may guide health educators and practitioners to design interventions to teach coping strategies to these children to help them deal with peer-weight teasing," Olvera said. "The findings also support social policies of no tolerance of weight-related teasing, particularly in school settings"
The study was published recently in the Journal of Early Adolescence.
SOURCE: University of Houston, news release, Nov. 10, 2015

Thursday, November 19, 2015

World Toilet Day is November 19th

Poorly built toilets and sewage systems are a major cause of illness and groundwater contamination. As clean water becomes more scarce, disposing of human waste in ways that do not cause more water contamination becomes increasingly important. A woman walks a child to a sheltered pit toilet as a man pours water for a child to wash his hands.


Human waste (feces and urine) can pollute water, food, and soil with germs and worms, leading to serious health problems. The safe disposal of human waste (sanitation) by building and maintaining toilets and washing hands prevents the spread of germs and is necessary for good health.
Whether your community uses pit toilets, toilets that turn human waste into fertilizer (ecological sanitation), toilets that flush human wastes and water (sewage), or another type of toilet, the main goal is to prevent human waste from contaminating drinking water, food, and our hands. Just as important as a safe and comfortable toilet is a way to wash hands after using it. Safe toilets and hand washing together can prevent most of the illnesses that come from germs in human waste.
Over 2.4 billion people around the world lack toilets, which means they lack access to good sanitation which helps them avoid disease in their homes, their communities and their water systems. 

It means that they struggle to avoid illness when they go out to relieve themselves, and if they're sick they struggle even harder to get well. It means that women risk violence every time they look for a quiet, private place to go.

Maybe if we forced our government leaders to dig their own latrines - and use and clean them - they'd develop the political will to solve the essentially simple problem of lack of access to sanitation. Until that happens, we can provide people with the knowledge to build and maintain healthy sanitation systems.   
  
 
 

Wednesday, November 18, 2015

Breastfeeding and Eyesight

Breastfeeding may help protect premature infants from a common eye disease that can lead to blindness.
A new study looks at how nursing affects the incidence of retinopathy of prematurity… a condition where abnormal blood vessels grow in the retina, increasing risk of detachment.
Researchers analyzed medical records of more than 2,200 preterm infants comparing breastfeeding to formula feeding.
While any amount of breastfeeding played a protective role in preventing retinopathy of prematurity, exclusive or mainly breastfeeding was associated with significant benefits in preventing severe disease.
The authors say these findings may be related to the antioxidant and immune protective properties of breast milk, which contains vitamin C, vitamin E and beta-carotene.
 Dr. Cindy Haines of HealthDay TV

Thursday, November 12, 2015

Sweetened Drinks and Heart Failure

What you drink may be as important as what you eat when it comes to heart health.
A new study finds men who drink two or more servings of sweetened beverages per day are at increased risk of heart failure. Researchers tracked the health of around 42,000 men for more than a decade. Participants were asked to fill out food frequency questionnaires that looked at their average consumption of 96 food and drink items. During the monitoring period, about 3,600 new cases of heart failure were diagnosed and another 509 people died of the condition. Men who consumed two or more daily servings of sweetened drinks had a 23 percent higher risk of developing heart failure compared to those who did not. According to the study, tens of millions of people worldwide are affected by heart failure. The authors say these findings may aid in heart failure prevention strategies, such as improving diet recommendations.
Source:-  https://www.nlm.nih.gov/medlineplus/videos/news

Wednesday, November 11, 2015

Bioethical issues in medical practice Rights and duties of a parent



A girl suffering from intellectual disability, serious enough so that she could not take care of herself became pregnant at the care home. By the time the pregnancy was discovered she was pregnant for over four months. The girl was admitted to a government hospital and assessed for MTP. The girl insisted- from the point of view of her limited understanding of the matter- that she wanted to keep the child and bring it up herself. Doctors at the hospital where she was admitted after the pregnancy was discovered were of the opinion that she was intellectually unfit to look after herself, what to say of a child. What should the doctors do?

a) Carry out MTP regardless of the girl’s wishes

b) Allow the pregnancy to continue possibly to the future detriment of the unborn baby.

c) Any other recourse such as going to court – but what if the court orders continuance of the pregnancy? Who will look after the baby?




Source
Smita N Deshpande
Head, Dept. of Psychiatry, De-addiction Services
PGIMER-Dr. Ram Manohar Lohia Hospital
Park Street, New Delhi

Breastfeeding and Allergy Protection

Breastfeeding provides many emotional and physical benefits to babies, but allergy protection may not be one of them.
A new study finds no significant difference in allergies between children who were breastfed and those who were formula fed. Researchers analyzed the medical records of 194 children… 4 to 18 years old… who were diagnosed with allergic rhinitis or hay fever. They were divided into two groups based on their infant feeding history. 134 were breastfed and 60 were formula fed. The number of patients with a positive skin prick test for hay fever was the same in both groups.
They also had similar numbers of patients with asthma, eczema and food allergies.
One study author stresses breastfeeding is good for babies, and new mothers should continue to breastfeed. He says, “Larger studies need to be done to determine how these results might apply to the larger population."
       Source:-  Dr. Cindy Haines of HealthDay TV

Saturday, October 24, 2015

WHO Recommendations for Prevention and Treatment of Maternal Peripartum Infections. September 2015

Key Messages
  1. • Bacterial infections around the time of childbirth account for about one-tenth of maternal deaths    and contribute to severe morbidity and long-term disability for many affected women.
  2. • Standard infection prevention and control measures are a cornerstone of peripartum infection prevention(e.g.,hand hygiene and use of clean equipment).
  3. • WHO recommendations for prevention and treatment of maternal peripartum infections include both recommended and non-recommended interventions during labour, childbirth, and the postpartum period.
  4. • Clinical monitoring, early detection, and prompt treatment of peripartum infection with an appropriate antibiotic regimen are essential for reducing death and morbidity in affected women.
  5. • Recommendations for antibiotic prophylaxis/treatment for specific indications balance health benefits for the mother and newborn with safety concerns (e.g., adverse effects) and the public health imperative to control antibiotic resistance.

Good Clinical Practice:  
Observe Standard Infection Prevention and Control Measures and Judicious Use of Antibiotics to Control Antimicrobial Resistance 

  1. • Identify and correct predisposing factors to infection (e.g., by providing nutritional advice and addressing nutritional deficiencies, anaemia, and other maternal medical conditions [e.g., diabetes]) during antenatal care. 
  2. • Promote hand hygiene, use of clean products (e.g., blood products), use of clean equipment, and aseptic surgical practices (e.g., standard skin preparation techniques and proper use of antiseptic agents for surgical site preparation). 
  3. • Maintain clean hospital environment (e.g., clean water, appropriate waste disposal, and sanitation).
  4. • Develop and implement local protocols on infection prevention and control practices in accordance with existing WHO guidance.
  5. • Promote judicious use of antibiotics (administer only for recommended indications; use narrowest antibacterial spectrum and simplest effective dose; verify woman’s history of drug intolerance; monitor local bacteria and antibiotic susceptibility and resistance patterns). 



Tuesday, October 20, 2015

Cardiac Arrest in Pregnancy AHA scientific statement on maternal resuscitation

October 19, 2015
The American Heart Association’s (AHA) scientific statement on maternal resuscitation includes up-to-date and comprehensive information, guidelines, and recommendations for all aspects of maternal resuscitation. The statement is intended to help health care providers be prepared and provide the best possible care for a maternal cardiac arrest. Among the recommendations are:
• The newly developed in-hospital and out-of-hospital basic life support and advanced cardiovascular life support algorithms should be the backbone of the response plan to a maternal cardiac arrest.
• Special attention should be paid to manual left uterine displacement (LUD), the difficult airway, and appropriate use of perimortem cesarean delivery (PMCD).
• A maternal cardiac arrest committee must be formed at every institution.
• Emergency response plans specific to each institution must be developed and implemented.
Citation: Jeejeebhoy FM, Zelop CM, Lipman S, et al. Cardiac arrest in pregnancy: A scientific statement from the American Heart Association. [Published online ahead of print October 6, 2015]. Circulation. doi: 10.1161/CIR.0000000000000300. 
Prepare for emergent c-section as soon as cardiac arrest identified in the pregnant woman 
Quickly determine gestational age during initial resuscitation of mother 
Once procedure begins, ideally two teams now working independently 
 CPR is continued on mother Factors that increase the infant’s chance of survival 
 Short interval between arrest and delivery 
 No sustained prearrest hypoxia of mother 
 Minimal or no signs of fetal distress before arrest 
 Aggressive/effective resuscitation of mother 
 Procedure performed in center with neonatal ICU 
 Emergency C-section within rescuer’s procedural range of experience/skills

Katz and colleagues recommended 
 “initiation of C-section within 4 minutes of maternal arrest and fetal delivery within 5 minutes.” These recs have been supported by other studies and consensus panels 
Forms the basis of the “4 minute” rule 
Case reports of prolonged time (>20) do not make this “4 minute rule “ absolute

Vitamin D status is inversely associated with anemia and serum erythropoietin during pregnancy


Findings the STUDY by Thomas C, Guillet R, Queenan R, Cooper E, Kent T, Pressman E, Vermeylen F, Roberson M, O'Brien K; American Journal of Clinical Nutrition (Oct 2015) 
DESIGN The trial was a prospective longitudinal study of 158 pregnant adolescents (aged ≤18 y). Maternal circulating biomarkers of vitamin D and iron were determined at midgestation (∼25 wk) and delivery (∼40 wk). Linear regression was used to assess associations between vitamin D and iron status indicators. Bivariate and multivariate logistic regressions were used to generate the OR of anemia as a function of vitamin D status. A mediation analysis was performed to examine direct and indirect relations between vitamin D status, hemoglobin, and erythropoietin in maternal serum.

BACKGROUND Vitamin D and iron deficiencies frequently co-exist. It is now appreciated that mechanistic interactions between iron and vitamin D metabolism may underlie these associations.
OBJECTIVE We examined interrelations between iron and vitamin D status and their regulatory hormones in pregnant adolescents, who are a group at risk of both suboptimal vitamin D and suboptimal iron status.
RESULTS Maternal 25-hydroxyvitamin D [25(OH)D] was positively associated with maternal hemoglobin at both midgestation and at delivery (P<0 .01="" 25="" 8="" a="" adjustment="" adolescents="" after="" age="" an="" and="" anemia="" associated="" at="" be="" between="" both="" by="" concentrations="" could="" delivery="" direct="" enrollment="" erythropoietin.="" erythropoietin="" explained="" for="" greater="" hemoglobin="" in="" indirect="" inversely="" maternal="" mediated="" midgestation="" nmol="" observed="" odds="" of="" p="" race="" relation="" significant="" than="" that="" the="" those="" times="" was="" with=""> CONCLUSIONS In this group of pregnant adolescents, suboptimal vitamin D status was associated with increased risk of iron insufficiency and vice versa. These findings emphasize the need for screening for multiple nutrient deficiencies during pregnancy and greater attention to overlapping metabolic pathways when selecting prenatal supplementation regimens.

Source: Am J Clin Nutr 

Monday, October 19, 2015

Polio death in Lao renews int'l effort to eradicate polio around world

VIENTIANE, Oct. 17 (Xinhua) -- The recent death of a polio-stricken 8-year-old Lao boy had refocused local and world attention to polio, an ailment which is now almost extinct in other parts of the world.
The death has drawn the attention of policymakers from the 10-member Association of South-East Asian Nations (ASEAN) as they gather in the nation's capital Vientiane for a five-day Ministerial Meeting on Rural Development and Poverty Eradication.
A personal tragedy for the boy's family and a deep concern for local and national Lao health authorities, the death also marks a setback in the global fight against the disease and the attainment of a "polio-free world."
The incident has also drawn attention to the plight of children in the developing country of some seven million, whose population is mostly young people and is set to surpass 10 million by the end of the decade.
One particularly passionate advocate of children in Laos and beyond is United Nations Children's Fund (UNICEF) Country Representative for Laos, China's Ms Hongwei Gao.
Speaking to Xinhua's Vientiane Bureau, Ms. Gao said the death was a reminder that every child must be immunized to prevent polio and other potentially fatal or debilitating illnesses.
"The polio virus can cause lifelong paralysis. There is no cure but it can be prevented by vaccine. We are now close to a polio-free world, but there is only one way to reach it: take action and immunize all children," she said.
Meanwhile, the launch of a national polio vaccination campaign by the country's Prime Minister Thongsing Thammavong Thursday was a demonstration of high level commitment to the cause.
"In the past two or three years the government of Laos has sharply increased this budget allocation to support national immunization program to buy good quality vaccines...this is evidence of action to concretely support child development," Ms. Gao said.
She said Laos had made great strides to achieve the Millennium Development Goals set for 2015, particularly in reducing extreme poverty and hunger, decreasing child and maternal mortality rates, and ensuring that more children are enrolled in schools.
However, Ms. Gao said the country's high rate of malnutrition or under nutrition among some 44 percent of Lao children remained an area requiring continued improvement, particularly in affected rural and remote areas.
"Nutrition is the one indicator where Lao is really lagging behind other countries and this is a huge challenge to national development. If not addressed properly, this would result in huge loss in human capital," she said.
Improved sanitation and food preparation practices and exclusive breastfeeding for the first six months of the child's life are among the remedies, she said.
"What does it take to ensure that a child has good nutritional status?"
It takes, of course, good and sufficient food, and good and efficient feeding practices by parents," Ms. Gao said.
According to Ms. Gao, a well coordinated effort to boost children's safety and their active participation in socio-economic development could particularly benefit countries with young populations such as Laos.        More

Friday, October 16, 2015

Positive Living With Sickle Cell Disease

If you or your child has sickle cell disease (SCD), you should learn as much as you can about the disease. Your health care providers are there to help you, and you should feel comfortable asking questions.

Adopt Healthy Lifestyle

Like all people, you or your child should strive to maintain a healthy lifestyle that includes:
  • A nourishing diet
  • Enough sleep
  • Regular physical activity
People with SCD often tire easily, so be careful to pace yourself and to avoid very strenuous activities.
Don’t smoke and try to avoid second-hand smoke. If you drink alcohol, try to quit and drink extra water to avoid dehydration.

Prevent and Control Complications

Avoid situations that may set off a crisis. Extreme heat or cold, as well as abrupt changes in temperature, are often triggers. When swimming, ease into the pool rather than jumping right in.
Avoid overexertion and dehydration. Take time out to rest and drink plenty of fluids.
Do not travel in an aircraft cabin that is unpressurized.
Take your medicines as your doctor prescribes. Get any medical and lab tests or immunizations that your doctor orders.
See a doctor right away if you have any of the following danger signs:
  • Fever
  • Stroke symptoms
  • Problems breathing
  • Symptoms of splenic enlargement
  • Sudden loss of vision
  • Symptoms of severe anemia
If your child attends daycare, preschool, or school, speak to his or her teacher about the disease. Teachers need to know what to watch for and how to accommodate your child.

Get Ongoing Care

Make and keep regular appointments with your SCD doctor or medical team. These visits will help to reduce the number of acute problems that need immediate care. Avoid seeing your doctor only when you or your child has an urgent problem that needs care right away.
Your SCD medical team can help prevent complications and improve your quality of life.

Coping With Pain

Every person experiences pain differently. Work with your doctor to develop a pain management plan that works for you. This often includes over-the-counter medicines, as well as stronger medicines that you get with a prescription.
You may find other methods that help your pain, such as:
  • A heating pad
  • A warm bath
  • A massage
  • Physical therapy
  • Acupuncture
  • Distracting and relaxing activities, such as listening to music, talking on the phone, or watching TV

Mental Health

Living with SCD can be very stressful. At times, you may feel sad or depressed. Talk to your doctor or SCD medical team if you or your child is having any emotional problems. Tell your doctor right away if you or your child is feeling very depressed. Some people find counseling or antidepressant medicines helpful.
You may find that speaking to a counselor or psychiatrist, or participating in a support group is helpful. When families and friends provide love and support to people with SCD, they can help to relieve stress and sadness. Let your loved ones know how you feel and what you need.

Patients in India With Sickle Cell Anemia Suffer Due To Insufficient Healthcare Services

World Sickle Cell Day with the theme strengthening the primary health services for sickle cell patients is commemorated on June 19 every year. World Health Organization (WHO) estimates that 5% of the world's population is afflicted by genetic blood disorders like sickle cell anemia.
Patients in India With Sickle Cell Anemia Suffer Due To Insufficient Healthcare Services


In India, Nagpur is in the center of sickle cell belt and the health services in the city cater to patients from all over Central India. These services, however, leave a lot of scope for improvement.

Maharashtra fares poorly in this regard. Patients depend on tertiary care hospitals for treatment and management of the disease as the primary health centers, rural hospitals and even district hospitals in the state do not provide much.

"Primary health is a secondary issue for the authorities. The benefits of most schemes don't trickle down to the lowest levels at all. When it comes to sickle cell disease, even patients in Nagpur don't have many facilities. A huge number of people suffering from sickle cell disease (SCD) are from rural areas. They are even more helpless, as they cannot afford to run to Mumbai for every little episode or flare up of the condition, which is pretty common," said Sampat Ramteke, President of NGO Sickle Cell Society of India (SCSI).

The situation is so bad that there is just one government-run center in the entire state that conducts a prenatal test for detection of SCD. This center, National Institute of Immuno-haematology at KEM Hospital of Mumbai, is run by Indian Council of Medical Research (ICMR), and not by the state government.

"Conducting prenatal tests is the easiest way to eradicate the disease. There should be more government-run centers as private centers are too expensive for the economically backward classes. Traveling to bigger cities to consult doctors at higher centers is an expensive affair. We often have parents who decide to stop treatment and leave the children to their fate due to lack of funds," said Sanjeevani Satpute, district sickle cell counselor.

Source: Medindia

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