Zika Virus Tied to Rare Disorder That Can Cause Paralysis

By Steven Reinberg
HealthDay Reporter

MONDAY, Feb. 29, 2016 (HealthDay News) — The Zika virus may cause Guillain-Barre syndrome, a disorder in which the body’s immune system attacks part of the nervous system, new research suggests.

Blood samples from 42 patients diagnosed with Guillain-Barre syndrome during a Zika virus outbreak in French Polynesia provide the first hard evidence that the mosquito-borne Zika virus might cause this severe neurological disorder, researchers said.

“The risk for a Zika-infected individual of developing Guillain-Barre syndrome is small — less than [one] case per 1,000 Zika infections. So, individuals with acute Zika infection should not be greatly alarmed by the fear of developing of Guillain-Barre syndrome,” said researcher Dr. Hugh Willison. He’s a professor of neurology at the University of Glasgow College of Medical, Veterinary and Life Sciences in Scotland.

The study can’t prove cause-and-effect, but as Zika cases increase, health officials need to plan to deal with the rise in cases of Guillain-Barre syndrome as well, he said.

Zika virus infections in pregnant women have been linked to a birth defect called microcephaly, a condition in which the brain and skull are significantly underdeveloped. Since the Zika epidemic began last spring, it’s believed there have been more than 5,600 suspected or confirmed cases of microcephaly in Brazil, the World Health Organization reported Friday.

“Since Zika infection may affect millions of persons, there will be a surge of Guillain-Barre syndrome cases for health services to cope with, even though the risk is small,” Willison added.

Despite the new findings, one expert said “it is difficult to conclusively prove Zika virus infection in all of these patients, because many also had been infected with the closely related dengue virus, which is common in French Polynesia. And interpretation of the antibody tests was difficult,” said David Smith, a clinical professor at the University of Western Australia in Perth.

“We need to look closely at future cases of Guillain-Barre syndrome occurring in Zika-affected areas to gather more data so we can better estimate the risk,” Smith said.

Guillain-Barre syndrome was uncommon in this study — less than 0.1 percent of the people estimated to be infected with Zika virus — and may turn out to be rarer than that, said Smith, who co-authored an accompanying journal editorial.

“Zika virus is very likely to be able to trigger Guillain-Barre syndrome, but we don’t yet know exactly how low that risk is,” he said. “This does not alter the advice about the precautions people should take to avoid mosquito exposure when traveling to Zika-affected areas.”

The report was published in the Feb. 29 online edition of The Lancet.

From October 2013 to April 2014, French Polynesia experienced the largest Zika outbreak reported to date. About 32,000 people saw a doctor about a Zika virus infection.

Guillain-Barre syndrome is the leading cause of non-trauma paralysis, according to the study authors. Symptoms develop quickly and include weakness in the legs and arms, muscle weakness and pain, the U.S. National Institute of Neurological Disorders and Stroke says.

The syndrome is usually triggered by an infection, such as herpes, influenza or dengue fever, the researchers said.

To see if there was a link between Guillain-Barre syndrome and Zika, researchers compared three groups of patients. One group had 42 patients with Guillain-Barre syndrome. Another group had 98 patients who were in the same hospital but didn’t have a fever (the “control” group). And the third group had 70 patients diagnosed with Zika infection but who didn’t have Guillain-Barre syndrome.

Most patients with Guillain-Barre syndrome (88 percent) reported symptoms of Zika about six days before neurological symptoms appeared, the study found. The most common symptoms of Zika include fever, rash, joint pain, or conjunctivitis (“pink eye”).

Blood tests showed that 100 percent of the people with Guillain-Barre syndrome showed a specific immune system response for Zika. By comparison, just 56 percent of those in the control group with the non-fever illness showed this response, the study said.

Most people with Guillain-Barre syndrome — 95 percent — also had signs of past dengue infection. A majority of patients in the other two groups also showed signs of past dengue infection. Dengue is another mosquito-borne illness and it’s endemic to the area, the study authors noted. They added that past infection with dengue didn’t increase the risk of Guillain-Barre syndrome among patients with Zika.

All of the Guillain-Barre syndrome patients likely had a type of the disorder called acute motor axonal neuropathy, the study authors said. In addition, those with Zika-related Guillain-Barre syndrome recovered faster than is expected.

Among the patients with Guillain-Barre syndrome, 16 were admitted to the intensive care unit, and 12 needed breathing assistance. Patients were hospitalized for about 11 days, but those in intensive care remained for an average of 51 days, the study found. Three months after leaving the hospital, 57 percent of the patients were able to walk without assistance. None of the patients died, the investigators reported.

Based on the experience in French Polynesia, Willison estimates that the risk of Guillain-Barre syndrome in the general population during the outbreak in French Polynesia was 0.24 per 1,000 Zika virus infections. That works out to 24 people per 100,000 infections, according to Willison.

“Public health officials, neurologists and critical care and emergency medicine specialists need to be alert to the likely rise in Guillain-Barre syndrome cases that will occur in other parts of the world that are currently going through epidemics of acute Zika infection,” Willison said.

Since it first surfaced last spring, the virus has spread to over 34 countries and territories in Latin America and the Caribbean. The World Health Organization now estimates there could be up to 4 million cases of Zika in the Americas in the next year.

More information

For more on Guillain-Barre syndrome, visit the U.S. National Institute of Neurological Disorders and Stroke.

To see the CDC list of sites where Zika virus is active and may pose a threat to pregnant women, click here.

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FDA Orders ‘Black Box’ Warning Label on Essure Long-Acting Contraceptive

By Dennis Thompson
HealthDay Reporter

MONDAY, Feb. 29, 2016 (HealthDay News) — A special “black box” warning should be added to packaging for the Essure implantable birth control device, based on concerns over serious complications, the U.S. Food and Drug Administration announced Monday.

The FDA also ordered Essure’s manufacturer, Bayer, to conduct a new clinical study to gather more data about the health risks the device might pose for “in a real-world environment.”

Essure is a permanent and nonsurgical form of birth control for women. It consists of flexible coils that are inserted through the vagina and cervix into the fallopian tubes, the FDA explained in a statement.

Scar tissue forms naturally around the coils, creating a barrier intended to prevent sperm from reaching the egg as they travel down the fallopian tubes into the uterus.

However, since the FDA approved Essure in 2002, the agency says it has received about 10,000 complaints about the device.

Complications from using Essure can include pain, abnormal bleeding, allergic reaction and tearing of the uterus or fallopian tubes if the device migrates, the FDA said.

Dr. William Maisel, deputy director for science and chief scientist at the FDA’s Center for Devices and Radiological Health, spoke about Essure during a news briefing late Monday. He said that the agency has also received 631 reports of women becoming pregnant while using the product, and 294 reports of pregnancy losses.

Still, Maisel said, “it’s important for women to know that Essure is extremely effective at preventing pregnancy. However, in order for it to be effective, the device must be placed properly and women must rely on an alternative form of birth control until they undergo an Essure confirmation test.”

According to Maisel, “like all forms of birth control, Essure is not perfect and women may become pregnant despite use of the device. The lack of an Essure confirmation test is the most common factor contributing to unintended pregnancies in women with Essure.”

Some have alleged that clinical trial records that led to Essure’s approval were altered to favor the device, but Maisel said that an FDA re-analysis of the evidence has concluded these charges are baseless.

“In the end, our analysis did not find evidence of systematic or intentional modifications of study subject responses,” he said. “The agency believes the original clinical data relied upon represents valid scientific evidence.”

In addition to the boxed warning, the FDA also wants Bayer to include a “patient decision checklist” in Essure’s packaging, “to ensure women receive and understand information regarding the benefits and risks of this type of device.”

The checklist would be reviewed and signed by the patient and her doctor. It goes over a series of health issues that should deter a woman from using Essure, and requires that she promise to return to her doctor in three months to make sure the device has been properly placed.

The clinical trial ordered by the FDA will assess rates of complications with Essure and compare them to the complications associated with tubal ligation.

The study also will evaluate how complications affect a patient’s quality of life, and identify reasons why women don’t come back for follow-up testing three months after insertion to make sure that Essure has been properly placed.

The public and industry will have 60 days to comment on this draft guidance from the FDA, the agency said.

More information

Visit the U.S. Food and Drug Administration for more on Essure.

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Young Athletes Pressured by Parents May Resort to ‘Doping’

MONDAY, Feb. 29, 2016 (HealthDay News) — Young male athletes under parental pressure to succeed are more likely to use banned substances to boost their sports performance, a new study finds.

Researchers at the University of Kent in England asked 129 young male athletes, average age 17, about their attitudes on “doping” — the use of prohibited drugs, such as steroids, hormones or stimulants, to boost athletic ability.

These substances, sometimes called performance-enhancing drugs, can potentially alter the human body and biological functions. However, they can be extremely harmful to a person’s health, experts warn.

In addition, the study participants were also asked about four different aspects of perfectionism. The four areas were: parental pressure; self-striving for perfection; concerns about making mistakes; and pressure from coaches.

Only parental pressure was linked to positive feelings about doping among the athletes, the study authors found.

The findings suggest parents need to recognize the consequences of putting too much pressure on young athletes, said lead researcher Daniel Madigan, a Ph.D. student in the university’s School of Sport and Exercise Sciences.

“The problem of pressure from parents watching their children play sports is widely known, with referees and sporting bodies highlighting the difficulties and taking steps to prevent it,” Madigan said in a university news release.

“With the rise of so-called ‘tiger’ parenting — where strict and demanding parents push their children to high levels of achievement — this study reveals the price young athletes may choose to pay to meet their parents’ expectations and dreams,” Madigan added.

The study findings are scheduled for publication in the April print issue of the Journal of Sports Sciences.

The researchers plan to investigate if the same problem occurs in young female athletes, and if there are differences between athletes in team versus individual sports.

More information

The U.S. Anti-Doping Agency outlines the side effects of performance-enhancing drugs.

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How to Sculpt a Waist and Booty Like Sofia Vergara’s

Photo: Getty Images

For some, Sofia Vergara left her fashion mark on the Academy Awards red carpet in that gorgeous navy Marchesa dress. For others, it was all about that white, body-hugging Mark Zunino number she donned at Vanity Fair’s post-Oscars bash. Either way, one thing is clear: Vergara sure does know how to play up her, ahem, assets.

Longing for the Modern Family star’s killer curvy frame? We’ve got moves from two of her trainers for you to try. Ready, set, sweat!

For your waist

Trainer: Anna Kaiser

Go-to move: The Waist Cincher, because “a small waist helps accentuates those gorgeous curves,” says Kaiser.

How to do it: Stand with feet a little wider than hip-width and hands at sides. Bend knees slightly and then reach right hand over as far as possible to the left as you rest your left forearm on left thigh. Reverse motion; as you return to start, bend left knee, lifting left foot behind right leg so that your right hand and left sole touch. Simultaneously, reach left hand over to right as far as possible. This is one rep. Continue alternating sides. Do 10 total reps.

RELATED: The Hilarious Way Sofia Vergara Stays Motivated to Work Out

For your booty

Trainer: Gunnar Peterson

Go-to move: High Knee Step-Ups, because they challenge your balance, forcing each butt muscle to work individually, says Peterson.

How to do it: Stand facing a bench and step your left foot up onto it. Press into your left foot to come to standing one-legged on the bench while quickly raising right knee to chest level. Swiftly lower right leg back down. Perform 10-20 reps, then switch legs and repeat. Do 2-5 sets two to three times a week for a stronger, firmer booty in two to three weeks.

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Lack of Sleep May Give You the ‘Munchies’

MONDAY, Feb. 29, 2016 (HealthDay News) — Lack of sleep may give you the “munchies,” a small study suggests.

Sleep deprivation appears to boost levels of a chemical that makes eating more pleasurable — similar to the effects of marijuana, University of Chicago researchers said.

“We found that sleep restriction boosts a signal that may increase the hedonic aspect of food intake, the pleasure and satisfaction gained from eating,” Erin Hanlon, a research associate in endocrinology, diabetes and metabolism, said in a university news release.

Previous research has linked too little sleep with overeating, unhealthy food choices and weight gain, but the reasons for the connection were unclear, the researchers explained.

This study found that sleep loss increases blood levels of a chemical signal called endocannabinoid 2-arachidonoylglycerol (2-AG). It enhances the joy of eating, particularly sweet, salty and fatty snack foods, according to background notes with the study.

For the study, 14 young and healthy volunteers were monitored. The researchers tracked their hunger and eating habits in two time periods: four days when the participants received about 7.5 hours of sleep nightly, and four days when they averaged only 4.2 hours of sleep.

When sleep-deprived, the volunteers’ 2-AG blood levels rose and remained high through the evening. When they had access to snacks, they couldn’t resist cookies, candy and chips, even though just two hours earlier they had had a meal that provided 90 percent of their daily caloric needs. They also consumed twice as much fat as when they had gotten a good night’s sleep, the researchers said.

Their appetites for unhealthy treats were strongest in the late afternoon and early evening, times of the day when snacking has been linked to weight gain, according to the study published Feb. 29 in the journal Sleep.

“Sleep restriction seems to augment the endocannabinoid system, the same system targeted by the active ingredient of marijuana, to enhance the desire for food intake,” Hanlon said.

The findings support previous research and apply to “normal life conditions,” she added.

For example, “if you have a [candy] bar, and you’ve had enough sleep, you can control your natural response,” Hanlon explained. “But if you’re sleep-deprived, your hedonic drive for certain foods gets stronger, and your ability to resist them may be impaired. So you are more likely to eat it. Do that again and again, and you pack on the pounds.”

More information

The U.S. Centers for Disease Control and Prevention has more about sleep.

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Daylight Saving Time Tied to Brief Spike in Stroke Risk

By Amy Norton
HealthDay Reporter

MONDAY, Feb. 29, 2016 (HealthDay News) — Changing the clocks for daylight saving time may cause a short-lived spike in some people’s risk of suffering a stroke, a preliminary study hints.

Looking at a decade’s worth of stroke data, Finnish researchers found that the national incidence of stroke tended to rise slightly over the two days following daylight saving time transitions — whether the clocks were turned forward or back.

The findings do not prove that daylight saving time is to blame.

On the other hand, it’s hard to imagine other factors that would explain such a specific pattern, said researcher Dr. Jori Ruuskanen, a neurologist at Turku University Hospital.

Plus, he said, there is a known link between disruptions in the body’s circadian rhythms and stroke risk. Circadian rhythms refer to the shifts in the body’s biological processes that happen over 24 hours — largely in response to light and darkness.

Those rhythms can be thrown off in different ways, Ruuskanen said. Shift work and insomnia are two examples, he noted, and both have been tied to increased risks of health conditions, including stroke.

Ruuskanen is scheduled to present the findings in April at the American Academy of Neurology’s annual meeting in Vancouver, Canada. Research presented at meetings is considered preliminary until published in a peer-reviewed medical journal.

Dr. Andrew Lim is a neurologist at Sunnybrook Health Sciences Center, in Toronto, who studies sleep and circadian rhythms. He agreed that daylight saving time could plausibly affect stroke risk.

“Sleep is associated with many physiological changes that are normally thought of as being relatively protective against stroke, like lower blood pressure,” explained Lim, who was not involved in the new study.

When sleep is disrupted, he said, there may also be shifts in those protective biological processes.

For the study, Ruuskanen’s team looked at Finnish stroke figures for the years 2004 to 2013. The investigators then compared just over 3,000 people who’d been hospitalized for an ischemic stroke during the week after a daylight saving transition with nearly 12,000 people who’d suffered a stroke in the two weeks before or after a transition week.

Ischemic strokes are caused by a blood clot in an artery supplying the brain, and they account for 87 percent of all strokes, according to the American Stroke Association.

Overall, the researchers found, stroke incidence was 8 percent higher during the first two days after a daylight saving transition.

Adults older than 65 and people with cancer seemed particularly vulnerable: They were 20 percent to 25 percent more likely to have a stroke right after a daylight saving transition, versus the other time periods studied.

Ruuskanen emphasized that the study found a small increase in strokes at the population level — which means that for any one person, daylight saving time transitions would not have a big impact on stroke risk.

And it’s not that a clock change would trigger a stroke in someone who would otherwise have remained healthy. “This probably means that any ‘extra’ strokes occurring after the daylight saving change would otherwise have occurred some time later,” Ruuskanen said.

Lim agreed that the risk has to be kept in perspective. “In the big scheme of things, the increase in risk is small and transient,” he said, “and the effect of other factors, such as managing blood pressure, is more important.”

That said, Lim added, some planning may help people minimize any sleep disruptions. “It may be generally helpful to adjust gradually to daylight saving time rather than all at once,” he said.

March 13 is the day when clocks spring forward an hour this year. So, people could try going to bed and waking up 15 minutes earlier than normal on the Thursday before, Lim said. On that Friday, bump that up to 30 minutes, and then aim for 45 minutes on that Saturday, he added.

According to Ruuskanen, there is one way to prove whether daylight saving time truly contributes to strokes: “If we, in our country, abandoned daylight saving time and, in a follow-up of several years, saw that the small increase in stroke incidence disappears, it would make a strong argument that it actually is the clock change that raises stroke risk,” he said.

More information

The American Stroke Association has more on stroke risk factors.

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For Cancer Patients, Pain May Rise as Finances Dwindle

By Dennis Thompson
HealthDay Reporter

MONDAY, Feb. 29, 2016 (HealthDay News) — Cancer patients skating near financial ruin will likely suffer more pain and worse symptoms than those who have some savings to fall back on, a new study reports.

Lung or colon cancer patients with two or fewer months of financial reserves had a significantly poorer quality of life than those who had more than a year of funds, according to a study involving more than 3,400 patients.

Patients already stretched thin financially at the time of diagnosis tended to have worse overall health, more pain, greater physical impairment and deeper depression than those with more money on hand, the researchers reported.

A person’s suffering tended to increase as finances dwindled, said study lead author Dr. Christopher Lathan, medical director of the Dana-Farber Cancer Institute at St. Elizabeth’s Medical Center, in Boston.

“There was a very clear relationship,” Lathan said. “The less financial reserve you had, the greater impact it seemed to have on all these measures.”

The study findings were published Feb. 29 in the Journal of Clinical Oncology

Previous studies have shown that income level and access to quality health insurance can dictate your likelihood of surviving cancer, Lathan said.

But a high income doesn’t necessarily mean you’re living within your means, nor does a low income preclude saving money for a rainy day, Lathan noted. So he and his colleagues decided to focus on a person’s financial strain and the effect it has on their cancer.

They gathered data from a cancer outcomes study involving more than 10,000 patients diagnosed with lung or colon cancer between 2003 and 2005. They whittled their pool of patients down to 3,419 who were willing to complete a follow-up interview that included questions about household finances.

About 40 percent of lung cancer patients and 33 percent of those with colon cancer reported limited financial reserves.

The researchers said they found that financial strain had enough impact to be an independent risk factor for increased pain and symptoms, even after taking into account race and household income — two variables closely related to finances that also affect quality of life during cancer treatment.

Financial strain “stands alone,” Lathan said. “It actually had its own effect, separate from race and income.”

The make-or-break point appeared to be two months. “The people at the highest risk were those at the lowest category, which is they could not make it two months or less,” Lathan said.

Exactly why isn’t clear, he said. It could be that people with bad finances find it tough to access quality health care from the start, and delay treatment because they can’t get to the right medicines or the best doctors, Lathan said.

However, it’s also possible these people start out with access to good cancer care, but their access slips away as cancer expenses quickly burn through their money, he said.

The stress that comes from financial insecurity also can play a role, said Dr. Lowell Schnipper, a professor at Harvard Medical School in Boston and chair of the American Society of Clinical Oncology’s Value in Cancer Care Task Force.

Stress is “tightly connected to perceptions of pain,” Schnipper said, noting cancer patients face “intense worry because of all the other obligations people have caring for themselves through what could be a mortal illness.”

The medical community can take steps to assist financially strapped cancer patients, Lathan and Schnipper said.

Social workers in cancer wards can help these patients navigate the complicated medical system, find clinical trials, and overcome basic difficulties such as transportation to treatment and keeping track of their prescriptions, Lathan said.

“You don’t have to fix all of the financial problems of a person,” he said. “You just have to provide some targeted intervention that might have the maximum impact on their outcome.”

Social workers also can help patients sign up for programs that provide free chemotherapy drugs to those who can’t afford the total cost of the drugs or even the copay, Schnipper added.

But first, doctors need to know that the patient has financial problems.

“We should probably be asking that of people when they come to see us,” Lathan said, suggesting financial questions be part of a patient’s initial workup.

More information

For more information on managing cancer care, visit the U.S. National Cancer Institute.

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This Is How Celebs Got Ready for the Oscars

Beauty’s biggest night of the year went down on Sunday, February 28, and celebs brought their A game (and then some) to the red carpet. Seriously, so much makeup goodness, we can’t.

Getting Oscars-ready is an all-day adventure, and sitting in hair + makeup for hours could get a little intense if it weren’t for the dawn of social media. Thanks to Instagram, celebs shared behind-the-scenes beauty moments and we’ve rounded up our favorite looks for you to lust over.

RELATED: A Moment to Honor Daisy Ridley’s Oscars Up-Do

This article originally appeared on MIMIchatter.com.

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