Health Assistance to Developing Countries Up Since 1990: Study

TUESDAY, June 16, 2015 (HealthDay News) — There has been an increase in health-related development assistance to low-income countries since 1990, a new study finds.

The increased funding has focused mostly on HIV/AIDS, maternal health and newborn and child health.

“Understanding how funding patterns have changed across time… may help identify where funding gaps persist and where cost-effective interventions could save lives,” Joseph Dieleman, of the Institute for Health Metrics and Evaluation at the University of Washington in Seattle, and colleagues wrote.

Even with increased assistance, a child’s risk of dying before the age of 5 in a low-income country was 12 times higher than in the United States in 2013. A mother’s risk of dying in childbirth was 21 times higher in a low-income country compared to the United States, the researchers noted. Most of these deaths are preventable, they added.

Development assistance for health rose 11 percent a year from 2000 to 2010. But, there hasn’t been a significant increase in development assistance for health since 2010, the study found.

Between 1990 and 2014, $458 billion was distributed from high-income countries to developing countries to maintain or improve health. Assistance was almost $7 billion in 1990. That increased to nearly $36 billion in 2014.

The U.S. government was the largest source of health-related development assistance. The United States contributed more than $143 billion between 1990 and 2014. That works out to about 31 percent of the total amount, the researchers said. The United Kingdom was the second-largest contributing country with 7 percent of the total — or almost $33 billion from 1990 to 2014.

Private foundations provided nearly $70 billion in health-related development assistance to low-income countries between 1990 and 2014, including more than $6 billion last year.

Since 1990, 28 percent of health-related development assistance was for maternal health and newborn and child health. HIV/AIDS programs received 23 percent of the assistance, the study found.

The study was published June 16 in the Journal of the American Medical Association.

With growing austerity in wealthy nations, it could be difficult to maintain health-related development funding for low-income counties, Dr. Andy Haines, of the London School of Hygiene and Tropical Medicine in the U.K., noted in an accompanying editorial.

“Work such as that described in [this study] should be supported and expanded. Additional data are needed to provide better evidence for decision-making and strengthen the case for funding to address the health problems of poor populations living in low-income countries that cannot fund the provision of essential health care for their own populations in the near future,” Haines wrote.

More information

The World Health Organization has more about health financing.

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Menopausal Women’s Sleep May Suffer at Different Times of the Month

TUESDAY, June 16, 2015 (HealthDay News) — As women begin menopause, hormone fluctuations increase the risk of sleep problems during certain phases of the menstrual cycle, according to a small new study.

Researchers analyzed the sleep patterns of 20 women in the earliest stage of menopause (perimenopause), including 11 who had difficulty sleeping at least three times a week for at least a month.

The investigators found that women have more sleep disturbances just prior to menstruation than after menstruation, according to the study published June 16 in the Journal of Clinical Endocrinology & Metabolism.

The days before they got their periods was when their progesterone levels were higher, the researchers said.

“Measures of electrical brain activity found that the hormone progesterone influences sleep, even at this late reproductive stage in perimenopausal women,” researcher Fiona Baker, of the Center for Health Sciences at SRI International in Menlo Park, Calif., and the University of the Witwatersrand in Johannesburg, South Africa, said in a journal news release.

“Menstrual cycle variation in hormones is one piece in the overall picture of sleep quality in midlife women,” she said.

“This research can lead to a better understanding of the mechanisms behind sleep disturbances during the approach to menopause and can inform the development of better symptom management strategies,” Baker concluded.

More information

The American Academy of Family Physicians has more about menopause.

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New Drug Shows Promise Against Psoriasis

TUESDAY, June 16, 2015 (HealthDay News) — Many patients with the skin disease psoriasis showed significant improvement when taking an experimental drug called ixekizumab, according to a late-stage, phase 3 clinical trial.

“The visible effects of psoriasis can have a major and life-ruining impact on people’s confidence and self-esteem,” study leader Chris Griffiths, a professor of dermatology at the University of Manchester in England, said in a university news release.

“What we saw in this trial was not just the physical aspects of the disease clearing up, but people on the new drug also reporting a marked improvement in their quality of life as they felt more confident and suffered less from itching — far more than in the other two groups,” he said.

The trial was funded by drug maker Eli Lilly and included 2,500 patients with moderate-to-severe psoriasis. Half took ixekizumab, while the other half took an inactive placebo or the widely used psoriasis drug etanercept (brand name Enbrel).

After 12 weeks of treatment, 40 percent of those who took the new drug were free of all psoriasis, and more than 90 percent showed improvement, the research team reported recently in The Lancet. About half of the patients showed improvement as early as week four, Griffiths’ team said

Overall, the patients taking ixekizumab had better results than those taking etanercept or the placebo, the research showed.

As the researchers explained, the new drug works by neutralizing the inflammatory effects of a protein believed to be one of the causes of psoriasis.

“The objective for treating psoriasis has been to reduce the visible symptoms. But new drugs are fast showing us that a realistic goal for all patients should be attaining clear skin and this trial very much sets us on that path,” Griffiths said in the news release.

One expert in the United States said the trial results are welcome news.

“This represents another in a series of recent breakthroughs in the treatment of psoriasis,” said Dr. Andrew Alexis, chair of the department of dermatology at Mount Sinai St. Luke’s and Mount Sinai Roosevelt in New York City. “In addition to improving or clearing the visible features of psoriasis, treatment with ixekizumab also resulted in significant improvement in quality of life,” he said.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more about psoriasis.

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Pesticide Used Decades Ago May Raise Breast Cancer Risk: Study

By Kathleen Doheny
HealthDay Reporter

TUESDAY, June 16, 2015 (HealthDay News) — Although the pesticide DDT was banned in the United States in 1972, women exposed to the chemical while they were still in the womb may be more likely to develop breast cancer than women who had less exposure to the pesticide, a new study contends.

“We discovered that daughters who are highly exposed to DDT before birth had four times the chance of breast cancer before the age of 52 than women who were not,” said study co-author Barbara Cohn, director of the Child Health and Development Studies at the Public Health Institute in Berkeley, Calif.

“This is a strong effect compared to other modifiable risk factors,” Cohn said. For instance, research suggests drinking two alcoholic beverages a day can boost risk by 40 percent, she said.

Although Cohn found an association between pre-birth DDT exposure and later breast cancer, she emphasized that no study of this type can prove cause and effect.

“We can never measure every other single factor” that could affect the outcome, Cohn said. The DDT, she said, could “ride along with another environmental exposure,” for instance.

The study, funded by the U.S. National Institutes of Health, was published June 16 in the Journal of Clinical Endocrinology & Metabolism.

While DDT is banned in the United States, it’s still in use in other parts of the world, Cohn said. In the United States, many women now in their 50s and 60s — an age when the risk of breast cancer tends to rise — were likely to be exposed to DDT before birth, she said.

For the study, the researchers tracked more than 20,000 pregnancies among women who were members of the Kaiser Foundation Health Plan from 1959 through 1967. The women gave birth to 9,300 daughters during those years.

The researchers looked at DDT levels in the mother’s blood samples during pregnancy or soon after childbirth. Until 2012, they also tracked whether or not breast cancer developed in the daughters of these women by age 52.

During the 54-year follow-up period, the researchers examined DDT levels in mothers of 118 daughters who developed breast cancer. They compared these women to 354 women from the group who didn’t develop breast cancer.

Women exposed to the highest levels of DDT in the womb had a 3.7 times higher risk of breast cancer than those who had the lowest exposure to DDT, the study revealed.

And the higher the DDT levels in the mother’s blood samples, the more likely a woman was to be diagnosed with more advanced breast cancer, according to the study.

This link held strong even after Cohn’s team took into account the mother’s history of breast cancer.

Most of the women with breast cancer (83 percent) had estrogen-receptor positive cancer, which is thought to need estrogen to grow. Prior research has suggested that DDT may have a weak estrogen-like activity, according to the study authors. However, Cohn said she doesn’t know what the mechanism might be behind the link between DDT exposure and breast cancer risk.

Shiuan Chen, the chair of cancer biology at City of Hope Cancer Center in Duarte, Calif., agreed that explaining the link between high DDT blood levels and the higher risk of breast cancer is not possible from this study.

Women born when the pesticide was still commonly used probably have no way of knowing whether they were exposed, or what levels they were exposed to, Cohn and Chen said.

Chen’s advice to women is to follow standard recommendations for screening, such as getting regular routine mammograms. “I don’t think we can say more than that” based on this study’s findings, he said.

“The best thing any woman can do is talk to her doctor about steps to reduce her risk of breast cancer,” Cohn said. The discussion should be based on her known risk factors and medical history.

Cohn plans to follow more generations to see if the breast cancer risk holds, she said. Some animal studies suggest such vulnerability may persist for generations.

More information

To learn more about breast cancer prevention, visit the American Cancer Society.

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Appendicitis Can Often Be Treated With Antibiotics

By Steven Reinberg
HealthDay Reporter

TUESDAY, June 16, 2015 (HealthDay News) — Although surgical removal of the appendix has long been a standard treatment, a new study found that almost three-quarters of people treated with antibiotics could be spared the invasive procedure known as appendectomy.

“For more than a century, appendectomy has been the standard treatment,” said the study’s lead author Dr. Paulina Salminen, of Turku University Hospital in Finland.

But about 80 percent of patients with an inflamed appendix, commonly called appendicitis, don’t need to have their appendix surgically removed, and those who ultimately do need the surgery aren’t hurt by waiting, according to Salminen.

She thinks that this and other studies will change how appendicitis is treated. “Now we know that only a small proportion of appendicitis patients need an emergency operation,” Salminen said.

However, there are two types of appendicitis — one that always requires surgery and a milder form that can be treated with antibiotics, Salminen explained. “The majority of appendicitis is the milder form, making up almost 80 percent of the cases of appendicitis,” she said.

The more serious type of appendicitis can cause the appendix to rupture. Treating this type of appendicitis requires that the appendix be removed, she said.

A CT scan can accurately detect which type of appendicitis someone has, Salminen added.

The study’s findings were published June 16 in the Journal of the American Medical Association.

For the study, Salminen and colleagues randomly assigned 530 patients with acute appendicitis to appendectomy or a 10-day course of antibiotics.

The researchers found that appendectomies were 99.6 percent successful. Among patients treated with antibiotics and followed for a year, 73 percent did not need surgery. However, 27 percent of the patients treated with antibiotics had to have their appendix removed within a year after treatment.

But there were no major complications associated with delaying surgery, the researchers said.

Dr. Edward Livingston, deputy editor of JAMA and coauthor of an accompanying editorial, said, “It’s kind of lost to history why people started doing appendectomies, but it has become so routine that when someone comes in with appendicitis they get whisked into the operating room.”

However, a lot has changed in 130 years, he said. For example, the ability to diagnose appendicitis has improved. “It’s almost perfect with CT scans,” Livingston said.

In addition, the antibiotics available are very powerful and can kill anything in the appendix that can cause infection, he said. “These changes have made us rethink how we approach appendicitis,” Livingston said.

More than 300,000 appendectomies are done each year in the United States. However, most patients can be treated with antibiotics alone, he said.

“Appendicitis of this type is not an emergency. You can always give somebody antibiotics and see how they do, and if the appendicitis comes back you can take out their appendix and not have complications related to the delay,” Livingston said.

He added that even though an appendectomy is usually well tolerated, there are risks and pain. And, having an operation is expensive.

“I am a surgeon and I hope to get through life without ever having an operation,” he said. “So if I were given the option of taking antibiotics and not have surgery, I would take antibiotics in a heartbeat.”

More information

For more about appendicitis, visit the U.S. National Institutes of Health.

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Does the Belly Button Challenge Really Reveal Whether You Need to Lose Weight?

Photo: Getty Images

On the heels of the thigh-gap craze, social media is offering up yet another viral and ludicrous measure of a “good” body: The Belly Button Challenge, which started trending on China’s version of Twitter last week and quickly spread around the world, involves reaching one arm around your back to try and touch your navel. The idea is that if you can reach, you’re fit; if you can’t, you need to lose weight.

Mmkay.

Where do we start?

RELATED: The Definitive Guide to Body Fat

The Daily Mail reports that web users claim the challenge is based on a U.S. study. But no one seems to be able to find the original research. Read: There’s no actual science involved here!

The notion is totally bunk, confirms Ronald S. Sha, MD, the medical director of the Duke University Diet and Fitness Center. “This is an amusing diversion that means absolutely nothing about an individual’s weight or health,” he told Health. “It’s much more a reflection of a person’s upper extremity flexibility and arm length than of a healthy weight.”

Plus, of course, even someone who “passes” the test because she is slender (and perhaps has extra-bendy shoulders and longish arms) could have many of the same medical issues as an obese person. The so-called “skinny fat” problem is a real and common phenomenon.

RELATED: Which Is Better for Weight Loss: Diet or Exercise?

It’s true that waist circumference is one of the factors doctors use to assess a person’s risk of heart disease, type 2 diabetes, and other health concerns. But there is a scientifically-approved method for measuring it, Dr. Sha points out—no contortion required.

If you want to check your belly fat at home, use a tape measure pulled snugly around your abdomen at the top of your hip bones and parallel to the floor. Note the inches after you exhale. For women, a waist circumference up to 35 inches is considered healthy.

As for the Belly Button Challenge, it’s just another example of an arbitrary beauty standard that requires women to twist themselves into pretzels. This time, literally.

Try the belly button challenge! http://t.co/YcdQlClMKo #bellybuttonchallenge #bellybutton http://pic.twitter.com/hXT3YhiXts

— Belly Fat Formula (@fatbellyblog) June 12, 2015

After Ice Bucket, now the world is taking the BELLY BUTTON CHALLENGE
http://ift.tt/1R5aVQI
#bellybuttonchallenge http://t.co/fx4QmnVSwX—
Daily Bhaskar (@daily_bhaskar) June 12, 2015

RELATED: 7 Foods That Fight Fat

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FDA Tells Food Industry to Stop Using Artificial Trans Fats

By Dennis Thompson
HealthDay Reporter

TUESDAY, June 16, 2015 (HealthDay News) — In a move that it says is designed to protect the heart health of Americans, the U.S. Food and Drug Administration said Tuesday that food manufacturers have three years to remove artificial trans fats from the nation’s food supply.

The FDA ruled that partially hydrogenated oils — the major source of trans fats in the American diet — are no longer “generally recognized as safe,” the designation that for decades has allowed companies to use the oils in a wide variety of food products.

Consuming trans fats simultaneously increases “bad” LDL cholesterol and drives down “good” HDL cholesterol in a person’s bloodstream. The FDA has estimated that removing partially hydrogenated oils from food could prevent as many as 20,000 heart attacks and 7,000 deaths from heart disease every year.

Partially hydrogenated oils are created by pumping hydrogen into vegetable oil to make it more solid, and are used to improve the texture, shelf life and long-term flavor of processed foods, according to the FDA.

Partially hydrogenated oils are most often found in processed foods such as baked goods like cakes, cookies and pies; non-dairy creamers; microwave popcorn; frozen pizza; margarine and other spreads; vegetable shortenings; and refrigerated dough products like biscuits and cinnamon rolls.

Companies have until June 18, 2018, to either reformulate their products and remove all partially hydrogenated oils, or petition the FDA to permit specific uses of the oils, the agency said Tuesday.

“Following the compliance period, no partially hydrogenated oils can be added to human food unless they are otherwise approved by the FDA,” the agency said in a news release.

Food manufacturers have voluntarily lowered the amounts of partially hydrogenated oils in food products by 86 percent since 2003, and continue to remove them from products, according to the Grocery Manufacturers Association.

“Part of the impetus for the reduction was FDA’s requirement, which became effective in 2006, that trans fat be declared on the Nutrition Facts label,” said Michael Taylor, the FDA’s deputy commissioner for foods and veterinary medicine, said during a media briefing Tuesday.

Despite this, even savvy consumers still are being exposed to minute levels of trans fats from partially hydrogenated oils, added Susan Mayne, director of the FDA’s Center for Food Safety and Applied Nutrition.

That’s because under current rules, products that have less than 0.5 grams of trans fats are labeled as zero grams of trans fats on the Nutrition Facts label.

“Even if consumers choose food products that say they have zero grams of trans fats on the label, they still can be getting small amounts of partially hydrogenated oil that can add up to a considerable intake of trans fat when you look at the overall diet,” Mayne said.

Dr. Georges Benjamin, executive director of the American Public Health Association, praised the FDA’s announcement, calling it the result of “nearly 25 years of scientific research and advocacy.”

“The evidence is clear. There is no safe level of trans fat,” Benjamin said in a statement. “Removing this source of industrial trans fat in the food supply will prevent thousands of preventable illnesses and deaths each year from heart disease.”

Jim O’Hara is director of health promotion at the Center for Science in the Public Interest, which petitioned the FDA to ban trans fats nine years ago. He said, “This is going to be a huge public health victory. It’s time to get trans fats out of the food supply.”

In November 2013, the FDA released a tentative determination that partially hydrogenated oils should not be generally recognized as safe, and opened the matter up for public comment.

The agency ended up receiving more than 6,000 comments from consumers, industry, advocacy groups and academic researchers, Taylor said.

More information

For more on trans fats, visit the U.S. Food and Drug Administration.

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Legalizing Medical Marijuana May Not Raise Pot Use by Teens: Study

TUESDAY, June 16, 2015 (HealthDay News) — When states legalize medical marijuana, this does not lead to greater use of the drug by teens, a new study suggests.

The findings are published June 15 in The Lancet Psychiatry.

“Our findings provide the strongest evidence to date that marijuana use by teenagers does not increase after a state legalizes medical marijuana,” study author Deborah Hasin, professor of epidemiology at Columbia University Medical Center in New York City, said in a journal news release.

Since 1996, 23 states and the District of Columbia have legalized medical marijuana, raising concerns among some that this may increase teens’ acceptance of the drug and their access to it.

In their study, Hasin’s team looked at data collected from more than a million teens, aged 13 to 18, across 48 states between 1991 and 2014. The researchers found no significant difference in teen marijuana use in the 21 states that had passed medical marijuana laws by 2014, before and after states made such moves.

Hasin noted, however, that in “the states that passed medical marijuana laws, adolescent marijuana use was already higher than in other states.”

While marijuana use among teens was higher in states that went on to allow medical marijuana, rates of teen use in those states did not rise further after the states legalized medical marijuana, the study found.

The study was funded by the U.S. National Institute on Drug Abuse, Columbia University Mailman School of Public Health, and the New York State Psychiatric Institute. It was also presented Tuesday in Phoenix at the annual meeting of the College on Problems of Drug Dependence.

One expert in addiction services stressed, however, that marijuana should not be viewed as a “harmless” substance, especially for teens.

“In our experience working with adolescents, marijuana is usually the first drug of experimentation,” said Loretta Hartley-Bangs, program director of the Mineola Community Treatment Center at the North Shore-LIJ Health System in Mineola, N.Y.

Teens often “express the belief that [marijuana] is not harmful compared to other drugs and it is non-addictive,” she said. “Unfortunately, parents often believe the same — while they do not want their children smoking anything, they are relieved that they are not using ‘dangerous’ drugs such as heroin.”

But Hartley-Bangs said there’s a “hierarchy of drugs,” with each drug rising in level of danger, “which allows those involved to feel some sense of safety.”

She stressed that “we need to be careful not to give a mixed message regarding the safety of medical marijuana. Like other prescription medication, there are valid medical uses for it, but it can still be abused.”

Dr. Kevin Hill works in the division of alcohol and drug abuse at McLean Hospital in Belmont, Mass. In an accompanying journal editorial, he wrote that “the growing body of research that includes this study suggests that medical marijuana laws do not increase adolescent use.”

Hill believes that “future decisions that states make about whether or not to enact medical marijuana laws should be at least partly guided by this evidence.”

More information

The U.S. National Institute on Drug Abuse has more about the medicinal use of marijuana.

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Extreme ‘Preemie’ Infants at No Higher Risk If Included in Clinical Trials

TUESDAY, June 16, 2015 (HealthDay News) — Extremely premature infants who take part in randomized clinical trials don’t have worse outcomes while in the hospital compared to those who aren’t part of such research, a new study finds.

The researchers undertook the study because it wasn’t known if taking part in randomized clinical trials posed a risk to extremely premature infants. These findings may help ease concerns, according to Dr. Elizabeth Foglia, University of Pennsylvania, and colleagues.

The research included more than 5,000 extremely premature infants — born after just 22 weeks to 28 weeks gestation. About 3,800 babies were enrolled in at least one of six randomized clinical trials and nearly 1,600 were eligible but weren’t enrolled in any of the trials.

The primary outcome — a composite of death, a chronic lung disorder, severe brain injury, or a sight-threatening eye problem — didn’t vary significantly between the two groups. Sixty-eight percent of the enrolled infants and 69 percent of the non-enrolled infants had those problems.

There were also no differences between the two groups when the researchers looked at those complications individually. In addition, there were no differences between the two groups for rates of sepsis (an infection of the bloodstream), and necrotizing enterocolitis (severe inflammation of the intestines caused by reduced blood flow).

The study was published June 16 in the journal JAMA.

More information

The March of Dimes has more about premature babies.

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Short Boys Three Times More Likely to Get Growth Hormone: Study

TUESDAY, June 16, 2015 (HealthDay News) — Short boys are much more likely than short girls to receive growth hormones, a new study finds.

Researchers examined the medical records of more than 283,000 children and teens in the United States and found that short boys were up to three times more likely than short girls to receive recombinant human growth hormone treatment.

Specifically, males accounted for 74 percent of patients who received the hormone to treat idiopathic short stature — shortness due to an unknown cause. Among patients who received the hormone for any diagnoses, 66 percent were male.

The biggest gender differences in treatment occurred around puberty, when less time remains to correct poor growth in children, the researchers noted.

The findings were published online June 9 in the journal Scientific Reports.

“Growth is an important sign of child health, so growth failure merits equal consideration for both boys and girls,” study leader Dr. Adda Grimberg, a pediatric endocrinologist at the Children’s Hospital of Philadelphia, said in a hospital news release.

“Gender bias in treatment may have doubly undesirable effects — short girls who have an underlying disease may be overlooked, while short healthy boys may receive overzealous, unnecessary treatment with an expensive drug that requires years of nightly injections and has potential side effects,” Grimberg explained.

More information

The U.S. National Library of Medicine has more about growth disorders.

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