This Swedish Model Says She’s “Too Big” to Book a Gig

Photo: Agnes Hedengård/ Screenshot

Swedish model Agnes Hedengård is making headlines for a viral YouTube video she posted where she calls out the fashion industry for their rigid body standards. The 19-year-old, who says she has been modeling for 5 years, admits she can’t find work due to her shape. Hedengård is not only absolutely stunning, but also super thin. She has a BMI of 17.5 and casting directors have told her to get into “better shape.”

The model puts her body on full display in the video, literally showing what “wide hips” and a “big butt” look like in the modeling industry. She says that her purpose for sharing her experience (the video was originally posted in Swedish) is to show everyone just how warped the whole thing is.

This is an issue that affects everyone. It demonstrates how unattainable the “ideal body image” is and creates unrealistic expectations of beauty for both women and men.

Mega-model Cara Delevingne has shared similar frustration in recent interviews, telling London’s The Times that modeling made her feel “hollow” and said, “It is a mental thing as well because if you hate yourself and your body and the way you look, it just gets worse and worse.”

While Hedengård’s video paints the industry in a not-so-great light, there have been many changes over the past few years in efforts to create an environment of inclusivity. France has enacted BMI restrictions, Aerie’s latest ads are not retouched, and a transgender agency is opening in L.A.. We’ll just have to wait and see what the Internet’s push for body positivity will mean for the future.

This article originally appeared on MIMIchatter.com.

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Summer Is High Time for College Kids Trying Illegal Substances

THURSDAY, Aug. 27, 2015 (HealthDay News) — Many American college students start experimenting with booze or drugs over the summer, but winter is the peak time for them to begin illegal use of prescription medicines, according to a U.S. government study.

“These findings show that college students are vulnerable to substance use at any time — not just when they are away at school,” Kana Enomoto, acting administrator of the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA), said in an agency news release.

“That means that parents, college counselors, faculty members, staff, mentors, and other concerned people must take every opportunity to talk with college students about the risks of substance use and where they can turn to for help,” Enomoto added.

Researchers analyzed data collected from full-time college students, aged 18 to 22, between 2002 and 2013. The investigators found that 20 percent used alcohol, marijuana or other illegal drugs.

The study found that 383,000 students used marijuana for the first time each year, an average of about 1,000 a day. But first-time use of marijuana peaked in June at about 1,500 new users a day.

About 450,000 underage college students started drinking each year, an average of about 1,200 a day, the study found. The researchers reported that the start of underage drinking also peaked in June, at about 1,883 students a day.

But winter was the peak season for students to begin illegal use of prescription drugs, including painkillers (drugs such as Oxycontin, Vicodin or Percocet) and stimulants (such as Ritalin). About 251,000 college students started illegal use of pain relievers each year, an average of 700 a day. However, that number rose to 850 per day in December.

Illegal use of stimulants followed a different pattern, averaging 400 new college-age users a day. But that number rose to more than 500 a day in November, December and April, with a peak of 585 a day in November, the findings showed.

Many college midterm and final exams occur in those three months, which suggests that some students start illegal use of stimulants in the belief that it might help them on the exams, according to SAMHSA.

There is no proof that illegal use of stimulants improves academic performance, and such use can pose serious health risks, the agency warned.

The report also found that the peak times for college students to start smoking cigarettes are June, September and October.

More information

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

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Liver Damage From Hepatitis C More Widespread Than Thought

By Maureen Salamon
HealthDay Reporter

THURSDAY, Aug. 27, 2015 (HealthDay News) — Severe liver damage may be four times more common among Americans with the liver infection hepatitis C than previously believed, a new study suggests.

Analyzing nearly 9,800 patients with hepatitis C, researchers learned that using a biopsy alone to reveal liver cirrhosis — indicating scarring in the organ — is likely to seriously underestimate its prevalence.

The recent emergence of medications that can cure hepatitis C, a “silent killer” that often goes undetected until advanced disease sets in years later, adds weight to the new findings, doctors said.

“We thought it would be important to provide the health care community with some estimate as to the severity of liver disease among patients with hepatitis C because it’s a question that comes up very frequently: Just how sick is this community?” said study author Dr. Stuart Gordon, director of hepatology at Henry Ford Hospital in Detroit.

Hepatitis C is a viral infection that’s typically spread through contact with the blood of an infected person, and is estimated to kill 500,000 people worldwide each year, according to the World Health Organization. About 2.7 million Americans are thought to have chronic hepatitis C, which when untreated can lead to cirrhosis and liver failure or liver cancer, according to the U.S. Centers for Disease Control and Prevention.

For the study, Gordon and his team analyzed records from 9,783 hepatitis C patients cared for at four large U.S. health care systems. The records indicated that 29 percent of the patients had evidence of liver damage, or cirrhosis. But medical records didn’t indicate the cirrhosis in 62 percent of these patients, the study found.

Liver biopsy is considered the gold standard for diagnosing cirrhosis, but the researchers found a fourfold higher prevalence of cirrhosis among patients than shown by biopsy alone. Other clinical tests, including blood tests and a noninvasive scoring system known as the FIB-4 score, can also reveal cirrhosis but are underused, Gordon said.

“There are several messages in our paper, and one is that if you’re simply relying on liver biopsy to establish a diagnosis of liver cirrhosis, you’re going to be greatly underestimating the prevalence,” he said. “One has to be suspect and try to search for that diagnosis any way you can.”

Another liver disease expert agreed with this assertion.

“For a long time we’ve recognized that there are limitations to what has been our gold standard in diagnosing cirrhosis. But looking at one piece from one area of the liver doesn’t necessarily reflect what is going on everywhere in the liver,” said Dr. Andrea Cox, associate professor of medicine and oncology at the Johns Hopkins Infectious Disease Center for Viral Hepatitis in Baltimore.

“This [new study] is confirmation of the benefit in having multiple ways in assessing the state of someone’s liver,” added Cox, who wasn’t involved in the new research.

The study findings were published this month in The American Journal of Gastroenterology.

With the emergence of new medications that can cure hepatitis C — which previously had been treatable but incurable — it’s even more important that those infected know their status and seek care before the virus causes advanced liver disease or cancer, experts said. But the main obstacle to widespread use of the drugs is their enormous cost.

Last year, the U.S. Food and Drug approved several treatments for hepatitis C. One, known by the brand name Harvoni, can cure 90 percent of patients with hepatitis C type 1, the most common form, after 12 weeks of use. But Harvoni costs more than $94,000 for a full course of treatment and some health insurers have said they will only cover the cost of the drug for the sickest patients.

“Clearly we want to prevent patients from entering into the stage of cirrhosis, which is essentially a premalignant state where you have to be screened for liver cancer for the rest of your life,” said Gordon, explaining why treating hepatitis C is crucial.

In response to the high cost of hepatitis C drugs, a panel of health care experts has recommended that federal and state Medicaid programs expand access to these prescription medications, The New York Times reported Wednesday.

Restrictions on the drugs imposed by many states are inconsistent with sound medical practice, according to the experts from the Public Health Service and President Obama’s Advisory Council on HIV/AIDS.

While states can get discounts, the prices of the drugs are still more than $600 a pill.

The panel did not suggest how wider access to the drugs should be funded. But, it did say Medicaid and other public programs should reveal the prices they paid, and also said manufacturers should have to disclose the costs of developing and making the drugs, the Times reported.

Gordon said his research wasn’t intended to emphasize the need for treatment, but to emphasize the severity of liver damage among hepatitis C patients.

Despite the high cost of treatment, Cox said, it’s cost-effective for those with advanced liver disease whose health care costs are already climbing. Preventing hepatitis C infection is vital, she added, and scientists are developing an effective vaccine for the infection.

“This study highlights that we have effective measures for detecting liver disease,” she said, “and they need to be widely implemented.”

More information

The U.S. Centers for Disease Control and Prevention has more on hepatitis C.

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Oldest Sister at Greater Risk of Obesity, Study Contends

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, Aug. 26, 2015 (HealthDay News) — Firstborn girls are more likely to be overweight or obese in adulthood than their younger sisters, results of a new study suggest.

Firstborns had 29 percent greater odds of being overweight and 40 percent greater odds of being obese than sisters born second, the researchers said. In addition, firstborns were also slightly taller.

“This is the fourth study we have done to characterize the health risks of firstborn in four different populations,” said lead researcher Dr. Wayne Cutfield, a professor of pediatric endocrinology at the Liggins Institute of the University of Auckland in New Zealand.

“If you look at the health risks of those that are firstborn, you find that firstborns are more insulin resistant than later borns, which is a risk factor for diabetes, and they have higher blood pressure than later borns,” he said.

However, the new study is an observational study, so no definitive conclusions can be drawn about cause-and-effect between birth order and later weight status, Cutfield pointed out.

Still, Cutfield thinks that these risks might be due to less of the mother’s blood reaching the placenta during her first pregnancy than in later pregnancies because blood vessels are narrower in the first pregnancy.

In addition, firstborns tend to weigh less than later borns, which might be a result of less nutrients reaching the first fetus, he said.

As families have been getting smaller, firstborns make up a larger part of the population, which might explain some of the obesity epidemic, he suggested. “It’s a small contributor. It’s not a major contributor,” according to Cutfield.

He said that knowing the health risk of being firstborn is helpful because it empowers firstborns to make decisions about their lifestyle. Living a healthy lifestyle can reduce the risk of obesity, high blood pressure and diabetes, he pointed out.

“There are minor health risks associated with being firstborn,” Cutfield said. “I don’t want firstborns to think they will become obese or get diabetes or high blood pressure — it is a risk factor, and the risk of getting a disease is a combination of risk factors, not just a single risk factor,” he said.

The report was published online Aug. 26 in the Journal of Epidemiology & Community Health.

Using the Swedish Birth Register, Cutfield’s team collected data on girls born between 1973 and 1988 who were pregnant between 1991 and 2009. Complete data were available for more than 13,000 sister pairs — just under 27,000 women in total.

The researchers noted that this study’s findings corroborate previous studies that have shown a link between greater weight and height in firstborns in men.

Dr. David Katz, president of the American College of Lifestyle Medicine, said, “This study establishes an association in females, already seen in males, between the likelihood of obesity in adulthood and place in the birth order, but by design, it cannot say for sure why such an association exists.”

Perhaps firstborn children are less well-nourished in the womb or excessively nourished in early childhood. Perhaps there are life stresses unique to being the firstborn child that somehow pertain, he suggested.

Some factors related to obesity are not a matter of individual choice — no one chooses their place in a birth order. This study makes us consider aspects of obesity that are not related to personal responsibility, Katz said.

Being born first may play a small role in obesity, but the obesity epidemic is largely a consequence of society’s obsession with unhealthy food choices and a sedentary lifestyle, Katz said.

“Birth order is not a modifiable risk factor, but the obesogenic environment and a lifestyle at odds with weight control and health promotion certainly are,” he said. “Our attention, as ever, should be directed there.”

More information

For more on preventing obesity, visit the U.S. National Heart, Lung, and Blood Institute.

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Why I’m Still a 30-Year-Old (Hair) Virgin

Photo: Courtesy of Popsugar Beauty/Benjamin Stone

“Oh honey, don’t touch the color — this is the type of hair men are attracted to,” a hairdresser warned as he ran a round brush through my long, chocolate-hued hair, leaving it in ribbons around my shoulders. I’ll never pull the trigger, I thought, convinced. Basic wins again.

You see: I’m a 30-year-old (hair) virgin. And I just can’t seem to give it up. I slunk into the white leather salon chair, watching my fantasies of golden ombré ends, Jessica Alba “bronde” highlights, and even Katy Perry blue tints float away.

Don’t feel bad for me. I was blessed with a thick, wavy brunette mane (thanks for the genes, Dad!), which I appreciate immensely. But it left me with a conundrum: to dye or not to dye?

The first time I ever considered coloring it was in middle school. Jennifer Aniston was at the peak of her ’90s Friends days and every girl wanted “The Rachel,” complete with face-framing highlights. My mother forbade it. She has struggled with what she describes as thin, mousy hair. And as a result, she has lived vicariously through my mane, protecting every strand on my head as if it were her own. Threatening. Bribing. Begging. (You know how mothers can be!) So I never took the plunge. Never dyed a strand. Not even a gloss.

In the beauty industry, I am an anomaly among my rainbow-haired colleagues and friends. Sometimes I feel like they’re having more fun than I am. We’re in an age when women like Kim Kardashian can go from espresso to Ken Doll-blond and back to brunette within a month’s span. Spotting a celebrity or blogger with powder blue or rose gold hair hardly turns a head. Over 190,000 women have used the hashtag #rainbowhair on Instagram, sharing photos of their tropical dye choices. We look like we all live in The Capitol from The Hunger Games.

I envy how these women can dye their hair without remorse or guilt, whereas I agonize over just squeezing on some lemon juice before the beach. Hollywood stylist George Papanikolas even offered to pay me $1,000 to be his hair model. Still, I wasn’t ready to hand over my V card. And while I don’t get to experiment as much as other women, there are plenty of perks to holding on to my natural hue.

So I asked my hairstylist Dhiran Mistry of John Barrett Salon in NYC why I should stay a virgin. Here’s what I learned:

Virgin hair is shinier

When you color hair, you have to break down the cuticle. “Think of the flaps on blinds,” he explained. “If you open the blinds, it lets toxins in. An open follicle on the hair shaft is prone to damage — from exterior elements like the sun.” Healthy, virgin hair tends to be smoother and reflects more light.

There is less root maintenance

Even if you cover up your grays when you get your hair dyed, they’ll pop back when your roots grow out. And according to Mistry, they’ll stick out more than if they were just blending in with your natural color. “Those three gray hairs will become superapparent on the hairline because you’ll have a line where your real color is and where your dyed hair is, and the grays will show up in that highlighted area,” he said. Personally, I just cut off my grays or use a bit of root concealer spray, like this one from Oribe.

It’s easier to manage

Chemicals in dyes dry out the hair, making it even more vulnerable to damage. “Hair is like a coil,” Mistry noted. “If you stretch out a coil and it’s not healthy, it won’t spring back to its normal position.” Superbleached strands usually lose their elasticity, making them harder to style.

Before you panic about your flaming faux red or golden-blond mane, realize that there are plenty of problem-solving products on the market to help keep dyed hair healthy. Plus, you can become a born-again hair virgin!

How to restore your strands

This may just be your excuse to finally get a lob. Mistry recommends dyeing your hair a hue that is as close as possible to your natural color. “Then, you have to grow it out and eventually cut it off,” he said. Tough love. But the payoff is worth it!

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Impotence Drug Aids Treatment of Rare Lung Disease: Study

By Dennis Thompson
HealthDay Reporter

WEDNESDAY, Aug. 26, 2015 (HealthDay News) — A combination treatment using the erectile dysfunction drug Cialis may greatly reduce death and hospitalization from an incurable lung disease that mainly affects women, a new clinical trial shows.

Cialis combined with a blood pressure medication called ambrisentan (Letairis) significantly reduced the progression of pulmonary arterial hypertension, according to results published in the Aug. 27 issue of the New England Journal of Medicine. The condition involves high blood pressure in the arteries leading into the lungs.

People who took the combination therapy were half as likely to die, require hospitalization or have severe progression of their illness, when compared with people who only received one of the two drugs, researchers found.

The results are so encouraging that the maker of Cialis, GlaxoSmithKline, has submitted them to the U.S. Food and Drug Administration so this combination use can be added to the drug’s label, said senior study author Dr. Lewis Rubin, an emeritus professor of medicine at the University of California, San Diego School of Medicine.

Dr. Carl Pepine, past president of the American College of Cardiology, said the results “offer an easy-to-use additional treatment for patients who have this unfortunate condition, who are largely women.”

The two drugs work in different ways to ease the effects of pulmonary arterial hypertension, so researchers decided to see if their impact would be greater used in tandem, Rubin explained.

“This is a complex disease. There’s no magic bullet,” Rubin said. “We postulated that the more pathways you target, the better the effect would be.”

Pulmonary arterial hypertension causes people to be chronically short of breath, as their blood has difficulty getting through the lungs to pick up oxygen. It eventually leads to heart failure because the heart has to pump harder to keep blood circulating through the body.

Pulmonary arterial hypertension is relatively rare, Rubin said, affecting about 50,000 people in the United States. Average survival is roughly two years following diagnosis.

Cialis works by blocking PDE5, an enzyme that breaks down a substance called nitric oxide that promotes dilation of blood vessels. With more nitric oxide available, the arteries feeding the lungs are better able to dilate, increasing blood flow.

Rubin said Cialis’ sister medication Viagra also has the same effect, but is not as long-lasting.

Both Cialis and ambrisentan are FDA-approved for pulmonary arterial hypertension. But ambrisentan works by inhibiting endothelin, a substance that causes blood vessels to constrict, he said. Thus, one drug promotes dilation of blood vessels while the other works to prevent constriction.

Researchers recruited 500 people with pulmonary arterial hypertension to take part in the clinical trial. The study involved 120 medical centers in 14 countries, and ran between October 2010 and July 2014.

About half of the participants received both drugs, while one-quarter received Cialis alone and another quarter received ambrisentan alone.

Only about 18 percent of people on combination therapy died or experienced severe progression of pulmonary arterial hypertension, compared with 31 percent of people taking either ambrisentan or Cialis alone.

And it appeared that using the two drugs together produced no additional side effects, Rubin and Pepine said.

“I was impressed with the relatively good tolerability,” said Pepine, director emeritus of the cardiovascular medicine division at the University of Florida College of Medicine in Gainesville. “I think that will encourage us to use this combination treatment earlier in the course of the disease. It’s possible we might be able to prevent these women from emerging into a very symptomatic stage, where their daily activities are greatly impaired.”

The men taking the combination therapy also might derive other benefits from the Cialis, given that the dosing is higher for pulmonary arterial hypertension than it is for erectile dysfunction, Rubin said.

“These are sick patients. It’s not uncommon for the men to have erectile dysfunction because they’re sick. Clearly, some of them are deriving some off-target benefits, if you will,” Rubin said. “But their main focus is they can’t breathe and their heart is giving out.”

The clinical trial was funded by the makers of the two drugs, Gilead Sciences and GlaxoSmithKline.

More information

For more on pulmonary arterial hypertension, visit the U.S. National Institutes of Health.

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Most Don’t Need ‘Bridging’ When They Stop Warfarin Temporarily

By Amy Norton
HealthDay Reporter

WEDNESDAY, Aug. 26, 2015 (HealthDay News) — Heart patients on the clot-preventing drug warfarin usually have to stop the medication before having surgery. Now, a new study shows they can safely do that without taking another anti-clotting drug — and they may even be better off.

The study, reported in the Aug. 27 New England Journal of Medicine, helps answer long-standing questions about how to manage patients taking warfarin (Coumadin) for an irregular heart rhythm known as atrial fibrillation.

Because warfarin is a powerful anticoagulant — which means it prevents blood clots — it can also raise the risk of internal bleeding. That’s why people typically have to stop using warfarin in the days before and after an elective surgery.

But it hadn’t been clear whether those patients need what doctors call “bridging anticoagulation.” That means taking another type of anti-clotting medication that is short-acting — usually heparin.

For years, it’s been up to individual doctors and patients to decide, said Dr. Thomas Ortel, the senior researcher on the new study, and a professor of medicine at Duke University Medical Center, in Durham, N.C.

“We’ve had no clinical trial to tell us whether we need to be [bridging] at all,” Ortel explained.

Now that clinical trial is done. And, it shows that for most atrial fibrillation patients, bridging with heparin is unnecessary, Ortel said.

In fact, the study found, bridging with heparin appears to raise the risk of major internal bleeding — without any reduction in the risk of blood clots.

“For years, we’ve thought that bridging would be beneficial,” said Dr. Alfonso Tafur, a vascular medicine specialist at NorthShore University Health System, in Chicago.

“But this study shows that for the majority of (atrial fibrillation) patients, bridging puts them at unnecessary risk,” said Tafur, who was not involved in the research.

The study included nearly 1,900 patients who were having elective surgery or other invasive procedures and were taking warfarin to treat atrial fibrillation.

Atrial fibrillation is an irregular heart rhythm in which the heart’s upper chambers quiver instead of efficiently pumping blood into the lower chambers, according to the American Heart Association. It’s not immediately life-threatening, but it boosts the risk of blood clots forming in the heart. Those clots can then be pumped out of the heart and into an artery supplying the brain, causing a stroke. That’s why these patients usually take an anti-clotting drug like warfarin to prevent these clots.

A problem with warfarin is that its effects take time to kick in, and time to wear off once a person stops using it. So when warfarin patients need surgery, they typically go off the drug about five days beforehand; once they restart, it takes another five to 10 days for the warfarin to be effective again, according to background information in the study.

In this study, Ortel’s team randomly assigned patients to take either heparin or an inactive placebo during that time window.

In the end, heparin showed no effect on blood-clot risk. Just 0.3 percent of treated patients developed a clot within a month of their procedure, versus 0.4 percent of patients given the placebo, the study found.

On the other hand, heparin did boost the odds of serious bleeding. Just over 3 percent of patients developed “major” bleeding, compared with just over 1 percent of placebo patients, the study found.

The findings suggest that bridging is unnecessary for most atrial fibrillation patients, Ortel said, but there are some who still might benefit.

Tafur agreed. He said that patients who are at particularly high risk of a blood clot — such as those who’ve had a stroke in the past — might still need heparin when they go off warfarin.

For them, Tafur said, the increased bleeding risk may be offset by the anti-clotting benefit.

If your doctor does recommend bridging, Ortel said, feel free to ask why it’s necessary.

There are times when warfarin patients may not have to stop the drug at all, Tafur pointed out. With relatively simple procedures, like tooth extractions and even catheter ablation — which is sometimes used to treat atrial fibrillation — a warfarin break may be unnecessary, he said.

And what about people who are on newer clot-preventing drugs, like dabigatran (Pradaxa), rivaroxaban (Xarelto) and apixaban (Eliquis)? Those medications act differently from warfarin, Ortel said, and bridging should be unnecessary in most cases.

More information

The American Heart Association has more on treating atrial fibrillation.

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Experimental Drug for Blood Cancer Shows Promise

WEDNESDAY, Aug. 26, 2015 (HealthDay News) — An experimental immune-boosting drug shows promise in fighting the blood cancer multiple myeloma, researchers report.

Preliminary testing of the drug daratumumab included 72 multiple myeloma patients who had previously received other types of treatment. Their disease had relapsed and no longer responded to treatment.

The patients received lower or higher doses of the drug for up to two years. Of the 42 patients who received a higher dose, 36 percent had at least partial remission, including two with complete remission, researchers report.

In this group, the disease was held in check for a median of 5.6 months. The researchers also found that two-thirds of patients who benefited from the drug had no advance of their cancer for at least 12 months.

Results of the combined phase 1 and 2 study strongly support testing the drug in a larger group of patients, the researchers said.

The most common side effects reported were fatigue, nasal congestion and fever. Less common but more serious side effects included pneumonia, low platelets, low white blood cell counts, anemia and excess blood sugar.

The study, published online Aug. 26 in the New England Journal of Medicine, was funded by biotechnology company Genmab and drug company Janssen.

The treatment of multiple myeloma has improved significantly in recent years, said senior study author Dr. Paul Richardson, director of clinical research at Dana-Farber Cancer Institute’s Jerome Lipper Multiple Myeloma Center in Boston. In particular, he singled out the introduction of so-called proteasome inhibitors and other drugs that stimulate the immune system to fight the cancer.

“Unfortunately, while these agents generally work for a considerable period of time, resistance inevitably emerges, and far fewer treatment options are available in this setting,” Richardson said in a Dana-Farber news release. “Therefore, there is a great need to develop new treatments for this patient population in particular.”

More information

The American Cancer Society has more about multiple myeloma.

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A Tired Surgeon Still a Good Surgeon, Study Finds

By Emily Willingham
HealthDay Reporter

WEDNESDAY, Aug. 26, 2015 (HealthDay News) — Don’t panic if your doctor worked into the wee hours of the night before he operates on you, new research suggests.

The risk of death, hospital readmission or complications following surgery was no more likely if the surgeon pulled a midnight shift before a daytime operation, the Canadian study showed.

“I believe what we are seeing in our study reflects self-regulation — that surgeons plan around their schedules based on their individual ability to tolerate sleep deprivation,” said senior study author Dr. Nancy Baxter, surgery division chief at St. Michael’s Hospital in Toronto. “Given our findings, they seem to be doing a good job of it.”

The study was published online Aug. 26 in the New England Journal of Medicine.

Baxter’s team looked at results for almost 39,000 patients undergoing one of 12 daytime surgeries, including gallbladder removal and hysterectomy.

For the analysis, the study authors paired patients who’d had the same surgeon perform the same procedure. In each pair, one patient got the surgeon after a night shift and the other got the same doctor fresh off of at least seven hours of not treating patients. In the end, the comparison included more than 1,400 surgeons and looked at how their patients fared 30 days after their operation.

It turned out that outcomes didn’t differ between the patients based on whether or not their surgeons had worked the midnight shift before the day of surgery.

Although these findings should reassure patients planning elective surgery, Dr. Carlos Pellegrini, past president of the American College of Surgeons and chair of surgery at University of Washington Medicine in Seattle, finds them worrisome for other reasons.

He said that the study is “very polished” but added, “my only concern is that those who have been hounding this idea that we can spend all night operating and operate in the morning, don’t take this paper as saying that you can do that and have the same outcomes.”

Senior study author Baxter agreed that the results should not be interpreted that way.

“Taking away the ability for physicians to self-regulate the work they do the day after being on call would really have the potential to cause harm,” she said. “Sleep deprivation affects us all, and some people deal with it poorly and some deal with it well, and only the individual physician can really judge this.”

This study, she added, shows that the surgeons seem to be doing “a pretty good job of judging for themselves and modifying their practice accordingly.”

Pellegrini also noted that the outcomes at 30 days are only short-term measures.

“You’re not looking at little details that would otherwise be hidden and not seen,” he said. “For example, the [results of] morning operations involving cancer where you remove an extra lymph node or do a dissection that is a little more accurate would only be apparent five years later, if you survived the cancer.”

Baxter said that the Sleep Research Society has endorsed model legislation to require doctors who have been awake for 22 of the previous 24 hours to inform their patients about their sleep deprivation and obtain patient consent to move forward with procedures.

Pellegrini agreed with that idea. “I assure you from my heart that if the person to be operated on is my wife or my son and I know that the surgeon has been up for a considerable time during the night and the operation is going to be a three- to four-hour operation, I will talk to that surgeon and say, ‘Not today, wait until tomorrow,'” he said.

As for why the surgeons had equal outcomes whether they’d pulled a night shift or not, Baxter said that while it’s possible that overnight work didn’t affect their performance, she thinks that explanation is less likely than others.

“More likely the current way doctors self-regulate mitigates the harms of overnight work for their patients,” she said. “For example, surgeons who don’t tolerate sleep deprivation well may never schedule surgery the day after taking [an overnight] call.” Another thing surgeons might do, she said, is to change their surgery plans for the next day by cancelling or delaying surgeries.

That’s precisely what Pellegrini recommends. “The obligation of the surgeon is to look at how I can be in the best physical and mental shape, including lack of fatigue, to perform at my peak,” he said. “You may make that decision to say, ‘No, I’m not going to do this case in the morning because this may take me seven hours and I don’t want to be six hours into it and realize I’m dead tired.'”

More information

Visit the University of Maryland for more on preparing for surgery.

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Flu Vaccines Offer About 6 Months of Protection, Study Finds

WEDNESDAY, Aug. 26, 2015 (HealthDay News) — Flu vaccines offer moderate protection throughout most of the flu season, a new study shows.

The research included more than 1,700 Americans of all ages. The participants all got flu shots. The researchers followed them for four flu seasons, from 2010-2011 through 2013-2014.

Annual flu shots offered up to six months of protection, the study found.

“Previous studies have found that protection from contracting influenza declines over time following influenza vaccination due to decreasing antibody levels,” Dr. Jennifer Radin, of the U.S. Naval Health Research Center in San Diego, said in an American Society for Microbiology news release.

“However, we found during this study that those who received the vaccine had moderate, sustained protection up to six months post-vaccination, the duration of most influenza seasons. This means flu vaccination reduced one’s risk of a doctor’s visit by approximately 50 to 70 percent,” she explained.

The findings suggest that giving flu shots early in the fall, before the flu season begins, may prevent the greatest number of flu cases.

Radin and her colleagues also found a sharp drop in protection after six months, which shows the value of getting yearly flu shots.

The study was presented Monday at the International Conference on Emerging Infectious Diseases in Atlanta. Findings presented at meetings are generally considered preliminary until they’ve been published in a peer-reviewed journal.

More information

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

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