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Maybe You Can Forecast Your Health Better Than a Doctor

THURSDAY, Dec. 10, 2015 (HealthDay News) — How you rate your health could predict your risk of getting a cold, a new study suggests.

Psychologists from Carnegie Mellon University in Pittsburgh had 360 healthy adults between the ages of 18 and 55 complete a simple self-assessment. The results accurately predicted their susceptibility to the common cold.

The findings suggest it may be helpful for doctors to ask patients to rate their own health, according to the research team.

“Poor self-ratings of health have been found to predict poor health trajectories in older adults, including an increased risk for mortality,” said study leader Sheldon Cohen, a professor of psychology at the university.

Cohen said the link was significant even after accounting for the effects of objective indicators of health such as physical examinations, medical records and hospitalizations.

“We wanted to examine whether self-rated health predicted effective immune response in younger adults selected for their good health and whether this association was dependent on health practices and socioemotional factors,” he said in a university news release.

After completing the self-rating, the volunteers were exposed to a cold virus and monitored for five days. About one-third of them developed colds. Those who rated their health as fair, good or very good were more than two times as likely to develop a cold as those who rated their health as excellent. None of the participants rated their health as poor.

While the researchers only found an association, and not a cause-and-effect link, between self-rated health and risk of a cold or other infections, this association may be due to subtle sensations, feelings or symptoms that signal immune system problems, Cohen suggested.

“There are some things that we know about our bodies that aren’t easily detectable by our physicians,” he said.

The study was published in the November-December issue of the journal Psychosomatic Medicine.

More information

The American Academy of Family Physicians offers advice for maintaining your health.

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Not Enough Needle Exchange Programs Outside Cities: Study

THURSDAY, Dec. 10, 2015 (HealthDay News) — Injection drug users in rural and suburban areas have less access to needle exchange programs than those in cities do, even though addiction rates are rising in non-urban areas, a new study shows.

Providing injection drug users with new, sterile needles and syringes in exchange for used ones reduces their risk of contracting or spreading infections such as HIV and hepatitis C, the researchers explained.

Many needle exchange programs also provide naloxone, a medication that can reverse overdoses from heroin and narcotic painkillers.

The researchers found that 69 percent of needle exchange programs in the United States were in cities, with only 20 percent in rural areas and 9 percent in suburban areas.

The range of services provided by the programs in different locations also varied. For example, only 37 percent in rural areas offered naloxone, compared with 61 percent of those in cities.

The study was published in the Dec. 10 issue of the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

“Syringe service programs [SSPs] have been very effective in reducing HIV transmission in the U.S. and throughout the world,” said study author Don Des Jarlais, a professor of psychiatry and preventive medicine at the Icahn School of Medicine at Mount Sinai in New York City.

“Our data show that rural and suburban SSPs face some special challenges in recruiting clients, funding and staffing, but that these programs can provide the needed services when they are implemented. The biggest problem is simply that we do not have enough of them in rural and suburban areas. State and local governments can save lives by extending these programs,” Des Jarlais said in a hospital news release.

A recent study in the Journal of Urban Health found that half of all injection drug users live outside major urban areas.

CDC study co-author Ann Nugent said, “Over the last 20 years, syringe service programs have proven to be very potent weapons in the fight against HIV/AIDS.” Nugent is a senior research associate at the Baron Edmond de Rothschild Chemical Dependency Institute at Mount Sinai Beth Israel.

“The challenge today is to extend the lifesaving benefits of syringe exchange programs to all persons who need them — regardless of where they live,” she said.

More information

AIDS.gov has more on substance abuse and HIV/AIDS.

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Football Leads in College Sports Injuries, But Wrestling Most Dangerous

THURSDAY, Dec. 10, 2015 (HealthDay News) — Are you a student/athlete heading to college and hoping to steer clear of a sports injury? A new study suggests men should be careful if playing football and wrestling, and for women it’s soccer and gymnastics.

Football, especially, was the leading cause of the more than one million injuries suffered by college athletes in the United States between 2009 and 2014, according to researchers. They also found that more athletes suffered injuries during practices than during competition.

“Men’s football accounts for the most college sport injuries each year, as well as the largest proportion of injuries requiring 7 or more days before return to full participation, or requiring surgery or emergency transport,” wrote a team led by Dr. Alejandro Azofeifa, of the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA).

The researchers looked at data on injuries suffered by NCAA athletes in 25 sports between the 2009-10 and 2013-14 school years. They tabulated 1,053,370 injuries over the five years of the study, for an average of 210,674 injuries per year.

Football accounted for the most injuries, at more than 47,000 per year. The sport also had the highest rate of injuries during competition, at just under 40 per 1,000 times an athlete engaged in the sport (“athlete-exposures”).

However, when the researchers added in the relatively low rate of practice-linked injuries, the overall injury rate fell to 9.2 per every 1,000 athlete-exposures.

That means that men’s wrestling actually poses the highest risk for injury for male college athletes, with an overall rate of just over 13 injuries per 1,000 exposures.

Among women’s sports, gymnastics had the highest overall injury rate (10.4 per 1,000), as well as practice injury rate (10 per 1,000), while soccer had the highest injury rate during competitions (slightly more than 17 per 1,000).

The researchers also found that more injuries occurred during practices than during competition in all sports except men’s ice hockey and baseball. Overall, nearly 64 percent of injuries occurred during practices.

That means that efforts to curb injuries “that target not only competition, but also the more controlled practice environment” are needed, the researchers said.

The investigators stressed, however, that injuries suffered during competition did tend to be more severe than those suffered during practice. That’s probably due to “a higher intensity of activity during competitions compared with practices,” Azofeifa’s team said.

Overall, 4 percent of injuries required surgery and just under 1 percent required emergency transport.

Nearly half of all injuries suffered by college athletes were sprains or strains, and sprains and strains also accounted for about half of injuries that required athletes to sit out for at least a week, the study found.

The study appears in the Dec. 11 issue of the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

More information

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

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X-Rays May Miss Hip Arthritis, Study Finds

THURSDAY, Dec. 10, 2015 (HealthDay News) — X-rays don’t detect hip arthritis in many patients, resulting in delayed diagnosis and treatment, researchers report.

The researchers looked at information from almost 4,500 Americans taking part in two arthritis studies. In one study, only 16 percent of patients with hip pain had X-ray evidence of osteoarthritis in the hip and only 21 percent of those with X-ray evidence of arthritis had hip pain.

In the other study, the rates were 9 percent and 24 percent, respectively, according to the findings reported recently in the journal BMJ.

“The majority of older subjects with high suspicion for clinical hip osteoarthritis did not have radiographic hip osteoarthritis, suggesting that many older persons with hip osteoarthritis might be missed if diagnosticians relied on hip radiographs to determine if hip pain was due to osteoarthritis,” said study corresponding author Dr. Chan Kim.

Kim is an instructor of medicine at Boston University School of Medicine.

A missed or delayed diagnosis of hip arthritis can have serious consequences. Up to 10 percent of patients with hip arthritis don’t get enough exercise and are at increased risk for heart and lung disease, obesity, diabetes and falls, the researchers said.

“Given these findings, patients with suspected hip OA [osteoarthritis] should be treated regardless of X-ray confirmation,” Kim said in a university news release.

Hip arthritis is a major health issue that causes pain and disability. Each year, more than 330,000 hip replacements are performed in the United States, according to the researchers.

More information

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

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Depression May Be Tied to Lower Breast Cancer Survival

THURSDAY, Dec. 10, 2015 (HealthDay News) — Breast cancer patients with depression may have a much higher risk of death than those without the mental illness, a new study suggests.

“Low mood and depression are understandable reactions to a breast cancer diagnosis. Clinicians generally know to look out for this, but these findings emphasize the need to ask patients with cancer about their mood and for women to know it’s OK to ask for help,” Elizabeth Davies, of the division of health and social care research and cancer studies at King’s College London, said in a school news release.

“It is important women feel they can talk about these feelings and do not feel guilty about difficulty coping or depression, which can be a natural response to cancer diagnosis,” she added.

Although this study found a link between depression and breast cancer survival, it’s important to note that the research can’t prove cause-and-effect.

For the study, researchers reviewed the medical records of more than 77,000 women who were diagnosed with breast cancer between 2000 and 2009. The study followed the participants’ health until the end of 2010.

More than 420 of the women had a history of depression before learning they had breast cancer. More than 530 were diagnosed with depression after their cancer diagnosis.

Women with new depression had a 45 percent higher risk of death from all causes than other patients, the study found.

The link between newly diagnosed depression and increased risk of death remained even after the researchers accounted for factors such as older age, cancer stage, other illnesses and socioeconomic status.

Women with a history of depression before their cancer diagnosis also had a higher risk of death. Five years after the cancer diagnosis, 55 percent of these women were still alive, compared with 75 percent of those never diagnosed with depression, the study showed.

Depression-associated behaviors such as a less healthy lifestyle, chronic stress and being less likely to receive or comply with treatment could account for some of the increased risk of death among patients with depression, according to the researchers.

“Greater social support or psychological interventions for women with breast cancer could help to reduce the negative effects amongst those most at risk of depression,” Davies said.

The study was published recently in the journal Psycho-Oncology.

More information

Breast Cancer Research U.K. offers tips for coping with breast cancer.

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Timing May Be Key to Success of Surgery, Chemo for Early Breast Cancer

By E.J. Mundell
HealthDay Reporter

THURSDAY, Dec. 10, 2015 (HealthDay News) — The sooner early stage breast cancer patients have surgery following their diagnosis, and chemotherapy after their surgery, the better their chances of survival, two new studies find.

In one study, researchers at Fox Chase Cancer Center in Philadelphia analyzed data from more than 94,500 American women aged 66 and older. All were diagnosed with breast cancer between 1992 and 2009.

The team, led by Dr. Richard Bleicher, found a 9 percent increased risk of death from all causes for each 30-day delay in the time from diagnosis to surgery.

The link between time to surgery and risk of death from all causes was only statistically significant for patients with earlier stages of cancer, the researchers noted. In the study, delays seemed to affect prognosis for patients with stage 1 and stage 2 cancers, but not for those with stage 3 cancers.

The findings were similar when Bleicher’s team conducted a second analysis of data involving more than 115,700 American women age 18 and older, who were diagnosed with breast cancer between 2003 and 2005.

Even after adjusting for a number of other factors, a longer time to surgery was still associated with increased risk of death, the researchers found.

This is “the most comprehensive study of the subject ever performed, and includes two extraordinarily large groups from two of the largest cancer databases in the United States,” Bleicher, associate professor of surgical oncology, said in a Fox Chase news release. “The findings from the analysis answer a question that nearly every patient asks: ‘Will my prognosis be affected by the time it takes me to get to surgery?'”

Long delays were rare: Only 1.2 percent of patients in the first analysis and 1.5 of those in the second analysis had surgery more than 90 days after their breast cancer diagnosis, the researchers noted.

In a second study, researchers at the University of Texas MD Anderson Cancer Center in Houston tracked outcomes for almost 25,000 patients in California who were diagnosed with invasive breast cancer (stages 1 to 3).

The researchers wanted to see if survival was affected by the time elapsed between breast cancer surgery and the initiation of follow-up chemotherapy.

The women averaged 53 years of age and the median time to chemotherapy after their breast cancer surgery was 43 days, reported a team led by Dr. Mariana Chavez-MacGregor.

The researchers found no differences in outcomes for patients whose chemotherapy began anywhere between 31 days and 90 days after their surgery.

However, women whose post-op chemo started 91 days or longer after their surgery did fare worse. Those women had a 34 percent higher odds for death from any cause, and a 27 percent higher risk for death linked to breast cancer, compared to women whose chemo started sooner, the researchers said.

“Given the results of our analysis, we would suggest that all breast cancer patients that are candidates for adjuvant chemotherapy should receive this treatment within 91 days of surgery or 120 days from diagnosis,” Chavez-MacGregor and colleagues wrote.

“Administration of chemotherapy within this frame is feasible in clinical practice under most clinical scenarios, and as medical oncologists, we should make every effort not to delay the initiation of adjuvant chemotherapy,” they added.

Both studies were published Dec. 10 in JAMA Oncology.

Experts in breast cancer care agreed that timing is important to patient outcomes.

“Though these two studies are retrospective, and not the highest level of evidence, they nonetheless support the notion the delays of beyond 30 days in both time to surgery and time to adjuvant chemotherapy after breast surgery — especially in women with triple negative breast cancer — should kept to a minimum as much as possible,” said Dr. Charles Shapiro, director of Translational Breast Cancer Research at Mount Sinai Health System in New York City.

Another expert said that a patient’s medical team must work together to ensure that treatments occur in a timely manner.

“The best way to treat breast cancer is with a team approach,” said Dr. Frank Monteleone, chief of breast services and director of the Breast Health Center at Winthrop-University Hospital in Mineola, N.Y.

“Radiologists, breast surgeons, radiation oncologists and medical oncologists need to work together to ensure that the time between diagnosis, surgery and oncology treatment is done in the quickest time possible,” he said. “Also important is a supportive staff, including nurse navigators and social workers, to identify and reduce or eliminate barriers that will delay patients from receiving the care they need.”

Dr. Lauren Cassell, chief of breast surgery at New York City’s Lenox Hill Hospital, agreed. “There’s nothing wrong with a little helping hand in navigating the process, particularly for a patient who may be overwhelmed by her diagnosis,” she said.

More information

Breastcancer.org has more about breast cancer surgery.

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Could a Scan Someday Replace Lymph Node Biopsy?

By Alan Mozes
HealthDay Reporter

THURSDAY, Dec. 10, 2015 (HealthDay News) — Scientists are testing a noninvasive alternative to lymph node biopsy for detecting early signs that melanoma skin cancer has spread.

Patients currently undergo surgical removal, often involving a radioactiver tracer, of these lymph nodes to screen for wayward cancer cells. But researchers say that in most cases this approach uncovers no sign of cancer spread while exposing patients to unnecessary risks.

A team from Germany now reports that a new audio-visual imaging technique looks as effective as surgery for identifying melanoma metastasis.

“Thanks to the new imaging procedure, surgery will not be necessary for many patients in the future,” said study lead author Dr. Ingo Stoffels, of the department of dermatology at the Vein Center at University Hospital Essen. Nor is radiation a part of the experimental screening.

The findings were published in the Dec. 9 issue of Science Translational Medicine.

Melanoma is the fifth most common cancer in the United States, and the deadliest type of skin cancer, the study team said. Survival odds are highest the earlier a diagnosis is made, ideally before the cancer spreads through the patient’s immune-regulating lymphatic system.

The American Cancer Society says that when a patient diagnosed with melanoma is later found to have an enlarged lymph node, surgery follows. And even without lymph enlargement, high concern over the risk of melanoma spread can prompt pre-emptive surgery — what’s known as sentinel lymph node biopsy.

This type of biopsy involves insertion of a small amount of radioactive material at the site of the initial cancer diagnosis. The radioactive material is tracked as it spreads to nearby lymph nodes and, ultimately, the tell-tale “sentinel” nodes. Those nodes are then removed and assessed in a lab for signs of spread.

“We obviously have to do this type of surgery in order to ‘stage’ the cancer,” said Ashani Weeraratna, an associate professor at the Wistar Institute Melanoma Research Center in Philadelphia.

“But only about a third of patients are actually found to have metastatic cancer,” said Weeraratna, who was not part of the study team.

“There is always some risk with surgery. For example, surgery can lead to nerve damage, especially in the facial head and neck area,” she added.

With that in mind, Stoffels tested the potential of a nonradioactive and noninvasive diagnostic alternative: multispectral optoacoustic tomography (MSOT).

This system is designed to identify melanin pigment naturally found in melanoma tumor cells. Clinicians inject green dye, instead of radioactive material, into the initial cancer site, and track its spread to the key sentinel lymph nodes. Then a handheld laser pulses light through the patient’s skin and into the nodes, where it generates an ultrasound signal. That signal is then analyzed for signs of melanin. No melanin means no cancer spread, and no surgery.

In a lab setting, MSOT was applied to over 500 lymph nodes surgically removed from 214 melanoma patients. The new technique outperformed the standard diagnostic approach at correctly identifying cancer spread, the researchers said.

The technique was then applied to 20 melanoma patients who had not yet undergone surgery. The study found that MSOT accurately spotted every case of metastasis, and definitively ruled out cancer spread in almost half the patients, thereby sparing them surgery.

Stoffels said a larger follow-up study to confirm the findings is planned. He added that the technology might also help identify metastasis in patients diagnosed with breast cancer or penile cancer.

However, much more work is needed first.

“This is a really, really nice study,” said Weeraratna. “It’s a great start. But now we need to make sure that in the long-run this approach actually translates into cancer survival rates that are as good as what we have with lymph node surgery.”

More information

There’s more on melanoma at the U.S. National Cancer Institute.

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With Early Breast Cancer Treatment, Less May be More: Studies

Photo: Getty Images

Women with early-stage breast cancer have a few options when it comes to how to treat the disease. That choice can be based on the particularities of the cancer, to personal preference or, as is often the case, the recommendations of health groups, breast surgeons and oncologists. Certain data that would be helpful in informing that choice can be scant, however, including long-term health outcomes to the costs of different treatments. Now, two new studies add more nuance to the picture.

The first study, presented Thursday at the 2015 San Antonio Breast Cancer Symposium, found that mastectomies followed by breast reconstruction was both costlier and came with more complications than lumpectomies (sometimes referred to as breast-conserving therapy) followed by radiation.

In the study, Dr. Benjamin D. Smith, an associate professor and research director of the breast radiation oncology at the University of Texas MD Anderson Cancer Center, and his team used two databases to look up insurance claim information on younger and older women who were diagnosed with early-stage breast cancer in 2000 through 2011. The researchers also looked at results from the different treatment options offered to women with early-stage breast cancer. The studied authors assessed complications from the women’s treatments as well as complication-related costs and total costs.

MORE: Why Doctors Are Rethinking Breast Cancer Treatment

They found the risk for complications from mastectomy with reconstruction but without radiation was double that of lumpectomy with radiation for older and younger women. Costs from complications for the mastectomy with reconstruction was $8,608 higher compared to lumpectomy with radiation for younger women with private insurance and $2,568 higher for older women on Medicare.

One of the reasons some women opt for lumpectomy over mastectomy is that the procedure preserves the breast as much as possible. Many women who choose the mastectomy option, on the other hand, stress that it allows them to avoid radiation. (Others say they prefer surgery because they think it means they can’t have a recurrence of the cancer, which is incorrect.)

The rates of mastectomy and reconstruction rates have been on the rise in the U.S. over the last 10 years, and his study helps parse the harms associated with the procedure compared to others. “I was very surprised. I wasn’t expecting there to be such a difference, especially in terms of cost,” says Smith.

A second study led by Sabine Siesling, a senior researcher at the Netherlands Comprehensive Cancer Organisation, similarly found that breast-conserving therapy resulted in better health outcomes compared to mastectomies for women with early-stage breast cancer. Siesling and her team looked at the overall survival and disease-free survival rates among women after breast-conserving therapy or mastectomy.

They studied two groups of thousands of women with early-stage breast cancer and found that the women who underwent breast-conserving therapy were 21% more likely to still be living 10 years later compared to the women who underwent mastectomy. When looking at the smaller of the two cohorts, they also found that the women who underwent brachytherapy—an advanced procedure that that involves placing radioactive material inside your body—developed fewer regional recurrences or distant metastases (cancer that spreads from the initial organ to elsewhere in the body) compared to women who had mastectomies.

“I think this will be surprising for women because most trials and observational studies said there were similar prognosis. I think some women feel more secure if they’ve had they’ve had their breast amputated,” says Siesling. “I think the main message is that women should be very well informed at the time of decision-making.”

Dr. Mehra Golshan, a surgical oncologist at the Dana-Farber/Brigham and Women’s Cancer Center says the findings underline the basic fact that when you do a bigger surgery, there’s a longer recovery time which could contribute to more complications. “Women and and providers should know that once you do the surgery the woman should be prepared to deal with the wounds and recovery and possibility other surgeries,” he says. Golshan was not involved in the study.

Dr. Shelley Hwang, a surgical oncologist at Duke Medicine, says the findings have limitations since the women in the study get to choose what group they are in (since they choose their treatment method). There are other factors that women may take into account, like family history, that can’t be accounted for in the research design. Women who get more treatment might have a different risk, she says. “Overall, this underscores the findings of prospective randomized trials which show that breast-conserving therapy is not worse [than mastectomy], but the magnitude of benefit of breast-conserving therapy is difficult to quantify since there are imbalances in the groups,” she says. Hwang was also not involved in the trial.

This article originally appeared on Time.com.

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This Is What Happens When You Fall Asleep with Makeup On

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We’ve all been there. Whether you got caught up in an SVU marathon or that girl’s night out ran a little later than expected, sometimes you’re just too exhausted to remove your makeup before hitting the sack. This usually seems harmless enough at the time—you normally take great care of your skin, so what’s one night of laziness, right?

To find out just how bad it really is to fall asleep in makeup, we spoke with Mona Gohara, MD, an associate professor of dermatology at Yale. The bottom line, she says, is that your skin uses sleep as an opportunity to recover from the day—and makeup makes that harder to do. “At night, your skin cells are trying to regenerate and exfoliate off, so leaving a layer of makeup on creates a barrier that can lead to clogged pores and acne,” Dr. Gohara says. “One night of doing this would not be a catastrophe, but it really is a bigger issue if it becomes a habit.”

On nights when you abandon your skin care regimen, Gohara suggests giving your skin a little extra TLC the next morning. Wash your face once with a gentle cleanser, such as CeraVe Hydrating Cleanser ($10, drugstore.com), and then follow that with an exfoliator like Murad Transforming Powder Dual-Action Cleanser and Exfoliator ($30; sephora.com) to slough away dead skin cells. If you can, she also recommends giving your skin a breather by going makeup-free for the rest of the day.

To prevent future skin fails, Gohara recommends stashing makeup remover wipes like Yes to Cucumbers Face Cleanser Towelettes ($5; target.com) on your nightstand. While they’re no substitute for washing your face with cleanser and water, they’re better than nothing—and can help you avoid next-day breakouts.

RELATED: 14 Ways to Age in Reverse

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8 High-Sodium Bloat Bombs at Chain Restaurants

Photo: Getty Images

You already know that eating out can be a minefield of too-large portions, deceptive marketing (we see you, 1,000-calorie salads) and the temptation of fried appetizers and rich desserts. Being the savvy diner that you are, you already have strategies for dealing with all of the above.

But the sneaky monster of next-day bloat can be harder to fight. Why? It comes from the high sodium count in many restaurant dishes, which can be harder to sleuth out just from a menu description. It’s enough of an issue that New York City now requires chains to put a little salt shaker on menus next to dishes with more than 2,300mg sodium. (Just to put it into perspective, the American Heart Association recommends no more than 1,500mg sodium for the average person for the entire day.)

For those who live outside NYC, it’s a good idea to check your favorite eatery’s online menu before your visit not only for fat and calories, but also for sodium.

In the meantime, we dug into the menus at some of the nation’s most popular chains and found some shocking salt bombs to be avoided. We didn’t choose the biggest sodium offenders; instead, we sussed out seemingly innocuous menu items and found the scariest dishes among them.