Early Weight Loss With Parkinson’s May Be a Red Flag

MONDAY, Jan. 11, 2016 (HealthDay News) — People who lose weight in the early stages of Parkinson’s disease may have a more serious form of the movement disorder, according to a new study.

Parkinson’s is a chronic and progressive disease marked by tremors, impaired coordination, and slowness and/or stiffness. The cause and cure are unknown.

Weight loss is common in Parkinson’s patients, according to background information from the study. But the study findings, published online Jan. 11 in the journal JAMA Neurology, suggest that weight loss in the early stages of the disease could be a red flag for doctors.

“I suspect we may be looking at several subtypes of this disease,” study lead author Dr. Anne-Marie Wills, of Massachusetts General Hospital’s neurological clinical research institute, said in a hospital news release.

“The patients who experience early weight loss appear to have a more severe, systemic form of the disease, possibly due to involvement of the neuroendocrine system or the gastrointestinal nervous system, while those who gained weight may have a milder form of the disease,” she explained.

For the study, conducted between 2007 and 2013, the researchers examined data from more than 1,600 people who had been diagnosed with Parkinson’s within the previous five years.

Weight remained stable among 77 percent of the patients, while 9 percent lost weight and 14 percent gained weight during the study period.

Compared to those whose weight remained stable, patients who lost weight had faster worsening of symptoms, the study found. Worsening of symptoms was slowest among patients who gained weight. Rates of survival were similar for all three groups, but that may be because all were in the early stages of the disease, the researchers said.

It’s not known if maintaining or increasing weight could slow the progression of Parkinson’s.

Also, the study only found an association between early weight loss and worsening symptoms, not a cause-and-effect relationship.

“Since this is just the first observation of this association in Parkinson’s, we cannot recommend any changes to standard clinical care right now,” said Wills, who’s also an assistant professor of neurology at Harvard Medical School.

“But in my own practice, I try to prevent weight loss in patients, and I would recommend providers to be attentive to weight changes in their patients, even early in the disease,” she said.

More information

The Parkinson’s Disease Foundation has more about Parkinson’s disease.

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Scientists Spot Three More Genes Linked to Glaucoma Risk

MONDAY, Jan. 11, 2016 (HealthDay News) — The discovery of three more genes linked to the most common type of glaucoma could boost efforts to fight the eye disease, researchers report.

The three newly identified genes associated with primary open angle glaucoma bring the total number of such genes to 15, according to the study published online Jan. 11 in Nature Genetics.

“Just in time for Glaucoma Awareness Month (January), this unprecedented analysis provides the most comprehensive genetic profile of glaucoma to date,” Dr. Paul Sieving, director of the U.S. National Eye Institute (NEI), said in an institute news release.

“These findings open avenues for the pursuit of new strategies to screen for, prevent and treat glaucoma,” he added.

Glaucoma is the most common cause of irreversible vision loss, and it affects 60 million people worldwide and about 2.7 million Americans. The disease causes vision loss by increasing the fluid pressure inside the eyeball, squeezing and damaging the optic nerve, according to the NEI.

The causes of primary open angle glaucoma are believed to involve the interplay of many genes with environmental factors.

In the new study, which was funded by the National Eye Institute, the researchers pinpointed the three new genes linked with this form of glaucoma by comparing the DNA of more than 3,800 people of European ancestry with the disease, and more than 33,400 without it.

The investigators also analyzed additional data from Europe, Australia, New Zealand and Singapore.

Certain variations in the genes FOXC1, TXNRD2, and ATXN2 are associated with primary open angle glaucoma, study author Dr. Janey Wiggs said in the news release. Wiggs is the associate director of the Ocular Genomics Institute at the Massachusetts Eye and Ear Infirmary of Harvard Medical School in Boston.

All three genes are expressed in the eye, and TXNRD2 and ATXN2 are active in the optic nerve. Previous research linked FOXC1 and glaucoma, but only in rare cases of severe early onset glaucoma, the news release said.

More information

The American Academy of Ophthalmology has more about glaucoma.

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Exercise Eases Low Back Pain

MONDAY, Jan. 11, 2016 (HealthDay News) — Exercise may reduce your risk of low back pain, Australian researchers report.

They reviewed 23 studies that included nearly 31,000 people and found that exercise, alone or with education, can prevent back pain.

Specifically, exercise and education reduced the risk of a low back pain episode by 45 percent, and exercise alone reduced the risk of a low back pain episode by 35 percent and the risk of time off work due to back pain by 78 percent.

The benefits of exercise and education were reduced after one year, while the benefits of exercise alone disappeared after one year.

“This finding raises the important issue that, for exercise to remain protective against future (low back pain), it is likely that ongoing exercise is required,” Daniel Steffens, University of Sydney, Australia, and co-authors wrote.

They found no evidence that education alone, back belts or shoe inserts lowered the risk of back pain.

The study was published online Jan. 11 in the journal JAMA Internal Medicine.

More information

The American Academy of Family Physicians has more on low back pain.

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Heartburn Meds Linked to Chronic Kidney Disease

By Dennis Thompson
HealthDay Reporter

MONDAY, Jan. 11, 2016 (HealthDay News) — A type of heartburn medication called proton pump inhibitors may be linked to long-term kidney damage, a new study suggests.

Prilosec, Nexium and Prevacid belong to this class of drugs, which treat heartburn and acid reflux by lowering the amount of acid produced by the stomach.

People who use proton pump inhibitors (PPIs) have a 20 percent to 50 percent higher risk of chronic kidney disease compared with nonusers, said lead author Dr. Morgan Grams, an assistant professor of epidemiology at Johns Hopkins University in Baltimore.

The study was published Jan. 11 in JAMA Internal Medicine.

The study doesn’t establish a direct cause-and-effect relationship between the drugs and chronic kidney disease. However, Grams said, “We found there was an increasing risk associated with an increasing dose. That suggests that perhaps this observed effect is real.”

Proton pump inhibitors were used by more than 15 million Americans in 2013, according to background notes.

But as many as 70 percent of these prescriptions have been handed out inappropriately, and 25 percent of long-term users could stop taking the medication without suffering increased heartburn or acid reflux, the study authors said.

Use of the prescription heartburn drugs already has been linked to short-term kidney problems such as acute kidney injury and an inflammatory kidney disease called acute interstitial nephritis, Grams said.

Newer studies now show a link between the drugs and chronic kidney disease, in which the kidneys lose their ability to filter blood effectively.

Over time, chronic kidney disease can lead to kidney failure, forcing someone to undergo regular dialysis and possibly a kidney transplant, according to the U.S. National Institutes of Health.

In this new study, researchers used data on self-reported proton pump inhibitors use among more than 10,000 people taking part in a national study on hardening of the arteries. The researchers also evaluated data on outpatient PPI prescriptions among nearly 250,000 patients of a health care system in Pennsylvania.

From the start, PPI users in both groups were more likely to have health problems, such as obesity, high blood pressure and heart problems, the study noted.

In both groups, researchers associated use of the drugs with an increased risk of chronic kidney disease over 10 years.

The researchers also compared people using the drugs once a day with people who used them twice a day. They found twice-daily use was associated with a 46 percent increased risk of chronic kidney disease, versus a 15 percent increased risk in those taking one daily dose.

No one is sure how the drugs might damage the kidneys, but a couple of leading theories exist, Grams said. The medications can cause magnesium levels to decline in the body, and a lack of this important mineral could damage the kidneys. The kidneys also might become damaged over time if patients suffer repeated bouts of acute kidney inflammation due to proton pump inhibitors.

Gastroenterologists already are cautious regarding the use of the drugs, because they’ve been tied to other health problems such as bone fractures and infections of C. difficile and pneumonia, said Dr. Arun Swaminath, director of the inflammatory bowel disease program at Lenox Hill Hospital in New York City.

“We have started to limit the time you have to be on it, and limit the amount you take,” Swaminath said.

Because the new study isn’t a clinical trial, it doesn’t prove that PPI use causes chronic kidney disease, said Dr. Kenneth DeVault, president of the American College of Gastroenterology and chair of medicine at Mayo Clinic in Jacksonville, Fla.

“These types of studies, these big data studies, can sometimes suggest a signal that something’s going on, but I don’t know if they prove it,” DeVault said.

It’s possible that the drug users suffer chronic kidney disease more often because they have overall poorer health, he said.

Grams said the study authors tried to address that concern by comparing PPI users to people using another heartburn medication called H2 blockers. Both patient groups tended to be equally unhealthy, but PPI users had a 39 percent higher risk of chronic kidney disease, the researchers said.

While this study shouldn’t lead anyone to knee-jerk stop using proton pump inhibitors, people who use them regularly should talk with their doctor about whether they really need them, Grams and DeVault said.

“If you don’t need these medicines, you shouldn’t take them,” DeVault said. “That said, there are reflux patients with heartburn who really need the PPIs to help them with their symptoms.”

Doctors also might opt to prescribe an H2 blocker like Pepcid, Tagamet or Zantac. “To me, this is a cheaper, safer alternative that might work as well with some patients,” Swaminath said.

More information

For more on chronic kidney disease, visit the National Kidney Foundation.

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Kids With Vision-Damaging Cancers May Face Ills Later

MONDAY, Jan. 11, 2016 (HealthDay News) — Some survivors of childhood cancers that affect vision may face increased risk for long-term health and economic problems, two new studies suggest.

The studies, published online Jan. 11 in the journal Cancer, provide new insight that could help improve patient care and follow-up, the researchers say.

One study included 470 adult survivors of retinoblastoma who were followed for an average of 42 years. Retinoblastoma, the most common eye tumor of young children, can occur in one or both eyes. Most patients live for many years after treatment.

Compared to a control group of adults who never had the cancer, retinoblastoma survivors were more likely to have various types of health problems, including second cancers, the study found. This increased risk was highest among those who had retinoblastoma in both eyes. These patients are known to have a genetic risk for new cancers.

But some good news emerged, too: When the researchers excluded vision problems and new cancers, survivors who had retinoblastoma in one eye were not at higher risk for chronic health problems than the control group.

Significantly, most retinoblastoma survivors rated their health as good to excellent, suggesting these patients “maintain comparatively normal health many years after completing therapy,” Dr. Danielle Novetsky Friedman, of Memorial Sloan Kettering Cancer Center in New York City, and colleagues said in a journal news release.

Lifelong screening of these patients will enable timely treatment of any health problems they may experience, the researchers added.

The other study included 1,233 adult survivors of childhood brain tumors. Of those patients, more than 22 percent suffered vision loss.

There was no link detected between vision loss and mental health, but survivors who were blind in both eyes were at increased risk of being unemployed, unmarried and living with a caregiver.

However, the researchers saw no clear connection between less severe vision loss — such as blindness in one eye — and increased risk of such situations, Dr. Peter de Blank, of Case Western Reserve University School of Medicine in Cleveland, and colleagues said in the news release.

They noted that chemotherapy improves vision in about one-third of children with brain tumors involving visual pathways, and stabilizes vision in another third. However, they said vision will deteroriate in another third of patients despite intense treatment.

More information

The U.S. National Cancer Institute has more about retinoblastoma.

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Young Adults Would Delay Seeking Stroke Treatment: Survey

MONDAY, Jan. 11, 2016 (HealthDay News) — Immediate treatment of stroke is crucial, but a new survey finds that three-quarters of young American adults would delay going to the hospital if they had stroke symptoms.

Ideally, people with an ischemic stroke (blocked blood flow to the brain) should receive medical care within three hours to give them the best chance of restoring blood flow to the brain and minimizing or reversing stroke damage, the researchers explained.

“Timely treatment for stroke is probably more important than for almost any other medical problem there is,” Dr. David Liebeskind, professor of neurology at Ronald Reagan UCLA Medical Center in Los Angeles, said in a university news release.

“There is a very limited window in which to start treatment because the brain is very sensitive to a lack of blood flow or to bleeding, and the longer patients wait, the more devastating the consequences,” added Liebeskind. He is also director of outpatient stroke and neurovascular programs and director of the neurovascular imaging research core at the medical center.

Treatment with clot-busting drugs must begin within three hours to have optimal effect.

For the survey, the researchers asked more than 1,000 people nationwide what they would do within three hours of having common symptoms of stroke, such as weakness, numbness, and difficulty speaking or seeing.

Among those younger than 45, only about one-third said they would be very likely to go to the hospital, the survey found. And 73 percent said they would likely wait to see if their symptoms improved.

The new findings show “a real problem,” Liebeskind said. “We need to educate younger people about the symptoms of stroke and convince them of the urgency of the situation, because the numbers are going up.”

Since the mid-1990s, strokes among people younger than 45 have risen as much as 53 percent, the study authors pointed out.

Everyone should know the signs of stroke and seek immediate medical help if they or someone else experiences them, the authors stressed.

“Believe it or not, it’s on the order of minutes or hours when somebody has to seek medical attention,” Liebeskind said. “There simply is no time to wait. It’s a message that we clearly need to get to younger people more effectively.”

The study authors added that to recognize the signs of stroke and know what to do, people should memorize the acronym “FAST,” which stands for: Face drooping; Arm weakness; Speech difficulty; Time to call 911.

More information

The National Stroke Association has more on how to recognize the signs of stroke.

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Obamacare Enrollment Initiative Targets Latinos

By Karen Pallarito
HealthDay Reporter

MONDAY, Jan. 11, 2016 (HealthDay News) — With only three weeks left in the latest Affordable Care Act enrollment period, U.S. health officials and community advocates are ramping up efforts to sign up difficult-to-reach Latino Americans.

The U.S. Department of Health and Human Services (HHS), the nonprofit coalition Enroll America and other national enrollment partners have launched a “Latino Week of Action” targeting uninsured consumers in Latino communities across the country.

More than 15 national organizations are hosting local and online events this week to educate consumers and provide resources to help them sign up for health insurance coverage under the Affordable Care Act, also known as Obamacare.

“With the help of our partners, we’re going to push for a very strong finish,” HHS Secretary Sylvia Mathews Burwell said during a media briefing to announce the enrollment initiative.

Latinos have seen some of the largest coverage gains in the first two open enrollment periods under the Affordable Care Act, Enroll America President Anne Filipic said at the briefing. Yet, they remain more likely to be uninsured than other Americans.

One in five Latino American adults still lives without health coverage, she said, citing a recent Urban Institute study. And four in five still don’t know that financial help is available to lower their monthly premium.

This year’s open enrollment period, which began on Nov. 1, 2015, ends on Jan. 31.

Consumers who enroll by Jan. 15 can get Obamacare coverage effective Feb. 1. Those who sign up later in January can get coverage that begins on March 1.

For Jan. 1, 2016, coverage, consumers had to enroll by Dec. 17, 2015. That deadline reflected a two-day extension granted as a result of unprecedented demand, federal officials said.

“On Dec. 15th — our busiest day in history — we signed up 600,000 people for health coverage in just 24 hours,” Burwell said.

As of Jan. 7, approximately 11.3 million people had signed up for coverage: 8.6 million through HealthCare.gov in 38 states and another 2.7 million in 13 state-based marketplaces, the U.S. Centers for Medicare and Medicaid Services reported last week. Those numbers reflect health plan selections — not the number of people who have paid their health plan premiums, which is the final step to initiate coverage.

HHS has seen an uptick in one key demographic this open enrollment period: the number of young adults, under age 35, enrolling in coverage. Signups through Dec. 26 totaled almost 4 million, compared to 1.1 million a year ago.

“It is too early to know, and it may be not possible to know, exactly what is driving the increase in enrollment this year compared to other years because there are so many factors,” said Dr. Meena Seshamani, director of the Office of Health Reform at HHS.

One potential driver is the Affordable Care Act’s coverage mandate. People who can afford coverage but choose to remain uninsured (and don’t qualify for an exemption from the law) will pay a penalty of at least $695, or $2,085 per family, when they file their 2016 federal taxes in 2017. With the increased rates this year, the penalties can run as high as 2.5 percent of household income.

“For some, having that penalty could be motivating them to come in for coverage,” Seshamani acknowledged.

But there are those who are apparently willing to pay the penalty.

Debra Hammer, a spokeswoman for Intuit Inc., which sells tax preparation software, said 3 percent of its 30 million TurboTax customers paid the penalty by the end of last year’s tax season, with the largest group being young single adults, ages 26 to 35, with no dependents and earning less than $50,000 a year.

“But, this year we’re anticipating that it will go to about 2.5 percent given that the penalty’s going up,” she said.

Last year, 40 percent of the company’s uninsured customers qualified for an exemption from the penalty, Hammer added.

Kimberly Tweed, director of marketing and development at CompleteCare Health Network in Bridgeton, N.J., oversees a team of certified application counselors who help people in New Jersey enroll through HealthCare.gov. She said consumers are aware of the penalty and are weighing their options.

“At least when they’re buying health insurance, they’re getting something back for it,” she said.

More information

Enroll America’s Get Covered Connector can help you schedule an appointment, in English or Spanish, for enrollment assistance.

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Half of U.S. Teens Exposed to Secondhand Smoke, CDC Says

By Maureen Salamon
HealthDay Reporter

MONDAY, Jan. 11, 2016 (HealthDay News) — Despite widespread laws banning smoking in public places, new research indicates nearly half of American teens who’ve never used tobacco are exposed to harmful secondhand smoke — many in their homes and family cars.

Examining U.S. data from more than 18,000 middle school and high school students, researchers found that 48 percent reported exposure to secondhand smoke in 2013. Additionally, secondhand smoke exposure was reportedly nine times higher among never-smoking teens with no smoke-free rules in their home and car, compared to those with 100 percent smoke-free rules.

“The findings weren’t really a surprise as much as a call for public health action,” said study author Brian King, deputy director for research translation in the U.S. Centers for Disease Control and Prevention’s Office on Smoking and Health.

“The continuing research [on secondhand smoke] really helps us put a finger on who’s exposed and in what location,” he said.

The study was published online Jan. 11 in advance of the February print issue of the journal Pediatrics.

Secondhand smoke exposure is known to contribute to several health problems in children, including respiratory symptoms, impaired lung function, middle ear disease and sudden infant death syndrome, according to the study.

While 26 U.S. states and the District of Columbia have implemented comprehensive smoke-free laws prohibiting smoking in all indoor public places and work sites — including restaurants and bars — several states have no statewide laws addressing secondhand smoke in public areas, and others have less stringent restrictions.

Analyzing questionnaire responses from students in grades 6 through 12 in 2013, King and his colleagues found that 16 percent were exposed to secondhand smoke at home and 15 percent in a vehicle. Additionally, 17 percent reported secondhand smoke exposure at school, 27 percent at work and 35 percent in indoor and outdoor public areas.

“We did assess the extent of exposure based on whether youth were [protected] by smoke-free policies, and it’s no surprise that those covered by policies had lower exposure,” King said.

Regarding home and car exposure, “I think it really comes down to individual families to take that action,” he added.

Dr. Normal Edelman, senior scientific advisor for the American Lung Association, called the research “very useful.” He noted that comprehensive public no-smoking policies have helped lower U.S. smoking rates by helping some smokers break the habit.

“We’ve made great strides in protecting adults from secondhand smoke … and the health effects have been dramatic,” Edelman said. “So now it’s time to protect kids from secondhand smoke, and this [study] shows that many of our kids are exposed to at least some secondhand smoke. Clearly, if they live with smokers, they’re exposed to a lot, and I think those kids are most at risk.”

Edelman added that smoking rates — hovering at about 18 percent nationally — need to be lowered further. He agreed with King that greater implementation of smoke-free laws, along with personal policies in private homes and cars, would better protect children.

“We do a lot of things to watch out for our fellow humans, or at least we try,” Edelman said.

More information

The American Cancer Society offers more about the health risks of secondhand smoke.

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Gender Wage Gap Linked to Depression and Anxiety: Study

SUNDAY, Jan. 10, 2016 (HealthDay News) — The wage gap between American women and men might be one reason why women have higher rates of depression and anxiety, a new study suggests.

Women with lower incomes than men with similar levels of education and experience were about 2.5 times more likely to have major depression than men. But, women who had incomes similar to their male counterparts didn’t have a greater risk of depression than men, the research revealed.

“Our results show that some of the gender disparities in depression and anxiety may be due to the effects of structural gender inequality in the workforce and beyond,” study author Jonathan Platt, a Ph.D. student at the Columbia University Mailman School of Public Health’s department of epidemiology, said in a university news release.

“The social processes that sort women into certain jobs, compensate them less than equivalent male counterparts, and create gender disparities in domestic labor have material and psychosocial consequences,” he said.

The study was published in the January issue of the journal Social Science & Medicine.

The researchers looked at data gathered from more than 22,000 working adults, aged 30 to 65. The information was collected between 2001 and 2002.

Overall, women were nearly twice as likely as men to have been diagnosed with depression in the past year, the study found.

In addition to finding that women who earned less than men were far more likely to be depressed, the investigators also found that women had more than double the risk of generalized anxiety disorder in the past year.

But, again, when the researchers broke the results down by earnings, they saw the gender wage gap made a difference. Women who earned less than men had about a four times higher risk of anxiety disorder than men. The risk for women whose incomes were similar to their male counterparts was greatly decreased, the study showed.

These findings suggest that women may be more likely to place the blame for their lower income on themselves, and not on gender discrimination, the study authors said.

“If women internalize these negative experiences as reflective of inferior merit, rather than the result of discrimination, they may be at increased risk for depression and anxiety disorders,” Platt said.

According to Katherine Keyes, the study’s senior author and an assistant professor of epidemiology at Columbia: “Our findings suggest that policies must go beyond prohibiting overt gender discrimination, like sexual harassment.”

It’s commonly believed that gender differences in depression and anxiety have biological roots, Keyes said in the news release.

But, she added, “these results suggest that such differences are much more socially constructed than previously thought, indicating that gender disparities in psychiatric disorders are malleable and arise from unfair treatment.”

It’s important to note, however, that the study wasn’t designed to prove a cause-and-effect relationship between income disparity and mental health.

More information

The U.S. National Institute of Mental Health has more about depression.

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Are We Programmed to Overeat in Winter?

SATURDAY, Jan. 9, 2016 (HealthDay News) — You can blame evolution for your tendency to overeat during the winter, and for the likely failure of your New Year’s resolution to lose weight, researchers report.

Humans developed a natural urge to eat too much, but have no built-in control to keep from becoming overweight or obese, according to researchers from the University of Exeter in England.

That’s because being overweight was not a significant survival threat to our ancestors, while being underweight was dangerous. And the compulsion to maintain body fat is even stronger in the winter, when our ancestors typically had trouble finding enough food, the study authors explained in a university news release.

The investigators used computer modeling to predict how much fat humans and other animals should store. Their findings were published Jan. 5 in the journal Proceedings of the Royal Society B.

“You would expect evolution to have given us the ability to realize when we have eaten enough, but instead we show little control when faced with artificial food,” study lead author Andrew Higginson, of the College of Life and Environmental Sciences, said in the news release. “Because modern food today has so much sugar and flavor, the urge humans have to eat it is greater than any weak evolutionary mechanism which would tell us not to.”

Higginson said the model also predicts all animals and humans should gain weight when food is harder to find. “Storing fat is an insurance against the risk of failing to find food, which for pre-industrial humans was most likely in winter. This suggests that New Year’s Day is the worst possible time to start a new diet,” he said.

More information

The U.S. Centers for Disease Control and Prevention explains how to prevent weight gain.

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