For Refugee Children, Support Breeds Success

FRIDAY, June 3, 2016 (HealthDay News) — With adequate support, refugee children do as well in school as other youngsters, despite having more behavioral and emotional problems, a new research review finds.

Canadian researchers analyzed data from 34 studies on learning difficulties among refugee children published between 1996 and 2015.

“Despite the thousands of refugees resettled annually, there isn’t a lot of research exploring learning challenges of refugee children, and no research at all on autism spectrum disorder, language impairments or dyslexia,” said study co-author Dr. Ripudaman Minhas, a developmental pediatrician at St. Michael’s Hospital in Toronto.

“However, the existing evidence suggests that children of refugee backgrounds have the potential to perform just as well as their peers when provided with supportive resources and even have similar rates of high school completion,” Minhas added in a hospital news release.

Canada has recently accepted 25,000 Syrian refugees, many of them children.

Major risk factors for poorer school performance among refugee children include: history of trauma; low teacher and parent expectations; stereotyping by teachers; and language problems. Victims of racism and bullying are also more likely to perform poorly, the study found.

Factors associated with better school performance include: high levels of academic and life ambition; parental support and involvement in education; good home life; higher teacher expectations; and correct grade placement. Understanding and support from other students also helps, the researchers found.

Emotional and behavioral issues — such as anxiety, depression, aggression and hyperactivity — are more common among refugee children younger than 10, according to the study.

“Many refugees settled in developing or developed countries have fled situations of war, discrimination or trauma — often void of basic human rights, including consistent access to education,” Minhas said.

“Although it’s clear that refugee children’s pre-migration experiences influence their learning and can cause difficulties, some of the most important factors for success occur in the post-migration environment, many of which can be addressed in the country of settlement,” Minhas said.

The findings were published in May in the journal Pediatrics.

More information

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

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Minimally Invasive Hip Surgery Isn’t Always the Right Choice

By Chuck Green
HealthDay Reporter

FRIDAY, June 3, 2016 (HealthDay News) — Minimally invasive hip surgery may not always be the best option to relieve serious, ongoing hip pain, a new study suggests.

Researchers found that more than one-third of people in their 60s who had the minimally invasive procedure — known as hip arthroscopy — ended up needing a hip replacement within two years.

Hip arthroscopy relies on small incisions around the hip to allow for the insertion of a tiny camera, as well as surgical tools, according to the American Academy of Orthopaedic Surgeons (AAOS).

Hip arthroscopy can be used to treat a number of painful conditions, the AAOS says.

For example, the procedure can be used to repair torn cartilage or remove extra bone that occurs in the very earliest stages of osteoarthritis, explained Dr. Stuart Weinstein.

“Hip arthroscopy has been an amazing development and has helped many patients with hip disorders,” said Weinstein, chair and professor of orthopaedic surgery at the University of Iowa Carver College of Medicine. He wasn’t part of the current study team.

The use of hip arthroscopy has skyrocketed. Between 2006 and 2010, the estimated use of this surgical procedure increased by 600 percent, the study authors said.

For the study, Dr. William Schairer, who’s with the Hospital for Special Surgery in New York City, and colleagues reviewed information from two surgical databases. One was in California, the other was in Florida. The investigators found more than 7,300 patients who’d had hip arthroscopy and had at least two years of medical follow-up.

The mean age of the patients was 44. And about 60 percent of the group was female, according to the report.

Overall, 12 percent had hip replacement surgery within two years of having a hip arthroscopy, the findings showed.

People who had hip arthroscopy in hospitals that performed a high volume of those procedures were less likely to need a hip replacement within two years, the study authors said.

The researchers also found other risk factors that increased the odds of needing a hip replacement. These included older age (over 60), obesity, or arthritis related to wear and tear of the joint (osteoarthritis). Rates of hip replacement were lowest in people under 40, the study found.

Because hip arthroscopy is a relatively new procedure, Dr. Shane Nho said it wasn’t surprising that the study found some risk factors.

“Sometimes, we don’t know who the best people are to operate on until we’ve (done procedures) for a decade or two,” said Nho, an orthopedic surgeon at Rush University Medical Center in Chicago. He wasn’t involved in the current research.

In his experience, Nho said hip arthroscopy for a labral tear in the right patient is an “excellent” surgery. It helps accommodate the ability of patients to keep their own joints and maintain a healthy, active lifestyle, he said. The labrum is cartilage that acts like a seal to help keep the top of your thighbone in your hip socket.

Hip arthroscopy has been highly effective among those younger than or around ages 40 to 50, Nho added. For example, he performs about 10 to 15 hip arthroscopies a week — mostly on those in their 40s, high school or college athletes, and serious runners.

Nho said he sometimes advises patients not to have the procedure but, ultimately, it’s their call.

“Sometimes, if someone just wants to eliminate the pain, they might make a separate decision. Certainly, that’s up to them. After all, no one knows their threshold for discomfort better than they do,” Nho said.

Weinstein said people should discuss their condition with a hip expert to learn about all of their options.

The study was published recently in Arthroscopy: The Journal of Arthroscopic and Related Surgery.

More information

To find out more about hip arthroscopy, visit the American Academy of Orthopaedic Surgeons.

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Cheaper Breast Cancer Drug Does Well in Clinical Trial

FRIDAY, June 3, 2016 (HealthDay News) — For women with advanced HER2-positive breast cancer, a similar but less expensive experimental drug works just as well as the standard drug Herceptin (trastuzumab), a new study finds.

HER2-positive tumors contain certain genes that are associated with more rapid tumor growth and a worse prognosis, according to the American Cancer Society.

The new drug targeting these tumors is what’s known as a biosimilar drug — in this case, a drug similar to Herceptin. Biosimilars are designed to mimic the brand-name medicine, and are expected to produce roughly the same results in patients, the U.S. Food and Drug Administration explained.

Researchers conducted a randomized phase III clinical trial of the biosimilar trastuzumab antibody drug MYL-1401O. Their trial included 500 patients. The trial was conducted at 95 sites in Africa, Asia, Europe and Latin America.

The women received chemotherapy and either Herceptin or MYL-1401O for at least eight cycles, followed by Herceptin alone until their disease progressed.

Six months later, response rates were similar in both groups, 70 percent with MYL-1401O and 64 percent with Herceptin, the study found.

Rates of serious side effects were also similar — 36 percent in the Herceptin group and 38 percent in the MYL-1401O group. The most common serious side effect was a low white blood cell count. There was no difference in measures of heart function between the two groups. There were four treatment-related deaths in each group, the researchers reported.

The study was funded by Mylan Pharmaceuticals. The findings were scheduled to be presented Friday at the annual meeting of the American Society of Clinical Oncology, in Chicago. Study results presented at meetings are generally viewed as preliminary until they’ve been published in a peer-reviewed journal.

Herceptin “has markedly improved survival of women with HER2-positive breast cancer, but many women around the world can’t benefit from [the drug] due to its high cost,” lead study author Dr. Hope Rugo said in a society news release.

Rugo, a professor of medicine at the University of California, San Francisco, said that this is one of the first clinical trials to show equivalency of a Herceptin-like biosimilar to the brand-name drug.

“We hope that the introduction of biosimilars will expand patient access to this effective drug, which has already benefited the lives of thousands of people across the globe,” Rugo concluded.

More information

The U.S. National Cancer Institute has more about breast cancer treatment.

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‘Smart Bomb’ Targets Tough-to-Treat Breast Cancer

By Kathleen Doheny
HealthDay Reporter

FRIDAY, June 3, 2016 (HealthDay News) — A new drug therapy shows promise for treating triple-negative breast cancer, an especially aggressive form of the disease, researchers say.

A recent trial — the second of three needed for approval in the United States — found the treatment halted cancer progression for nearly six months, twice as long as other treatments, the researchers reported.

The experimental approach pairs an antibody drug with chemotherapy.

“The antibody drug finds the cancer cells and delivers the chemotherapy only to those cancer cells,” said study researcher Dr. Aditya Bardia, an attending physician at Massachusetts General Hospital Cancer Center. “That is why we are able to give a high dose of chemotherapy to the cancer cells.”

The regimen, called sacituzumab govitecan (IMMU-132), acts like a “smart bomb,” the researchers said.

The antibody targets a protein known as Trop-2 that’s found in most triple-negative breast cancers. Targeting the protein keeps damage to surrounding healthy tissues to a minimum, Bardia said.

Extending progression-free time to nearly six months “is really significant,” said Dr. Linda Bosserman, an assistant clinical professor at the City of Hope Medical Group in Rancho Cucamonga, Calif. She did not participate in the study.

Bosserman said the researchers found potentially long-term disease control for some patients.

If the results bear out, she added, “I’d have patients lining up to get this, because it has tolerable, treatable side effects with significant disease control, so they can have improved quality of life.”

The U.S. Food and Drug Administration has given the new drug “breakthrough” status, a distinction used to expedite review of promising new treatments for life-threatening conditions. A phase 3 study — the final phase needed for approval — is planned, Bardia said.

As many as one in five breast cancers are triple-negative, Bardia said. They are so named because they lack the “receptors” known to fuel most breast cancers, including estrogen, progesterone and HER2 receptors.

Currently, there is no standard chemotherapy for triple-negative breast cancers that have spread, relapsed and are resistant to treatment. The drugs doctors usually use against breast cancer aren’t very effective for this fast-growing disease, which recurs quickly. In general, they stop the cancer from progressing only for a few months, the researchers said.

On the new intravenous treatment, however, “the progression-free survival was 5.6 months, about twice as long as one would anticipate with standard chemotherapy,” Bardia said.

Median survival (half longer, half less) was 14.3 months, Bardia reported. With standard cancer drugs, median survival is about 10 to 13 months, the researchers said.

The researchers gave the drug to 62 patients with at least two previous cancer treatments. The participants got the drug once a week for two weeks in 21-day cycles until progression resumed.

About one-third had tumor shrinkage of 30 percent or more, which is termed a partial response. Two had complete remission, the researchers reported.

The two most common side effects were low white blood cell counts and diarrhea. “Both were manageable,” Bardia said. No one dropped out due to side effects.

The study was funded by Immunomedics, Inc., the drug’s maker. The results were scheduled for presentation Friday at the annual meeting of the American Society of Clinical Oncology, in Chicago. Studies presented at medical meetings are viewed as preliminary until the findings can be peer-reviewed.

More information

To learn more about triple-negative breast cancer, visit the American Cancer Society.

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1 in 5 Ovarian Cancer Patients Doesn’t Get Life-Extending Surgery: Study

FRIDAY, June 3, 2016 (HealthDay News) — Surgery may significantly extend ovarian cancer patients’ lives, but one in five women does not have the procedure, a new study finds.

“Though surgery isn’t right for every patient, we suspect that some women do not receive beneficial surgical treatment because they have poor access to specialty care,” said lead researcher Dr. David Shalowitz. He is a fellow in gynecologic oncology at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia.

“While some women may benefit more from non-surgical treatment, the results of our study showed that on average, women who received surgery lived more than four years, compared to less than one year for those who received only non-surgical treatment,” he said in a university news release.

The researchers analyzed data from more than 210,000 women diagnosed with ovarian cancer in the United States between 2003 and 2011. The investigators found that, regardless of cancer stage, those who had surgery lived an average of 57 months, compared to less than 12 months for those who had chemotherapy or radiation therapy, and 1.4 months for those who received no treatment.

The study also found that 95 percent of patients who did not undergo surgery had advanced cancer, and that among patients older than 75 with stage 3 or 4 cancer, nearly half did not have surgery and about 25 percent received no treatment.

Surgery is a standard part of treatment recommendations, the researchers said.

“Our results reinforce that patients should not be triaged away from surgical care simply because of advanced age or stage, as there seems to be a survival benefit associated with surgical treatment for these groups as well,” Shalowitz said.

“However, we were particularly concerned that nearly 23 percent of elderly patients with advanced-stage ovarian cancer received no treatment. These untreated cases warrant further investigation as they may represent sentinel cases of failure to access or deliver appropriate cancer care,” he concluded.

The findings were published online in May in the journal Gynecologic Oncology.

More information

The U.S. Office on Women’s Health has more on ovarian cancer.

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Many Take Opioids Months After Hip, Knee Replacements

FRIDAY, June 3, 2016 (HealthDay News) — A significant number of patients continue to take powerful prescription opioid painkillers many months after joint replacement surgery, a new study shows.

The findings are important because joint replacement surgery is increasingly common and there are sharply rising rates of opioid overdoses in the United States. Common prescription opioid painkillers include drugs such as OxyContin, Vicodin and Percocet.

In fact, an autopsy report released Thursday showed that music legend Prince died in April after taking fentanyl, a powerful synthetic opioid painkiller. The artist was said to have suffered from severe hip pain after years of performing intense acrobatics during his shows.

For the new study, researchers looked at 574 patients undergoing knee or hip replacement surgery. About 30 percent of the patients were taking potentially addictive opioid painkillers before their surgery. Among this group, 53 percent of knee patients and 35 percent of hip patients were still taking the narcotics six months after their surgery.

The investigators also found that among patients who did not take opioids prior to having surgery, 8 percent of knee patients and 4 percent of hip patients were still taking the painkillers six months after receiving their joint replacement.

The strongest predictor of long-term opioid use among the study participants was taking high doses of the drugs before joint replacement surgery, the study authors said.

The results suggest that some patients continue to use opioids despite improvements in their hip or knee pain.

Also, some patients who did not use opioids before joint replacement will become chronic users after the surgery. And continued narcotic painkiller use after joint replacement surgery is more common than previously believed, said researcher Jenna Goesling, from the University of Michigan in Ann Arbor.

Goesling and colleagues published their report in the June issue of the journal Pain.

One long-term goal in pain management for joint replacement patients is to find ways to help patients stop using opioids after their surgery, the researchers said in a journal news release.

More information

The U.S. Department of Health and Human Services has more about opioids.

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Report Hints Zika Can Spread Through Oral Sex

By Steven Reinberg
HealthDay Reporter

FRIDAY, June 3, 2016 (HealthDay News) — A new report from France suggests that the Zika virus can be transmitted through oral sex.

Zika is typically spread through the bite of the Aedes Aegypti mosquito, but the new case adds to building evidence that the virus may be transmitted through sexual contact more readily than thought.

Zika symptoms are typically mild in most people. However, the virus can cause a catastrophic birth defect known as microcephaly in babies born to women who become infected while pregnant. These infants are born with abnormally small heads and underdeveloped brains.

In the face of the growing reality of sexual transmission of Zika, U.N. health officials announced updated guidelines this week. The advisory urges that women planning to become pregnant wait at least eight weeks before trying to conceive if they or their partner live in — or are returning from — areas where the Zika virus is active. The guidelines had previously recommended a four-week waiting period.

And if the male partner has had symptoms of Zika infection, couples should wait six months before trying to have a baby, the World Health Organization officials added.

In the new report, doctors said a 24-year-old woman in Paris came down with Zika symptoms after having sex seven times with a 46-year-old man. The man had developed Zika symptoms just before leaving Brazil and arriving in Paris last February.

Each time, the couple had vaginal sex without ejaculation and oral sex with ejaculation, according to the report.

Dr. Yazdan Yazdanpanah, report co-author and an infectious disease specialist at the National Institute of Health and Medical Research in Paris, told The New York Times that the couple was using oral sex as a method of birth control.

The woman became sick shortly afterwards, and both she and the man were tested for presence of the Zika virus, according to the report.

The man had high levels of the virus in his semen and urine, but none in his blood or saliva. The woman had the virus in her urine and saliva, and antibodies to the virus in her blood. However, the doctors noted that they found no sign of Zika in a vaginal swab taken from the woman.

The French doctors added they can’t rule out vaginal transmission or even infection during deep kissing, since the man’s saliva was not tested while he had symptoms.

The report was published June 2 in the New England Journal of Medicine.

The vast majority of Zika infections have occurred in Latin America, with Brazil the hot zone with an estimated 5,000 cases of microcephaly. There have been no reports of Zika-induced microcephaly contracted in the United States. But two babies have been born in the United States with the birth defect after their mothers contracted the virus while traveling during pregnancy in countries where Zika is active.

And U.S. health officials have said they expect to see Zika infections in Gulf Coast states such as Florida, Louisiana and Texas as the summer mosquito season picks up.

Earlier this month, U.S. health officials reported that the number of pregnant women in the United States infected with the Zika virus had tripled because cases were now being counted in a more comprehensive way.

So far, an estimated 280 infected women are being followed in the United States and its territories, according to two registries that have been created by the U.S. Centers for Disease Control and Prevention.

Previously, only cases of pregnant women who had Zika-related symptoms or pregnancy complications were being tallied, CDC officials said. But recently published reports have found that some pregnant women show no symptoms of Zika infection, yet still give birth to babies with microcephaly.

To limit any potential spread of Zika virus via mosquitoes, health officials on the federal, state and local level are deploying a three-pronged strategy: improving mosquito control; expanding their ability to test for Zika; and urging the public to protect themselves against mosquitoes.

Women of child-bearing age who live in an active Zika region should protect themselves from mosquito bites by wearing long-sleeved shirts and long pants, using mosquito repellent when outside, and staying indoors as much as possible, according to the CDC.

More information

Visit the U.S. Centers for Disease Control and Prevention for more on the Zika virus.

This Q&A will tell you what you need to know about Zika.

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

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Many Addicts Going Without Meds That Curb Opioid Abuse

FRIDAY, June 3, 2016 (HealthDay News) — The United States is in the grip of an epidemic of opioid abuse. However, new research suggests that drugs that help addicts kick their habit after hospitalization are too seldom used.

“Given the high rates at which follow-up services are not provided,” the fact that many opioid abusers don’t get anti-addiction meds is a “concern,” says a team led by Sarah Naeger of the U.S. Substance Abuse and Mental Health Services Administration.

Her team noted that, according to 2013 federal government data, nearly 1.9 million Americans are now addicted to opioids such as Oxycontin, Vicodin, Percocet, fentanyl and even heroin. In fact, the U.S. Centers for Disease Control and Prevention estimates that more than half of all fatal drug overdoses in 2013 involved an opioid.

The issue made news again Thursday when it was revealed that an overdose of one powerful synthetic opioid painkiller, fentanyl, was behind the April 21 death of music icon Prince.

Often, addicts who overdose or encounter other drug-related issues are hospitalized. Current post-discharge recommendations include the receipt of medicines such as buprenorphine, naltrexone and methadone, to help the patient kick the opioid habit.

These medicines reduce opioid cravings, help relieve opioid-withdrawal symptoms, improve treatment adherence and reduce illegal opioid use.

But how often do these medicines actually make it to patients? To find out, Naegar’s team examined data on more than 35,000 U.S. adults under the age of 65. All were hospitalized for opioid abuse, dependence or overdose between 2010 and 2014.

In the month after leaving hospital, less than 17 percent of patients received a medication for opioid use disorder, the study found.

That could have repercussions for re-use of opioids: The study also found that in that same month, more than a fifth of patients filled an opioid painkiller prescription.

So what medicines were patients getting to help them instead? According to the study, antidepressant prescriptions were filled by 40 percent of patients, antipsychotic prescriptions were filled by 16 percent, and prescriptions for benzodiazepines (drugs such as Ativan, Valium and Xanax) were filled by 14 percent.

And, 35 percent of patients did not fill any prescriptions at all in the month after hospital discharge.

Naeger’s team also noted that more than 7 percent of patients filled prescriptions for both a benzodiazepine and an opioid painkiller. That could spell trouble, since use of the two medications together puts patients at risk for serious or life-threatening problems, the researchers said.

The fact that most addicts may not receive anti-addiction drugs after hospitalization is troubling, Naeger’s team said. These drugs “provide a safe, controlled level of medication to address the physiological effects of opioid addiction and can be safely administered for as long as needed,” the study authors said.

It isn’t clear why so many patients aren’t receiving this recommended therapy, the researchers said. “Further research will be needed,” they wrote, to determine what can be done to improve outreach and recovery for people addicted to opioids.

The study was published online June 1 in the journal Psychiatric Services in Advance.

More information

The U.S. Department of Health and Human Services has more about opioids.

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The right probiotic for a healthy gut

Without a healthy digestive system, the hours slogging it out at the gym might be worth next to nothing. We take a look at the new probiotic drink making leaps in the science of gut health, PERKii. 

The probiotic market is a flooded one, so picking the perfect product for you is all about understanding the science. 

The gut

Often labelled the body’s ‘second brain’, the gut or digestive system has a hand in all the tasks your body performs – from hormonal regulation of your metabolism and immune system to breaking down the foods you eat into the nutrients necessary for everyday tasks. If the gut’s not functioning properly, it can manifest in an array of digestive issues, such as bloating, cramping and mental fog. Low energy levels and an inability to lose weight are also common.

So why probiotics?

For the gut to function correctly it relies on a proper balance of ‘good’ and ‘bad’ gut microbiota (read: bacteria). Probiotic products – usually taken orally in tablet or drink form – are designed to facilitate this balance by providing good bacteria to the gut in large quantities.

The problem? The stomach is a highly acidic environment, which tends to kill probiotics before they can do their job. This means that when you down that probiotic capsule or dairy-based drink, you have no idea how many probiotics you are actually getting.

Plus, how many of you are dairy intolerant? If your gut is being stressed by an influx of yoghurt, the probiotics are going to do very little for you anyway.

The PERKii science

Enter, PERKii.

Born at the prestigious University of Queensland, PERKii utilises eight years of research by some of the region’s top scientists.

The difference is in the technology known as Progel™which microencapsulates the probiotics to ensure they are delivered to the gut live – without degrading or escaping in the acidic environment.

Your gut can realise the probiotic’s full benefits in a way that has never been possible before.

Using it

Unlike many probiotic products on the market, PERKii is lactose free, making it a lot easier to consume – have it with brekkie, lunch or dinner, or as a quick sip on the go; it won’t cause the same stress to your belly. In fact, since it’s made from 85 per cent water and contains just one-and-a-half teaspoons of natural sugars from apples, it won’t do any damage to your waistline either (think just 26 calories per bottle.)

Ditch the sugary soft drink or alcoholic bev, and do your health some good. Let’s just say it doesn’t taste bad either. We like. 

Get your hands on PERKii through selected retailers nationally. For more information, visit the PERKii website.

 

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Weight-Loss Surgery May Boost Survival

THURSDAY, June 2, 2016 (HealthDay News) — Weight-loss surgery might significantly lower obese people’s risk of premature death, a new study finds.

About five years after surgery, the death rate was just over 1 percent for those who had weight-loss surgery and 4 percent among those in the non-surgery group, researchers said.

For the study, the researchers — led by Christina Persson from the University of Gothenburg in Sweden — reviewed data from almost 49,000 obese people in Sweden. They were between 18 and 74 years old.

More than 22,500 people had weight-loss surgery between 2000 and 2011. The study compared them with about 26,000 people who did not have the surgery. Most of those in the surgery group had the procedure known as gastric bypass (93 percent).

According to the study, the overall death rate decreased by 57 percent in the surgery group, compared to the non-surgery group. This figure held steady after researchers adjusted for age and other previous conditions such as heart disease, cancer and diabetes.

Accidents, suicide, heart disease and cancer were the most common causes of death among those who had weight-loss surgery. Heart disease and cancer were the most common causes of death among those who did not have the surgery.

Heart disease and cancer accounted for most of the significant difference in death rates between obese people who had weight-loss surgery and those who didn’t, the researchers said.

The study was scheduled to be presented Thursday at the European Obesity Summit. Findings presented at meetings are generally viewed as preliminary until they’ve been published in peer-reviewed journals.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about weight-loss surgery.

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