Aspirin Often Wrongly Prescribed for Atrial Fibrillation

By Steven Reinberg
HealthDay Reporter

MONDAY, June 20, 2016 (HealthDay News) — More than one-third of U.S. patients with the abnormal heartbeat atrial fibrillation who need a blood thinner to prevent strokes aren’t getting one, researchers say.

About 40 percent of “a-fib” patients deemed at moderate to severe risk of stroke because of age or other conditions are prescribed aspirin alone rather than recommended blood thinners such as Xarelto (rivaroxaban) or warfarin, according to a new study.

“Despite clear guideline recommendations that patients at risk for stroke that have atrial fibrillation should be given blood thinners, many of these patients are not prescribed these potentially lifesaving medications,” said lead researcher Dr. Jonathan Hsu. He is an assistant professor of medicine, cardiology and cardiac electrophysiology at the University of California, San Diego.

Another heart specialist agreed. “Aspirin is not an anticoagulant and is not effective in preventing strokes in patients with atrial fibrillation,” said Dr. Samuel Wann, a cardiologist at Columbia St. Mary’s Hospital in Milwaukee. Wann is co-author of an editorial published with the study.

Also, even though women are at higher risk for stroke, men are more likely to get recommended blood thinners, the researchers noted.

In atrial fibrillation, the upper chambers of the heart beat rapidly and not in sync. The consequence of this irregular heartbeat is that blood clots can form and travel to the brain, causing a stroke. Blood thinners are used to help prevent clots.

This study — based on patients from 123 cardiology practices in the United States — highlights inappropriate prescribing practices, Hsu said. Aspirin helps prevent the molecules in blood called platelets from sticking together to form clots, but it’s not a blood thinner, he explained.

Hsu suggested that some doctors may be unaware of current guidelines. Also, he said some patients may not want to take blood thinners — perhaps because of the risk for bleeding — or are unaware of their higher odds for stroke.

Warfarin (Coumadin) was introduced about 60 years ago. Besides Xarelto, newer drugs include dabigatran (Pradaxa), apixaban (Eliquis) and edoxaban (Savaysa). But some patients find the newer drugs too expensive and the need for monthly doctor visits for blood tests while on warfarin too cumbersome, Hsu said.

“Nobody ever thanks me for putting them on a blood thinner, but we know this prevents strokes,” Hsu added.

According to the latest guidelines, patients with atrial fibrillation who are 65 or older and those with at least one other condition — such as congestive heart failure, high blood pressure, diabetes or a prior stroke — should take a blood thinner. These factors are used by doctors to help assess stroke risk, Hsu said.

For the study, Hsu’s team used an American College of Cardiology registry to review medical records of more than 210,000 at-risk atrial fibrillation patients. They also conducted a secondary analysis of nearly 300,000 patients considered at-risk based on an updated guideline.

In both of these high-risk groups, roughly 40 percent were treated with aspirin and about 60 percent were prescribed a blood thinner, the investigators found.

Patients prescribed aspirin alone were more likely to be younger, thinner and female. They were also more likely to have another medical condition, such as diabetes, high blood pressure, high cholesterol, heart disease or a history of heart attack or heart bypass surgery, the findings showed.

Those prescribed blood thinners were more likely to be male, heavy, to have had a prior stroke or blood clot or congestive heart failure.

The study was published online June 20 in the Journal of the American College of Cardiology.

More information

For more on atrial fibrillation, visit the American Heart Association.

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Parkinson’s Rates Rising Among American Men

MONDAY, June 20, 2016 (HealthDay News) — Rates of Parkinson’s disease may be on the rise for U.S. men over the past three decades, and the trend could be tied to declines in smoking, a new study suggests.

“I believe this will be the first of several reports in the United States to demonstrate what the Parkinson’s Disease Foundation has come to realize — that the number of people living with Parkinson’s is dramatically undercounted,” said one expert who reviewed the findings, James Beck. He is vice president of scientific affairs at the Parkinson’s Disease Foundation.

In the new study, a team led by the Mayo Clinic’s Dr. Walter Rocca tracked long-term data on people living in Olmsted County, Minn.

The research showed that rates of Parkinson’s disease nearly doubled for men between 1996 and 2005, and the increase was steepest for men aged 70 and older.

Rates of a related condition called “parkinsonism” among men also rose sharply between 1996 and 2005.

No similar increases were seen among women, the researchers said.

The increase may stem from an otherwise very positive health trend among American men over the past few decades: A steep decline in smoking.

Prior research has suggested that smoking might reduce the risk of Parkinson’s. So, the decline in the habit among American men — after peaking in the 1940s and 1950s — might lead to higher rates of Parkinson’s decades later, the researchers theorized.

The authors of the new study emphasized that this theory has not been proven, and that their findings about declining Parkinson’s disease rates among men in Minnesota require further investigation.

“The trends could be spurious and need to be confirmed in other populations,” according to the researchers.

Beck also noted that the Minnesota population is not particularly “ethnically diverse,” so “it will be critical to see if the results hold true in other communities.”

Dr. Andrew Feigin is a neurologist and Parkinson’s expert at Northwell Health’s Neuroscience Institute in Manhasset, N.Y. He agreed that many studies “have shown that cigarette smoking is associated with a reduced risk of Parkinson’s disease, so a decline in smoking might be expected to result in an increase in [the disease].” But he also agreed that more and better studies are needed to confirm the trend.

The new report was published online June 20 in the journal JAMA Neurology.

About 1 million people in the United States suffer from Parkinson’s disease. Another 50,000 to 60,000 are diagnosed with the neurodegenerative disorder each year, according to the National Parkinson Foundation. Symptoms of the disease include shaking, tremor, slowness of movement, stiffness and trouble with balance.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more on Parkinson’s disease.

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No Amount of Lead Is Safe for Kids

MONDAY, June 20, 2016 (HealthDay News) — No amount of lead exposure is safe for children, and stricter regulations are needed to protect youngsters from this serious health threat, the American Academy of Pediatrics (AAP) says.

There’s growing evidence that even low levels of lead exposure previously considered safe can cause permanent mental, behavioral and school problems in children, according to the pediatricians’ group.

Identifying and eliminating lead sources before exposure occurs is the only reliable way to protect children from this danger, the AAP said. This requires stricter regulations, more federal resources and joint action by government officials and doctors, according to the updated AAP recommendations.

“We now know that there is no safe level of blood lead concentration for children, and the best ‘treatment’ for lead poisoning is to prevent any exposure before it happens,” Dr. Jennifer Lowry said in an academy news release. She is chair of the AAP Council on Environmental Health and an author of the policy statement.

“Most existing lead standards fail to protect children. They provide only an illusion of safety. Instead, we need to expand the funding and technical guidance for local and state governments to remove lead hazards from children’s homes, and we need federal standards that will truly protect children,” Lowry said.

The AAP added that new federal standards defining and testing for lead hazards in house dust, water and soil are needed. The group also wants to see laws that require removal of lead from contaminated housing and child care facilities, and that lead concentrations in water from school water fountains are not higher than 1 part per billion.

Until recently, children were considered to have a blood lead “level of concern” if they had a concentration of 10 or more micrograms per deciliter of blood. But evidence now suggests that problems begin at levels less than half that amount. Those problems can include lower IQ scores, poorer school performance, inattention, impulsivity, aggression and hyperactivity, the AAP said.

Protecting children from lead would save billions of dollars yearly in costs associated with lead exposure, the AAP said. For example, every $1 invested to reduce lead hazards in housing units would save society $17 to $221. The AAP said that benefit is comparable to that of childhood vaccines.

Even though lead is no longer used in gasoline, paint and many other consumer products, many sources of lead exposure still remain. For example, about 37 million U.S. homes have lead-based paint, according to the doctors’ group. The AAP said other sources include contaminated soil and water, and certain toys, hobby materials, dishware, vinyl mini-blinds and other items.

Pediatricians and other primary care providers should screen children for elevated lead levels if they are between 1 to 2 years of age and live in areas where 25 percent or more of housing was built before 1960, the AAP recommended.

The AAP also advises monitoring of children with blood lead concentrations of more than 5 micrograms per deciliter.

The recommendations were published online June 20 in the journal Pediatrics.

More information

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

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Almost 2 Million U.S. Kids Get Concussions a Year: Study

By Steven Reinberg
HealthDay Reporter

MONDAY, June 20, 2016 (HealthDay News) — Close to 2 million U.S. children and teens may suffer concussions annually, say researchers who add that the prevalence of head injuries among American youth has been underestimated for years.

Using data from hospitals, doctor visits and athletic trainers, the investigators estimated between 1 million and 1.9 million concussions occur annually among kids aged 18 and younger due to sports and recreation injuries.

But more than half a million of these head injuries aren’t seen in emergency rooms or by physicians, which is why official tallies are usually too low, they noted.

“There is a lot of uncertainty in how many concussions from sports and recreation occur each year because many concussions are not reported,” explained lead researcher Dr. Mersine Bryan, a pediatrician at the University of Washington and Seattle Children’s Hospital.

“Better surveillance for concussions due to sports and recreational activities is needed, so we can understand how kids are getting concussions and ways we can prevent concussions,” Bryan added.

These head injuries are often serious. According to the U.S. Centers for Disease Control and Prevention, a blow to the head resulting in concussion can stretch and damage brain cells and create chemical changes in the brain.

For this study, researchers used three national databases to try to target the total number of childhood concussions. Other research has typically been limited to high school head injuries or ER visits, they noted.

They found that among children diagnosed with concussion, nearly 378,000 were seen by doctors; from 115,000 to 167,000 were treated in emergency rooms; and roughly 3,000 to 5,000 were hospitalized, the researchers found.

But between 500,000 and 1.2 million concussions were reported to certified athletic trainers, the researchers added. These accounted for 23 percent to 53 percent of sports- and recreation-related concussions among high school students, Bryan said.

Concussions were tagged as sports-related if medical records mentioned a sport, whether the injury was from a fall, collision or another mechanism. Head injuries were deemed recreation-related if they occurred in playground-type settings or during activities such as bicycling or skateboarding.

One brain specialist said that even these new estimates are likely way too low.

Dr. John Kuluz, director of traumatic brain injury and neurorehabilitation at Nicklaus Children’s Hospital in Miami, said doctors’ coding errors on medical forms can result in questionable findings.

“The main problem I have with these estimates is that they are based on diagnostic codes,” he said. “Many doctors do not use the code for concussion. I see it time and again — they use a code like closed head injury, because it’s easier to click on.”

If researchers only look for the concussion code, they’ll miss a lot, Kuluz said.

A study published in May in the journal JAMA Pediatrics also found that many childhood concussions go unreported.

In that report, four out of five children were diagnosed at a primary care practice, not the emergency department.

Responding to that report, Dr. Debra Houry, a CDC injury specialist, said more must be done to track pediatric concussions treated outside the ER.

“Better estimates of the number, causes and outcomes of concussion will allow us to more effectively prevent and treat them, which is a priority area for CDC’s Injury Center,” Houry said.

Kuluz said that parents should suspect a concussion after a head injury “when their child is acting different in any way, when they are dazed or confused or dizzy — even if it’s short-lived.”

If you do suspect a concussion, take your child to an emergency room, he said.

But not every child with a bump on the head has a concussion, Kuluz said. “It’s okay to wait a day to see if the symptoms disappear. It’s not always necessary to rush your child to the emergency room,” he added.

“However, if symptoms persist or worsen, or if there is a change in their consciousness, their thinking or the way they act or are sleepy or vomiting, they should seek immediate attention,” Kuluz said.

Complete rest is essential after a concussion to help the brain heal, according to the CDC.

The report was published online June 20 in the journal Pediatrics.

More information

For more on concussion, visit the U.S. Centers for Disease Control and Prevention .

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Report Faulty Tobacco Products to FDA

SUNDAY, June 19, 2016 (HealthDay News) — If your water pipe, e-cigarette, hookah or smokeless tobacco is defective or causing a health problem, the U.S. Food and Drug Administration wants to hear from you.

To report problems related to these or any other tobacco products, you can use the agency’s online Safety Reporting Portal (see below).

“There is no known safe tobacco product, but FDA can play a role in helping prevent certain unexpected health consequences,” said Dr. Ii-Lun Chen, of the agency’s Center for Tobacco Products.

Consumers are encouraged to report problems such as: cigarettes containing mold or foreign objects; a tobacco product that smells or tastes wrong; mislabeling; fires or burns caused by tobacco products, and unexpected health problems.

These health issues might include accidental exposure of children to tobacco products; unusual reactions in long-time users, or allergic reactions or poisonings.

“FDA wants to prevent certain unexpected health consequences that could occur from defective tobacco products, as well as health or safety problems beyond those typically associated with tobacco product use,” Chen said in an FDA news release.

The portal has instructions and questions that lead consumers through each reporting section. People who can’t submit complaints online can call the Center for Tobacco Products at 1-877-CTP-1373.

More information

Here’s where you can find the FDA’s Safety Reporting Portal.

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How to Prevent Painful Swimmer’s Ear

SATURDAY, June 18, 2016 (HealthDay News) — Swimmer’s ear — a common summertime problem among children — is easy to prevent, an expert says.

“Swimmer’s ear is a bacterial or fungal infection caused by water caught in the ear canal. The tell-tale signs are swelling of the ear canal and some drainage or discharge,” said Dr. Nina Shapiro, director of pediatric otolaryngology at Mattel Children’s Hospital of the University of California, Los Angeles.

Other types of ear infections cause pain inside the ear, but swimmer’s ear causes pain when the outside of the ear is touched, Shapiro said in a university news release.

Swimmer’s ear can be prevented by using the corner of a washcloth or towel to dry ears after swimming. If a hair dryer is available, use the low setting and place the dryer about one foot away from the ear to dry it, Shapiro said.

Never use a cotton swab to clean or dry the ear canal because it can damage the ear drum, she warned.

You can get over-the-counter ear drops to prevent swimmer’s ear, but these should not be used on children who have ear tubes, ruptured eardrums or have had ear surgery, Shapiro said.

If a child does develop swimmer’s ear, doctors may prescribe anesthetic, antibiotic or antifungal ear drops, she said.

More information

The American Academy of Pediatrics has more about swimmer’s ear.

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How to Prevent Painful Swimmer’s Ear

SATURDAY, June 18, 2016 (HealthDay News) — Swimmer’s ear — a common summertime problem among children — is easy to prevent, an expert says.

“Swimmer’s ear is a bacterial or fungal infection caused by water caught in the ear canal. The tell-tale signs are swelling of the ear canal and some drainage or discharge,” said Dr. Nina Shapiro, director of pediatric otolaryngology at Mattel Children’s Hospital of the University of California, Los Angeles.

Other types of ear infections cause pain inside the ear, but swimmer’s ear causes pain when the outside of the ear is touched, Shapiro said in a university news release.

Swimmer’s ear can be prevented by using the corner of a washcloth or towel to dry ears after swimming. If a hair dryer is available, use the low setting and place the dryer about one foot away from the ear to dry it, Shapiro said.

Never use a cotton swab to clean or dry the ear canal because it can damage the ear drum, she warned.

You can get over-the-counter ear drops to prevent swimmer’s ear, but these should not be used on children who have ear tubes, ruptured eardrums or have had ear surgery, Shapiro said.

If a child does develop swimmer’s ear, doctors may prescribe anesthetic, antibiotic or antifungal ear drops, she said.

More information

The American Academy of Pediatrics has more about swimmer’s ear.

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Aging May Blunt Some of Exercise’s Benefits

FRIDAY, June 17, 2016 (HealthDay News) — Aging may dampen some beneficial effects of exercise, a new study suggests.

But, that’s no reason for seniors to morph into couch potatoes, health experts say.

For the new study, researchers compared men aged 18 to 30 with men 55 and older who used exercise bikes for 30 minutes. During that time, blood samples were collected six different times, to assess cell function and antioxidant response.

Antioxidants are believed to protect healthy cells from damage caused by unstable molecules called “free radicals,” according to the U.S. National Institutes of Health.

“Through this study, we were able to determine that an individual’s antioxidant response to exercise becomes suppressed with age,” researcher Tinna Traustadottir, an associate professor of biology at Northern Arizona University, said in a university news release.

“Exercise is effective and critical for people of all ages, but this study shows that older adults do not achieve the same beneficial cellular responses as younger adults from a single bout of moderate exercise,” she said.

“By better understanding the molecular signals promoting beneficial effects of exercise, definitive recommendations could be made for improving the body’s reaction to oxidative stress, which could lower the risk for many chronic diseases,” the researchers said.

Oxidative stress involves the overproduction of oxygen byproducts that are toxic to cells.

Still, health experts advise seniors to make exercise a key part of their lives. According to the U.S. National Institutes of Health, studies have shown that exercise “provides many health benefits and that older adults can gain a lot by staying physically active.

“Even moderate exercise and physical activity can improve the health of people who are frail or who have diseases that accompany aging,” according to the NIH.

The study was published in the July issue of the journal Free Radical Biology and Medicine.

More information

The U.S. National Institute on Aging has more about exercise and physical activity.

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Eyeliner Makeup Techniques Are Taking Over Instagram

Photo: Getty Images

Poke around any of your social media feeds for long enough and you’ll quickly discover that the techniques being employed by makeup artists, beauty vloggers, and cosmetic enthusiasts are anything by boring. Obviously, the classic cat eye is here to stay, but people are branching out and trying new eyeliner techniques. Spoiler: They are good!

These are just a few that have caught our attention recently, and we’re sure they’ll keep coming, too.

Blue on blue on blue.

We really can’t get enough rainbow eyeliner. We love that this MUA used a lot of drugstore brands to create the look, as well.

How about this super colorful, thick, outlined eyeliner? And the little gems on the inner corners make this look even more fun.

Confetti eyeliner is like a party for your face. This one kind of feels like a nod toward Seurat’s pointillism, as well.

Glitter ombre liner makes the world a better place.

We covered bubble eyeliner a little while ago, and it’s just as cool now as as it was then.

This post originally appeared on InStyle.com.

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Why IVF Made Maria Menounos Feel Self-Conscious at Her Health Cover Shoot

Photo: James White

Wouldn’t you love to chat with Health cover star Maria Menounos? Our executive editor Lisa Lombardi was lucky enough to talk with the E! star yesterday on her radio show, “Conversations with Maria,” about no-gym workouts, photo shoot insecurities, and the reality of fertility treatments.

“So how do you guys pick a cover?” Menounos asked Lombardi at the start of the show. “Like, why me?”

The answer to that question was easy: “What we look for, in general, in our cover celebrities is women who are living the life, who believe in health and fitness, and who take really good care of themselves,” Lombardi explained.

There’s no doubt that Menounos does just that. The two-time Health cover girl stays fit “pretty much year-round” by mixing up her workouts often. “I’m either hiking or I’ll play basketball or I’ll go on a kick like now that I’m on with my FitBit, and getting my steps,” Menounos said.

RELATED: Maria Menounos Opens Up About IVF: “It’s Exhausting, Physically and Mentally”

But the star admitted that she actually felt self-conscious before her recent cover shoot for Health. “This time, because I was in the middle of IVF, my body was not right,” Menounos said. Even after working out with friend and trainer Harley Pasternak for the three weeks leading up to the shoot, Menounos wasn’t feeling like herself.

Still, she said she felt grateful for the opportunity to speak openly about the challenges that accompany the IVF process. After undergoing the fertility treatment twice, she’s learned that “bloating and extra weight gain are okay and normal, and [I’m] not crazy or doing something wrong.”

The candid star also encouraged other women who are undergoing IVF to speak up. “It’s amazing to me how silent people are, that are going through this,” she said. “When it’s all secretive, no one can learn and help each other.”

RELATED: Maria Menounos Snapchats Her Egg-Retrieval Procedure

Check out the full interview below for more of the conversation.

You’ll also get a sneak peak at what’s inside our July/August issue (including wacky breast trends and avocado fudge pops!) on stands now.

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