Blood Test May Rule Out Too Many Donor Hearts

TUESDAY, June 21, 2016 (HealthDay News) — A blood test that’s used to check the health of a donor heart may not accurately predict if a heart transplant will be successful, a new study finds.

Placing less emphasis on this blood test could increase the number of hearts available for end-stage heart failure, the researchers said.

“Heart transplantation is an incredible therapy for patients with end-stage heart failure, but there are only 2,000 to 2,400 transplants each year,” said senior study author Dr. Snehal Patel.

“A lot of focus has been on finding ways to sign up more people as organ donors, but there is also a problem in that only an average of one in three donor hearts are placed,” explained Patel. He is an assistant professor of medicine at Montefiore Medical Center and Albert Einstein College of Medicine in New York City.

The blood test in question checks levels of a protein called troponin I. This protein enters the bloodstream when a person suffers a heart attack or other heart muscle damage, the study authors said.

“If the heart looks OK but troponin I is elevated, many centers will reject the organ out of concern that this marker indicates dysfunction of the heart that will become evident after the stress of the transplant process. We looked at whether this is true,” Patel said.

For the study, the researchers looked at how well U.S. patients did after nearly 11,000 heart transplant surgeries. The patients were all 18 and older.

The investigators found no association between donor troponin I levels and the risk of death during the year following transplant.

In addition, donor troponin I levels had no significant effect on recipients’ survival at 30 days, one year, three years or five years, the findings showed. Troponin levels also didn’t seem to affect the risk of serious complications.

The study was published in the June 21 issue of Circulation: Heart Failure.

“Our research shows that transplant centers should not exclude donor hearts based solely on elevated troponin I if the organ is otherwise suitable. At our institution it has already changed how we evaluate donors, and I think this data will lead to changes nationwide,” Patel said in a journal news release.

More information

The U.S. National Heart, Lung, and Blood Institute has more about heart transplant.

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Long Work Hours May Hurt Your Health

By Kathleen Doheny
HealthDay Reporter

TUESDAY, June 21, 2016 (HealthDay News) — Years of working long hours may help you climb the career ladder, but those hours may take a steep toll on your health — and that’s especially true for women, new research says.

“People who habitually put in a lot of long hours for many years, even decades, are really running an increased risk of potentially seeing chronic disease later in life,” said study researcher Allard Dembe. He’s a professor of health services management and policy at the College of Public Health at Ohio State University.

The link between long work hours and disease ”seems to be present a bit in men but is tremendously more evident in women,” said Dembe. While the study cannot prove cause and effect, he said, the associations were strong in women.

When the researchers compared men who worked more than 60 hours a week to those who worked 30 to 40, they found those who worked the longer hours had more than twice the risk of getting osteoarthritis or rheumatoid arthritis.

But men’s risk for other chronic or serious diseases didn’t go up substantially. In fact, those who worked 41 to 50 hours had a lower risk of heart disease, lung disease and depression, researchers noted.

But when the study compared women who worked 30 to 40 hours a week to those who worked more than 60 hours a week, women who worked more had substantially higher rates of disease. Women who worked 60 or more hours had more than three times the risk of heart disease, non-skin cancer and diabetes, nearly three times the risk of asthma, and nearly four times the risk of arthritis, the study showed.

The risks for women began to climb when they worked more than 40 hours and escalated above 50 hours. The gender differences were surprising, Dembe said, as was the strength of the increased risks he found for women.

The study included information on the working habits of nearly 7,500 U.S. men and women over more than three decades. Most of the study volunteers were over 50 toward the end of the study.

The researchers then looked to see if there was any link between work hours and the diagnosis of eight different diseases. These included heart disease, non-skin cancer, arthritis, diabetes, chronic lung disease, asthma, depression and high blood pressure, the study said.

Twenty-eight percent of those in the study worked 30 to 40 hours weekly. Most people — 56 percent — in the study worked 41 to 50 hours a week, the study said. Thirteen percent put in 51 to 60 hours weekly, while 3 percent toiled for 60 hours or more a week, the study found.

Dembe could not explain why more work hours seemed to have such an impact on women’s health, but believes that women’s multiple roles are at the root. “My speculation is, they have to balance all these other roles, parenting, child care, domestic responsibilities, worrying about everyone’s health care,” he said.

Working the long hours can interfere with sleep and keep the body in a constant state of stress, Dembe said.

The study findings make sense, said cardiologist Dr. Nieca Goldberg. She’s medical director of the Joan H. Tisch Center for Women’s Health at New York University Langone Medical Center, in New York City.

“These women [who log long work weeks] are not taking care of themselves,” Goldberg speculated. “Maybe they are not going to screening tests [such as mammograms].” Working long hours and taking care of a family may leave little time to prepare meals, she said, so these women may be eating and serving their family fast food or other takeout that is unhealthy.

Women working long hours who are single mothers may have even more responsibilities and stress, she said.

So, what can women do to protect their health? “Obviously, people need to work and pay their rent,” Goldberg said. However, she tells women who work long hours to step back and take stock. Is there something they can cut out? Perhaps doing less volunteer work until the work load on the job declines?

Goldberg said taking some time for yourself every day is crucial. That could mean getting some exercise, reading a book, watching TV or even just sitting doing deep breathing. “Clear your head,” she said.

The study was published in the Journal of Occupational and Environmental Medicine.

More information

To learn more about women and heart disease, visit SecondsCount.org.

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More Evidence Obamacare Is Lowering Numbers of Uninsured

TUESDAY, June 21, 2016 (HealthDay News) — Michigan hospitals saw a rapid decrease in the number of uninsured patients after ‘Obamacare’ helped the state expand Medicaid, researchers report.

The Healthy Michigan Plan, launched in April 2014, enrolled hundreds of thousands of low-income adults in Medicaid, the government health insurance plan, under the Affordable Care Act.

Within three months, the proportion of uninsured patients seen at the state’s 130 hospitals fell by nearly 4 percent. The proportion with Medicaid coverage rose more than 6 percent, University of Michigan researchers found.

“This is evidence that broader availability of insurance coverage for residents of Michigan is translating into coverage at the time when people are most in need of it — namely, when they are sick enough to be in the hospital,” said lead author Dr. Matthew Davis.

“The Healthy Michigan Plan appears to be shifting the balance for almost all Michigan hospitals, to have a higher proportion of patients who have insurance coverage,” Davis, a professor of health management and policy, explained in a university news release.

Overall, 94 percent of hospitals treated fewer uninsured patients. And 88 percent had more Medicaid-covered patients in the last nine months of 2014 than in the same period in the previous two years, the researchers said.

But even though more patients had coverage, hospitals did not have a sudden increase in non-elderly adult patients. There were actually slightly fewer hospitalizations statewide in the year after Medicaid expansion than in the two years before expansion, according to the study.

Some critics of Medicaid expansion feared hospitals would be swamped with pent-up demand for care, the researchers noted.

The study authors said that the findings confirm that Medicaid expansion helps relieve hospitals of the burden of caring for patients with little or no means to pay.

“When uninsured individuals are so ill they need to be hospitalized, it poses financial risks to them as well as to the hospitals that they’re admitted to,” said Davis.

“Medicaid expansion in 31 states and the District of Columbia has reduced that risk,” he added. “Meanwhile, uninsured individuals in states that haven’t expanded the program continue to face that risk — as do the hospitals there.”

The findings were published June 21 in the Journal of the American Medical Association.

More information

The U.S. Centers for Medicare & Medicaid Services has more on Medicaid.

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Exercise May Help Thwart Ovarian Cancer

TUESDAY, June 21, 2016 (HealthDay News) — Lack of exercise is associated with an increased risk of ovarian cancer and of death from the disease, two new studies suggest.

“Women may be overwhelmed with mixed messages about physical activity or exercise recommendations and opt to be inactive because they feel that they cannot meet the recommended amount of physical activity,” said Kirsten Moysich, senior author of both studies.

“Our findings suggest that any amount of regular, weekly recreational physical activity may reduce the risk for and improve survival from ovarian cancer, while a lack of regular exercise throughout adulthood is associated with an increased risk of developing and dying from ovarian cancer,” Moysich, a professor of oncology at Roswell Park Cancer Institute, in Buffalo, N.Y., said in an institute news release.

In one study, the researchers analyzed data from more than 8,300 ovarian cancer patients and more than 12,600 women without ovarian cancer. Those who said they had done no recreational physical activity during their lives were 34 percent more likely to develop ovarian cancer than those who exercised regularly, the researchers found.

The link between inactivity and a higher risk of ovarian cancer was seen in both normal-weight women and those who were overweight or obese, according to the study. The findings were recently published online in the journal Cancer Epidemiology, Biomarkers & Prevention.

The other study of more than 6,800 ovarian cancer patients found that women who were inactive in the years before the diagnosis were 22 percent to 34 percent more likely to die of the disease than those who had done at least some regular weekly exercise. Again, this was true in both normal-weight women and those who were overweight or obese.

The study was published online June 14 in the British Journal of Cancer.

“While the current evidence regarding the association between different amounts of physical activity and ovarian cancer remains mixed, our findings demonstrate that chronic inactivity may be an important independent risk and prognostic factor for ovarian cancer,” said Rikki Cannioto, first author of both studies and a research affiliate at the cancer institute.

Less than 45 percent of ovarian cancer patients survive five years, the researchers said in background notes. While these studies can’t prove that exercise would prevent these cancer deaths, they suggest regular exercise could be of benefit.

More information

The American Cancer Society has more on ovarian cancer.

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‘Love Hormone’ Gene May Be Key to Social Life

TUESDAY, June 21, 2016 (HealthDay News) — Lower activity of a specific gene may affect a person’s social behavior, including the ability to form healthy relationships, researchers say.

The OXT gene is involved in the production of oxytocin, a hormone linked with a large number of social behaviors in people. It’s sometimes referred to as the “love hormone.”

The University of Georgia team assessed more than 120 people, conducting genetic tests and assessments of social skills, brain structure and brain function.

The investigators found that those with lower activity of the OXT gene had a harder time recognizing emotional facial expressions and tended to be more anxious about their relationships with loved ones.

These low-OXT people also had less activity in brain regions associated with social thinking. And they had less gray matter in an area of the brain important for face processing and social thinking, the study found.

“All of our tests indicate that the OXT gene plays an important role in social behavior and brain function,” lead author Brian Haas, an assistant professor of psychology, said in a university news release.

These are preliminary findings and further studies are needed, but this research could lead to new and better treatments for a number of social disorders, Haas said.

The study was published June 20 in the Proceedings of the National Academy of Sciences.

More information

The American Psychological Association has more on oxytocin.

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Zika’s Delivery Via Mosquito Bite May Boost Its Effect

TUESDAY, June 21, 2016 (HealthDay News) — The inflammation caused by a mosquito bite helps Zika and other viruses spread through the body more quickly, a new study in mice suggests.

“Mosquito bites are not just annoying — they are key for how these viruses spread around your body and cause disease,” said senior study author Dr. Clive McKimmie. He is a research fellow in the School of Medicine, at the University of Leeds in England.

“We now want to look at whether medications such as anti-inflammatory creams can stop the virus establishing an infection if used quickly enough after the bite inflammation appears,” he said in a university news release.

The researchers studied the bites of the Aedes aegypti mosquito, which spreads infections such as Zika, dengue and chikungunya. When a mosquito bites you, it injects saliva into your skin. The saliva prompts immune cells to swarm the site.

But instead of helping, some of the immune cells get infected and replicate the virus, according to the study.

“This was a big surprise we didn’t expect,” McKimmie said. “These viruses are not known for infecting immune cells. And sure enough, when we stopped these immune cells coming in, the bite did not enhance the infection anymore.”

The findings suggest that it might be possible to use anti-inflammatory drugs to treat mosquito bite inflammation before any symptoms begin.

“We think creams might act as an effective way to stop these viruses before they can cause disease,” McKimmie said.

Experts note that research on animals often fails to produce similar results in humans. However, If this approach proves effective, it could be used against a large number of viruses, the researchers suggested.

Right now, the epicenter of the Zika outbreak is in Brazil, where close to 5,000 babies have been born with a devastating birth defect after their mothers were infected with Zika early in pregnancy. The affected babies have microcephaly, which is when an infant is born with an abnormally small head and brain, and other neurological problems.

U.S. health officials are increasingly worried that Zika will strike the U.S. territory of Puerto Rico and Gulf Coast states on the mainland as the mosquito season starts to heat up this summer.

“Nobody expected Zika, and before that nobody expected chikungunya,” McKimmie said. “There are estimated to be hundreds of other mosquito-borne viruses out there and it’s hard to predict what’s going to start the next outbreak.”

The study was published June 21 in the journal Immunity.

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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Nearly 10 Million Americans Are Severely Nearsighted

TUESDAY, June 21, 2016 (HealthDay News) — About 9.6 million Americans are severely nearsighted, a new study finds.

Rates of nearsightedness — also known as myopia — in the United States rose from 25 percent in the early 1970s to 40 percent around 2000, the study authors said.

Most cases of nearsightedness can be corrected with eyewear or surgery. However, severe nearsightedness can cause complications that threaten vision.

The new study is based on federal data, plus an analysis of an American Academy of Ophthalmology database. The researchers estimate that nearly 820,000 Americans have a degenerative form of myopia called progressive high myopia, which can cause weakening of the retina.

More than 40,000 of these individuals may also develop an even more serious condition called myopic choroidal neovascularization.

This is “a severe complication of myopia with abnormal fragile blood vessels growing underneath the retina that can bleed — leading to severe visual loss,” explained Dr. Mark Fromer. He is an ophthalmologist at Lenox Hill Hospital in New York City.

“This is the first study of its kind to determine the prevalence of this debilitating disease in the United States,” said Fromer, who reviewed the new findings.

Rates of progressive high myopia are higher among women than men — 0.42 percent versus 0.25 percent — and about 527,000 women have the condition, compared with 292,000 men, according to the study published online June 21 in the journal Ophthalmology.

“The findings emphasize the growing issue of nearsightedness and the burden it creates in terms of medical complications that cannot be fixed with just glasses or contacts,” study lead author Dr. Jeffrey Willis, a retina fellow at the University of California, Davis Eye Center, said in a journal news release.

More information

The U.S. National Eye Institute has more on nearsightedness.

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Fertility Treatments Not Linked to Twins’ Birth Defects

By Randy Dotinga
HealthDay Reporter

TUESDAY, June 21, 2016 (HealthDay News) — Twins born after fertility treatments may be susceptible to different — and fewer — birth defects than other twins, new research suggests.

The study confirms that twins have a higher risk of birth defects than singletons, but it questions the notion that fertility treatments contribute to those abnormalities.

“Our results suggest that the risks of specific types of birth defects in twins may be different depending on whether fertility treatments were used,” said study lead author April Dawson, a health scientist with the National Center on Birth Defects and Developmental Disabilities at the U.S. Centers for Disease Control and Prevention.

Jeffrey Roth, a research professor of pediatrics with the University of Florida, said the findings “may begin to lower the anxiety of women who receive fertility treatment that their offspring face an elevated risk of birth defects.”

Still, he said the findings are incomplete due to limited statistics about babies and their birth defects, meaning that “the take-home message from this study needs to be considered very cautiously.”

Dawson didn’t disagree. “The number of women in our study who reported use of fertility treatments was very small, limiting our ability to draw conclusions about the risk of birth defects among twins in this group.”

According to U.S. statistics, twin births have jumped 75 percent since 1980, accounting for 3.5 percent of births in 2014.

Two factors explain the rise in twins — the growth in the use of fertility treatments and greater numbers of women having kids later in life. Both boost the twin rate, specialists say.

The higher twin rate hasn’t affected the birth defect rate, however. About 3 percent of babies born each year in the United States have birth defects, or one in 33, said Dawson.

“Although the birth rate of twins has increased over time, twins are still a relatively small proportion of live births, so the impact of twin births on the overall rate of birth defects is small,” she noted.

Dawson and her colleagues launched the new study to better understand the risks of various birth defects in twins and gain insight into the role of fertility treatments on these abnormalities.

For the study, they analyzed a database of babies born from 1997-2007 in 10 U.S. states. They found the odds of several types of birth defects were higher in twins.

Those who underwent fertility treatments were linked to higher risks of five of 25 defects, but the risks for several couldn’t be calculated due to small numbers of mothers who used fertility treatments. Conceiving twins naturally was linked to higher risks of 29 of 45 defects, although again, some risks couldn’t be calculated.

“Among mothers who did not use fertility treatments to get pregnant, twins were at increased risk of many different types of birth defects, in particular ventricular septal defects [defects of the wall separating the left and right sides of the heart] and cloacal exstrophy [a defect of the abdominal wall],” Dawson said.

“Among mothers who used fertility treatments to get pregnant, twins were at increased risk of several different defects of the heart, omphalocele [a defect of the abdominal wall] and a defect of the eye,” she added.

It’s not clear why these differences in risk exist, Dawson said. As for the overall higher risk of birth defects in twins, she said there are several possibilities. Something may cause both twins and birth defects, she theorized. Or twin fetuses may suffer from a lack of space in the uterus, cutting down on blood supply and proper nutrition.

Roth stressed that the study is limited because it only goes to 2007, although the rate of twins has continued to rise since then. More recent statistics might reveal different connections between twins, fertility treatments and birth defects, he said.

The study was published June 20 in the Journal of Epidemiology & Community Health.

More information

The Children’s Hospital of Wisconsin has more about twins and birth defects.

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Most Americans Are Eating Better

By Steven Reinberg
HealthDay Reporter

TUESDAY, June 21, 2016 (HealthDay News) — More than half of Americans were eating healthier in 2012 than they were in 1999, a new study finds.

In fact, the percentage of adults with poor diets dropped from 56 percent to 46 percent during that period. By 2012, people ate more whole grains, fruit, nuts, seeds and fish while cutting back on sugar-sweetened drinks, the researchers found.

“Many Americans are starting to pay attention to healthier diets. This is encouraging, and farmers, food manufacturers, retailers and restaurants should take notice,” said lead researcher Dr. Dariush Mozaffarian. He is dean of the Tufts Friedman School of Nutrition Science and Policy in Boston.

Despite these gains, the number of Americans eating an “ideal” diet increased only slightly, from 0.7 to about 1.5 percent, the investigators found. An ideal diet includes fruits, vegetables, fish, whole grains and less meat, salt and saturated fat.

Moreover, disparities persisted in the quality of diet based on race or ethnicity, education and income. Among whites, those with a poor diet decreased from 54 percent to 43 percent. But little change was seen among blacks, Mexican-Americans and Hispanics, the findings showed.

Not only did these disparities persist, but based on income, they may have widened slightly, Mozaffarian said.

In addition, Americans weren’t eating more total fruit and vegetables, and they were still consuming too much processed meat, saturated fat and salt, he said.

A poor diet leads to poor health, particularly obesity, diabetes, heart disease and some cancers. Each year, more than 650,000 Americans die from conditions related to diet, the researchers said.

Improving America’s diet goes beyond what people can do by themselves, Mozaffarian said.

“Government, industry and advocacy efforts are needed to improve many aspects of our food system, in particular to further promote minimally processed, healthier foods and reduce refined grains, starches and sugary drinks,” he said.

Programs and policies that change the “food environment, rather than focusing on education or labeling alone, are crucial to help ensure healthier food for all,” Mozaffarian said.

“Like we’ve done for health and safety, like we’ve done for car safety, or like we’ve done for water and sanitation, we need systems approaches to improve the food system,” he said. “We do it for almost every other product, but we don’t do it for food.”

The report was published June 21 in the Journal of the American Medical Association.

For the study, Mozaffarian and colleagues collected data on nearly 34,000 adults who took part in U.S. National Health and Nutrition Examination Surveys between 1999 and 2012. In the surveys, people were asked about their diet.

Dr. Margo Denke, author of an accompanying editorial, said that “all sectors of the population are drinking fewer sugary drinks, likely because we are now drinking bottled water, and we are eating a little more whole grains.” Denke, of Bandera, Texas, was formerly with the University of Texas Southwestern Medical Center at Dallas.

“What we haven’t yet succeeded in doing is consuming less salt, more fish and shellfish, and more fruits and vegetables,” she said.

The reasons diets are changing are complex, Denke said. However, some of the lack of change is due to the cost and availability of fruits and vegetables and fish, she noted.

But people can change their diet, Denke said. Some changes are simple substitutions: bottled water instead of sugary drinks; whole grain products instead of refined-grain products; fish or shellfish two nights a week instead of chicken, beef or pork, she suggested.

Other changes involve adoption of new things: fruit instead of salty or sweet snacks, and switching to low-salt luncheon meats and canned soups, Denke added.

“Look at your mealtime plate and see if you can make half of the plate containing low-carbohydrate vegetables, such as carrots, greens, peppers, broccoli, cauliflower, beets or zucchini,” she said. “You can do it. Small changes can change your diet to a healthier one.”

More information

Visit the U.S. National Heart, Lung, and Blood Institute for more on a healthy eating plan.

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Do Too Many Lung Cancer Patients Miss Out on Surgery?

By Alan Mozes
HealthDay Reporter

TUESDAY, June 21, 2016 (HealthDay News) — Many patients with advanced lung cancer might live longer if treated surgically, but few go that route, new research indicates.

A study of U.S. patients with late-stage non-small cell lung cancer found only 11 percent underwent surgery — and 27 percent got no treatment at all. Yet surgery, either alone or with other treatments, prolonged survival by as much as 41 months, researchers said.

“We were surprised by the findings, but they have to be considered with caution,” said study lead author Dr. Elizabeth David, an assistant professor of surgery at the University of California, Davis Medical Center, in Sacramento.

“Surgery is not appropriate for every patient with stage 3 or 4 lung cancer,” she noted. “We just need to make sure that appropriate patients are evaluated by surgeons, and we are working on ways to make that easier.”

At stages 3 and 4, the cancer has spread, which reduces the odds for a cure, experts say.

Dr. Norman Edelman, senior medical advisor for the American Lung Association, said it’s not clear from the study that a more aggressive approach to surgery would in fact lead to longer survivals.

“It is easy to imagine that surgeons were selecting out those in each stage which they thought would do better based upon variables not included in this study,” he noted. It’s “human nature to want to operate on those whom they think have the best chance for a good result,” Edelman said.

Non-small cell lung cancer is the No. 1 cancer killer worldwide, taking the lives of an estimated 1.4 million adults each year, according to background notes with the study.

One problem is that the vast majority of patients don’t get diagnosed until they have late-stage disease. And the U.S. National Cancer Institute cautions that “for most patients with non-small cell lung cancer, current treatments do not cure the cancer.”

Life-prolonging treatment, such as chemotherapy and chemo/radiation combo therapy, is available. However, the benefit of surgery has been less clear.

To assess treatment outcomes, UC Davis investigators analyzed California Cancer Registry data on more than 34,000 residents with stage 3 or stage 4 non-small cell lung cancer between 2004 and 2012.

They found that the 11 percent who underwent surgery, either alone or alongside additional treatments, experienced survival benefits of up to several years.

The 27 percent who got no treatment had an average survival rate of just two months.

About 20 percent of the patients got chemotherapy only and survived an average of 11 months. One-quarter underwent combination chemo/radiation therapy, prompting a survival rate of 12 months. Radiation alone resulted in a four-month survival rate.

But patients treated with both chemotherapy and surgery saw survival rates approaching 41 months. Those who underwent chemo, radiation and surgery saw survival in excess of 33 months, while surgery alone resulted in a nearly 29-month survival. Radiation plus surgery led to a survival rate approaching 19 months, the study found.

The authors said more patients are receiving chemo and fewer are getting surgery. But they couldn’t explain why.

“Large data sets don’t tell you why things are happening, they just tell you what is happening,” said David. She added that it’s critical that patients and doctors “understand that survival is different with each treatment regimen” so they can opt for the most beneficial option available.

It’s also unclear why so many patients get no treatment. The authors suggested some patients might think the side effects aren’t worth the limited benefits, while poorer and more rural patients might have difficulty accessing treatment.

Dr. Suresh Ramalingam, assistant dean for cancer research at Emory University School of Medicine in Atlanta, said the study results should be interpreted cautiously.

The findings “should not serve as a call to perform more surgery for patients with advanced-stage [non-small cell lung cancer],” he said.

“Surgery is used in very selected instances for patients with ‘minimal burden’ disease,” Ramalingam said. “These patients are likely to do better than patients with many sites of disease, regardless of the use of surgery.”

The study findings were published June 10 in the Annals of Thoracic Surgery.

More information

There’s more information on non-small cell lung cancer treatment at the U.S. National Cancer Institute.

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