Patient Positioning Might Hamper Accuracy of Breast MRI

WEDNESDAY, June 22, 2016 (HealthDay News) — There’s evidence that the position a woman is placed in during her pre-surgical breast MRI could influence — for better or worse — the scan’s accuracy.

The small study, from radiologists at Brigham and Women’s Hospital in Boston, suggests that MRI images taken before breast cancer surgery could provide incorrect data if the patient is placed face-down during the scan.

In contrast, “supine [face up] MRI before surgery may provide surgeons with more detailed and accurate information, and could lead to effective tumor removal,” lead researcher and radiologist Dr. Eva Gombos said in a hospital news release.

A breast MRI is commonly performed before breast cancer patients undergo breast-conserving lumpectomy, to help the surgeon see the size, shape and location of the tumor.

“The real benefit of breast MRI in a patient with breast cancer is preoperative planning, to determine if there is additional cancer in the same breast or in the other breast prior to surgery,” explained Dr. Kristin Byrne. She is a radiologist at Lenox Hill Hospital in New York City who reviewed the study findings.

However, many of these MRIs are performed while the patient is face-down.

There’s a reason for that, Byrne said. “When the patient is on her back, the breasts often droop to the sides at different angles and it can look different each time they are imaged, leading to misinterpretation,” she explained.

However, the Boston researchers noted that surgery is performed with the patient in the opposite position from the face-down direction in which she received her scan.

In the study, Gombos and colleagues looked at 12 breast cancer patients undergoing lumpectomy. Six of them ended up having MRI breast scans both before and after their surgeries.

Overall, the face-down (prone) position during MRI resulted in significant deformity (on the scan) of both the breast and the tumor’s position within the breast, according to the study published June 22 in the journal Radiology.

There was “change in size and shape caused by displacement and deformation of the tumor between standard imaging in the prone position and operative supine position,” Gombos reported.

So, study senior author Dr. Mehra Golshan suggested that conducting MRI in both the face-up and face-down positions “may help detect a remnant tumor and ensure clear margins to prevent re-operation.” Golshan, chair of surgical oncology at the hospital, noted that “among women undergoing breast-conserving surgery, 15 to 40 percent need to have a second operation to remove remnant tumor.”

Gombos stressed that the study is small and needs to be “validated in future large studies.”

For her part, Byrne said there are just too many unanswered questions from the study to draw any firm conclusions.

“Breast MRI imaging is performed with the patient face down because it allows consistency in positioning, which is important for follow-up imaging,” she said.

“Only six patients were studied and one had to go back for re-excision [of the tumor],” Byrne added. “So it’s definitely not proven that surgical management or outcome were altered in this study.”

She also noted that few U.S. hospitals currently offer breast MRI to help women and their physicians plan their surgeries. And use of this technology has its drawbacks, since “the additional time for the procedure needed puts the patient at additional risk for infection and anesthesia-associated risks,” Byrne said.

More information

The American Cancer Society has more on surgery for breast cancer.

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Daisy Ridley’s Face Mask Mishap Is All of Us

The Internet is a wide, wonderful place full of life hacks and beauty tips, unfortunately, not all advice is created equal, as actress Daisy Ridley recently learned when she searched online for at-home skin remedies.

RELATED: Daisy Ridley Posts an Awesome Message About Self-Esteem

Ridley stumbled upon a face mask recipe involving turmeric, a golden-hued spice that is known to have major skin benefits. Unfortunately, as The Force Awakens actress explains in an Instagram video, she may have been a little too heavy-handed with the stuff. While she’s still wearing the very, very yellow mask, her hands were already stained the same bright shade from applying it, leading her to believe that once she washed her face her skin would also be tinged yellow. Eeks!

Now this scenario would be bad enough for any old civilian, but Ridley was due on set of Star Wars Episode 8 in the morning and, well, they weren’t expecting her to show up with turmeric-stained skin. Kind of a problem.

She seemed hopeful the whole thing would actually turn out fine and will update her Insta followers accordingly. We’re keeping our fingers crossed.

RELATED: Watch Daisy Ridley and John Boyega Perform an Impressive Star Wars Rap

A week ago, Ridley was very open on the ‘gram about suffering from polycystic ovaries, a condition which has wreaked havoc on her skin. She has adjusted her diet to help alleviate some of the symptoms, but admitted to feeling terribly self-conscious about her appearance.

We’ve said it a thousand times and we’ll say it again—stars really are just like us…at least sometimes.

This article originally appeared on InStyle.com/MIMI.

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How One Father’s Tattoo Is Raising Awareness for Childhood Cancers

Irregular Heartbeat More Deadly in Blacks: Study

WEDNESDAY, June 22, 2016 (HealthDay News) — Black Americans with a common heart rhythm disorder are at higher risk than whites for serious heart complications and death, a new study finds.

The disorder, called atrial fibrillation, affects about 1 percent of American adults and more than 5 percent of those 65 and older. Atrial fibrillation can raise a person’s risk for stroke.

The new findings may “put the focus on improving prevention efforts for adverse outcomes in blacks with atrial fibrillation,” said study lead author and cardiologist Dr. Jared Magnani.

The research might also “drive further studies into the reasons behind why this is happening,” said Magnani, of the University of Pittsburgh Medical Center’s Heart and Vascular Institute.

The study included more than 15,000 blacks and whites, average age 54, who were followed for an average of 21 years. During that time, nearly 2,350 cases of atrial fibrillation were found. Blacks with atrial fibrillation had up to two times greater risk of stroke, heart disease, heart failure and death from all causes than whites with the same heart rhythm disorder.

“We knew blacks were likely to have an increased risk of stroke, but the findings for heart failure, [heart disease] and mortality are novel and important,” Magnani said in a university news release.

“There needs to be further investigation,” added Magnani, who completed his research while at Boston University School of Medicine. “It’s going to be important to dissect the mechanisms behind why blacks with atrial fibrillation are highly more likely to have adverse outcomes than whites.”

Cardiologists Dr. Thomas Stamos and Dr. Dawood Darbar, from the University of Illinois at Chicago, wrote an accompanying editorial on the study. They noted that it’s only the latest to show “cardiovascular disorders with either an increase in incidence or worse outcome in black individuals compared with white individuals.

“The reason for these disparities remains unclear,” they added. “Despite an intense search over the last decade, no consistent genetic cause has been identified. What is known is that there are a number of socioeconomic factors found more commonly among black individuals that strongly correlate with worse cardiovascular outcomes.”

The study was published online June 22 in the journal JAMA Cardiology.

More information

The U.S. National Heart, Lung, and Blood Institute has more on atrial fibrillation.

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A Little Guidance Is Key to Getting That Cancer Screen

WEDNESDAY, June 22, 2016 (HealthDay News) — The use of patient navigators — people who help patients receive health care services — improved cancer screening rates among low-income and ethnic minority patients, a new study reports.

“These findings demonstrate how effective patient navigators can be for patients who, for a variety of reasons, encounter obstacles to receiving cancer screening,” said study author Dr. Sanja Percac-Lima. She is physician leader for cancer outreach at the Massachusetts General Hospital (MGH) Center for Community Health Improvement.

“Health disparities pose a major challenge to low-income and ethnic minority patients, and our study suggests a proactive approach may help increase their chances of receiving the care they need,” Percac-Lima explained in a hospital news release.

The research included more than 1,600 patients at 18 MGH primary care practices. The patients were overdue for breast, cervical and/or colorectal cancer screenings. They were considered at-risk of not getting the screenings based on previous missed appointments. In addition, their primary language was not English.

Of those patients, almost 800 were assigned a patient navigator. The patient navigator contacted patients in their own language, educated and encouraged them, arranged transportation and accompanied them to screening visits, and helped overcome other barriers to screening.

Thirty-two percent of patients with a patient navigator completed at least one overdue screening. Just 18 percent of patients without a patient navigator completed at least one late cancer screening, according to the study.

“Patient navigators provide a critical bridge between patients and caregivers that enhances and improves care. By employing these types of tactics, we can address critical health disparities for at-risk communities,” concluded Percac-Lima. She’s also an assistant professor of medicine at Harvard Medical School in Boston.

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

More information

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

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Australia’s Gun Laws Silence Mass Shooters

WEDNESDAY, June 22, 2016 (HealthDay News) — Since tighter gun laws were introduced in Australia 20 years ago, there hasn’t been a single mass shooting in that country, researchers report.

There has also been a large decline in overall gun-related deaths in Australia since the laws were enacted, the study found.

“We are unaware of any other nation that has enacted such a substantial change in gun laws as has been implemented in Australia,” Simon Chapman, of the University of Sydney, and colleagues wrote in the report.

“Comparative studies of Australia’s experience with broadly comparable nations would provide further evidence of the effects of such law reform,” the study authors concluded.

These findings come in the wake of the mass shooting at the Pulse nightclub in Orlando, Fla., and failed attempts to pass gun-control legislation in the United States. Although the United States represents only 5 percent of the world’s population, about 31 percent of all public mass shootings originate in America, a report from CNN estimates.

Australia introduced its sweeping gun laws in 1996. The laws were developed in response to a mass shooting that killed 35 people and wounded 19 others. The male shooter used two semiautomatic rifles. The new law banned such weapons, including rapid-fire long guns already owned by Australians, the study authors explained.

By early 1997, all six states and two territories in Australia had a mandatory buyback program. Gun owners were paid market price when they turned in their prohibited firearms. By the fall of 1997, severe criminal penalties could be imposed if someone still had a rapid-fire long gun. Those penalties included heavy fines and the possibility of jail, the researchers said.

Between 1979 and 1996 — before the gun laws were enacted — there were 13 fatal mass shootings in Australia. A fatal mass shooting was defined as five or more victims, not including the shooter, according to the report.

Between 1997 and May 2016 — after the gun law reform — there were no fatal mass shootings, the researchers noted.

In addition, the average rate of gun-related deaths fell from 3.6 per 100,000 people in 1979-1996 to 1.2 per 100,000 people in 1997-2013, the findings showed.

There was also a significant downward trend in gun-related suicides, the study revealed, but the difference in gun-related murders was not statistically significant.

Findings from the study were published online June 22 in the Journal of the American Medical Association.

According to Daniel Webster, the author of an accompanying journal editorial, the findings from Australia show “how a nation can come together to forge lifesaving policies despite political and cultural divides.”

Similar gun-control policies would be unlikely in the United States due to political, cultural and legal challenges, added Webster, who is from the Johns Hopkins Bloomberg School of Public Health in Baltimore.

Australia was also able to enact comprehensive regulations to limit the misuse of handguns, Webster said. These laws are more restrictive than anywhere in the United States, even in areas with strict gun laws, he noted.

Australian citizens, professional organizations and academic researchers were all involved in demanding that their lawmakers adopt measures to prevent the terror of gun violence and the tragic loss of life, Webster pointed out.

“Citizens in the United States should follow their lead,” he concluded.

More information

There’s more about gun violence at the Brady Campaign to Prevent Gun Violence.

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Everything You Need to Know About the Bullet Journaling Trend

Doctor’s appointments, upcoming deadlines, your grocery list. It can be difficult to keep track of everything when you have so much going on. And no matter how many apps you download or reminders you set on your phone, important tasks can still get lost in the day-to-day shuffle.

If you struggle to get organized, you may want to try your hand at bullet journaling, a popular trend that promises to help you master your schedule once and for all.

RELATED: 4 Genius New Ways to Stay Motivated Toward Any Goal

Bullet journaling (or #bujo, as it’s known on social media) was developed by Ryder Carroll, a Brooklyn-based art director. Bullet journals are notebooks customized with daily and monthly to-do lists that are structured in short, bulleted sentences (hence the name).

To get started, all you need is a notebook and a pen. According to Carroll’s website, any blank notebook will work. But many #bujo fans swear by the Behance Dot Grid Book ($33; amazon.com) or the Moleskine Classic Notebook ($18, amazon.com).

Bullet journals are built around four “modules” that you create when setting up your notebook:

• The index: The first few pages of your bullet journal where you add the topics of your collections (such as shopping lists or reading lists) as well as page numbers for easy reference.

• Future log: A list of items that need to be scheduled months in advance and don’t require your immediate attention.

• Monthly log: A reference page that includes a calendar and a list of tasks to be completed that month.

• Daily log: This is for day-to-day use, where you simply “rapid log” your to-dos for the day—meaning you jot down tasks in quick sentences.

RELATED: The Healing Powers of Keeping a Journal, and 3 Ways to Stick to It

Unlike other productivity apps or paper planners, bullet journals are flexible enough that you can customize them to your schedule or organizational style. The handy index at the front of the journal makes it easy to find what you’re looking for (say, that upcoming fundraiser, or meeting with your boss), and rapid logging makes you more likely to actually use your journal, since shorter entries require less effort.

Intrigued? Check out Carroll’s helpful video above for more instructions. Then get inspired by these beautiful journals we’ve spotted on Instagram.

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Many Male Docs May Overlook Female Heart Risks: Study

WEDNESDAY, June 22, 2016 (HealthDay News) — Many male primary care doctors regard heart disease as a man’s issue and don’t assess risk in female patients, a new French study finds.

Many of these physicians “will be surprised by our findings, and I hope this will help them ensure they assess [heart] risk equally in their male and female patients,” said lead author Dr. Raphaelle Delpech. She’s a primary care physician at INSERM, the French National Institute of Health and Medical Research.

Delpech’s team looked at more than 2,200 patients seen by 52 primary care physicians. Information on heart disease risk factors such as smoking, blood sugar and cholesterol were recorded less often in the medical files of female patients than males, the study found.

This lack of information makes it more difficult to assess heart disease risk, according to the study published June 21 in the European Journal of Preventive Cardiology.

“It appears that [primary care doctors] are more attentive to these factors in their male patients,” Delpech said in a journal news release.

“This could be because [heart disease] is more frequent among men, who have historically been more likely to adopt risky habits like smoking,” Delpech added.

The patients who were least well assessed for heart risk were women seen by male primary care physicians, she noted.

Female doctors may, ” follow guidelines more routinely and are less likely to vary their practice, especially according to their patients’ gender,” Delpech said.

Assessing heart risk in all patients — regardless of their sex — is another step toward reducing deaths from this disease in both men and women, she concluded.

Heart disease is the number one killer worldwide, according to the World Health Organization.

Deaths from heart disease have fallen since the 1980s, but more so in men than in women, Delpech said.

“We know that men receive better cardiovascular [heart] care and secondary prevention after a first event. We hypothesized that primary prevention might also be better in men,” she added.

More information

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

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Behavior Woes Hamper Boys More Than Girls in School: Study

WEDNESDAY, June 22, 2016 (HealthDay News) — Behavior problems are more likely to hold boys back in school than girls, a new study shows.

“When I compared 4- and 5-year-old boys and girls who had the same levels of behavior problems — including difficulty sustaining attention, regulating emotions, delaying gratification, and forming positive relationships with teachers and peers — I found that boys were less likely to learn and more likely to be held back in school,” said study author Jayanti Owens. She is a professor at Brown University in Rhode Island.

“My study also showed that the way schools respond to boys’ behaviors plays a significant role in shaping their educational outcomes years later,” Owens said in an American Sociological Association news release.

“Relative to the other early childhood family and health factors I considered, gender differences in both students’ behavior and educators’ responses to behavior problems explained more than half [59 percent] of the gender gap in schooling completed among adults,” Owens added.

The findings are based on an analysis of data from children in the United States born to women in their early- to mid-20s in the 1980s and followed into adulthood.

In elementary school, boys reported significantly greater exposure to negative school environments and peer pressure compared to girls, the study found. In high school, boys reported significantly higher rates of grade repetition and lower educational expectations.

“Although the same behaviors have a worse impact on boys’ education, it is also the case that, on average, boys start school with higher levels of behavioral problems than girls,” Owens noted.

“That boys typically have worse behaviors when they start school may help explain why their behaviors are more detrimental to achievement — stereotypes about boys’ bad behavior may cause educators to take more and harsher actions against male students. This process may lead to a compounding and cyclical relationship between boys’ behavior problems and lower achievement,” Owens explained.

More support at home and in school could help encourage these boys to develop self-regulation and social skills early in life, she suggested.

The study was released online June 22 in the journal Sociology of Education.

More information

The American Academy of Pediatrics has more about child behavior.

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Alternative Medicine Taking Hold Among Americans: Report

By Dennis Thompson
HealthDay Reporter

WEDNESDAY, June 22, 2016 (HealthDay News) — Americans spend a good chunk of their health care dollars on alternative medicine, such as acupuncture, yoga, chiropractic care and natural supplements, a new government report shows.

In fact, they paid more than $30 billion out of pocket in 2012 on chiropractors and other complementary health practitioners, as well as supplements and other forms of alternative medicine.

“Substantial numbers of Americans spent billions of dollars out-of-pocket on these approaches — an indication that users believe enough in the value of these approaches to pay for them,” said study co-author Richard Nahin.

He is lead epidemiologist at the U.S. National Center for Complementary and Integrative Health.

Expenditures in 2012 included:

• $14.7 billion out-of-pocket on visits to complementary practitioners such as chiropractors, yoga instructors, acupuncturists or massage therapists — nearly 30 percent of what people spent on traditional medical services.
• $12.8 billion on natural product supplements, which was about one-quarter of what people spent on prescription drugs.
• $2.7 billion on books, CDs, videos and other self-help materials related to complementary health.

Overall, spending on complementary medicine amounted to just over 9 percent of out-of-pocket health care expenditures and about 1 percent of all money spent on health care in the United States, the researchers found.

Most of this alternative health care is being used by adults, not children, the report found. The researchers said about $28 billion was spent on adults, compared with just $1.9 billion for children.

Even people with lower incomes spend quite a bit on complementary medicine, according to the report published June 22 in the National Health Statistics Reports.

Nahin and his colleagues found that families making less than $25,000 a year spent, on average, $314 out-of-pocket on visits to complementary health practitioners in 2012, and an average $389 on natural supplements.

“That’s telling us that even people with low incomes are willing to spend a substantial amount on these products and interventions,” Nahin said.

Families earning much higher incomes — $100,000 or more a year — spent an average of $518 on complementary practitioners and an average of $377 on supplements, the findings showed.

Other data suggests that there are trends within complementary medicine regarding the popularity of different approaches.

For example, Nahin explained, the use of yoga has increased dramatically, while chiropractic care and massage therapy has tended to remain level.

“Yoga is going up because it’s more accepted in the culture, and it’s being used for lifestyle changes and as a form of low-impact exercise,” Nahin said.

But while people use yoga to promote wellness and well-being, they use chiropractic care and acupuncture as a treatment for a medical condition, most often chronic pain, he said.

“If you look at data on back pain across the last 10 years, it’s been fairly flat,” Nahin said. “It hasn’t changed, so perhaps use of these types of practitioners that treat back pain wouldn’t change.”

While it remains a multi-billion dollar industry, the use of natural supplements actually has decreased a bit, Nahin said, possibly due to increased attention from health researchers regarding these products.

Sales of fish oil supplements have increased fourfold since 2002, based on studies showing the heart health benefits of omega 3 fatty acids, Nahin pointed out. However, research that found no substantial benefit from echinacea and ginkgo biloba has likely helped drive down sales of those particular supplements.

According to Stephanie Romanoff, communications director for the Academy of Integrative Health & Medicine, consumer demand for complementary medicine has caused more researchers to look into how well these approaches work, which in turn has provided consumers with better information.

“Integrative medicine is not going to have the same funding as pharmaceuticals do, but because of the consumer demand and increased interest from academia and our national government in integrative medicine and health, there has been an increase in research,” Romanoff said. “And increasingly, there’s more research validating the value of these approaches.”

People interested in trying chiropractic, acupuncture or some other form of complementary medicine should talk about it with their doctor, and make sure there is clear coordination between their primary care physician and their complementary medicine providers, Romanoff said.

“If someone is taking supplements or if they are seeing a different type of clinician, sometimes they don’t want to talk with their primary care medical doctor about it because they might feel self-conscious,” she said. “It’s absolutely critical that patients have those conversations and tell their doctors about the different types of care they’re receiving, and demand that there is coordination.”

Your doctor might even be able to point you to a properly accredited provider, particularly if your doctor is board-certified in integrative medicine, Romanoff added.

“Ask your primary care doctor for recommendations. That’s how I find many of my best clinicians,” she said.

More information

For more on complementary medicine, visit the U.S. National Center for Complementary and Integrative Health.

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