Summer rolls recipe

 

These fresh rolls are a perfect snack or a light lunch time treat, give them a go today.

What you'll need

• 50 g Vermicelli noodles
• 12 rice paper sheets 
• 100 g bean sprouts 
• 100 g carrot, cut into matchsticks 
• 100 g cucumber, cut into matchsticks 
• 5 g mint leaves
• 5 g coriander sprigs
• 5 g garlic chives
• 1 fresh yuzu  
• 50 ml Ginger & Ginseng Dressing

Ginger & Ginseng Dressing/ Dipping Sauce

• 5 g ginger 
• 200 ml ginseng tea
• 5 g miso paste
• 20 ml sweet chili sauce 
• 2 g white sesame seeds 
• 10 g peanut butter 
• 5 g garlic, finely chopped
• 5 g coriander 
• 5 ml soya sauce 
• 1 lemon, juiced 
• 2 g black pepper

What you'll do

1. Place the noodles in a heatproof bowl and cover with boiling water. Set aside for 5 minutes to soften. Drain.

2. Soak 1 rice paper sheet in warm water for 30 seconds or until soft (don’t soak the sheet for too long or it will tear).

3. Drain on paper towel. Place on a clean work surface.

4. Lay down a little of the noodles, bean sprouts, carrot and cucumber onto the softened rice paper.

5. Drizzle with a little Ginger & Ginseng dressing.

6. Top with 1 mint leaf and 1 coriander sprig.

7. Fold in ends and top with 1 garlic chive and roll up firmly to enclose filling.

8. Break up the yuzu segments and use the pods for garnish on the plate.

9. Serve with the dipping sauce on the side.

Recipe source: Amatara Wellness Resort

 

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Inherited Cholesterol Disorder Significantly Boosts Heart Risks

THURSDAY, June 30, 2016 (HealthDay News) — People who inherit a genetic disorder that causes high levels of “bad” LDL cholesterol have an increased risk for heart disease and hardened arteries, a new study finds.

The condition is called heterozygous familial hypercholesterolemia. It’s believed to affect about 1.5 million people in the United States, the researchers said.

The genes linked to this condition prevent the liver from removing LDL (low-density lipoprotein) cholesterol from the blood. This allows the bad cholesterol to build up. Doctors suspect this familial condition when LDL levels are above 190 milligrams per deciliter (mg/dL), the study authors explained.

The researchers reviewed data from six groups of people involved in previous studies. Compared to people with average LDL cholesterol levels (less than 130 mg/dL), those with familial hypercholesterolemia had a five times higher risk for heart disease.

Those with genetically inherited high cholesterol were also more likely to have diseases caused by hardening of the arteries, including earlier development of heart disease — up to 20 years earlier in men and 30 years earlier in women, the research revealed.

Even when the researchers included other risk factors for heart disease in their analysis, the risks were still higher for those with the genetic cholesterol disorder.

The findings may help doctors explain the risks of familial hypercholesterolemia more clearly to patients. That’s important because the disorder can be treated with cholesterol-lowering drugs to decrease the risks for coronary heart disease and stroke, the investigators said.

“Clinician-patient discussions about guideline-supported therapies can be informed by this data,” according to the study authors, who were led by Dr. Donald Lloyd-Jones at Northwestern University in Chicago.

Using the data, doctors could present certain scenarios to their patients. For example: if a 25-year-old woman with newly diagnosed familial hypercholesterolemia leaves her cholesterol untreated, her risk of coronary heart disease death or nonfatal heart attack would be comparable to that of a 55-year-old woman, the researchers said.

“Such an analogy, paired with counseling about how to improve risk, may motivate behavioral changes as well as adoption of and adherence to evidence-based medications,” the study authors said.

The findings were published June 29 in the journal Circulation.

More information

The U.S. National Human Genome Research Institute has more on familial hypercholesterolemia.

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Video May Aid End-of-Life Decision-Making

THURSDAY, June 30, 2016 (HealthDay News) — Watching a video about end-of-life care options may help patients with advanced heart failure choose the approach best for them, a new study finds.

The choices include comfort-focused care versus more invasive care that could extend their days.

“Because the course of heart failure is uncertain, in part because of improved therapies, doctors may be reluctant to initiate a conversation with their patients about advance care planning,” said study lead author Dr. Areej El-Jawahri.

She is director of the bone marrow transplant survivorship program at Massachusetts General Hospital Cancer Center in Boston, and a member of the Video Images of Disease for Ethical Outcomes Consortium, which develops videos for decision-making support.

Heart failure means the heart struggles to provide the body with enough blood to remain healthy. People with advanced heart failure tend to feel short of breath and fatigued with little or no activity, and they often need hospitalization.

The study included 246 advanced heart failure patients, average age 81, who were given verbal descriptions of three end-of-life care options.

These options included: life-prolonging care such as CPR, having a tube inserted into their windpipe and being placed on a breathing machine; limited care such as intravenous therapy and hospitalization, but no CPR or breathing machine; and comfort care.

Comfort care, which is typically provided at home, focuses on quality of life. It can include hospitalization if required for symptom relief.

Half the patients also watched a six-minute video that was narrated by a doctor and depicted the three levels of care. These patients were also encouraged to discuss end-of-life care with their doctor.

The findings were published online June 29 in the journal Circulation.

“We found that when patients were better informed, it’s easier for them and their doctors to discuss end-of-life issues,” El-Jawahri said in a journal news release.

Compared to those who did not see the video, patients who watched it were more likely to prefer comfort care (51 percent vs. 37 percent), almost twice as likely to say they did not want CPR, and much more likely to say they did not want a breathing machine (77 percent vs. 48 percent).

The video viewers were also four times more likely to discuss their end-of-life choices with their doctor within three months, the study found.

Patients who watched the video also were much more knowledgeable about end-of-life care levels than the others, according to the U.S. National Heart, Lung, and Blood Institute-funded study.

More information

The American Academy of Family Physicians has more on heart failure.

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Uncle Sam Wants You … Slimmer

THURSDAY, June 30, 2016 (HealthDay News) — Military personnel are expected to meet strict weight and body fat standards. But one in five U.S. military service members is obese, new research shows.

“We count on our military to be in the best shape both physically and mentally, and these data show there is a need to improve efforts to maintain a healthy weight within our Armed Forces,” said Catherine Champagne, a member of The Obesity Society’s advocacy committee.

Analyzing data compiled on 42,200 current and former military personnel from 2001 to 2008, the researchers found obesity affected 32 percent of veterans and 20 percent of active service members. The percentage of obese veterans wasn’t significantly different between one and three years after discharge, suggesting the increase in obesity occurs soon after active duty ends, the study noted.

The study also found that veterans are just as likely as civilians to be obese. And obesity among active-duty personnel as well as veterans is associated with depression, post-traumatic stress disorder (PTSD) and other mental health issues, the researchers noted.

High blood pressure, diabetes and sleep apnea were also much more common among the obese participants, according to the study.

“Because military personnel — and especially veterans — make up a sizable portion of the U.S. population, this research is important to the overall health of the country,” Champagne said in a Obesity Society news release.

A study co-author said a healthier military would reduce health-care costs.

“Establishing lifelong healthy behaviors for active duty and veteran military personnel could not only ensure a fit force, but also reduce post-service-related costs for the Department of Defense, Department of Veterans Affairs and the U.S. health care system,” said study leader Toni Rush. “More importantly, it could enhance the quality of life for thousands of veterans.”

Although greater muscle mass among service members may have affected some of the data, the researchers said their findings could be used to improve health programs and policies targeting U.S. service members and veterans.

“The findings show that even when equipped with the knowledge of how to implement healthy behaviors, it can be difficult to maintain a healthy weight when motivational drivers change,” Champagne said. “Given the associations of obesity and its complications, this should be seen as a national priority both for the American people and its military.”

Obesity is a leading barrier to military service for people aged 17 to 24, she and her colleagues pointed out.

The findings were published in the July issue of the journal Obesity.

More information

The U.S. Centers for Disease Control and Prevention provides more information on obesity.

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Men Face Greater Risk of Cardiac Arrest: Study

By Steven Reinberg
HealthDay Reporter

THURSDAY, June 30, 2016 (HealthDay News) — Men are significantly more likely to have their heart stop suddenly than women are, a new study finds.

About one in nine men will suffer a cardiac arrest before the age of 70, compared to about one in 30 women. At age 45, men have nearly an 11 percent lifetime risk of sudden cardiac death, compared with a 3 percent risk among women of the same age, researchers report.

“Most of these deaths are occurring prematurely — before age 70 — which means that this is a very important and largely preventable cause of death that’s really affecting families in a devastating way,” said lead researcher Dr. Donald Lloyd-Jones. He is chair of preventive medicine at Northwestern University Feinberg School of Medicine, in Chicago.

About 450,000 Americans die from sudden cardiac death each year, and most never have any symptoms of a heart problem, he said. Men are especially at risk because heart disease tends to develop earlier in men than in women, Lloyd-Jones explained.

“We need to get more serious about screening men for risk factors for cardiac arrest,” he said. The major risk factors include smoking, high blood pressure, high cholesterol and diabetes.

“Know your numbers, especially your blood pressure, but also know your cholesterol or whether you have diabetes,” he said. “At 50, men should also have a baseline electrocardiogram, which might reveal heart problems.”

For the study, Lloyd-Jones and his colleagues examined data on more than 5,200 men and women, aged 28 to 62, who took part in the long-running Framingham Heart Study, which began in 1948.

That study looked at four major risk factors for heart trouble — blood pressure, cholesterol, smoking and diabetes. None of the participants had a heart problem at the start of the study. Because most of those in the study were white, the findings cannot necessarily be applied to other groups, the researchers cautioned.

Over decades of follow-up, 375 people died from a cardiac arrest. The risk for sudden cardiac death was even higher — 12 percent — among men who had two or more risk factors, the researchers found.

In addition, high blood pressure alone or in combination with other risk factors was linked to a higher risk of sudden cardiac death. High blood pressure was the single most accurate predictor of cardiac arrest for both men and women, Lloyd-Jones said.

Dr. Michael Sayre, a professor of emergency medicine at the University of Washington in Seattle, said that “men have more risk factors, such as smoking and high blood pressure, putting them at risk for cardiac arrest.” He wasn’t involved in the new study.

However, the number of cardiac arrests has dropped dramatically because more people are controlling their blood pressure, cholesterol and blood sugar, and have quit smoking, he added.

“In our system, over 30 years, the number of cardiac arrests is less than half of what it used to be,” Sayre said.

“We used to have 300 of these a year, and now there’s closer to 100,” he said. “Even though we are doing better than we did 15 years ago, there are still too many [cardiac arrests]. We can do better.”

Many people confuse cardiac arrest with a heart attack, which is when part of the heart is damaged after being deprived of oxygen, usually because of a blocked artery. Cardiac arrest is the sudden and complete stoppage of the heart.

The findings were published June 29 in the Journal of the American Heart Association.

A study in the June 22 issue of the same journal found another difference between men and women when it comes to cardiac arrest. Women who survive cardiac arrest are less likely than men to get aggressive lifesaving care at the hospital, those researchers reported.

In that study, women treated for cardiac arrest were 25 percent less likely to have an angiography — imaging to look for blocked heart arteries. Women were also 29 percent less likely to undergo angioplasty, a technique to open blocked arteries, the study found.

“Although we have made a lot of improvement in treating patients with cardiac arrest over the last decade, there is room for improvement, especially in women,” said lead researcher Dr. Luke Kim, an assistant professor of medicine at Weill Cornell Medical College in New York City.

More information

Visit the American Heart Association for more on cardiac arrest.

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Zika Brain Damage May Occur in Babies With Normal-Sized Heads

By Dennis Thompson
HealthDay Reporter

WEDNESDAY, June 29, 2016 (HealthDay News) — In the ongoing crisis around Zika-linked birth defects, attention has been largely focused on infants born with too-small heads, or microcephaly.

However, a new report suggests that newborns with normal-sized heads may also sometimes be affected by the mosquito-borne virus, including brain damage.

Of the more than 600 cases of “definite or probable” Zika virus infection in Brazilian infants involved in the new study, more than 100 had head circumferences within the normal range, researchers reported June 29 in The Lancet.

“Therefore, the current focus on microcephaly screening alone is too narrow,” study lead author Cesar Victora, of the Federal University of Pelotas, in Brazil, said in a journal news release.

“Although we believe that the underreporting of microcephaly cases is rare during the epidemic, newborns infected with the virus late in pregnancy may go unreported due to their head size being within normal range,” Victora said.

He also noted that another sign of maternal Zika infection — a rash in late pregnancy — was also absent in one-third of the cases.

In some cases, women experienced the Zika-linked rash in late pregnancy and delivered babies with brain damage — even though their babies were born with normal-sized heads.

Victora’s team noted that a baby’s skull typically finishes its development by week 30 of gestation, suggesting that Zika infection in newborns might be causing brain damage without the telltale sign of microcephaly.

“Our findings suggest that among pregnancies affected by Zika virus, some fetuses will have brain abnormalities and microcephaly, others will have abnormalities with normal head sizes, and others will not be affected,” Victora said.

Brazilian experts Dr. Jorg Heukelbach of the University of Ceara, and Dr. Guilherme Loureiro Werneck of the University of Rio de Janeiro, wrote a journal commentary on the new findings. They explained that what’s sorely needed is a definitive test for Zika infection.

“The development of an accurate [blood] test that could be incorporated into routine prenatal care will be essential, and its validation a research priority,” the two experts wrote.

A second study, published the same day in The Lancet, strengthened the case that maternal Zika infection does cause birth defects.

Researchers in Brazil said they detected Zika virus in autopsied brain tissue of a baby with microcephaly who died two months after birth, as well as in the brain tissue of two other affected babies who died shortly after being born. Similar evidence was also found in placental tissue from two fetuses whose mothers suffered a miscarriage at 11 and 13 weeks of pregnancy.

In Latin America, thousands of babies have already been born with microcephaly. No nation has been more affected than Brazil. As a result of the Zika epidemic, more than 7,000 cases of microcephaly have been reported there, according to the journal news release.

Meanwhile, the search for an effective vaccine against Zika continues. On Tuesday, researchers announced that studies involving mice support the effectiveness of two vaccine candidates against the Zika virus.

This “critical first step” is leading to trials in monkeys and humans, “and gives us early confidence that development of a protective Zika virus vaccine for humans is feasible,” said researcher Col. Nelson Michael.

He is co-leader of the Walter Reed Army Institute of Research (WRAIR) in Silver Spring, Md., and one member of a team involved in the search for a vaccine against the mosquito-borne virus.

A vaccine effective against Zika would be invaluable. Reporting June 28 in the journal Nature, researchers said one of the new shots was developed at Harvard Medical School in Boston and is partly based on a Zika strain isolated in Brazil.

The other vaccine, using a strain isolated in Puerto Rico, has been developed by Michael’s team at WRAIR.

Both vaccines shielded mice against Zika infection with just a single shot required, the researchers said.

Clinical trials in humans are scheduled to begin later in 2016, the scientists said.

The Zika threat to the United States is real, according to Dr. Tom Frieden, who directs the U.S. Centers for Disease Control and Prevention. Speaking earlier in June, he warned, “in coming months it’s possible that thousands of pregnant women in Puerto Rico could become infected with Zika. This could lead to dozens or hundreds of infants being born with microcephaly in the coming year.”

So far the CDC says there have been no local transmissions of Zika reported in the United States. However, the number of cases of infection among pregnant women keeps climbing.

As of June 16, the U.S. Centers for Disease Control and Prevention reported 265 cases of pregnant women on the U.S. mainland who have been infected with Zika, which typically involves relatively mild symptoms in most adults. However, it can cause devastating birth defects in babies that include microcephaly.

Zika is typically transmitted via the bite of the Aedes aegypti mosquito. But, transmission of the virus through sex is more common than previously thought, World Health Organization officials have said.

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

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

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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New Drug Shows Promise for Rare Blood Cancers

By Amy Norton
HealthDay Reporter

WEDNESDAY, June 29, 2016 (HealthDay News) — An experimental drug called midostaurin may reverse organ damage in people with certain rare, fatal blood cancers, an early clinical trial finds.

Researchers found that the drug at least partly reversed organ damage in 60 percent of patients with advanced systemic mastocytosis — an umbrella term for several rare cancers that affect blood cells called mast cells.

Normally, mast cells release histamines and other chemicals during inflammatory and allergic reactions. In aggressive cases of systemic mastocytosis, abnormal mast cells build up in the bone marrow, skin, gut, spleen, liver and lymph nodes.

As a result, people with the cancers constantly feel sick, said Dr. Robert Hromas, a blood cancer specialist at the University of Florida.

“They’re debilitating,” he said. “You feel miserable all the time.”

No good treatment options exist for people with advanced mastocytosis. So the new findings are “a real advance,” said Hromas, who wasn’t involved in the study.

“This is a drug that works,” he said. “And until now, we’ve really had nothing.”

The study does not prove that midostaurin extends people’s lives, said Hromas, who is also a spokesman for the American Society of Hematology.

But patients who responded to the drug did see most of their symptoms improve, and they reported a higher quality of life — which is important, Hromas pointed out.

The findings, published in the June 30 issue of the New England Journal of Medicine, add to evidence of midostaurin’s benefits.

The drug, a twice-daily pill, has already been shown to lengthen the lives of patients with a subtype of acute myeloid leukemia.

In February, the U.S. Food and Drug Administration granted midostaurin “breakthrough therapy” status, which will speed the agency’s review of the drug.

As it stands, the only drug approved to treat advanced systemic mastocytosis is Gleevec (imatinib). But it doesn’t work for most patients, said study leader Dr. Jason Gotlib, an associate professor of medicine-hematology at Stanford University School of Medicine, in Stanford, Calif.

That’s because about 90 percent of patients have tumors with a mutated gene that makes them resistant to Gleevec, Gotlib explained.

That mutation occurs in a protein called KIT, which controls the growth of mast cells.

“It’s the gas pedal driving these cancers,” Hromas said. “And midostaurin targets it.”

To test the drug, Gotlib and colleagues at 29 medical centers around the world recruited 116 patients with advanced systemic mastocytosis, including mast-cell leukemia. Novartis, which is developing midostaurin, partially funded the study.

All of the patients received midostaurin. Overall, 60 percent responded to the drug — meaning that at least some of their organ damage receded, or completely resolved.

Of patients who had an enlarged spleen, for example, 77 percent showed a reduction in the organ’s size. That’s important, Gotlib said, because spleen enlargement causes pain, poor appetite and weight loss.

For the most part, patients who responded to the drug saw their symptoms improve. The exceptions were nausea and vomiting, which are the most common side effects of midostaurin, Gotlib said.

Because the study had no comparison group, it’s not clear what kind of effect the drug might have on survival, Hromas said.

There were hints of a benefit, though. Eighteen percent of the patients had a particularly aggressive cancer called mast-cell leukemia. They typically survived for just over nine months, whereas the disease usually kills people within six months, Gotlib said.

Across the whole study group, patients typically lived for almost 2.5 years.

The findings are encouraging, Gotlib noted. “But,” he stressed, “we need to do better.”

He said future studies should try combining midostaurin with other treatments — including bone marrow transplants, which have shown promise in recent research.

For now, patients with advanced systemic mastocytosis may be able to get midostaurin through the Novartis “compassionate use” program, Gotlib said.

“But we hope it will be approved soon,” he added.

Hromas made another point: Midostaurin was nearly abandoned after early research in other cancer patients did not pan out.

“I think that’s a lesson for oncology, in general,” Hromas said. “We may have drugs ‘on the shelf’ that look like they don’t work, only because we haven’t found the right segment of patients yet.”

More information

The National Organization for Rare Disorders has more on systemic mastocytosis.

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Stem Cells Deemed Safe for ALS Patients

By Amy Norton
HealthDay Reporter

WEDNESDAY, June 29, 2016 (HealthDay News) — Scientists report that stem cell therapy appears to be safe for people with the invariably fatal disease amyotrophic lateral sclerosis (ALS), but it’s not yet clear whether the treatment provides any benefits.

In a preliminary study of just 15 ALS patients, researchers found that most were able to tolerate spinal injections of large doses of stem cells, although two patients developed serious complications.

Experts called it an important start in developing a therapy for the incurable disease, commonly known as Lou Gehrig’s disease.

“This is a baby step forward,” said lead researcher Dr. Jonathan Glass, of Emory University, in Atlanta.

“We can say this procedure is doable in ALS patients,” Glass said. “Now we have to test whether it’s actually therapeutic.”

Dr. Ericka Simpson, a neurologist and ALS researcher who was not involved in the study, said the finding offers “significant hope.”

It’s “groundbreaking” that the researchers were able to safely inject large numbers of stem cells into the already damaged spinal cords of ALS patients, said Simpson. She is an associate professor of clinical neurology at Houston Methodist, in Texas.

But, she stressed, major questions remain — including whether the tactic remains safe in the longer term.

Stem cells are primitive cells that give rise to mature cells; they also have the potential for uncontrolled growth. In theory, Simpson explained, they could eventually cause cancerous tumors, for example.

Each year, about 5,000 Americans are diagnosed with ALS, according to government statistics.

No one knows exactly what causes ALS, but it involves a breakdown in the nerve cells in the brain and spinal cord that control muscles throughout the body. Gradually, those muscles weaken and stop functioning; once the muscles of the diaphragm and chest are affected, people can no longer breathe on their own.

Most people with ALS die of respiratory failure within three to five years of their first symptoms, according to the U.S. National Institutes of Health.

Glass and his team started studying the potential of using stem cells in ALS back in 2010. “We didn’t know if it would even be possible,” he said.

Now that the approach appears relatively safe, the question is what can stem cells do against ALS? According to Glass, the goal is not to “replace” damaged nerve cells in the spine.

“Just replacing cells won’t do the job,” he explained: Any new cells would still lack the vital connections with each other and with the body’s muscles.

Instead, lab research suggests that if enough stem cells are infused into the spine, they release chemicals that can protect existing nerve cells and their connections.

“The hope is to keep [nerve cells] alive longer, and maintain their connections to muscles for a longer period,” Glass said.

The ALS study patients, who were from three U.S. medical centers, had first developed symptoms within the past two years. Each patient received anywhere from 10 to 40 injections of neural stem cells into the spinal cord — with the number of cells ranging from 2 million to 16 million.

Neural stem cells are the progenitors of various mature nerve cells. The cells used in this study were derived from the spinal cord of an 8-week-old fetus whose tissues were donated, according to Glass.

Over nine months, most of the patients tolerated the treatment fairly well, the researchers said. The most common problems were temporary pain after the injections and side effects from the immune-suppressing drugs that were necessary to dampen any reaction to the foreign cells.

Two patients did have serious complications, the study authors said.

“One patient developed spinal cord swelling after the surgery, and he was worse off after the procedure than before — which is what we worried about going into this,” Glass said.

The second patient developed chronic pain about a month after the procedure — for reasons that are unclear, according to Glass. It’s possible, he said, that the transplanted cells caused an immune system reaction.

If stem cells turn out to have benefits, those risks may be worth it to patients, Glass pointed out.

“Right now, I know all of these patients are going to die,” he said. “So what’s an acceptable risk? That’s a very personal question.”

Glass stressed, however, that stem cells remain experimental and unproven.

That’s crucial, he said, because desperate patients have already been taken in by “clinics,” typically in other countries, that claim to have stem cell therapies for ALS.

Simpson agreed. “Unfortunately, there are ‘snake oil’ salesmen out there, taking advantage of vulnerable people,” she said.

She and Glass both said they’ve seen patients who’ve traveled to countries like China, India and Mexico for stem cell “treatments,” only to return sicker and $50,000 poorer.

The findings were published online June 29 in the journal Neurology.

More information

The ALS Association has an overview of ALS.

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Reassessing the Annual Pelvic Exam

WEDNESDAY, June 29, 2016 (HealthDay News) — Women, the U.S. medical establishment isn’t doing away with annual pelvic exams — at least just yet. But a panel of U.S. medical experts has concluded there’s no proof the dreaded checkup benefits healthy women who aren’t pregnant.

In a draft recommendation released Tuesday, the U.S. Preventive Services Task Force said it couldn’t weigh in for or against routine pelvic exams based on current evidence.

“The Task Force is calling for more research to better understand the benefits and harms of performing screening pelvic exams in women without any complaints or symptoms,” said Dr. Francisco Garcia, a task force member. He is director and chief medical officer of the Pima County Department of Health in Tucson, Ariz.

The task force statement applies only to symptom-free, non-pregnant women. Women should still be screened for cervical cancer — every three years from ages 21 to 29 and every five years from ages 30 to 65. Sexually active women should also be screened for gonorrhea and chlamydia, the task force said.

“Women with gynecologic symptoms or concerns should discuss them with their clinicians,” said task force member Dr. Maureen Phipps, chair of obstetrics and gynecology at the Warren Alpert Medical School of Brown University in Providence, R.I.

Women all over will likely rejoice if the periodic exam falls by the wayside. Clothed only in a surgical gown with their feet elevated in surgical stirrups, patients endure prodding and poking while a doctor explores the vagina, cervix, uterus, fallopian tubes and ovaries.

Nearly 63 million pelvic exams were performed in the United States in 2010, according to the task force. But it found “insufficient” data to support their value. What evidence there is may be of poor or conflicting quality, the task force statement said.

While no studies evaluated the exam’s ability to prevent disease or death, research did turn up harms such as unnecessary surgeries caused by “false positive” test results, the task force noted.

Other influential medical groups have also questioned the value of annual pelvic exams. The American College of Physicians in 2014 recommended discontinuing routine pelvic exams because of little evidence of benefit.

But the annual exam still has the support of the American College of Obstetricians and Gynecologists (ACOG), which believes these visits help build doctor-patient trust.

How the U.S. task force recommendation will affect current practice — or insurance coverage — remains to be seen. Although the U.S. government doesn’t have to heed the panel’s findings, it usually does. This, in turn, could alter coverage by Medicaid, Medicare and the Affordable Care Act as well as private insurance companies.

The panel will welcome public comments through July 25, and then issue its final statement sometime after that.

Dr. Jill Rabin is co-chief of the division of ambulatory care at Women’s Health Programs-PCAP Services, at Northwell Health in New Hyde Park, N.Y.

She said she agrees with ACOG that all women should see their obstetrician/gynecologist annually.

“There’s much more to an annual exam than a pelvic examination,” she said, citing potential health problems that may not have obvious symptoms.

As for an annual pelvic exam, Rabin called for “shared decision-making between the patient and her physician.”

More information

Visit the American College of Obstetricians and Gynecologists for its well-woman recommendations.

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Testosterone Therapy May Boost Older Men’s Sex Lives

By Dennis Thompson
HealthDay Reporter

WEDNESDAY, June 29, 2016 (HealthDay News) — Aging men who are losing their sexual pep can receive a love-life boost from testosterone replacement therapy, according to results from the largest “low-T” clinical trial to date.

Older men treated with testosterone gel experienced a moderate but significant improvement in their sex drive, sexual activity and erectile function compared to men given a placebo gel, said lead researcher Dr. Glenn Cunningham. He’s a professor of endocrinology at Baylor College of Medicine in Houston.

“We found that testosterone improved all three, which is pretty remarkable, particularly when you’re dealing with an older age population,” Cunningham said of the study, which was partially funded by the pharmaceutical industry.

According to Dr. Brad Anawalt, older men who use testosterone therapy won’t find themselves transformed into sexual dynamos. But they will experience a measurable improvement in their sex lives, he said. Anawalt, who reviewed the study’s findings, is a professor of endocrinology with University of Washington School of Medicine in Seattle.

“Men treated with testosterone reported an increase in orgasm of about one every week versus one every 10 days,” Anawalt said. “That works out to one more orgasm per month compared to placebo. Significant? Up to the man.”

All men experience a natural decline in testosterone levels as they age. That causes a decrease in energy and sex drive in some, the study authors said.

A low testosterone — or “low-T” — industry has flourished over the past 15 years, with aging baby boomer men looking to testosterone therapy as a potential “fountain of youth.” The number of men beginning testosterone treatments has nearly quadrupled since 2000, the study authors noted.

But some health experts have remained cautious and even skeptical, arguing that hormone therapy should be reserved for men suffering severe symptoms of low testosterone, such as impotence or muscle wasting.

Dr. Landon Trost said the results of the new study show that aging men who experience normal declines in testosterone can benefit from replacement therapy. Trost is an assistant professor of urology and expert on male sexual dysfunction at the Mayo Clinic in Rochester, Minn.

“The study would argue that normal is normal,” Trost said. “Even if there’s an age-related decline, that should be considered abnormal.”

Treatment with testosterone gel can cost between $200 and $400 a month, Trost said, while regular testosterone injections run less than $100 per month. Men also can have delayed-release testosterone pellets implanted, which costs about $1,000 every three to four months.

This study is part of the Testosterone Trials, a series of seven clinical trials sponsored by the U.S. National Institutes of Health to assess the effectiveness of hormone therapy in men 65 or older with symptoms related to low testosterone levels.

Earlier results from the trials indicated that men might receive some sexual benefit from testosterone therapy, but wouldn’t receive much of a boost in their vitality or physical function.

For this trial, 470 men older than 65 were randomly assigned to use either a testosterone gel or a placebo gel for one year. All of the men had low testosterone levels due to aging, and low libido. They all also had a heterosexual partner willing to have sex with them at least twice a month.

Pharmaceutical company AbbVie, which makes a testosterone gel called AndroGel, provided funding for the study, as well as the testosterone gel and placebo gel used in the study.

Men using testosterone gel experienced a significant increase in their sexual activity, the researchers found. Questionnaires revealed improvement in 10 out of 12 measurements of sexual activity, including frequency of sex, masturbation, sexual daydreams, sexual anticipation, and nighttime erections.

By comparison, men in the placebo group had similar questionnaire responses throughout the study.

Despite these findings, testosterone therapy might not be good for every aging man, Cunningham cautioned. The goal of the Testosterone Trials was to figure out if hormone replacement therapy actually worked. Safety concerns weren’t investigated.

“I think you do have to recognize there is potential risk with testosterone in older men, and so you have to balance that,” he said.

Testosterone therapy could potentially increase a man’s long-term risk of prostate cancer or heart disease, Cunningham said. The therapy also tends to thicken blood, resulting in an increased risk of stroke or heart attack.

Men shouldn’t receive testosterone therapy if they have prostate cancer or have had a heart attack or stroke within the past six months, he said.

Prior studies on prostate cancer patients have shown that men are willing to trade some life for their libido, Trost noted. In those studies, men said they would be willing to give up 3 or 4 months of additional life to avoid prostate cancer treatments that would cost them their libido or erectile function.

The U.S. Food and Drug Administration has ordered a clinical trial examining the safety risks of testosterone-replacement therapies, and currently is reviewing the protocols for that trial, Cunningham said.

“That trial will be conducted, but it will take probably five or six years,” he said. “We’re probably not going to have real good information regarding risk for another six or seven years.”

The clinical trial results were published online June 29 in the Journal of Clinical Endocrinology and Metabolism.

More information

For more on testosterone therapy, visit the American Urological Association.

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