Disaster Plans Must Consider Children, Pediatrics Group Says

MONDAY, Oct. 19, 2015 (HealthDay News) — Disaster response plans need to place more emphasis on the needs of children, a new American Academy of Pediatrics (AAP) policy statement says.

Events such as natural disasters, terrorist attacks, industrial accidents or disease outbreaks can be especially harmful to children for a number of reasons, the experts pointed out.

For example, children take more breaths per minute, are closer to the ground, and have a large surface area relative to their body mass and more permeable skin than adults, the AAP said in a news release. These factors make children more vulnerable to smoke, debris and other environmental threats.

Exposure to toxic substances poses a long-term threat to young children because they are in a period of critical development. Exposure to radiation and cancer-causing chemicals can damage young children’s DNA and increase their lifetime cancer risk, according to the AAP.

Youngsters may not know to run away or avoid dangers, and may even approach them out of curiosity. Also, infants and younger children require appropriately sized medical equipment and doses of medicine, which aren’t always readily available.

It’s crucial for hospitals to have plans for providing care for children during and after disasters, said statement co-author Dr. Joseph Wright, chair of the department of pediatrics and child health at Howard University College of Medicine in Washington, D.C.

“As a hospital-based provider, I’m particularly intrigued by the fact that in the intervening years since 9/11, a national assessment shows that hospital emergency departments are less likely to have included explicit pediatric elements in their institutional disaster planning than compared to a similar assessment done in the early 2000s,” Wright said in the news release.

In 2003, 76 percent of U.S. emergency departments said they included the specific needs of children in disaster planning, but that fell to 47 percent by 2014, Wright said.

Statement co-author Dr. Scott Needle, chief medical officer of the Healthcare Network of Southwest Florida, added that pediatric primary care practices also need to have plans.

“Fewer than half of pediatric offices have preparedness plans. This is particularly concerning because office pediatricians are a key source of health care, including immunizations and mental health care, for families in the community,” Needle said in the news release.

Disaster exercises and drills need to include children as both victims and responders, according to the AAP statement. Details of the policy statement were published online Oct. 19 in Pediatrics.

“Disaster response plans are especially important in settings where children are separated from their families, such as schools and child care centers,” Dr. David Schonfeld, a member of the AAP Disaster Preparedness Advisory Council, said in the news release.

“Care must be taken that the drills themselves do not inflict psychological trauma on children, however. Staff and students should be informed before an exercise is conducted, especially if it includes scenarios (such as armed assailants) that are sure to be frightening to many children and staff,” Schonfeld added.

More information

The U.S. National Library of Medicine has more about disaster preparation and recovery.

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Not All Large Breast Tumors Warrant Mastectomy, Study Says

MONDAY, Oct. 19, 2015 (HealthDay News) — A combination of breast conservation surgery and radiation is as effective as breast removal for some women with large, localized invasive breast tumors, a new study contends.

Breast-conserving lumpectomy is usually limited to women with small tumors, the researchers said.

“For decades, breast cancers have been felt to be amenable to lumpectomy with radiation only if the tumors were 5 centimeters [nearly 2 inches], or smaller. This is because the prospective trials that compared [lumpectomy and mastectomy] didn’t enroll patients whose tumors were larger than 5 centimeters,” lead investigator Dr. Richard Bleicher, of the department of surgical oncology at Fox Chase Cancer Center in Philadelphia, explained in a Fox Chase news release.

“Since there are no clinical trials evaluating breast conservation therapy versus mastectomy for tumors over 5 centimeters,” breast conservation is still not recommended for that scenario in current guidelines, he added.

Bleicher and his colleagues analyzed data from nearly 5,700 women who had nonmetastatic breast tumors larger than 5 centimeters who had surgery between 1992 and 2009. Nonmetastatic means the tumors had not spread elsewhere in the body.

Of those women, nearly 16 percent had breast conserving lumpectomy and radiation rather than breast removal.

Over a median follow-up of seven years, overall survival and breast-cancer specific survival rates were similar for both groups of women, according to the study published online Oct. 19 in the journal Cancer.

“This study, the largest of its kind, demonstrates that women who are felt to be amenable to [tissue removal] by their surgeons can have a lumpectomy and radiotherapy to the breast, and have an equivalent outcome as mastectomy,” Bleicher said.

The researchers said previous studies have shown a link between breast conservation and higher quality of life because of better body image and greater satisfaction with treatment.

“Many surgeons may not do breast conservation for patients with large tumors, even when their breast size is generous enough to accommodate such a large tumor removal,” Bleicher said. “We now have data demonstrating that breast conservation appears safe and should remain an option when the surgeon feels that the patient’s breast size can accommodate the [tissue removal].”

More information

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

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Misty Copeland Gets Candid About Body Image Issues

Photo: Getty Images

If you’ve been following the career of ballerina Misty Copeland, it’s nearly impossible not to consider this woman to be the epitome of strength.

Not only is she physically strong, but the 33-year-old rose above a difficult childhood to become the first African-American woman to earn the title of principal dancer in the American Ballet Theater. But body insecurities are a universal plight and Copeland’s consumed her for a portion of her career.

In the documentary A Ballerina’s Tale, the dancer is very open about the issues she struggled with every day.

“I didn’t want to stare at myself in the mirror,” she says. “I didn’t even want to come to class in the morning.”

The film, which is currently in theaters and available on VOD, is incredibly inspiring, with some painful moments that are also teachable for all of us who struggle with insecurities.

This article originally appeared on MIMIChatter.com.

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Misty Copeland, Gisele, and More Reveal Trials of Womanhood in Under Armour Sports Bra Campaign

Misty Copeland Just Changed the Face of Ballet Forever

MIMI Chatter is an endless stream of beauty content. We bring together the must-knows and the how-tos from your favorite sites, beauty influencers, our editors, and YOU.

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Researchers Move Closer to Alzheimer’s Blood Test

MONDAY, Oct. 19, 2015 (HealthDay News) — Researchers say they have moved closer to developing a blood test for Alzheimer’s disease.

Such a test would enable doctors to diagnose patients at the earliest, most treatable stage so patients could make lifestyle changes that may slow progression of the brain disease, reported the team at the Rowan University School of Osteopathic Medicine in Stratford, N.J.

“There are significant benefits to early disease detection because we now know that many of the same conditions that lead to vascular disease are also significant risk factors for Alzheimer’s,” lead researcher Robert Nagele said in an association news release.

The scientists focused on use of autoantibodies in the blood as biomarkers for the presence and stage of Alzheimer’s disease. Autoantibodies are immune proteins that mistakenly attack the body’s own cells.

The findings were presented Sunday at an American Osteopathic Association meeting in Orlando, Fla.

Currently, there is no approved blood test for Alzheimer’s, an incurable brain disease that affects about 5.3 million Americans. With this disease, the brain begins to change years before symptoms emerge.

“People found to have preclinical disease can take steps to improve their vascular health, including watching their diet, exercising and managing any weight and blood pressure issues to help stave off or slow disease progression,” Nagele said.

The blood test under development by Nagele and his colleagues also shows promise in detecting other diseases, including Parkinson’s, multiple sclerosis and breast cancer, they said.

Data and conclusions presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.

More information

The U.S. National Institute on Aging has more about Alzheimer’s disease.

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Preteen Girls Worry About Breast Cancer If It’s in the Family

By Kathleen Doheny
HealthDay Reporter

MONDAY, Oct. 19, 2015 (HealthDay News) — Preteen girls with a strong family history of breast cancer worry more than their peers without that background about getting breast cancer themselves, new research shows.

Although the researchers found the girls with a family history of breast cancer as well-adjusted as other girls their age, the study noted that chronic fears can lead to risky behavior in adolescence.

The research involved more than 800 girls whose mothers or other close family members have had breast cancer or mutations known to increase the risk of breast cancer.

“They seem to do as well as peers when it comes to general psychological adjustment,” said Dr. Angela Bradbury, lead study author and assistant professor of medicine at the University of Pennsylvania Perelman School of Medicine. However, she found, “they do have more worry [about breast cancer].”

Also, the greater the mothers’ distress, the more distressed their daughters, she said.

Whether this anxiety is cause for concern isn’t clear, and the study doesn’t show that a family’s cancer history causes psychological problems.

“A certain amount of worry can be motivating, and that can be good,” Bradbury said. Girls with a family history of breast cancer, for instance, might pay closer attention to prevention measures, such as getting regular exercise or, later, getting routine screening as recommended.

On the other hand, they may feel that’s futile, and take worse care of themselves, she said. The study noted, for example, that chronic stress can be associated with behaviors such as tobacco and alcohol use.

“We need more data to see if that worry is harmful or an opportunity,” Bradbury said.

Having a first-degree relative — mother, sister, daughter — with breast cancer roughly doubles the risk of breast cancer, according to the American Cancer Society.

The new study, published online Oct. 19 in the journal Pediatrics, looked at 869 mother-daughter pairs to see to see how this legacy affected the girls’ psychosocial development. The girls, ages 6 to 13, and their moms were surveyed in four U.S. cities and Ontario, Canada, from August 2011 to July 2013.

The researchers asked about general adjustment, distress about breast cancer, perceived risk of breast cancer and other data. The mothers answered questions if their daughters were 9 or under; otherwise, both mothers and daughters answered.

The girls with a family history of breast cancer were nearly three times as likely to report themselves at increased risk of breast cancer as their peers without that history. However, many girls in both groups were unsure of their risk, Bradbury found.

Sara Rivero-Conil, a pediatric psychologist at Nicklaus Children’s Hospital in Miami, wasn’t surprised that the girls with breast cancer in the family were as well-adjusted as their peers. She said they might even be better adjusted than girls who haven’t had to deal with that frightening diagnosis.

“Children exposed to more of these medical traumas do tend to group up quickly. They are kind of forced to,” said Rivero-Conil, who wasn’t involved in the study.

To defuse worry, she recommends mothers with breast cancer discuss their condition with their daughters.

“Give them facts about the diagnosis and about the treatment,” Rivero-Conil said. She also said it’s a good time to talk to daughters about what they can do in terms of diet and other lifestyle measures to minimize risk.

“Acknowledge their emotions,” she said. “This is scary.”

Next, said Rivero-Conil, talk as a family to plan how to get through it together.

Mothers with breast cancer should make sure they themselves are adjusting well and coping. When mothers become less anxious, she said, it’s a good bet their daughters will, too.

More information

To learn more about breast cancer family history, see the American Cancer Society.

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It’s Time for Your Flu Shot

By Steven Reinberg
HealthDay Reporter

MONDAY, Oct. 19, 2015 (HealthDay News) — The start of flu season is just around the corner and U.S. health officials are urging everyone aged 6 months and older to get their yearly flu shot.

The flu vaccine is the best way to protect yourself and those around you from getting the flu, said Dr. Lisa Grohskopf, a medical officer in the influenza division at the U.S. Centers for Disease Control and Prevention.

“Flu is a serious illness,” she said. “Most people are going to feel very ill for a time and will get better without any bad things happening, but we can’t predict who is going to get super sick.”

Grohskopf said that those who are likely to get very sick and run the risk of complications, including hospitalization and death, are people 65 and older, very young children and people with chronic health problems such as asthma, heart disease, diabetes and those with weakened immune systems.

“But even younger, healthy people can get seriously ill,” she said.

The most common complication from flu is pneumonia, Grohskopf said.

In a typical flu season, flu complications — including pneumonia — send more than 200,000 people to the hospital. Death rates linked to flu vary from year-to-year, but have gone as high as 49,000 deaths in a year, the CDC says.

Pregnant women are also at increased risk from the flu, Grohskopf warned. And it’s vital that women with newborns get their flu shot to help protect their infants who can’t be vaccinated until they are at least 6 months old, she said.

How effective the vaccine is in preventing the flu depends on how good a match it is to the strains of flu virus circulating that year. Most years, the vaccine is between 40 to 60 percent effective, according to the CDC.

Last year, the vaccine offered little protection against the most common flu strain that circulated, an H3N2 virus, Grohskopf said.

That happened because the virus that experts predicted to be the predominate one changed, and the new H3N2 virus was not included in the vaccine, she explained.

This mismatch caused a severe flu season, especially for the very old and very young, and led to a record number of hospitalizations for flu among the elderly, Grohskopf said.

This year’s vaccine contains the new H3N2 strain. And although it’s too early to tell which strains will be predominant, Grohskopf added, it’s likely that last year’s H3N2 strain will still be the most common one around.

This year’s vaccine also includes two other strains that are expected to be around as well.

Plenty of vaccine should be available, Grohskopf said. Manufacturers are expected to produce 170 million to 179 million doses.

The vaccine is available in a variety of forms, including a shot, a nasal spray and an ultra-thin needle, called an intradermal flu vaccine. People allergic to eggs can get an egg-free vaccine, and seniors can get a high-dose vaccine, Grohskopf said.

The vaccine is safe, she said. “You can’t get the flu from a flu shot,” Grohskopf said. However, side effects from the flu vaccine may include fever and muscle aches, according to the CDC.

People can get their flu shot at their doctor’s office, at many pharmacies and even at work. It takes about two weeks after vaccination for the body to develop protection from the flu, according to the CDC.

October is the ideal time to get vaccinated, Grohskopf said. But it’s never too late, even after the flu season starts, she added.

“The important thing is to get the flu shot,” Grohskopf said.

Dr. Marc Siegel, an associate professor of medicine at NYU Langone Medical Center in New York City, called flu a community disease.

“It’s not all about you,” he said. “You want to create a ring of immunity, so don’t just do it for yourself, do it for other people around you.”

To help prevent flu, Siegel also advises staying home when you have the flu, washing your hands often and covering your cough.

“Stop being afraid of the flu shot — be afraid of the flu,” Siegel said.

More information

For more about the flu, visit the U.S. Centers for Disease Control and Prevention.

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No Amount of Alcohol Safe During Pregnancy, Doctors Say

By Randy Dotinga
HealthDay Reporter

MONDAY, Oct. 19, 2015 (HealthDay News) — While some studies have hinted that a little alcohol might be harmless during pregnancy, a leading U.S. pediatricians’ group has issued a new warning that no amount of drinking is safe while pregnant.

“The only guarantee of having no effects from alcohol is no prenatal alcohol exposure,” said Dr. Janet Williams, a professor of pediatrics at the University of Texas Health Science Center and co-author of the new statement and report from the American Academy of Pediatrics (AAP).

It’s likely, she added, that future research will continue to show that “alcohol has subtle yet important lasting effects on academic performance, attention, behavior, cognition, memory, language skills, and visual and motor development.”

Physicians and researchers have been warning about the hazards of alcohol use during pregnancy for decades. Yet almost half of all women of childbearing age in the United States reported consuming alcohol within the past month, the researchers said, and nearly 8 percent of women continue to consume alcohol during pregnancy.

The AAP published its new statement in part to update health workers and the public, Williams said.

According to the new report, published online Oct. 19 in the journal Pediatrics, alcohol use during pregnancy can cause thinking and behavioral problems that last a lifetime. “No amount of alcohol intake should be considered safe,” the report stated, and “there is no safe trimester to drink alcohol.”

The report said that all forms of alcohol — beer, wine and liquor — pose similar risks. Getting quickly drunk, known as binge drinking, poses a higher risk in line with the extra amount of alcohol consumed, the report noted. According to Williams, binge drinking in women is defined as four or more standard drinks, typically within two hours.

Some studies published over the last few years have hinted that a small number of drinks during pregnancy could be safe. For example, research published in 2010 in the Journal of Epidemiology and Community Health found no extra behavioral or thinking risks from having one or two drinks a week.

However, “studies do not conclude that alcohol use is safe,” Williams said. Instead, they only show “that in certain study populations under certain conditions, there is or is not sufficient evidence of effect that can be attributable to alcohol exposure.”

Indeed, according to Janni Niclasen, an assistant professor of psychology at the University of Copenhagen who has studied alcohol and pregnancy, “With our current research methods, we will never be able to conclude from human studies whether there is a safe lower level below which drinking is not associated with any harm to the developing fetus.”

Of course, many women inadvertently drink alcohol without realizing that they’re pregnant. And alcohol often plays a role in sexual encounters aimed at producing a baby, including those that may occur when a woman doesn’t know she’s pregnant. So, should women of childbearing age always avoid alcohol?

Williams isn’t willing to go that far, and would only say that alcohol and pregnancy don’t go together. She added that some women, despite the findings of research, “continue to rationalize that their own alcohol use during pregnancy is sufficiently low or infrequent to be safe.”

Niclasen, the Denmark researcher, said women who are pregnant or trying to become pregnant should avoid all alcohol. “I am often called a moralist for having this perspective, but I think we need to focus on the development and future life of the unborn children,” she said.

Christina Chambers, a professor of pediatrics at the Center for Better Beginnings at the University of California, San Diego, offers this advice: “Women of childbearing age who drink alcohol should consider their pattern of drinking. For example, avoid binge drinking and avoid pregnancy as long as they are drinking. If pregnancy is planned, then alcohol can be discontinued.”

There may be no risk “if a woman has consumed small amounts of alcohol prior to knowing she is pregnant,” she said, but “the best advice is to avoid pregnancy if drinking and to avoid drinking if pregnant.”

According to both Williams and Chambers, alcohol use poses risks in all stages of pregnancy, and neither would say the risk is higher in certain stages.

Overall, Chambers said, the AAP’s statement “is an important stand to take, and hopefully it will lead to less stigma associated with [fetal alcohol spectrum disorders] and to more access to and uptake of prevention and treatment services.”

More information

For more about alcohol and pregnancy, visit the March of Dimes.

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Dermatologist Offers Tips for Dealing With Warts

SATURDAY, Oct. 17, 2015 (HealthDay News) — No one is completely immune from warts, but some people are more susceptible to these unattractive skin growths, one expert says.

Warts plague children and teens more often, along with people who frequently bite their nails, and those with weakened immune systems, said Dr. Adam Friedman, an associate professor of dermatology at the George Washington School of Medicine and Health Sciences.

“Warts are caused by a virus, and the virus can sometimes spread from one place on your body to another or from person to person,” Friedman said in an American Academy of Dermatology (AAD) news release.

“However, each person’s immune system responds to the wart virus differently, so not everyone who comes in contact with the virus develops warts,” he added.

There are ways to prevent warts from spreading. Don’t pick or scratch your warts, and don’t touch someone else’s wart. Wash your hands after treating warts, Friedman advised.

Another way to help prevent the spread of warts is to wear flip-flops in public showers and pool areas. It’s also important to keep warts on your feet dry, because moisture helps warts spread, according to the AAD.

Most warts go away without treatment within two years, but there are home treatments that can help get rid of them sooner, Friedman said.

One method is to use an over-the-counter wart treatment product with salicylic acid. Before using the product, soak the wart in warm water and then sand the wart with a disposable emery board. Be aware that it can take several months to see good results, Friedman said.

Duct tape is another option. Cover the wart with duct tape and change the tape every few days. Doing so may peel away layers of the wart-affected skin and trigger the immune system to fight the wart, according to Friedman.

Before applying duct tape, soak the wart in warm water, and then sand it with a disposable emery board. Remove and reapply duct tape every five to six days until the wart is gone, he suggested.

Consult a dermatologist if the skin around your wart is raw or bleeding; you can’t get rid of your wart; your wart hurts, itches or burns; you have many warts; you have a wart on your face or genitals; or you have a skin growth and unsure if it’s a wart, because some skin cancers can look like a wart, Friedman said.

More information

The American Academy of Dermatology has more about warts.

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Nerve Disorder in Horses May Offer Clues to Alzheimer’s

FRIDAY, Oct. 16, 2015 (HealthDay News) — Some signs of a rare nerve disorder in horses are similar to those in people with Alzheimer’s disease and other brain disorders, a new study shows.

The deadly disease in horses — called equine grass sickness — could offer clues about the human conditions, according to the researchers at the University of Edinburgh in Scotland.

“This is the first study to show similarities between an apparently unrelated neurodegenerative disease of large animals and human neurological conditions,” said study author Dr. Thomas Wishart. “Although the causes of these conditions are unlikely to be shared, the findings suggest that similar mechanisms could be involved in the later stages of disease.”

The causes of grass sickness, which attacks nerve cells and leads to stomach problems and muscle tremor, are unknown.

The investigators analyzed nerve tissue from six horses killed by the disease. They discovered proteins commonly found in the brains of people with Alzheimer’s disease, including a buildup of amyloid protein.

However, findings of animal studies don’t necessarily apply to humans.

More than 500 proteins were altered in the nerve tissue of the horses killed by grass sickness, according to the study, published recently in the journal Molecular and Cellular Proteomics.

The findings could lead to new ways to test horses for the condition, which can be difficult to diagnose and can result in death within a few days. In the United Kingdom, about 2 percent of horses die from grass sickness each year, the researchers said.

More information

The American Academy of Family Physicians has more about Alzheimer’s disease.

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FDA Approves Drug to Reverse Blood Thinner’s Effect

FRIDAY, Oct. 16, 2015 (HealthDay News) — Emergency use of a drug to reverse the blood-thinning effects of another drug has been approved by the U.S. Food and Drug Administration.

Praxbind (idarucizumab) was cleared for use in patients who are taking the anticoagulant Pradaxa (dabigatran) when there is an urgent need to reverse Pradaxa’s blood-thinning effects.

“The anticoagulant effects of Pradaxa are important and lifesaving for some patients, but there are situations where reversal of the drug’s effects is medically necessary,” Dr. Richard Pazdur, director of the Office of Hematology and Oncology Products at the FDA’s Center for Drug Evaluation and Research, said in an FDA news release.

“Today’s approval offers the medical community an important tool for managing patients taking Pradaxa in emergency or life-threatening situations when bleeding can’t be controlled,” he added.

Pradaxa is prescribed to prevent stroke and blood clots in people with a common heart rhythm disorder called atrial fibrillation, and for the treatment and prevention of deep venous thrombosis and pulmonary embolism (which usually occurs when clots that form in veins break free and travel to the lungs).

Praxbind is an injected drug that is the first reversal medication approved specifically for Pradaxa. In three clinical trials involving over 280 volunteers who did not require a blood thinner, those who received Praxbind showed an immediate reduction in the amount of Pradaxa in their blood that lasted for at least 24 hours. The most common side effect was headache.

Another study included 123 patients who were taking Pradaxa and received Praxbind because they had uncontrolled bleeding or required emergency surgery. The blood-thinning effects of Pradaxa were fully reversed in 89 percent of the patients within four hours of receiving Praxbind. The most common side effects were low potassium, confusion, constipation, fever and pneumonia.

The use of Praxbind to reverse the blood-thinning effects of Pradaxa puts patients at risk for blood clots and stroke, and they should resume taking Pradaxa as soon as possible, the FDA said.

Both Praxbind and Pradaxa are marketed by Boehringer Ingelheim of Ridgefield, Conn.

More information

The U.S. National Library of Medicine has more about blood thinners.

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