Gulf War Veterans’ Illnesses Still Poorly Understood: Report
THURSDAY, Feb. 11, 2016 (HealthDay News) — Scientists and doctors still lack good insight into Gulf War illness and other health problems plaguing U.S. veterans of the 1990-91 Persian Gulf War, a new report says.
More than $500 million in U.S. government-funded research on Gulf War veterans was conducted between 1994 and 2014, producing many results. But there has been little overall progress in understanding the health effects of serving in that war, according to an Institute of Medicine (IOM) committee.
Echoing conclusions of a 2010 IOM report, the new U.S. Department of Veterans Affairs-sponsored study said Gulf War veterans appear to be at increased risk for Gulf War illness, chronic fatigue syndrome, digestive disorders, and such mental health conditions as post-traumatic stress disorder, anxiety, depression and substance abuse.
The review of available scientific and medical literature also found evidence of a link between Gulf War deployment and amyotrophic lateral sclerosis (ALS), fibromyalgia, chronic pain and sexual problems.
While ALS — also called Lou Gehrig’s disease — was the only neurologic disease for which there was evidence of an association with Gulf War service, veterans of that war are still young in terms of the development of degenerative brain diseases.
Therefore, the IOM committee said the VA should continue to monitor Gulf War veterans for degenerative brain diseases that take a long time to develop, such as ALS, Alzheimer’s and Parkinson’s.
There was not enough information to determine whether Gulf War veterans are at added risk for cancer, but the committee said the VA should continue to assess cancer rates among these veterans.
Evidence for Gulf War illness has increased in recent years, but there has been little improvement in understanding the disease or how to treat or manage it. A debilitating disorder, its symptoms include fatigue, joint and muscle pain, headaches, concentration and memory difficulties, gastrointestinal problems and skin rashes.
Current evidence suggests that a single cause cannot explain the wide range of symptoms, and the panel said it is unlikely that a definitive cause or causes can be pinpointed, especially so long after the war.
The findings from this and previous reports suggest that the “conditions associated with Gulf War deployment are primarily mental health disorders and functional medical disorders and that these associations emphasize the interconnectedness of the brain and body. All these conditions have no objective medical diagnostic tests and are diagnosed on the basis of subjective symptom reporting,” according to a news release from the IOM, part of the private, nonprofit National Academies of Sciences, Engineering, and Medicine.
Research should continue and focus on treating and managing Gulf War illness rather than its causes, the committee said.
More information
The U.S. Centers for Disease Control and Prevention has more about Gulf War illness.
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More Young Breast Cancer Patients Getting Gene Test
By Amy Norton
HealthDay Reporter
THURSDAY, Feb. 11, 2016 (HealthDay News) — A growing number of young women with breast cancer are being tested for the BRCA gene mutations that substantially raise the risks of breast and ovarian tumors, a new study shows.
Researchers found that of nearly 900 women who developed breast cancer at age 40 or younger, most had undergone BRCA testing within a year of their diagnosis.
And the percentage went up over time: By 2013, 95 percent had been tested, according to findings published online Feb. 11 in JAMA Oncology.
Experts called the results good news, since BRCA testing has long been recommended for women diagnosed with breast cancer before the age of 50.
“This is great, it’s heartening,” said Dr. Jeffrey Weitzel, director of clinical cancer genetics at City of Hope, in Duarte, Calif.
But, he added, women in the study were largely white, well-educated and had health insurance — and it’s unlikely that disadvantaged U.S. women would show the same high rate of BRCA testing.
“We need to keep working on extending the reach of genetic testing,” said Weitzel, who co-wrote an editorial published with the study.
Media coverage following actress Angelina Jolie’s disclosure that she carried the BRCA1 mutation has improved awareness about the testing and cancer preventive surgeries, previous research has suggested.
Jolie had both of her breasts removed in 2013 after learning she has the BRCA mutation. And, in 2015, she had her ovaries and fallopian tubes removed due to the significantly increased risk of ovarian cancer that stems from having the BRCA1 mutation. But, the authors of the new study note that the rise in gene testing among patients in this study largely predated Jolie’s disclosure.
Inherited mutations in the BRCA1 and BRCA2 genes account for 5 to 10 percent of all breast cancers, and about 15 percent of all ovarian cancers, according to the U.S. National Cancer Institute.
Since the mutations raise the risk of early cancer, women who develop either disease at a young age have a relatively higher chance of harboring the flawed genes.
So BRCA testing is recommended for women diagnosed with breast cancer before age 50. That’s, in part, to help guide their treatment decisions, explained Dr. Ann Partridge, the senior researcher on the new study, and an oncologist at Dana-Farber Cancer Institute, in Boston.
Women who carry the mutations have a high risk of developing a second cancer in the other breast, so some may want to opt for a double-mastectomy as a preventive measure. (Experts also advise women with BRCA mutations to have their ovaries removed by age 40, since there is no screening test for ovarian cancer, or any way to prevent it.)
BRCA testing also gives families information, Partridge explained. “On one hand, it could give them some peace of mind if the test is negative,” she said. If it’s positive, then certain family members may want to be tested, too, she added.
For the current study, Partridge and her colleagues surveyed 897 women who’d been diagnosed with breast cancer at age 40 or younger, at some point between 2006 and 2013. All were treated at one of 11 hospitals in Massachusetts, Colorado and Minnesota.
Of women diagnosed in 2006, 77 percent said they’d received BRCA testing. That went up to 95 percent among women diagnosed in 2013, the study reported.
Overall, about 12 percent of women who were tested had a BRCA mutation. And most of those women — 86 percent — decided to have a double-mastectomy, the study showed.
But half of the women who tested negative for a BRCA mutation also had a double-mastectomy, the researchers found.
That’s concerning, both Partridge and Weitzel said. Women without the gene mutations have a low risk of developing a second cancer in the other breast, and there’s no evidence that a double-mastectomy improves their long-term survival.
“We don’t want to be doing procedures that aren’t medically indicated,” Partridge said.
It’s not clear why so many women with negative test results opted for a double-mastectomy — but it’s also not surprising, Partridge noted, since it’s consistent with past studies.
“Some women may do it for peace of mind,” Partridge said, “or because they do believe it will improve their survival, even though there’s no evidence.”
At a time of high anxiety, she said, some women may not fully process the risk/benefit information they’re hearing.
According to Weitzel, BRCA testing should ideally include genetic counseling, to help ensure that women understand their results.
But in reality, that counseling does not always happen, he said.
Under the Affordable Care Act, also known as Obamacare, BRCA testing is a covered preventive service for women at high risk of having a mutation. And, Weitzel said, Medicaid is now paying for testing, though the coverage varies by state.
There’s still work to be done to improve “underserved” women’s access to BRCA testing and counseling, Weitzel said — including women in lower-income countries.
More information
The U.S. National Cancer Institute has more on BRCA testing.
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CDC Reports Link Between Zika Virus and Microcephaly in Brazil
By Dennis Thompson
HealthDay Reporter
THURSDAY, Feb. 11, 2016 (HealthDay News) — Traces of the Zika virus have been identified in the tissue of two babies who died in Brazil from a birth defect marked by underdeveloped heads and brains, U.S. health officials said Wednesday.
The discovery doesn’t prove the Zika virus is the cause of thousands of cases of microcephaly in Brazilian babies since the spring. But, it’s the firmest connection yet that the mosquito-borne pathogen may be to blame, Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, told a Congressional panel, USA Today reported.
“This is the strongest evidence to date that Zika is the cause of microcephaly,” Frieden told the House Foreign Affairs Committee. But, he added, more tests are needed to confirm that the Zika virus is the cause of the birth defect.
Frieden and Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, appeared before the panel to lobby for President Barack Obama’s request for $1.8 billion in emergency funds from Congress to combat the threat of Zika virus.
The Zika virus was first identified in Uganda in 1947, and until last year was not thought to pose serious health risks. In fact, approximately 80 percent of people who become infected never experience symptoms.
But the increase of cases and birth defects in Brazil in the past year — suspected to exceed more than 4,100, making that nation the epicenter of the epidemic — has prompted health officials there to warn pregnant women or those thinking of becoming pregnant to take precautions or consider delaying pregnancy.
And the CDC is recommending that pregnant women avoid the regions of Central and South America and the Caribbean, where Zika virus has been identified and officials have described it as spreading “explosively.”
On Thursday, it was reported that two American women who had contracted the Zika virus while traveling abroad had miscarried after returning home. The virus was found in their placentas, according to a CDC spokesman, the Washington Post reported.
This is the first time that U.S. health officials have reported miscarriages in American women who had become infected while traveling abroad, although there have been many miscarriages reported in Brazil, the newspaper said.
Also Thursday, Brazilian health officials said they had entered into an agreement with the University of Texas to develop a Zika vaccine, with the hope that it would be ready for clinical testing within a year, the Associated Press reported.
Brazil’s Health Minister, Marcelo Castro, said his government will invest $1.9 million into the research, which will be done jointly by the University of Texas and the Evandro Chagas Institute in Belem. He also said his agency had reached vaccine partnerships with the CDC, the news service said.
Since the Zika epidemic first surfaced in Brazil last spring, the virus has spread to 30 countries and territories in Latin America and the Caribbean. The World Health Organization (WHO) now estimates there could be up to 4 million cases of Zika in the Americas in the next year.
The Obama administration’s request for funding, made Monday, would allow for an expansion of mosquito-control programs, speed development of a vaccine, develop diagnostic tests and improve support for low-income pregnant women.
The earliest a vaccine could be developed would be some time next year, Fauci has said.
The White House’s $1.8 billion funding request followed a WHO emergency declaration last week that the Zika virus is now a global health threat, based on the suspicion that the virus may be to blame for the thousands of birth defects in Brazil in the past year.
The Obama administration action also followed a new advisory from the CDC that pregnant women with a male sex partner who has traveled to, or lives in, an area affected by active Zika virus transmission should refrain from sex or use condoms until the pregnancy is over.
The CDC said the precaution is in place “until we know more” about the dangers of sexual transmission of the virus.
The CDC advisory followed a report out of Texas that one confirmed case of Zika virus infection was transmitted through sex, not a mosquito bite.
The Dallas County Health and Human Services Department reported last week that an unidentified patient had become infected with the Zika virus after having sex with an individual who had returned from Venezuela, one of the Latin American countries where Zika is circulating.
Scientists have suspected that Zika could be transmitted sexually, and there have been scattered reports of similar occurrences in recent years.
If research proves that the virus can be spread through sex, it could complicate efforts to contain infections from the virus.
The U.S. blood supply is also being monitored closely. The American Red Cross on Feb. 3 asked potential blood donors who have traveled to areas where Zika infection is active to wait 28 days before giving blood.
The chances of Zika-infected blood donations remain extremely low in the United States, Dr. Susan Stramer, vice president of scientific affairs at the American Red Cross, said in a statement at the time.
According to the White House, the CDC had reported 50 laboratory-confirmed cases among U.S. travelers from December 2015 through Feb. 5, 2016. There has so far been no transmission of the Zika virus by mosquitoes within the United States. But, some Americans have returned to the United States with infections from affected countries in South America, Central America, the Caribbean and the Pacific Islands, the AP reported.
More information
For more on Zika virus, visit the U.S. Centers for Disease Control and Prevention.
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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What the Color of Your Pee Means About Your Health
Image: Courtesy of Daily Burn
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What Your Urine Color Means About You
Clear
By now you’ve heard that drinking eight glasses of water a day and staying hydrated is important for your health. But if your urine looks like water, you’re probably overhydrated, says Jane Miller, MD, associate professor of urology at the University of Washington. You likely aren’t doing yourself any harm, but there’s no data to support the need for drinking eight or more glasses of water a day, Miller says. Plus, you’ll just wind up spending half your day in the bathroom if you’re drinking too much.
Pale Yellow
Consider this your toilet bowl goal. You should strive to have light yellow pee, somewhere between clear and the color of apple juice. You’re probably sufficiently hydrated if your pee is pale yellow, but it doesn’t necessarily mean anything about your health beyond that if your pee is darker or lighter, says Miller.
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Bright Yellow
If your pee looks like a neon billboard, blame B vitamins, Miller says. Riboflavin (B2) is naturally fluorescent when exposed to UV light. It might be jarring to see, but it’s nothing to worry about. Your body excretes the riboflavin it doesn’t need through urine, which is why excess amounts, either consumed in food or through taking supplements, could make your pee look bright yellow. Almost all multivitamins contain riboflavin, as do food such as eggs, organ meats, lean meats and dairy.
Brownish-Yellow
Pee that’s the color of apple juice is the darkest end of the “normal” urine spectrum. While you might assume it means you’re super dehydrated, it really just means your pee is extra concentrated, says Miller. “Just because urine is concentrated doesn’t mean you are dehydrated. Your kidneys are very good at concentrating urine to keep you from becoming symptomatically dehydrated.” That said, if your urine is dark often, it wouldn’t be a bad idea to drink more water, especially if you’re exercising a lot.
RELATED: Is It Possible to Drink Too Much Water?
Brown
Brown urine can be associated with myoglobinuria, or the presence of myoglobin — a protein found in muscle — in the urine. It’s most commonly associated with rhabdomyolysis, or “rhabdo,” which is a form of muscle damage that causes muscle fibers to die and be released into the bloodstream (you may have heard about it in discussions about CrossFit). Without prompt medical care, rhabdo could lead to lasting kidney damage.
RELATED: 12 Things I Wish I Knew Before I Started CrossFit
Greenish-Blue or Orange
We wouldn’t blame you for freaking out if your pee showed up blue in your bowl. But if you’re being treated for a UTI, strange greenish-blue pee could be a side effect. That’s because Uribel, a medication used to treat urinary symptoms and irritations, contains methylene blue, a dye that can show up in your urine.
Likewise, if you’re being treated with Phenazopyridine, a urinary tract analgesic used for UTIs or bladder irritation, your pee could turn orange. This is a normal side effect of the medication, and should clear up when your treatment is finished. In both cases, consult with your doctor if you’re concerned!
Pink or Red
A crimson hue could mean a few things. The least worrisome would be that you’ve been eating lots of beets, says Miller. In large amounts, the pigments in beets can actually turn your pee red. This discoloration isn’t harmful and should resolve fairly quickly, says Miller. If it doesn’t, you’ll want to get your urine tested for blood, which is another reason your pee might be red. Bloody urine could be a sign of a urinary tract infection (UTI) or urinary stones, which are usually accompanied with pain and discomfort. Kidney, ureter and bladder cancers can also present with blood in the urine, and typically don’t have other symptoms, such as pain, associated with the bloody urine, says Miller. “Although all important, this is the most serious, and why you should let your [healthcare] provider know — even if it goes away quickly — because some cancers bleed intermittently.”
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The Surprising Beauty Tool That Can Lengthen Lashes, Cover Grays, and More
Stay away from the extensions: You can add instant oomph to your hair, brows, and lashes with fibers. These tiny, hairlike pieces latch onto strands to plump them up without looking fakey-fake. Three picks:
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If You Want to Boost Brows
Photo: Toppik.com
Try: Toppik Brow Building Fibers Set ($20; toppik.com)
Start with the wax, made of shea butter and jojoba oil to condition and tame brows, then use the colored keratin protein fibers to fill in bare spots.
RELATED: 18 Fashion and Makeup Mistakes That Are Aging You
If You Want to Lengthen Lashes
Photo: Ulta.com
Try: Lorac Pro Plus Fiber Mascara ($23; amazon.com)
The tapered brush delivers nylon fibers that cling to lashes. Focus on the tips for length or the base for all-around fullness.
RELATED: 10 Foods for Stronger Nails and Thicker Hair
If You Want to Pump Up Strands
Photo: Viviscal.com
Try: Viviscal Conceal and Densify Volumizing Fibers ($25; amazon.com)
Run the comb applicator through roots to distribute electrostatically charged tinted fibers, which add volume and cover grays.
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Study Links Child Abuse, Neglect to Earlier Onset of Bipolar Disorder
THURSDAY, Feb. 11, 2016 (HealthDay News) — People with bipolar disorder who have a history of being abused or neglected as children may have more severe symptoms and a higher risk of suicide, new research suggests.
“Our findings have important implications for clinical practice, as they suggest that a history of childhood maltreatment could be used as an early indicator of high risk for poor outcomes among individuals with bipolar disorder,” said study author Jessica Agnew-Blais, a postdoctoral researcher at King’s College London in England.
“This information could be valuable for identifying patients with bipolar disorder who may benefit from greater support and treatment,” she said in a college news release.
The researchers reviewed 30 studies. While they only found an association, rather than a cause-and-effect link, they said bipolar patients who suffered from neglect or physical, sexual or emotional abuse as children were more likely to have more severe manic, depressive and psychotic symptoms compared to those who weren’t abused.
People with bipolar disorder who were abused as children also had a higher risk of anxiety disorders and substance and alcohol abuse disorders, the research showed.
Those abused as children developed bipolar symptoms more than four years earlier, the study found. They also were nearly four times more likely to have post-traumatic stress disorder. And they were nearly twice as likely to attempt suicide as those who weren’t mistreated during childhood, the researchers said.
The study adds to growing evidence on the long-lasting mental health effects of childhood abuse and neglect, the researchers said.
One in every 25 adults will be diagnosed with bipolar disorder at some time in their life. People with the condition experience significant swings in mood, energy and activity levels, the researchers said.
“These findings lend support to the notion that maltreatment can affect neurobiological processes associated with progression of the disorder,” Agnew-Blais said.
Further research is needed to determine how a history of childhood abuse or neglect may affect treatment of bipolar patients, study senior author Andrea Danese, a senior lecturer at King’s College London, said in the news release.
The study was published Feb. 9 in The Lancet Psychiatry.
More information
The U.S. National Institute of Mental Health has more about bipolar disorder.
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Gains in Kid’s Health Coverage Continue, But Many Still Uninsured
THURSDAY, Feb. 11, 2016 (HealthDay News) — Despite a significant increase in the number of American children with health insurance, many still lack coverage, a new study reveals.
From 2013 to 2014, the number of uninsured children fell from 5.9 million to 4.9 million. In 2013, 7.5 percent of youngsters were uninsured, compared to 6.3 percent in 2014 — a 16 percent decrease.
While the findings show progress, nearly 5 million Americans under age 19 still lack health insurance, according to the Robert Wood Johnson Foundation report prepared by University of Minnesota researchers.
“Despite the politicking around health policy lately, I think we can all agree that coverage for kids is essential for their healthy development,” Kathy Hempstead, the foundation’s director of coverage issues, said in a news release from the organization.
“The last year has shown continued progress in expanding coverage to children and the reduction of differences by race, ethnicity and income, but there is more work to be done,” she added.
The percentage of uninsured children fell sharply in 23 states and no states had significant increases, the investigators found.
The states with the largest declines in uninsured children were Arizona, Colorado, Minnesota, Nevada and Rhode Island.
Nearly half of the 4.9 million uninsured children are in six states: Texas (880,000), California (550,000), Florida (410,000), Georgia (210,000), Arizona (180,000), and New York (160,000).
Of these six states, four had the largest decrease in the number of children without coverage from 2013 to 2014: California (down 210,000), Texas (down 95,000), Florida (down 87,000), and Georgia (down 53,000).
Two states — Massachusetts and Vermont — had fewer than 2 percent of children who were uninsured. In three states, more than 10 percent of children lacked coverage: Alaska (12.3 percent), Texas (11.8 percent), and Arizona (10.5 percent).
Nationwide, decreases in rates of uninsured children were highest among Hispanics, non-whites and low-income families. In the past, all three groups were most likely to be uninsured, the study authors said.
In 2014, just over 34 percent of children were enrolled in Medicaid and the Children’s Health Insurance Program, while 59 percent had private coverage, the findings showed.
“It’s likely the case that more children gained coverage as eligible parents signed up for free or low-cost health insurance, and we’re likely to see that trend continue,” Lynn Blewett said in the news release. Blewett is director of the University of Minnesota’s State Health Access Data Assistance Center, which compiled the report.
More information
The U.S. Department of Health and Human Services has more about health plan coverage for kids.
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6 ways to beat cravings
Retrain your brain to decrease those unwanted cravings with these 6 tips.
If your food choices disappoint your tastebuds, you’re more likely to resort to an unhealthy sweet treat to make up for feeling deprived. Here’s how you can reduce those hunger pangs.
1. Choose low-GI foods
“Foods with a lower glycaemic index (GI) of 55 or less are more slowly digested, absorbed and metabolised and cause a lower and slower rise in blood glucose and insulin levels,” says Melanie McGrice, accredited dietitian and director of Nutrition Plus clinics in Melbourne. “Low-GI foods also help you feel more sated after a meal and reduce risk of weight gain and conditions like diabetes.” Every day, aim to eat five serves or more of fresh vegetables and two of fruit plus wholegrains and some lean protein at every meal.
2. ‘Healthify’ takeaway meals with homecooked makeovers
Prepare homemade burgers with wholemeal buns and stacks of salad vegetables. Make fish and chips but grill the fish and bake large pototo wedges with a dash of olive oil.
3. Downsize your utensils
“Eating soup from a teaspoon or risotto from a small entrée fork encourages slower eating, so you feel more full and satisfied after a meal,” says McGrice. Chopsticks also encourage smaller mouthfuls.
4. Mix it up
Rigid, restrictive food regimes substantially reduce our pleasure of eating, are often nutritionally unsound and increase the risk of cravings and ‘all or nothing’ thinking about food. The Dietitians Association of Australia recommends aiming to eat 20 different nutritious foods every day.
5. Top ‘n’ tail
Roberts calls this method the ‘sandwich’ technique. “You put a moderate portion of a high-kilojoule food in the middle of a meal with lower kilojoule foods that are high in fibre and protein at the beginning and end,” she explains. This makes you feel you’ve been at a banquet. Soups make good starters and salads are a nice crispy third course.
6. Don’t blow off breakfast
Eat some filling slow-cooked porridge or eggs and dark rye toast. People who skip breakfast tend to have lower dopamine levels, shows research from the University of Missouri. This may explain why they are also more likely to crave sweet or savoury food later in the day.
Words by Stephanie Osfield
NEXT: Find out how to spot false food cravings.
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Lasting Damage Seen in LGBT Teens Who Suffer Harassment
WEDNESDAY, Feb. 10, 2016 (HealthDay News) — Lesbian, gay, bisexual and transgender (LGBT) teens who experience severe harassment can suffer from serious mental health problems, a new study suggests.
“With bullying, I think people often assume ‘That’s just kids teasing kids,’ and that’s not true,” said study author Brian Mustanski, director of Northwestern University’s Institute for Sexual and Gender Minority Health and Wellbeing in Chicago.
“If these incidents, which might include physical and sexual assaults, weren’t happening in schools, people would be calling the police,” he said in a university news release.
“You can’t equate someone giving you a dirty look with someone physically assaulting you. Victimizations that are more severe are going to have bigger effects. We scored them in a way that represented that, and we saw they had a profound effect on mental health rates over time,” Mustanski explained.
In the study, the researchers followed almost 250 LGBT youth in Chicago for four years. During that time, nearly 85 percent of the participants had decreasing levels of harassment, about 10 percent had significant increases in harassment, and about 5 percent had consistently high levels of harassment.
Females were more likely than males to have decreasing levels of harassment during the study period, and males were more likely to be subjected to physical and verbal assaults, the researchers found.
LGBT youth at greatest risk for lasting mental health problems — such as depression and post-traumatic stress disorder — were those who suffered moderate harassment (such as having things thrown at them) that increased over time and those who had continuously high levels of harassment (such as physical or sexual assault) during the study.
“We were happy to see that for most kids, the levels of victimization were lower overall or decreasing over time. But we were struck by how severe it was for some of these kids who were getting highly victimized over their four years of high school,” Mustanski said in the news release.
“If that’s your experience for several years of high school, you can imagine how scarring that would be,” he added.
The findings were published recently in the American Journal of Public Health.
More information
The U.S. Centers for Disease Control and Prevention has more on LGBT health.
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