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Surgery, Stents Equally Effective for Opening Neck Arteries: Study

THURSDAY, Feb. 18, 2016 (HealthDay News) — Surgery to open narrowed neck arteries and stenting to keep the arteries open are equally safe and effective at reducing stroke risk, a new study reveals.

About 5 percent to 10 percent of all strokes in the United States are caused by narrowing of the so-called carotid arteries — the major arteries in the neck, explained lead investigator Dr. Thomas Brott. He is a neurologist and professor of neurosciences at the Mayo Clinic in Florida.

“Since there are about 800,000 strokes a year, we’re talking about 40,000 to 50,000 strokes a year. If we can find the best way to prevent those strokes, then we will have provided a service to those patients,” Brott said in a clinic news release.

Plaque buildup in the neck arteries can reduce blood flow and cause clotting, increasing the risk of stroke. Surgery removes the narrowed segment of the artery. Stenting involves placing a tiny tube, called a stent, in the narrowed area to open the artery wider.

The study included more than 2,500 people with an average age of 69. The researchers followed the patients’ health for up to 10 years after undergoing either stenting or surgery. About 7 percent of patients in both groups had a stroke during the follow-up period, the investigators found.

Regardless of the procedure, re-narrowing of the neck artery occurred in about 1 percent of patients per year, the study revealed.

“This very low rate shows these two procedures are safe and are also very durable in preventing stroke,” Brott said.

“Because Medicare-age patients with carotid narrowing are living longer, the durability of stenting and surgery will be reassuring to the patients and their families,” he added.

The findings were scheduled to be presented Thursday at the annual meeting of the American Stroke Association in Los Angeles, and published in the Feb. 18 online edition of the New England Journal of Medicine.

The findings show that doctors and patients can choose either option based on the patient’s medical condition and preferences, Brott concluded.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about stroke prevention.





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Untreated High Blood Pressure Greatly Raises Risk of ‘Bleeding’ Stroke

THURSDAY, Feb. 18, 2016 (HealthDay News) — People with untreated high blood pressure face a much greater risk of a bleeding stroke, but that risk is even higher for blacks and Hispanics, a new study warns.

“The average age for a brain hemorrhage [bleeding stroke] is much younger in minorities, especially in African-Americans, so they may suffer more disability earlier in life than others,” study author Dr. Kyle Walsh said in an American Stroke Association news release.

“It’s important to be aware of having high blood pressure in the first place, and once diagnosed, to have it treated appropriately,” added Walsh, an assistant professor of emergency medicine at the University of Cincinnati.

The study included more than 4,600 white, black and Hispanic Americans who were followed for six years. During that time, half of them suffered a bleeding stroke.

Compared to having normal blood pressure, having untreated high blood pressure increased the risk of a bleeding stroke by 11 times in blacks; 9.8 times in Hispanics; and 9.5 times in whites.

Among bleeding stroke patients with a previous diagnosis of high blood pressure, high blood pressure was more likely to be untreated in Hispanics (48 percent) and blacks (43 percent) than in whites (33 percent).

Less access to medical care may be one reason Hispanics and blacks are more likely to have untreated high blood pressure, the researchers suggested.

Even among people with treated high blood pressure, blacks were 75 percent more likely and Hispanics 50 percent more likely than whites to have a bleeding stroke, according to the study findings. They were to be presented Thursday at the annual meeting of the American Stroke Association, in Los Angeles.

Studies presented at medical meetings are considered preliminary, because they have not undergone the scrutiny given to research in published journals.

More information

The American Academy of Family Physicians has more about high blood pressure.





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Results of Many Clinical Trials Take Years to Publish

By Alan Mozes
HealthDay Reporter

THURSDAY, Feb. 18, 2016 (HealthDay News) — Medical researchers conducting the majority of clinical trials in the United States fail to report their results in a timely manner, new research reveals.

Less than one-third of clinical studies performed at major academic medical institutions are published within two years of completion — a lapse that deprives the scientific community of time-sensitive, valuable information, investigators said.

“The reasons are unclear, but the consequences are profound,” said study co-author Dr. Harlan Krumholz, a professor of medicine at the Yale School of Medicine in New Haven, Conn.

“By not reporting results, the scientific findings literature is harmed because it is incomplete,” Krumholz said. “Patients are harmed because their doctors have access to only part of the evidence that has been generated, and the people who agreed to be in the studies are dishonored.”

Randomized clinical trials are the best way to assess the effectiveness and safety of medical drugs and devices, the study authors explained. However, “the culture of medical research has evolved to the point where it is common practice not to report or publish studies, leaving it to the discretion of the researchers,” Krumholz said.

To evaluate human-study reporting practices at leading academic medical institutions, the investigators examined information from the ClinicalTrials.gov database in 2013. This database is the largest such registry in the United States.

The researchers focused on U.S. studies with registrations indicating that all data-collecting efforts were scheduled to conclude at some point between 2007 and 2010.

Krumholz and colleagues identified more than 4,300 completed studies, conducted by 51 well-known academic institutions.

“We found that none of the prominent academic centers were doing well. All had many studies that were either not reported or published, or certainly not done within even two years of completing the studies,” Krumholz said.

Even when the government mandates the results be made public, they often go unreported, he added.

Overall, only 29 percent of the studies were published within two years of completion, the investigators found. And the findings of only 13 percent were reported on the ClinicalTrials.gov website in the same time frame.

Eventually, two-thirds of the studies were published, though often long after the two-year wrap-up mark, according to the report in the Feb. 17 online edition of the BMJ.

Publication patterns varied widely, Krumholz and colleagues found. While some major academic medical centers published the findings of roughly 40 percent of their fully completed studies within 24 months, others reported less than 11 percent of their findings in that time frame.

With regards to the ClinicalTrials.gov website, reporting patterns ranged from less than 2 percent to about 40 percent. Similar variations were seen in reporting results from completed stages of ongoing clinical trials.

Unfortunately, “there is little consequence to not publishing,” Krumholz said, calling this an increasingly common and “perplexing” practice.

“We have tried to understand what accounts for the lack of publication,” he said. “Certainly, undesirable results might be part of the issue. The bottom line, though, is that it is an abrogation of our responsibility as scientists and health care professionals,” Krumholz added.

Another study published last March in the New England Journal of Medicine found that only about one out of 10 clinical trials met federal requirements to report results on ClinicalTrials.gov within one year of the study’s completion.

In 2000, Congress authorized the creation of ClinicalTrials.gov to publicly report information about clinical trials. Later, a new law expanded the website’s mandate, requiring sponsors of most trials to report basic summary results so Americans could have access to the data, according to background notes in the NEJM study.

“There’s been a lot of prior concern that industry often withheld evidence that came to light later about their medical products, and that medical journals were selectively reporting the positive results from trials,” Dr. Monique Anderson of Duke University, an author of the 2015 study, said at the time.

Jeff Francer, vice president of law for the Pharmaceutical Research and Manufacturers of America, a Washington, D.C.-based trade group, said that “biopharmaceutical companies remain committed to enhancing public health through responsible clinical trial data sharing.”

Francer said his organization and its European counterpart — the European Federation of Pharmaceutical Industries and Associations — abide by a set of principles detailing their trial-data sharing goals.

Under these principles, he said, “member companies have committed to enhance clinical trial-data sharing with qualified researchers, share results with the patients who participate in clinical trials, enhance public access to clinical study information, and reaffirm their commitment to publish medically significant clinical trial results.”

More information

There’s more on ClinicalTrials.gov at the U.S. National Institutes of Health.





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Fatal Overdoses Rising From Sedatives Like Valium, Xanax

By Steven Reinberg
HealthDay Reporter

THURSDAY, Feb. 18, 2016 (HealthDay News) — While deaths from overdoses of heroin and narcotic painkillers like Oxycontin have surged in recent years, a new report finds the same thing is happening with widely used sedatives such as Xanax, Valium and Ativan.

In 2013, overdoses from these drugs, called benzodiazepines, accounted for 31 percent of the nearly 23,000 deaths from prescription drug overdoses in the United States, researchers said.

“As more benzodiazepines were prescribed, more people have died from overdoses involving these drugs,” said study author Dr. Joanna Starrels, an associate professor of medicine at Albert Einstein College of Medicine in New York City.

“In 2013, more than 5 percent of American adults filled prescriptions for benzodiazepines,” she said. “And the overdose death rate increased more than four times from 1996 to 2013.”

This epidemic hasn’t received the attention it deserves, Starrels added. “There’s been a large public health response to the epidemic of prescription narcotics use and addiction and overdose, but there has not been much response to the increase in prescription benzodiazepine deaths,” she said.

The rate of deaths from benzodiazepines is still lower than deaths from narcotic overdoses, but these deaths often involve narcotics as well. “About 75 percent of overdoses that involve benzodiazepines also involve narcotics,” Starrels said.

Benzodiazepines are sedatives and can slow breathing, “particularly when taken with alcohol or narcotics such as Oxycontin or heroin,” she said.

For the study, Starrels and colleagues used data from the Medical Expenditure Panel Survey, which tracks drug prescriptions, and the U.S. Centers for Disease Control and Prevention, which monitors deaths from drug overdoses. The data covered the years 1996 to 2013.

The researchers found that the number of adults using a benzodiazepine increased 67 percent over the 18-year period — from 8.1 million prescriptions in 1996 to 13.5 million in 2013.

In addition, the average quantity of filled prescriptions more than doubled between 1996 and 2013. At the same time, the overdose death rate for these drugs increased from 0.58 deaths per 100,000 in 1996 to over 3 deaths per 100,000 in 2013 — a more than fivefold increase, the researchers said.

The overall number of overdose deaths from benzodiazepines has leveled off since 2010, Starrels said, but that rate continues to rise among adults over 65 and for blacks and Hispanics.

The findings were published online Feb. 18 in the American Journal of Public Health.

It’s estimated that one in 20 adults fills a benzodiazepine prescription in a year. These drugs are prescribed for anxiety, mood disorders and insomnia.

“Benzodiazepines are commonly prescribed agents and should be used judiciously,” said Dr. Scott Krakower, the assistant unit chief of psychiatry at Zucker Hillside Hospital in New Hyde Park, N.Y.

Patients are often unaware of the toxic effects these drugs can have, especially when combined with other substances, such as alcohol and narcotics, Krakower explained.

In addition, patients typically under-report the dosage and quantity of those drugs, “making it difficult for primary care doctors to know what their patients are taking,” he said.

Children are also at risk, he warned. “There are also growing concerns of diversion of these drugs to children who are unaware of their lethal effects,” Krakower said.

Tighter regulations of these drugs are needed, he added. This includes prescribing smaller quantities and using other non-habit-forming drugs or longer-acting benzodiazepines, he suggested.

Parents and other family members should keep these drugs away from children. And more public education is needed about these drugs and “the dangers they have when combined with alcohol and other substances,” Krakower said.

Dependence on these drugs may lead to “drug-seeking behaviors and could have lethal consequences,” he added.

More information

Visit the U.S. National Institute on Drug Abuse for more on sedatives.





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Could a Clot-Busting Drug Help Treat a ‘Bleeding’ Stroke?

THURSDAY, Feb. 18, 2016 (HealthDay News) — In what one expert called a “counterintuitive” finding, research suggests that the powerful clot-busting drug known as tPA might help patients suffering a hemorrhagic (“bleeding”) stroke.

According to the American Stroke Association, only about 15 percent of strokes are caused by runaway bleeding in the brain; the other 85 percent are caused by a clot.

And while it makes sense to use the clot-busting tissue plasminogen activator (tPA) to break up a brain clot, it would seem counterproductive to use the same drug in the case of a bleeding stroke.

However, two new studies to be presented Thursday at the stroke association’s annual meeting in Los Angeles suggest that tPA may, indeed, have a role to play in the treatment of a bleeding stroke. Both studies were funded by the U.S. National Institutes of Neurological Disorders and Stroke.

One study involved 500 patients suffering from hemorrhagic stroke who were treated at 73 hospitals worldwide. Researchers led by Dr. Daniel Hanley, of Johns Hopkins University in Baltimore, found that directing tPA at the brain’s ventricles — fluid-filled cavities — cut the death rate from bleeding stroke by 10 percent, without increasing the number of patients who were severely disabled.

The doctors explained that tPA is used to clear the brain’s ventricles of blood that has pooled there as a result of the hemorrhagic stroke.

The technique appears to have a good safety profile, with similar or even lower rates of brain infections or other serious side effects compared to standard treatment, Hanley’s team reported.

A second study was led by Dr. Issam Awad of the University of Chicago. His team looked at tPA use in the treatment of intraventricular (within the ventricles) hemorrhagic stroke. Almost 500 patients with this type of stroke received either tPA or a saline solution.

While patients with smaller amounts of pooled blood did not seem to derive a benefit from the treatment, the therapy did seem to help those whose ventricles contained larger amounts of blood, Awad’s team found.

That “high-bleed” group had almost twice the likelihood of a good functional outcome after their stroke compared to those who didn’t get the tPA, the researchers reported. And with multiple doses of tPA, even more of the bleed was removed from the brain, the Chicago team said.

According to a stroke association news release, Awad’s team believes the findings “could change neurosurgical techniques and patient care” in the treatment of hemorrhagic stroke.

One expert agreed that the results of both studies are unexpected but potentially valuable.

“Contrary to belief, infusion of clot-buster drugs into the brain improved outcomes in patients with a brain bleed — this is counterintuitive, as one would not think that infusing a clot-buster drug would be appropriate and safe,” said Dr. Paul Wright, chair of neurology at North Shore University Hospital in Manhasset, N.Y.

However, the new research suggests the treatment could be warranted, he said, since hemorrhagic strokes are particularly deadly.

The research “showed that when 90 percent of the blood cleared [with tPA], the odds of good functional recovery doubled,” said Wright, who is also chief of neurology at Long Island Jewish Medical Center in New Hyde Park, N.Y.

“Until now, medical management for hemorrhagic stroke was extremely limited,” he noted. But the new research “solidifies a treatment protocol that enables us to provide better hope for functional recovery in a critically ill and usually fatal condition.”

The two studies have not yet been published in a peer-reviewed journal, however, and experts note that findings presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

More information

Find out more about the signs, symptoms and treatment of hemorrhagic stroke at the U.S. National Library of Medicine.





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A Third of U.S. Adults Don’t Get Regular, Refreshing Sleep: CDC

By Dennis Thompson
HealthDay Reporter

THURSDAY, Feb. 18, 2016 (HealthDay News) — One of every three Americans doesn’t get enough sleep on a regular basis, a new study from the U.S. Centers for Disease Control and Prevention says.

About 35 percent of U.S. adults are sleeping less than seven hours a night, increasing their risk of a wide variety of health problems, CDC researchers reported on Feb. 18 in the agency’s Morbidity and Mortality Weekly Report.

Getting less than seven hours of sleep a night has been associated with increased risk of obesity, type 2 diabetes, high blood pressure, heart disease, stroke, frequent mental distress and death, the study authors said.

“People have to recognize that sleep is just as important as what they’re eating and how much they’re exercising,” said Dr. Shalini Paruthi, co-director of the Sleep Medicine and Research Center at St. Luke’s Hospital in St. Louis. “It’s one of the pillars of good health.”

The CDC study is the first to document estimated sleep duration for all 50 states, as well as the District of Columbia, the researchers said.

The American Academy of Sleep Medicine (AASM) and the Sleep Research Society recommend that adults ages 18 to 60 sleep at least seven hours each night to promote optimal health and well-being.

“There seems to be sort of a good cutoff point, where if you get at least seven hours, your body and brain will function at their best,” said Paruthi, noting that a 15-member AASM panel came to this conclusion after reviewing thousands of sleep studies.

The percentage of people getting a good night’s sleep varied widely from state to state, ranging from 56 percent in Hawaii to nearly 72 percent in South Dakota, the CDC reported.

Work appears to help people get a good night’s rest. People who are unable to work or are unemployed had lower healthy sleep duration (51 percent and 60 percent, respectively) than did employed folks (65 percent), researchers said.

People with higher education also appeared better able to sleep well. The percentage of people who get healthy sleep duration was highest among people with a college degree or higher (72 percent), the survey noted.

Married folks also sleep better, with 67 percent getting healthy sleep compared with 62 percent of people never married and 56 percent of those divorced, separated or widowed, the study showed.

Most people don’t get enough sleep because they aren’t scheduling a good night’s rest as part of their busy day, Paruthi said.

“Our society is very go-go-go. There’s a lot of things to get done in one day,” she said. “Sleep tends to be something that people fail to prioritize.”

Poor health also might play a role in robbing people of rest. About a quarter of the U.S. population suffers from sleep apnea, a condition in which breathing pauses or grows shallow during sleep, said Dr. Jordan Josephson, an ear, nose, throat and sinus specialist at Lenox Hill Hospital in New York City.

Sleep apnea is strongly linked to excess weight, according to the U.S. National Institutes of Health. The CDC researchers found that people in the southeastern region of the United States and the Appalachian Mountains got the least sleep, and notably, these regions also have high rates of obesity and other chronic conditions.

People who snore and never feel well-rested should keep in mind they might be suffering from sleep apnea, Josephson said.

“If you’re snoring, chances are that even if you’re getting your seven hours, it’s not a good seven hours,” he said. “You should see your physician and take it seriously.”

The AASM has a list of “sleep hygiene” tips for people who want to improve their sleep. They include:

  • Go to bed at the same time each night and rise at the same time each morning.
  • Make sure the bedroom is a quiet, dark and relaxing environment, kept at a comfortable temperature.
  • Get a comfortable mattress and sheets, and use the bed only for sleeping and sex.
  • Exercise regularly and maintain a healthy diet.
  • Avoid exposure to screens or bright light prior to bedtime.
  • Don’t eat a large meal before bedtime, and avoid alcohol and caffeine.
  • If you don’t fall asleep after 20 minutes, get out of bed and do something relaxing before trying again.

More information

For more information on sleep, visit the U.S. Centers for Disease Control and Prevention.





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4 Bad Habits That Are Making You Hurt All Over

Photo: Getty Images

Photo: Getty Images

Always standing the same way or holding the phone on one side? You’re creating tightness or asymmetry that can eventually cause problems. Here, advice to tackle some offenders.

1. You carry your bag on one shoulder

Most of us rely on one side to schlep stuff, but constantly stressing those joints will leave you with one group of muscles that are shorter and tighter than the other.

The simple fix: Tote your purse on your right shoulder while going to work, and on the left while coming home, says David Reavy. Or use a backpack to even out the load.

RELATED: 27 Mistakes Healthy People Make

2. You hold the phone to the same ear

Favoring one ear can lock your upper back and shoulders as you cradle the phone under your head. (Quick trivia: Tend to hold the phone on your left? You’re probably right-brain dominant and more emotional. Hold it on the right? You may be more analytical, says Brad Cox, an orthopedic acupuncturist and the CEO and co-founder of Acumobility, a mobility products and education company.)

The simple fix: Go wireless. Use headphones or a headset for every call, advises Cox.

3. You wear heels day and night

We get it—you look ah-mazing in stilettos! But “you need to lower your heel heights so you don’t exacerbate poor posture or keep your muscles in a shortened position,” says Katy Bowman. “Even if you wear a 1/2-inch heel everyday, you’re teaching your calves to stay in that position.”

The simple fix: It’s fine to wear heels, but make sure you mix in flats, too.

RELATED: How to Get Rid of 15 Pesky Health Problems

4. You lean into your right hip, always

Few stand in perfect alignment; it seems only natural to shift to one side. But this may make one side tighter, which can throw off your balance and lead to injury, says Cox. (That’s especially true if you run, which requires a constant shifting between the two sides.)

The simple fix: Be aware of which leg you favor, and switch it up whenever possible. Also, stretch and strengthen both halves of your body equally.




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Travelers to Zika Areas Should Wait to Donate Blood, FDA Says

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Getty Images

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People who travel to places where there is ongoing transmission of the Zika virus should not donate blood for a significant period of time, according to U.S. health officials.

On Tuesday, the U.S. Food and Drug Administration (FDA) issued new recommendations that people who have been to areas of Zika transmission, have possibly been exposed to the virus, or have a confirmed Zika infection should be deferred from donating blood. “We are issuing this guidance for immediate implementation in order to better protect the U.S. blood supply,” Dr. Luciana Borio, the FDA’s acting chief scientist said in a statement.

So far there are no reports of the Zika virus entering the U.S. blood supply, but the FDA writes that “the risk of blood transmission is considered likely based on the most current scientific evidence of how Zika virus and similar viruses (flaviviruses) are spread and recent reports of transfusion-associated infection outside of the U.S.”

The fact that most people infected with the virus will not exhibit symptoms also has the agency concerned.

While it’s difficult to estimate how many people have been or will be infected with the Zika virus worldwide—due to the fact that many people are asymptomatic and the virus only remains in a person’s system for about a week—some estimates suggest that three to four million infections are expected in the Americas in the next year. The number of American travelers who could be deferred for blood donation is significant. For instance, it’s estimated that millions of Americans travel to Mexico each year, including over 150,000 U.S. citizens who cross the border every day, according to the U.S. Department of State.

For areas without an active circulation of the Zika virus, the FDA says donors who are at risk of having Zika should be deferred for one month. This includes people who have had symptoms of an infection in the last four weeks, people who have had sexual contact with someone who has traveled to or lived in an area with Zika transmission during the last three months, and people who have traveled to affected regions during the last four weeks.

In addition, the FDA says for areas that do have active Zika cases, blood for certain transfusions should be obtained from areas in the United States that do not have circulation of the virus. You can read more about the FDA’s new recommendations here.

This article originally appeared on Time.com.




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7 Insider Secrets I Learned From Chrissy Teigen’s Makeup Artist

Spiders’ Size Exagerrated in Minds of Those Who Fear Them

THURSDAY, Feb. 18, 2016 (HealthDay News) — If you’re frightened of spiders, in your mind’s eye they may seem much bigger than they really are, a new Israeli study finds.

The research included female university students. They were divided into two groups, depending on whether they were afraid or unafraid of spiders.

Each of the women was then shown pictures of spiders, birds and butterflies.

Unsurprisingly, both groups said the spider pictures were more unpleasant than the other pictures. However, only those with a heightened fear of spiders overestimated the size of the spiders compared to the butterflies.

The participants’ estimation of spider size was affected by both how unpleasant they found the spider pictures and how much they were afraid of spiders, according to the study published in the journal Biological Psychology.

“We found that although individuals with both high and low arachnophobia [fear of spiders] rated spiders as highly unpleasant, only the highly fearful participants overestimated the spider size,” said lead researcher Tali Leibovich. She is a Ph.D. neurology researcher at Ben-Gurion University of the Negev.

The findings show “how perception of even a basic feature such as size is influenced by emotion, and demonstrates how each of us experiences the world in a unique and different way,” Leibovich said in a university news release

The research “also raises more questions such as: Is it fear that triggers size disturbance, or maybe the size disturbance is what causes fear in the first place? Future studies that attempt to answer such questions can be used as a basis for developing treatments for different phobias,” she said.

More information

Mental Health America has more on phobias.





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