Nipple-Preserving Mastectomies Appear Safe for High-Risk Women: Study

MONDAY, April 25, 2016 (HealthDay News) — Preventive breast removal (mastectomy) that preserves the nipple and surrounding skin may be as effective in preventing breast cancer in high-risk women as more invasive surgeries, a new study suggests.

The study included 348 women with BRCA genetic mutations that increase the risk of breast cancer. They had preventive nipple-sparing mastectomies between 1968 and 2013. Of those women, 203 had both breasts removed (bilateral mastectomy) and 145 had one breast removed preventively after cancer occurred in the other breast.

Three to five years after surgery, none of the women who had bilateral nipple-sparing mastectomy developed breast cancer at any site. No breast cancers developed in the remaining skin, nipples or lymph nodes on the side of the breast removal.

Seven women died from breast cancer during follow-up. All of them had a previous or concurrent breast cancer at the time of surgery and their late-stage disease was attributed to that cancer, according to the study that was to be presented at the annual meeting of the American Society of Breast Surgeons, in Dallas.

The findings show that nipple-sparing mastectomies, which leave women with more natural-looking breasts than other mastectomies, could be effective at reducing breast cancer risk in women with BRCA mutations, the researchers said.

“Nipple-sparing mastectomy is gaining wide acceptance because of its superior cosmetic results, but pockets of the medical community remain skeptical that it is the right choice for the BRCA population,” said study lead author Dr. James Jakub, a breast surgeon at Mayo Clinic in Rochester, Minn.

“This is the largest study of its kind to address the controversy, and to show that nipple-sparing mastectomy is as effective at preventing breast cancer as traditional mastectomy,” he said in a clinic news release.

“There is no question that this option of nipple-sparing mastectomy can often provide an outstanding cosmetic result and may make it easier for women who are at risk to take this preventive measure,” Jakub said.

“Though the nipple is preserved, it unfortunately will not have stimulation or arousal. Despite that, studies looking at the impact of risk-reducing surgery on quality of life, sexual satisfaction and intimacy, suggest that being able to preserve aesthetics and body image can improve all of these factors,” he concluded.

Because they were slated for a medical meeting, the findings should be considered preliminary until published in a peer-reviewed medical journal.

More information

The U.S. National Cancer Institute has more about surgery to reduce breast cancer risk.

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Pharmacists Can Manage Some Chronic Conditions Effectively, Study Suggests

By Dennis Thompson
HealthDay Reporter

MONDAY, April 25, 2016 (HealthDay News) — Pharmacists may do a better job than doctors helping chronically ill patients manage their blood pressure, cholesterol and blood sugar levels if they’re allowed to direct people’s health care, a new evidence review suggests.

The review also found that pharmacists could manage chronic diseases with about the same efficiency as doctors.

However, current evidence doesn’t show whether pharmacists can actually improve a patient’s overall health if they take over someone’s care from a doctor, said study senior author Dr. Timothy Wilt. He’s a professor of medicine at the University of Minnesota Medical School, and a staff physician at the Minneapolis VA Health Care System.

Wilt and his colleagues also couldn’t show whether having a pharmacist manage your care can help you live longer or reduce symptoms caused by chronic ailments such as heart disease or diabetes.

“That was a bit frustrating for us, because that’s really what patients really care about — will it help them live longer and live better?” Wilt said.

The reason for the interest in pharmacist-driven care is that some areas of the United States don’t have enough doctors. Due to these shortages, other types of health care workers, such as nurse practitioners or physician assistants, are being called on to help fill the gaps, Wilt said.

New legislation introduced in Congress would establish pharmacists as health care providers, and pay them accordingly through Medicare in communities where there aren’t enough doctors, the study authors said.

Pharmacists acting as a person’s primary care provider would be able to evaluate a patient’s health, advise them how to best manage their chronic conditions, and possibly even have the power to order tests or prescribe medicines, Wilt said.

They also could send patients to a doctor for any procedure they might need, such as an injection for knee pain or removal of a wart, he said.

To determine how well pharmacists might perform if they led the management of a person’s chronic disease, Wilt and his colleagues reviewed 63 published studies. The studies included 65 different patient populations with more than 33,000 people.

The findings suggest that patients receiving pharmacist-led care were more likely to achieve target goals for blood pressure, cholesterol and blood sugar compared with patients receiving usual care.

Pharmacist-led care also increased the dosage or the number of medications being received. “It’s not clear whether that’s a good thing or not,” Wilt said. “Some people should be on more medications, but for others, they should be on less.”

But the study authors concluded there’s not enough evidence to say whether people actually are healthier and do better when a pharmacist manages their care.

Anne Burns, vice president of professional affairs for the American Pharmacists Association, said the study shows “pharmacists’ medication expertise and extensive training can help to address unmet health care needs in this country.

“We are pleased that this study found that pharmacists can effectively manage the care of patients with chronic conditions,” Burns said.

There are a number of ways health care dollars could be saved if pharmacists are managing chronic diseases, Wilt said.

Pharmacists are paid less than physicians, and having them handle day-to-day chronic disease care would free up doctors to see patients with more serious and complex health problems, Wilt said.

Dr. David Katz, director of the Yale University Prevention Research Center, agreed that the findings show that “some portion of what now constitutes the primary care management of chronic conditions can be taken over ably by pharmacists.”

However, some tasks such as initial diagnosis, troubleshooting and customization of treatment should remain the responsibility of a physician, Katz said.

“But the [long-term] oversight of an established treatment plan may be provided as ably by a pharmacist as a physician, and at lower cost,” he said. “Health care professionals embracing complementary roles as part of an overall care team is one of the best, short-term strategies for raising the quality while lowering the costs of such care. I am all for it.”

The study was published online April 25 in the Annals of Internal Medicine.

More information

For more on pharmacist-led care, visit the American Society of Health-System Pharmacists.

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Fewer Children May Explain Why More Women Now Outlive Men

MONDAY, April 25, 2016 (HealthDay News) — Smaller families may be one reason why women now outlive men, a new study suggests.

Researchers analyzed data from 140,600 people in Utah and found that men who were born in the early to mid-1800s lived an average of two years longer than women born at the same time.

This difference gradually reversed, and women born in the early 1900s lived an average of four years longer than men, the findings showed.

At the same time, the number of children per woman fell from an average of over eight in the early 1800s to just over four in the early 1900s. In addition, the investigators found that women who had 15 children or more lived an average of six years less than those with only one child.

There was no association between the number of children fathered by men and their life span, according to the study published recently in the journal Scientific Reports.

The findings suggest that lower birth rates need to be considered when trying to determine why women tend to live longer than men, the study authors concluded.

The results highlight “the importance of considering biological factors when elucidating the causes of shifting mortality [death] patterns in human populations,” said study leader Elisabeth Bolund. She is a postdoctoral research fellow in the department of ecology and genetics at Uppsala University in Sweden.

“Our results have implications for demographic forecasts, because fertility patterns and expected life spans are continuously changing throughout the world,” Bolund explained in a university news release.

“For example, the results suggest that as more and more countries throughout the world go through the demographic transition, the overall sex differences in life span may increase,” Bolund concluded.

More information

The U.S. Centers for Disease Control and Prevention has more on life expectancy.

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Music Might Give Babies’ Language Skills a Boost

By Randy Dotinga
HealthDay Reporter

MONDAY, April 25, 2016 (HealthDay News) — Can listening to music boost your baby’s brainpower?

Maybe, at least in specific ways. A new study suggests that listening to music with a waltz-like rhythm — a difficult form of rhythm for infants to comprehend — and tapping out the beats with their parents improved babies’ processing of music patterns and speech sounds.

“Actively participating in music may be another important experience that can influence infants’ brain development and help them learn,” said study lead author T. Christina Zhao. She’s a postdoctoral fellow at the University of Washington in Seattle.

However, the researchers said that it’s not clear how long the effect of listening to music may last or how much exposure to music is needed to make improvements in music- and speech-pattern processing.

Previous research — known popularly as the “Mozart effect” — on how music in early childhood might have a positive impact on young children’s brain development has had mixed results. The differences were likely due to the design of the studies, the authors of the new study suggested.

For the new study, researchers randomly assigned 39 nine-month-old babies to be exposed to music or serve as a control group.

Nineteen of the babies made up the control group. These children played with toys during a dozen 15-minute sessions in a month.

The other 20 babies listened to “recordings of children’s music played while an experimenter led the babies and their parents through tapping out the beats in time with the music,” Zhao said.

“All the songs were in triple meter, like in a waltz, which the researchers chose because they’re relatively difficult for babies to learn,” she noted.

A week after the play sessions ended, the babies underwent brain scans. “While sitting in the brain scanner, the babies listened to a series of music and speech sounds, each played out in a rhythm that was occasionally disrupted,” Zhao said. “The babies’ brains would show a particular response to indicate they could detect the disruption.”

The researchers found that the brains of the babies in the music exposure group were better able to respond to disruptions in speech and music rhythm, Zhao said.

In the big picture, the findings “have broadened our understanding of how infants learn speech sounds and shed some light on how the brain may process music and speech sounds similarly,” she said.

The study was published April 25 in the Proceedings of the National Academy of Sciences.

Deanna Hanson-Abromeit, an assistant professor of music education and music therapy at the University of Kansas School of Music in Lawrence, endorsed the study.

“Music classes can be beneficial for parents and infants,” she said. “These classes can build community and provide resources to parents to teach songs and music-based experiences to build comfort in using music within the home and everyday life.”

But it’s important, Hanson-Abromeit said, to select a facilitator who understands child development — an early childhood teacher, music educator or music therapist.

What about the debunking of the Mozart effect?

Hanson-Abromeit said the original study that spawned the interest in classical music for kids was well done, but then came “a misinterpretation of several studies.”

The reality is that “music composed by Mozart is often too complex for a young infant to process,” Hanson-Abromeit explained.

Zhao and her colleagues hope to learn whether or not the apparent effects from listening to music are lasting, and if so, how much exposure might be needed. The researchers would also like to learn if listening to music helps the overall brainpower of infants, Zhao said.

More information

Purdue University has more about baby’s brain development.

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Female Pelvis Widens, Then Shrinks Over a Lifetime, Study Finds

By Amy Norton
HealthDay Reporter

MONDAY, April 25, 2016 (HealthDay News) — A woman’s pelvic structure keeps adapting over her lifetime — first widening to accommodate childbirth, then later narrowing, a new study suggests.

The researchers said their findings challenge the idea that a woman’s pelvis is set in stone.

Some scientists have proposed that the female pelvis was “programmed by evolution for childbirth,” explained lead researcher Marcia Ponce de Leon.

At the same time, it was thought that the male pelvis may change its developmental course starting around puberty, in response to rising testosterone levels.

“Our study shows the contrary,” said Ponce de Leon, a researcher at the University of Zurich, in Switzerland.

The male pelvis, she explained, seems to take on a genetically determined path in its development. Meanwhile, the female pelvis adapts over a lifetime — possibly in response to estrogen.

The researchers based their findings on CT scans from 275 people of all ages. Overall, they found that early in life, the pelvis develops similarly in girls and boys. Then around the age of 10, the sexes go off in distinct directions.

By age 25, a woman’s pelvic bone structures have changed to provide a wide birth canal. And the differences between the male and female pelvis are most marked between the ages of 25 and 30 — the time of peak fertility, Ponce de Leon noted.

But things start to shift again around age 40, the study found. At that point, the female pelvis takes on a more “male” trajectory, which causes the birth canal to gradually narrow.

The findings were published April 25 in the Proceedings of the National Academy of Sciences.

It’s not clear what the pattern these researchers discovered means for the average woman — including whether it can complicate childbirth for an older woman, said Dr. John De Lancey, a professor of obstetrics and gynecology at the University of Michigan, in Ann Arbor.

A woman in her 40s still has a decidedly “female” pelvis, explained De Lancey, who was not involved in the study.

And, “if you look at the pelvis of an 80-year-old,” he added, “you can absolutely tell if it’s female or male.”

Still, De Lancey said, the findings add to researchers’ understanding of an “unbelievable” process: how women are able to push out a 7.5-pound, big-headed baby.

“Humans have a very difficult childbirth compared with other animals,” De Lancey said. Obstructed labor is a common problem, he said, and it’s still a major cause of complications and death among women and newborns in developing countries.

According to one longstanding theory — called the obstetrical dilemma hypothesis — the human female pelvis is basically a “compromise.” Human newborns have large brains, and a wide pelvis would make it easier to give birth. However, a narrow pelvis may be more efficient for walking and running upright.

So, the theory goes, women are left with a pelvic structure that’s less than ideal for either.

Ponce de Leon and her team suggest a different theory: The female pelvis keeps adapting over time to “changing obstetric needs.”

The timing of those shifts — near puberty and the transition toward menopause — suggest that estrogen is steering female pelvic development, according to Ponce de Leon’s team.

De Lancey said it’s “likely” hormones play a role. But, he added, this study does not actually prove that.

It’s obvious why the female pelvis would shift to a wider birth canal after puberty, but it’s not clear why it begins to narrow when a woman is in her 40s.

“Our hypothesis is that the pelvis changes its shape ‘on demand,’ according to changing functions,” Ponce de Leon said. Later in life, she speculated, the smaller birth canal might give women greater stability in the pelvis and more support for their abdominal and pelvic organs.

One past study, the researchers said, found a correlation between the dimensions of a woman’s pelvis and her risk of pelvic floor disorders — where the muscles and soft tissues that support the pelvic organs weaken.

That can result in incontinence or pelvic organ prolapse, a condition in which the uterus, bladder or bowel protrude down into the vagina.

However, De Lancey said that in his own research, he’s found no evidence that women with prolapse have “pelvic dimensions” that differ from other women’s.

According to Ponce de Leon, her team’s findings could eventually prove useful in managing difficult childbirth.

“Our study proposes a hormonal, environment-sensitive mechanism for the developmental plasticity of the female pelvis,” she said. “Further investigation of this mechanism might help one day to alleviate the problem of obstructed labor.”

More information

The American College of Obstetricians and Gynecologists has more on labor and delivery.

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Move of the Week: 100s

Many barre and pilates classes challenge you to a round of 100s, to really zero in on your lower abs. Perfect your form with the help of Pure Barre’s Sarah Wingo, and you’ll have a tighter tummy in no time.

RELATED: Tracy Anderson’s 30-Day Core Challenge

Here’s how to do it: Curl back into a ball, chin to chest. Extend your legs 45 degrees. Zip them together, and point your toes. Place your hands alongside your body—arms straight, palms down, fingers together. Now pump your arms up and down 100 times.

Trainer tip: To achieve perfect form, press your lower back against the ground, and keep the tips of your shoulder blades off the mat. Relax your upper body, pull your naval straight down—and don’t forget to breathe!

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Cassey Ho and Demi Lovato Kick Off Bikini Season With Body Positive Posts

No stranger to body positivity, former Health cover star Cassey Ho posted an empowering PSA for her instagram followers on Sunday.

“As bikini season starts to roll in, let’s keep in mind that a girl wearing a swimsuit does not mean it’s a free ticket to judge her body,” the founder of POP  Pilates and Blogilates captioned a picture of herself on the beach. “In fact, don’t you dare judge anyone’s body without knowing their story, their strengths, and who they are.”

RELATED: Take the 30-Day Total Body Challenge with Cassey Ho

Ho, who has been open about her struggle with an eating disorder, went on to warn her fans not to fall into what she calls “the vanity trap.”

“Your body is simply a physical vessel for you to carry out the things you want to accomplish with your life,” she wrote. “Take care of your body, respect it, and it will do amazing things for you.”

Ho wasn’t the only star inspired to express some body love this weekend: Demi Lovato posted a bikini selfie on Snapchat in which she’s pinching her belly: “My body isn’t perfect, I’m not my fittest but this is me!! And I❤ it!” she wrote.

Photo: Snapchat

RELATED: These Are The Best Swimsuits for Bigger Busts

Thanks, ladies, for the helpful reminder that—as the weather warms up and the layers come off—there’s no better asset to flaunt than confidence.

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Babies Fed Rice-Based Cereals Have Higher Arsenic Levels, Study Finds

By Dennis Thompson
HealthDay Reporter

MONDAY, April 25, 2016 (HealthDay News) — Parents commonly give rice to their babies as a first food. Now, researchers say infants fed rice-based foods may have significantly higher “inorganic” arsenic concentrations in their urine than babies who never eat rice.

The highest arsenic concentrations were found in infants who frequently ate baby rice cereal, with levels more than three times that of babies who didn’t eat rice, the study reports.

Babies who ate foods mixed with rice or rice-based snacks had arsenic levels nearly double those of non-rice eaters, according to the report published April 25 in the journal JAMA Pediatrics.

“The arsenic in their urine increased with the number of servings of rice or rice-containing food,” said lead researcher Margaret Karagas, chair of epidemiology at Dartmouth University’s Geisel School of Medicine in Hanover, N.H.

It’s still unclear what health effects these levels of arsenic exposure could have on children, Karagas and other health experts said.

“It certainly sounds concerning,” said Dr. Ruth Milanaik, director of the neonatal neurodevelopmental follow-up program at Cohen Children’s Medical Center in New Hyde Park, N.Y. “It certainly requires more study.”

Milanaik also noted that the findings could have been influenced by other foods the babies were eating. For example, apple juice or drinking water containing arsenic could have been stirred into the babies’ rice cereal. “There are so many variables,” she said.

The study results come weeks after the U.S. Food and Drug Administration proposed limits on inorganic arsenic levels in infant rice cereals.

The FDA’s research found that more than half of infant rice cereals sampled from U.S. retail stores in 2014 failed to meet the agency’s proposed action level of 100 parts per billion of inorganic arsenic. By comparison, all samples of non-rice baby foods were found to be well below the FDA’s action level for arsenic.

“This is an important step, that they’ve taken the initiative to propose a limit that applies to infant rice cereals,” Karagas said of the FDA.

Arsenic is a known carcinogen and can also contribute to heart disease, according to the FDA.

Some evidence also suggests that arsenic exposure early in life can affect a child’s immune system and intellectual development, according to the FDA and background notes from the study authors.

Inorganic arsenic has shown up in infant plant-based foods including apple juice and applesauce due to its use in pesticides, Milanaik said.

“Even though in this country we’ve outlawed it, we used it for so long that it’s leached into our soil and really becomes part of our vegetation,” Milanaik said.

Karagas and her colleagues decided to study infants’ rice consumption when they learned that rice grains can absorb arsenic from the environment, she said.

The investigators obtained diet information and urine samples from 759 infants born to mothers enrolled in the New Hampshire Birth Cohort Study between 2011 and 2014.

The infants’ progress was tracked with phone interviews every four months until they turned 1. At that time, a final interview assessed dietary patterns during the past week, including whether an infant had eaten rice cereal, white or brown rice, or foods either made with rice or sweetened with brown rice syrup.

The researchers found that parents fed rice cereal to four out of five infants during their first year, and that more than three of five started on rice cereal as early as 4 to 6 months old.

At 1 year of age, 43 percent of infants ate some type of rice product within the last week, and one-quarter ate food either made with rice or sweetened rice syrup, the findings showed.

Of the infants who donated urine samples, 55 percent had consumed some type of rice product in the prior two days, the study found.

The American Academy of Pediatrics recommends that infants consume a diverse diet, including a wide variety of grains, Karagas said.

The study authors and the FDA suggest limiting rice consumption in early life. Concerned parents could feed their babies oatmeal or barley, Milanaik said. These, like rice, are iron-fortified.

The FDA also recommends cooking rice in excess water, and draining off that water, which can reduce 40 to 60 percent of the inorganic arsenic it contains.

More information

For more on arsenic in rice cereal, visit the U.S. Food and Drug Administration.

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Contraception Safety Program for Acne Drug Failing in Canada

MONDAY, April 25, 2016 (HealthDay News) — A Canadian program to prevent pregnancy in women who are taking the acne drug isotretinoin is failing because many women do not follow the program’s recommendations, a new study finds.

Isotretinoin increases the risk of birth defects and miscarriages, the researchers explained. First marketed as Accutane, isotretinoin is now sold under various brand names and aimed at patients with severe acne.

The Canadian program recommends informed written consent, two negative pregnancy tests before beginning treatment with isotretinoin, and the use of two reliable birth control methods while taking the drug.

The United States has similar safeguards in place. In 2005, the U.S. Food and Drug Administration approved a program requiring doctors to enroll patients who take isotretinoin in a national registry to guard against serious side effects that had been linked to the drug.

U.S. women must also have a pregnancy test within seven days before filling their prescription and must agree to use two methods of birth control and adhere to pregnancy testing on a monthly basis, according to the FDA.

In the Canadian study, researchers examined the medical records of more than 59,000 women, aged 12 to 48, in four provinces — British Columbia, Manitoba, Ontario and Saskatchewan — who took isotretinoin between 1996 and 2011.

During those 15 years, there were 1,473 pregnancies resulting in 118 live births. Of those births, 11 babies (9 percent) had birth defects. The study found that 30 percent to 50 percent of the women taking the drug did not comply with the guidelines to prevent pregnancy.

The study was published April 25 in the Canadian Medical Association Journal.

“Poor adherence with the Canadian pregnancy prevention guidelines means that Canada, inadvertently, is using pregnancy termination rather than pregnancy prevention to manage fetal risk from isotretinoin,” study author Dr. David Henry said in a journal news release. He is a senior scientist at the Institute for Clinical Evaluative Sciences and executive co-lead of the Canadian Network for Observational Drug Effect Studies.

“It appears that not all doctors and patients are sticking closely to the guidelines to prevent pregnancy during treatment with isotretinoin,” he added.

These and other findings show that it’s difficult to get women to follow pregnancy prevention measures while taking isotretinoin, according to study co-author Brandace Winquist, director of decision support for Cypress Health Region in Saskatchewan.

“Nevertheless, medical practitioners and patients must be constantly reminded of the risks of isotretinoin to the fetus and implement effective contraceptive measures,” Winquist said in the news release.

More information

The U.S. National Library of Medicine has more on isotretinoin.

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Bed Bugs Are Most Drawn to This Color

Photo: Getty Images

No two words stoke fear faster than “bed bugs.” They’re easy to spread, hard to see and nearly impossible, it seems, to eradicate.

Thankfully, a new study published in the Journal of Medical Entomology sussed out what could be a useful weapon against them: color.

The scientists made tiny tents out of folded cardstock in eight different colors and placed them in Petri dishes. They then plopped a bed bug in the middle, who had 10 minutes to decide which tent to hide in.

Overall, bed bugs strongly tended to choose red tents over the other colors, almost 29% of the time. Black was a close runner-up, drawing in bed bugs 23% of the time. Bed bugs pretty much avoided green and yellow tents.

That might be because colors like green and yellow signal the outdoors or brightly lit areas, places where bed bugs aren’t typically found. And as for their love of red? “We originally thought the bed bugs might prefer red because blood is red and that’s what they feed on,” said study co-author Corraine McNeill, assistant professor of biology at Union College in Nebraska, in a statement. “However, after doing the study, the main reason we think they preferred red is because bed bugs themselves appear red, so they go to these harborages because they want to be with other bed bugs, as they are known to exist in aggregations.”

Their color preferences depended on whether they were hungry, fed, old or young. Still, red and black were overwhelmingly the harbors of choice.

So should you burn your red sheets? If only it were that simple. On its own, the color of your linens probably isn’t going to inoculate you against an infestation, the scientists point out (though they’re not ruling out that possibility yet). The scientists do think, however, that this insight into a bed bug’s favorite color could one day enhance the efficacy of bed bug traps.

This article originally appeared on Time.com.

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