Base Quit-Smoking Day on Menstrual Cycle?

WEDNESDAY, June 1, 2016 (HealthDay News) — Certain weeks of a woman’s menstrual cycle may be better than others for quitting smoking, a small study suggests.

Success was less likely when a “quit day” fell during the follicular phase, or first half of the monthly cycle, researchers found.

“Understanding how menstrual cycle phase affects neural processes, cognition and behavior is a critical step in developing more effective treatments and in selecting the best, most individualized treatment options to help each cigarette smoker quit,” said lead author Reagan Wetherill.

Wetherill is a research assistant professor of psychology at the University of Pennsylvania, in Philadelphia.

Previous work by these researchers revealed that women in the follicular phase have enhanced responses to smoking cues in reward-related areas of the brain, the researchers said.

The new study included 38 women smokers, ages 21 to 51, who were not taking hormonal contraceptives. They underwent scans to assess how regions of the brain that help control behavior are functionally connected to regions of the brain that signal reward.

Some were in the follicular phase of their menstrual cycle, while others were in the luteal phase (after ovulation). Those in the follicular phase — the time from menstruation to ovulation — had reduced functional connectivity between the two key regions of the brain, the study found. This could make it harder to say no when attempting to quit, the researchers suggested.

Women suffer more severe health problems from smoking than men, including a 25 percent increased risk of heart disease and chronic obstructive pulmonary disease. Women also have greater difficulty quitting smoking than men, according to the researchers.

“The results from this study become extremely important as we look for more ways to help the over 40 million individuals in the U.S. alone addicted to cigarettes,” said study senior author Teresa Franklin, a research associate professor of neuroscience in psychiatry at Penn.

“When we learn that something as simple as timing a quit date may impact a woman’s cessation success, it helps us to provide more individualized treatment strategies for individuals who are struggling with addiction,” she explained.

The study was published online May 31 in the journal Biology of Sex Differences.

More information

The American Lung Association has more on women and smoking.

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Clean Pools Can Still Pose Health Hazards

By Christine Chen
HealthDay Reporter

THURSDAY, June 2, 2016 (HealthDay News) — Nothing seems better on a hot day than hopping into a cool swimming pool.

But, new research might prompt you to shower first and make sure your kids don’t pee in the water.

Researchers from the University of South Carolina report that the disinfectants used to keep pools clean can create dangerous disinfection byproducts (DBPs) when combined with sweat, personal care products and urine.

Some of these byproducts have caused genetic damage to cells in laboratory tests, while other reports have found higher rates of bladder cancer and respiratory issues in people who are around pools regularly, the researchers said.

And though the study findings held true for public pools, private pools and hot tubs, the researchers flagged indoor pools and hot tubs as a top concern, too.

“I never had my kids on a swim team in an indoor pool, swimming every day. I would make that same choice today knowing what I know,” said study co-author Susan Richardson, who’s with the university’s department of chemistry and biochemistry.

“The air you’re breathing is one of the disinfection byproducts — it’s that chlorine smell, but not actually chlorine. Instead, it’s a DBP, mainly trichloramine, the combination of urine and chlorine. It goes from the water to the air, easily. That chemical is a known respiratory irritant,” Richardson said.

Such irritants may raise the risk of colds and asthma complications, Richardson said. “I wouldn’t advise people to stay away from pools, but everything in moderation,” she added.

Richardson is less concerned about outdoor pools and hot tubs, because there is more ventilation in the open air. However, when those pools and hot tubs are used intensely, the DBP levels are worse, according to the study.

Richardson and her colleagues tested water samples from public and private pools and hot tubs, after both normal and intense use.

They found more than 100 DBPs — some of which are known to be mutagenic, or able to cause cell damage and DNA mutation.

On average, the researchers found tap water to be cleaner than disinfected pool water samples, which were twice as mutagenic. And, hot tub samples were four times as mutagenic, Richardson said, “because the warmer temperatures increase the reaction rate, forming these disinfection byproducts faster.”

The findings were published recently in the Journal Environmental Science & Technology.

So, how can one swim safely this summer?

For residential pools, Richardson suggests filters with silver in them, because they kill disease-causing pathogens without forming DBPs.

She also recommends using ozone and chlorine, which seemed safer than bromine in the research. Air ventilation for indoor pools is key, and she urges people to change pool and hot tub water completely and more frequently.

A public health official for Florida, the state with the second largest number of swimming pools, said reducing waterborne illness is a bigger priority compared to DBPs, and public pools are safe when proper steps are taken.

“It is more important to assure a high disinfectant residual and maintain proper pH levels to prevent waterborne diseases than to reduce disinfectants for the purpose of trying to reduce DBPs,” said Mara Gambineri, communications director for the Florida Department of Health.

Although public officials can’t enforce pre-swim showers or police urination in a pool, Gambineri added that posting clear signs and providing easy access to showers helps.

The U.S. Centers for Disease Control and Prevention recently reported closing one in five public kiddie pools after inspections in five states, while one in eight public pools and hot tubs were closed immediately due to a serious violation.

The CDC said thousands of public pools and hot tubs require closure every year, mostly due to contamination from people swimming while suffering diarrhea and children still learning toileting skills.

More information

There’s more on healthy swimming at the U.S. Centers for Disease Control and Prevention.

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Mindfulness Meditation Seems to Soothe Breast Cancer Survivors

By Kathleen Doheny
HealthDay Reporter

THURSDAY, June 2, 2016 (HealthDay News) — Mindfulness meditation seems to help breast cancer patients better manage symptoms of fatigue, anxiety and fear of recurrence, a new study suggests.

Previous research has found that mindfulness meditation can reduce stress and anxiety in the general population as well as in breast cancer survivors. But, there hadn’t been many large, clinical trials to test the value of the practice among breast cancer patients, said study author Cecile Lengacher, director of the predoctoral fellowship program at the University of South Florida, in Tampa.

In her study, those who took part in the six-week program had less anxiety, fear of recurrence and less fatigue compared to those who did not take the program, she found. The effect was small to moderate, she added.

“It works right away,” Lengacher said of the program, known as Mindfulness-Based Stress Reduction.

The results also seemed to last through 12 weeks of follow-up. “Even after they completed the program, the benefits continued through the 12 weeks,” she said. “It is a program that once you learn it, you have it for life.”

For the study, Lengacher and her colleagues randomly assigned 322 women who had been treated for breast cancer to the six-week mindfulness program or to a comparison group that did not learn the technique. At the study’s start, and again at six and 12 weeks, the researchers assessed the participants’ symptoms. In all, 299 women completed the study. The instruction helped reduce fear of recurrence and fatigue the most, the study found. The effect was small to moderate, Lengacher added.

At the core of the program are four techniques. They include: meditation with a focus on breathing, yoga, a body scan technique (where participants learn to become aware of the entire body) and walking meditation.

The instruction trains people to be aware and pay attention to the present. “We teach them to attend to the breath and to bodily sensations,” Lengacher said. Through the practice, “by this constant attention and concentration, the person learns to self-regulate their emotions.”

Being in the present, she said, “reduces the amount of worrying about the past, worrying about the future.”

The study findings rang true with Susan Castledine, 71, of Los Angeles, who was diagnosed with breast cancer two and a half years ago.

“I did tai chi all the way through, which I consider a form of meditation,” said the former school administrator and journalism instructor.

More recently, Castledine completed an online mindfulness program. “Not only did they talk about mindfulness and how they used it in their lives, they would do meditation with you,” she said of the program leaders.

These days, she tries to meditate every night, “anywhere from 2 to 15 minutes,” she said. Castledine also incorporates the mindfulness techniques into daily activities.

She said she finds it stress-relieving. “If I had been doing meditation at the time [of her treatment], I think it would have relieved my stress,” she added.

One cancer care expert was more cautious in interpreting the study findings.

The effects of the meditation “were meaningful, but they were moderate,” said Matthew Loscalzo, the Liliane Elkins Professor in Supportive Care Programs at the City of Hope Cancer Center, in Duarte, Calif.

“They were largest for the fear of recurrence problems,” he said.

One limitation of the study, he said, was that the follow-up was relatively brief, just 12 weeks. It’s also not possible to know whether the improvements in stress and other areas were completely due to the meditation, or also to the social support provided by the group.

Experts do know, Loscalzo said, that mindfulness meditation “can be helpful for anxiety and stress.” Less research has been done in cancer patients, he added.

The study was published online May 31 in the Journal of Clinical Oncology.

More information

To learn more about mindfulness meditation, visit the University of Massachusetts.

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15.5 Million Americans Now Surviving Cancer: Report

By Steven Reinberg
HealthDay Reporter

THURSDAY, June 2, 2016 (HealthDay News) — Cancer survivors in the United States reached record numbers this year — 15.5 million — and the American Cancer Society predicts they’ll total more than 20 million in another decade.

But along with these success stories comes a growing demand for medical, emotional and psychological support to aid survivors’ long-term recovery, according to a new cancer society report.

“Many cancer survivors have to cope with long-term physical and psychological effects of their cancer treatment,” said lead researcher Kimberly Miller, an American Cancer Society epidemiologist. “It’s important for the public health community to have a better understanding of the current and future needs of these survivors.”

Although new cancer cases are on the decline in the United States, survival numbers are up because of improved detection and treatment, as well as a growing and aging population, the study authors explained.

According to the report, nearly half of survivors are 70 and older, and 56 percent were diagnosed within the past 10 years. One-third were diagnosed less than five years ago.

Among men, survivors were most likely to have had prostate cancer (3.3 million), colon or rectal cancer (725,000), or melanoma (614,000). Women survivors most often had breast cancer (3.5 million), uterine (757,000), and colon or rectal cancer (727,000), the researchers found.

These aren’t necessarily the most frequently diagnosed cancers. For example, lung cancer is the second most commonly diagnosed cancer in men, but because of its poor survival rate, it ranks eighth among survivors, Miller said.

While older age is common, survivors’ age varies significantly by the kind of cancer, the findings showed. For example, 64 percent of prostate cancer survivors are 70 or older, compared with just 37 percent of melanoma survivors. And more than 65,000 cancer survivors are 14 and under, while 47,000 are 15 to 19, according to the report.

Because of the toll cancer takes on patients and their families, it is important to offer emotional, financial and physical support, said Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City.

“Cancer not only affects a specific organ but has effects on the mind and spirit as well,” said Bernik.

Many groups, such as the American Cancer Society and the U.S. National Cancer Institute, have made progress in providing services for patients outside of just the standard medical treatments, Bernik said.

Miller added that local groups of cancer survivors can help provide information and emotional support.

However, much more is needed as the number of cancer survivors increases, Bernik said. “Complicating the matter is the fact that every patient is an individual and often has unique needs. With time, the hope is that more programs will emerge to help with all aspects of cancer care,” she said.

Miller added that primary care doctors and survivors must work together to help deal with the lasting effects of the disease.

“A lot of people go to their primary care physician after completing treatment for information, and that’s an area where physicians may need more education and support,” Miller said.

Primary doctors can help survivors with cancer screening and encourage good habits, such as quitting smoking, eating a healthy diet and exercising. In addition, they can make referrals to mental health experts if a patient is psychologically distressed. “They just need the tools to manage care efficiently,” Miller said.

While most patients fare well emotionally, fears of cancer returning or a new cancer developing are common. Family and friends may find that many cancer survivors have “unmet psychosocial and medical needs,” the study authors explained.

The report, prepared by the American Cancer Society in collaboration with the U.S. National Cancer Institute, was published online June 2 in CA: A Cancer Journal for Clinicians.

Researchers defined a cancer survivor is anyone with a history of cancer, including those in treatment and those who are cancer-free.

More information

For more about surviving cancer, visit the American Cancer Society.

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Florida’s Tougher Laws May Be Cutting Opioid Prescriptions

THURSDAY, June 2, 2016 (HealthDay News) — The top prescribers of opioid painkillers in Florida wrote far fewer prescriptions for those drugs the year after the state implemented tough new drug policies, a new study reveals.

Two policies aimed at reducing the number of prescriptions for the potentially addictive opioids, such as Oxycontin, took effect in late 2011. One was the Prescription Drug Monitoring Program (PDMP), a database that tracks individual prescriptions, including patient names, dates and amounts prescribed.

This enables doctors to watch for people with multiple prescriptions from multiple doctors, which is associated with addiction and illicit use.

The second measure was the so-called “pill mill” law that requires pain clinics to register with the state and to be owned by a doctor. Pill mills are pain clinics that prescribe disproportionately high levels of opioid prescriptions.

One year after the new policies took effect, opioid prescriptions by the state’s top opioid prescribers fell 6 percent and the total volume prescribed by this group dropped 13.5 percent, the study found.

Among this group of doctors — who make up about 4 percent of opioid prescribers in the state but accounted for 40 percent of opioid prescriptions — the number of patients dropped by 5 percent, the researchers said.

Among the remaining 96 percent of opioid prescribers, prescriptions of the drugs fell just 0.7 percent after the new measures were introduced, the study showed.

“Our findings indicate how state policies such as PDMPs may reduce opioid use among the highest prescribers,” lead author Hsien-Yen Chang, of the Johns Hopkins Bloomberg School of Public Health, said in a school news release.

“But our report also shows that programs like PDMPs must be complemented by many other measures to combat the epidemic of addiction and non-medical opioid use,” added Chang. He is an assistant scientist in the department of health policy and management at the school.

It’s difficult to fully separate the impact of the PDMP and the pill-mill law, but doctors should get in the habit of checking the database before they write a prescription, the researchers suggested.

According to the study’s senior author, Dr. G. Caleb Alexander, “At some point, checking the prescription database before prescribing an opioid should be just as routine as doing a kidney test before starting a new blood pressure treatment.

“I think we’ll get to that point; we’ll see prescription databases used like these other tools and have an even greater impact,” added Alexander, an associate professor in the department of epidemiology at the Bloomberg School of Public Health.

Opioid misuse and abuse is an epidemic in the United States. An average of 44 people die from opioids each day, the researchers noted.

The U.S. Centers for Disease Control and Prevention recently issued new guidelines for opioid prescriptions, and every state in the country except for Missouri now has a prescription drug monitoring program, the researchers said.

The study was published online June 2 in the journal Drug and Alcohol Dependence.

More information

The U.S. Department of Health and Human Services has more about opioids.

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Delays in Spotting Dementia Can Bring Dangers

THURSDAY, June 2, 2016 (HealthDay News) — A delay in diagnosing dementia can put people at risk, a new study suggests.

People who have signs of probable dementia but haven’t yet been formally diagnosed are nearly twice as likely as those who’ve been diagnosed to be performing potentially unsafe activities such as cooking, driving, and managing their medications and finances.

The study included information from more than 7,600 Americans. All were 65 or older.

The findings showed:

• About 17 percent of people diagnosed with dementia and 28 percent of undiagnosed people were still driving.
• Twelve percent of diagnosed people and 29 percent of undiagnosed people kept handling their finances.
• Seventeen percent of diagnosed people and 42 percent of undiagnosed people continued to cook meals for themselves.
• Nearly 22 percent of diagnosed people and 50 percent of undiagnosed people were still handling their own medications.

However, the study did find that people with dementia symptoms — whether undiagnosed or diagnosed with dementia — were less likely to engage in such activities overall.

“That in itself is good news, though the numbers are still important from a public health and safety standpoint. Either the patients themselves or their family members are self-regulating and doing these activities less frequently as their disease is progressing,” said study leader Dr. Halima Amjad.

Amjad is a fellow at the Johns Hopkins University School of Medicine’s Division of Geriatric Medicine and Gerontology, in Baltimore.

Patients and their families need to be aware of dementia so doctors and loved ones can take measures to protect patients, the researchers said.

“When patients receive a formal dementia diagnosis, their families are typically aware that, at some point, their loved ones will not be able to drive or will need more help with their medicine,” Amjad said in a university news release.

“But when people are undiagnosed, families and friends may ignore or be unaware of functional problems that already exist,” she added.

About 5 million people in the United States have some form of dementia, including Alzheimer’s disease. That number is expected to nearly triple by 2050, the researchers said.

The study findings were published online June 2 in the Journal of the American Geriatrics Society.

More information

The American Academy of Family Physicians has more on dementia.

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U.S. Teen Birth Rate Continues to Fall, Hits New Record Low

THURSDAY, June 2, 2016 (HealthDay News) — The number of babies born to American teenaged girls fell another 8 percent in 2015, reaching a new record low.

According to the report from the U.S. Centers for Disease Control and Prevention, moms aged 15 to 19 accounted for about 22 of every 1,000 live births in 2015 — down from about 24 per 1,000 the year before.

Dr. Jennifer Wu, an obstetrician-gynecologist at Lenox Hill Hospital in New York City, applauded the news.

“Most teenagers are not financially or emotionally equipped to be mothers at this point in their lives,” said Wu.

“Teenage pregnancies present a myriad of social, medical and economic problems,” she added, and “most of these pregnancies are unplanned and these mothers miss out on important aspects of prenatal care.”

Overall, the report from the CDC’s National Center for Health Statistics saw a continuance of a trend in which American women are having children later in life. Birth rates were also down for women in their early and late 20s, the report found — but were rising for women in their 30s and 40s.

About 40 percent of births in 2015 occurred among unmarried women, a number unchanged from the previous year.

The news was mixed when it came the rate of healthy deliveries.

For example, the rate of preterm births rose slightly, to about 9.6 percent, the first such rise since 2007. The rate of babies being born underweight also edged up, from 8 percent in 2014 to close to 8.1 percent a year later.

However, the rate of cesarean deliveries — which come with risks to mother and baby — fell for the third year in a row, the CDC said. Just under one-third of deliveries are now done via C-section, the report found.

The report, published June 2, was based on nearly 100 percent of all birth certificates collected across the 50 states.

More information

There’s more on teen pregnancy at the American Academy of Pediatrics.

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‘Hard’ Tap Water Linked to Eczema in Babies

WEDNESDAY, June 1, 2016 (HealthDay News) — “Hard,” mineral-laden water may increase the risk of a baby getting the skin condition eczema, a new British study suggests.

Eczema is a chronic condition marked by itchiness and rashes. The study included 1,300 3-month old infants from across the United Kingdom. Researchers checked hardness — the water’s mineral content — and chlorine levels in the water supply where the babies lived.

Babies who lived in areas with hard water were up to 87 percent more likely to have eczema, the study found.

“Our study builds on growing evidence of a link between exposure to hard water and the risk of developing eczema in childhood,” said lead author Dr. Carsten Flohr, from the Institute of Dermatology at King’s College London.

The study wasn’t designed to prove a cause-and-effect relationship, so further research is needed to learn more about this apparent link, Flohr added.

“We are about to launch a feasibility trial to assess whether installing a water softener in the homes of high-risk children around the time of birth may reduce the risk of eczema and whether reducing chlorine levels brings any additional benefits,” Flohr said in a college news release.

Previous studies have found an association between water hardness and eczema risk in schoolchildren. This is the first study to examine the link in infants, the researchers said.

The study was published recently in the Journal of Allergy and Clinical Immunology.

More information

The American Academy of Family Physicians has more on eczema.

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The Many Ways Stress Can Affect Your Skin

Last week Anne Hathaway was apparently so stressed out by an upcoming appearance on The Ellen DeGeneres Show that she broke out in hives. “Proof that nerves are real,” she posted with a photo of the angry rash on Instagram.

And a few days ago actress Kirsten Storms announced she was taking a leave from her role as “Maxie” on daytime’s General Hospital due to skin issues linked to stress.

http://pic.twitter.com/aEOttx1fGH

— Kirsten Storms (@teenystweeting) May 29, 2016

With so many celebrities succumbing to stress-related skin problems, we started to wonder which skin conditions are aggravated by stress.

The answer, it turns out, is pretty much all of them.

“Any skin condition can be made worse from stress,” says Natalie Semchyshyn, MD, a cosmetic dermatologist and assistant professor of dermatology at Saint Louis University. “Stress, especially chronic stress, changes levels of certain hormones in your body, like cortisol, which can affect your immune system.”

And that can wreck havoc with your skin.

Hives, like those proudly displayed on Anne Hathaway’s chest, can happen to anyone, even if you’re not prone to skin problems.

“One of the major jobs of our skin is to block things out that we don’t want to come in. It’s the protective wrapper of the body,” explains Dr. Semchyshyn.

RELATED: 25 Surprising Ways Stress Affects Your Health

Stress dampens the immune system so that your skin is no longer as effective at keeping out intruders. Bad things creep in, your immune system reacts and, voila, you’ve got hives.

Acne is probably the most well-known example of a skin condition exacerbated by stress: Think of a teen who has a terrible acne flare right before final exams. If the acne gets infected because of a weakened immune system, the problem can get even worse.

Rosacea is another skin condition closely related to your mental state: Flushing, swelling, and uneven skin are hallmarks of rosacea. “One of the triggers [of flushing] is stress, if you feel embarrassed, or even good stress like working really hard on something,” says Dr. Semchyshyn. “It’s a visible response to stress going on inside your body.”

Psychological stress can also trigger a psoriasis flare-up—red, scaly patches of skin that are itchy and sometimes painful—as well as an eczema flare (an itchy rash).

RELATED: 21 Tips and Tricks for Treating Psoriasis

The silver lining in the skin-stress connection? Managing your stress can often provide the solution, or part of the solution, says Dr. Semchyshyn. She points to a growing body of research that suggests stress-relief techniques—including hypnosis, guided-imagery meditation, and mindfulness meditation—may also help calm your complexion.

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Program Cut Catheter-Associated Urinary Tract Infections

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, June 1, 2016 (HealthDay News) — If you find yourself hospitalized, you’ve got a one in five chance of needing a urinary catheter — raising your risk for a urinary tract infection.

Now, researchers report that a new program shows it might be possible to reduce both catheter use and its associated infections.

“Catheter-associated urinary tract infections are common and costly patient safety problems,” said lead researcher Dr. Sanjay Saint. He is a professor of internal medicine at the University of Michigan in Ann Arbor.

Roughly 250,000 such infections occur in hospitals each year in the United States, costing about $250 million, the researchers pointed out.

Although about 20 percent of hospitalized patients get a urinary catheter, one-third of the time they aren’t needed, Saint said. He believes that patients can play a role in reducing catheter use.

“A lot of patients and families don’t realize that there are problems with a urinary catheter, so they may request them because they think it will allow patients to stay in bed,” Saint said.

“Unfortunately, there are side effects with a catheter. And I’ve seen patients who have gotten up in the middle of the night and they trip and fall on the tubing,” he explained.

“Patients and families should request that a catheter not be put in, and if there is one there, the patient should ask every day whether it is still needed,” Saint suggested.

For the study, Saint and his colleagues tried the new program in 600 hospitals.

After 18 months of using the program, infection rates among hospital patients in general wards dropped by one-third, while catheter use had dropped about 1 percent.

But there was no drop in infections or catheter use in intensive care units (ICUs), the study findings showed.

Hospital-acquired urinary tract infection rates rose nationwide during the same time period, Saint noted.

The program Saint helped develop — called the “bladder bundle” — includes protocols, checklists, training and information-sharing that help doctors and nurses reduce catheter use and prevent infections.

Included in the program are:

• Daily checks to see if a catheter is still needed.
• Using other options to collect urine, such as bedpans.
• Training for managing urinary catheters.
• Use of infection-control techniques for catheter placement and maintenance.
• Feedback to the medical team about catheter use and infection rates.

The researchers found that catheter infection rates in the new program dropped 14 percent overall in general wards (non-ICU).

The findings were published June 2 in the New England Journal of Medicine.

Dr. Susan Huang, a professor of infectious disease at the University of California, Irvine, wrote an editorial accompanying the study. She said, “While we’ve known the correct care processes for managing urinary catheters, we haven’t been able to reliably reduce catheter-related infections.”

An intervention that focuses on changing the culture in hospitals to make them more responsive to the problem of infection control — one that involves “rallying around a focused problem and ensuring team-based solutions — is integral to improving infection control in hospitals,” she said.

As for improving infection control in intensive care units, Huang said, “further analysis may help us understand why this intervention didn’t work.”

“This program can reduce urinary infections in hospitals if a team is assembled to ensure adoption of best practices and to rapidly correct reasons for failing to comply with these processes,” she added.

More information

Visit the U.S. Centers for Disease Control and Prevention for more on urinary tract infections.

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