Sleep Apnea

      

(HealthDay News) -- Treatment at primary care centers is as effective as at specialist sleep centers in reducing daytime sleepiness caused by obstructive sleep apnea, a new study from Australia finds. People with obstructive sleep apnea experience repeated breathing interruptions while they sleep, resulting in poor sleep and daytime drowsiness. Left untreated, sleep apnea may lead to serious health problems, such as high blood pressure, stroke, heart failure, diabetes and depression.

Increasing rates of obstructive sleep apnea have led to long wait lists at specialist sleep centers. In order to improve that situation, the researchers suggested it might be a good idea for appropriately trained primary care doctors and nurses to become more involved in the diagnosis and management of obstructive sleep apnea. In their study, they compared outcomes among 81 patients treated at primary care practices and 74 patients treated at a university hospital sleep medicine center in Adelaide, South Australia. At six months follow-up, both groups of patients showed significant improvements in daytime sleepiness.



The study appears in the March 13 issue of the Journal of the American Medical Association. Treatment was about 40 percent cheaper at the primary care centers than at the sleep medicine center. The average per-patient cost was $1,819 (U.S. dollars) in the primary care group and $3,068 in the specialist care group, according to a journal news release. Sleep study costs, sleep physician consultations and travel expenses appeared to be the main reasons for the higher total price for patients in the specialist group, noted study author Ching Li Chai-Coetzer, of the Adelaide Institute for Sleep Health at the Repatriation General Hospital, and colleagues.



The authors said the fact that primary care centers can provide effective treatment for obstructive sleep apnea could be particularly beneficial for patients in rural areas and those in developing nations, where they may not have access to sleep specialists.

Vitamin D & Pregnancy

      

(HealthDay News) -- Women's vitamin D levels during pregnancy do not affect their children's bone health later in life, a new study shows. British researchers measured vitamin D levels in nearly 4,000 women during pregnancy and assessed the bone mineral density of their children when they were about 12. Bone mineral density is a measure of bone health. A lower mineral content is associated with poorer bone health and a higher risk of diseases such as rickets.


There was no significant association between a mother's vitamin D levels during pregnancy and her child's bone mineral density, according to the study published online March 18 in The Lancet. The University of Bristol researchers also found that mothers' vitamin D levels tended to be lowest during the first trimester of pregnancy, and then increased as the pregnancy progressed. As expected, vitamin D levels tended to be lower during the winter and higher during the summer. The skin produces vitamin D in response to sunlight and there are fewer daylight hours in winter than in summer.



The study also said that nonwhite mothers and those who smoked during pregnancy tended to have lower vitamin D levels, but this did not appear to have any affect on their children's bone health. The researchers said their findings suggest that U.K. health guidelines may be overstating the importance of vitamin D supplementation during pregnancy. Those guidelines recommend that all pregnant and breast-feeding women should take a 10 microgram vitamin D supplement every day.

Vitamin D helps keep bones and teeth healthy. Previous studies into the effects of pregnant women's vitamin D levels on children's bone health have been inconclusive, but this new study is more than 10 times larger than previous studies combined, according to a journal news release. "Suggesting to pregnant women that their child's future bone health depends on their pregnancy vitamin D status or that by taking supplements they will improve [their child's future bone health], ... I think our study challenges that [suggestion]," study leader Debbie Lawlor said in the news release.



In an accompanying editorial, Philip Steer, of Imperial College London, wrote: "In view of the inconsistency in results [of previous studies], it might seem unclear why vitamin D supplementation is officially recommended for all pregnant and breast-feeding women."



He added: "The safest approach is probably routinely to supplement pregnant women at greatest risk, as defined by the (U.K.) guidelines." These include women of South Asian, black African, black Caribbean or Middle Eastern origin, as well as women with little exposure to sunlight or who were obese before pregnancy, he noted. Steer added that pregnant women whose diets included few sources of vitamin D, such as oily fish, eggs, meat or fortified margarine or breakfast cereal, might also benefit from supplementation.



Other research has suggested a connection between vitamin D levels in pregnancy and infants' birth weight.

 

False Positive Mammograms

(HealthDay News) -- Women who have a false-positive mammogram result -- when breast cancer is first suspected but then dispelled with further testing -- can have lingering anxiety and distress up to three years after the misdiagnosis, a new study finds. The emotional fallout is probably so long-lasting, "because the abnormal screening result is seen as a threat to your own mortality," said study author Dr. John Brodersen, a researcher at the University of Copenhagen in Denmark.

The report is published in the March-April issue of the Annals of Family Medicine. False-positive mammograms are often cited by public health experts as a downside to mammography screening that needs to be considered when making recommendations about who should be screened, at what age and how frequently. They aren't uncommon: the risk of a false positive for every 10 rounds of screening ranges from 20 percent to 60 percent in the United States, Brodersen said.

After an abnormal mammogram, doctors typically order additional mammograms and, depending on those results, more tests such as an ultrasound or MRI, and finally a biopsy. Studies about the short-term and long-term consequences of false-positive mammogram results have produced mixed findings, which Brodersen said spurred him to conduct his study. He evaluated more than 1,300 women, including 454 who had abnormal findings on a screening mammogram and others who received normal results.

Of those 454 who first had abnormal results, 174 later found they had breast cancer. Another 272 learned the result was a false positive. (Eight others were excluded from the study due to unknown conclusions or a diagnosis of cancer other than breast cancer.) The women answered a questionnaire about their psychological state, such as their sense of calmness, being anxious or not about breast cancer and feeling optimistic or not about the future. They repeated the questionnaire at 1, 6, 18 and 36 months after the final diagnosis.

Six months after the final diagnosis, those with false positives had negative changes in inner calmness and in other measures as great as the women with breast cancer. Even at the three-year mark, women with false-positives had more negative psychological consequences compared with women with normal findings. The differences among those with normal, false-positive and breast cancer findings only began to fade at the three-year mark, the study found. Brodersen can't say if women who were more anxious about health or life in general to begin with were more likely to have long-term distress. "I have not investigated this aspect," he said.

Even without this information, the study is a good one, said Matthew Loscalzo, the Liliane Elkins Professor in Supportive Care Programs at the City of Hope Comprehensive Cancer Center in Duarte, Calif. "They looked at large enough numbers, so the data they are sharing is valid and should be taken very seriously," he said. The finding that some women are still stressed three years later does not surprise him, Loscalzo said. From his experience working with patients, Loscalzo said, women who receive a false-positive result do often feel at risk, even after getting the news they are cancer-free.

Many, he said, will definitely worry: "Will the next one be a breast cancer?" In a statement released Monday, the American College of Radiology said, in part: "Anxiety regarding inconclusive test results is real and is only natural." However, the organization of radiologists also cited what it said are study flaws. For instance, the researchers did not take into account whether women with false-positive results had a family history of breast cancer, or whether some women were ordered to have more frequent mammograms, both of which would likely raise anxiety levels.

Women who get an abnormal mammogram result need support, Loscalzo said. Women who undergo additional testing after an abnormal mammogram should ask to get their results as soon as possible, he added. If they are feeling anxious, he suggests they also tell their doctor they want to talk with a counselor, he said.

More information
To learn more about mammography results, visit the American Cancer Society.
Health News Copyright © 2013 HealthDay. All rights reserved.

Korrespondent Brittany Cascone and Kurriosity in Chicago at the Gray Institutes launch of Free 2 Play, a non profit program from the Gray Institute, designed to change the future of physical education in schools coast-to-coast.

 Read more about this event at: www.kurriosity.com and at www.f2pacademy.com

Kurriosity Korrespondent Brittany Cascone is in Chicago at the Launch event for Free 2 Play, a non profit program from the Gray Institute, designed to change the future of physical education in schools coast-to-coast.
 Read more about this event at: www.kurriosity.com and at www.f2pacademy.com

STDs in 2013

From the looks of the line at Victoria’s Secret, I’m willing to wager that you might be interested in a quickie (pun always intended) STD update.

So, while you were basking in a Valentine’s Day bubble of pink champagne, long-stemmed roses, and sweet Belgian chocolate, I was busy burning my minutes chatting up sexual health experts, entrepreneurs, and activists across the country. (Lucky for you, my sweetheart is used to rescheduling a dinner date for a deadline).

Here’s what I learned about STD stats (way more common than you’d think), what your doctor is checking for (a little less than you’d think), how to get tested (it’s easier than ever), and more.

 

1. Brush, Floss, Test

First off, get tested. Yes, you. With numbers like one in every two people getting an STD by age 25 and half of all sexually active people contracting HPV (human papillomavirus) at some point in their lives—every woman should take getting tested seriously.

Dr. Lisa Oldson, MD, STD expert and medical director of SexualHealth.com, an online space geared toward discreet (and speedy!) testing, explains the rationale behind routine screening: “Preventative care for your sexual health is just as important as your heart health, dental health, and so on… I don’t think it should be any different than going to see your dentist every 6-12 months, getting your cholesterol checked, or going to work out.”



2. Make Sure You Understand What “Testing” Means

OK, so hopefully I’ve convinced you. But Oldson also wants you to know most primary care doctors—two-thirds, to be exact—don’t do adequate STD testing. “That’s not the way it should be, but it’s a sad reality—doctors are human, too, and they’re often embarrassed to talk about this.”

Even if you’re going in for annual Pap smears, Oldson explains, does not mean you’re getting STD tested. “A Pap smear is only looking for a type of HPV that causes cervical cancer. It’s a common misconception that women think their MDs are doing comprehensive STD testing.”

Which means you’ll have to stop blushing, belly up, and ask your doc for comprehensive STD testing if have a new partner (or more than one since your last STD test). And this holds true even if you feel perfectly fine—some STDs show no symptoms at all and “the only way to know is to get tested,” explains Oldson.

And do consider dragging the new Mr. or Ms. Wonderful to the lab with you—Oldson is a huge advocate of couples testing. “It’s not a sexy topic—but everyone knows STD prevention should be addressed. I think most people are relieved if their partner brings it up.”



3. STD Testing Doesn’t Have to Suck

The good news is, advances in technology have also made STD testing less invasive—today’s screening for chlamydia and gonorrhea is as easy as urinating in cup. And online services like Oldson’s SexualHealth.com may allow you to skip sweating it out under the clinic fluorescents altogether.

“People can get tested the same day they register online or on the phone. It’s great for women to know they don’t have to wait and get an appointment with their doctor—they can run to the lab on their lunch hour, pee in a cup, get their blood drawn, and get results within a few business days.” Olson adds that if you are diagnosed, physicians are at the ready to review your results (and link you to a local clinic, if needed).

Sharing results with a new someone shouldn’t be excruciating either, says Ramin Bastani, founder and CEO of Qpid.me, a start-up that’s offering a novel way to talk about STD testing. “We want STD testing to suck a lot less,” he explains. “I got slapped by a girl that I’d gone home with because the ‘have you been tested’ conversation came up in a really weird way.”

A quick three-minute sign-up on Qpid.me sends a secure HIPAA-compliant request to where you were last tested, and after Qpid.me receives and verifies your results, you’ll be able to text them to a new suitor. You can also link to a private profile with a photo of yourself (the link expires after being accessed) for an extra level of assurance.

Says Bastani, “We don’t think we’re a silver bullet—we’re just one tool in the harm-reduction tool kit. Condoms are still important. This is just one piece of data to consider if you’re going to hook up with someone.”

4. STD’s Will Not Ruin Your Life

Although getting word that you’ve tested positive is hardly welcome news, Oldson wants to reassure women that “If you have an STD, it’s going to be OK. You don’t have to wear a scarlet letter or abstain from sex forever. You can still have children. Many STD’s are curable—and all of them are manageable.”

Even an ongoing diagnosis like genital herpes can be mitigated with medications to reduce transmission risk. And HIV is now considered a chronic condition, thought to be more like diabetes (as in, you have to take medication, see your medical providers regularly, and make lifestyle changes). “[HIV] is not a death sentence,” says Oldson. “I tell people, don’t stopsaving for retirement—you might need it.”

Jenelle Marie, who founded The STD Project (a web-based story-telling platform for those diagnosed with STDs) after contracting genital herpes, says, “When you know the statistics [an estimated 45-50 million people have Type 2 genital herpes—which is 1 in 6 sexually active people below the age of 50]—it’s maddening that people are made to feel so horrible.”

“I was so incredibly embarrassed and felt like I would never be able to have a healthy relationship or sex life and men wouldn’t want date me. Actually, it’s been quite the opposite, to my surprise—it hasn’t been a deal breaker.”

In fact, Marie hopes telling her story (and encouraging others to do so) will reduce stigma surrounding STDs. “The fear and the stigma is what keeps people from getting tested regularly… until we can eradicate that—you won’t be able to [fully] promote prevention.”

5. Practicing Prevention Never Goes Out of Style

And lastly, although medical advances have given us the ability to live healthier lives with STDs, it doesn’t mean you should let your guard down. “STDs are preventable. Keep a condom in your purse, backpack, wallet, or pocket—there is nothing to be ashamed of. It makes you smart and it makes you prepared,” says Oldson.

“No matter how advanced we get—prevention is still cheaper than treatment,” agrees HIV awareness activist Luvvie Ajayi. She cites a startling statistic: “Every 47 minutes a woman tests positive with HIV in the U.S.—and black women make up 66% of new infections in women.”

With that in mind, Ajayi and her co-founder Karyn Watkins launched The Red Pump Project. On March 10, 2013, National Women and Girls HIV/AIDS Awareness Day—they are encouraging women everywhere to slip on a pair of spikes or stilettos in a shade of fire-engine red and upload a photo to their Facebook fan page.

“When people hear the word activism, it sounds like a heavy word. But I would say activism is doing the small things—even it that means you tweet once a day about something you’re passionate about. We’d love people to sign up to Rock the Red Pump—so get those shoes ready for March 10!” says Ajayi.

So, what’s the takeaway as we slow to a close on today’s column of love? Sort of the same message I’m always giving, I suppose: Be smart and take care of yourself. Any time you take out of your schedule to treat that body (like a temple) is totally worth it.

Kurriosity is in the Windy City of Chicago, Illinois on assignment.

We are covering the launch of Free-2-Play, a non profit program from the Gray Institute, designed to change the future of physical ed...

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Kurriosity is in the Windy City of Chicago, Illinois on assignment.

We are covering the launch of Free-2-Play, a non profit program from the Gray Institute, designed to change the future of physical education in schools coast-to-coast. I have met some of the most amazing and inspiring coaches who are working together to on this special project to change the health of future generations of children around the world.

Over the past five weeks, the Gray Institute has been working on a "beta test" of the program with fifth grade student in Chicago and the results are amazing.

Instead of traditional PE class (that we all went through)these children actually work together with each other to motivate and inspire everyone in the class. I have worked with children on fitness programs for years--this is the first time I have ever seen every child in a class believe they are actually an athlete.

This has been such a humbling and eye-opening experience and I can't wait to write this story for all of you to see what this amazing program will accomplish to redesign every physical education program in the country.

Watch for my special report on "Free-2-Play next week---only on Kurriosity and KTV. Back to the conference!

Korrespondent Brittany Cascone

 

 

Is Being Tan for A Week Worth It When It Comes With A Greater Risk for Melanoma?

For those of you who still think being tan is in vogue, you might want to stop and listen.  Especially for those of you who are regular visitors to the local tanning salons.  In fact a new study finds that melanoma is on the rise, in particular in young women.  And it looks as though tanning and tanning beds might be one of the reasons for this rise in skin cancer.

According to the Mayo Clinic, women under 40 years of age are the hardest hit by skin cancer.  From 1970 to 2009 the numbers increased eightfold among women and fourfold for men, from ages 18-39.  The study went on to explore behaviors that might increase risks for melanoma, and voluntary exposure to artificial sunlamps was found to be prevalent among the females studied.

At the Centers for Disease Control and Prevention they explained concern about “melanoma rates and the damage done by early exposure to sun, but also the increasing use of tanning beds.”  While many types of cancers are on the decline, melanoma seems to be on the rise.

According to the National Institutes of Health, excess exposure to ultraviolet light increases risk for all skin cancers.  UV light is invisible radiation that can damage DNA in the skin and can be generated from sunlight, sunlamps and tanning beds.  People with fair skin are at greater risk, as they have less pigmentation to protect the body from UV radiation.  Other risk factors include severe sunburns as a child, unusual number of moles, a family history of melanoma and exposure to UV light.  Symptoms include changes in an existing mole or development or an unusual growth on your skin. 

The tanning industry defends that tanning lamps do not increase risks.  They state there is no consensus among researchers regarding melanoma and UV exposure from the sun or a tanning bed. 

For some reason, despite the questions surrounding the safety of the sun for our skin and melanoma, people still think we look healthier and more beautiful if we are tan.  Young women everywhere are still eager to get tan before the prom, to get an early start for their beach vacations or to look less pale in the dreary days of winter.  Perhaps they need to stop and think about what this is worth to them.  Tan for a day or a week versus being healthy and skin cancer-free for a lifetime? Seems like a simple answer to me.

Koach Marlo