Category Archives: Health

Depression May Boost Stroke Risk in Middle-Aged Women, Too


Although risk is still low, Australian study found it nearly doubled for depressed women in their 40s and 50s


WebMD News from HealthDay

By Steven Reinberg

HealthDay Reporter

THURSDAY, May 16 (HealthDay News) — Women in their 40s and 50s who suffer from depression are almost twice as likely to have a stroke as women who aren’t depressed, according to a large, long-running Australian study.

This is not the first study to link depression with an increased risk for stroke, in both men and women. Exactly how depression is associated with stroke is unclear, as is whether treating it reduces the risk, experts say.

“Although the absolute risk of stroke is low in mid-aged women, depression does appear to have a large adverse effect on stroke risk in this age group,” said lead researcher Caroline Jackson, an epidemiologist in the School of Population Health at the University of Queensland.

“Our findings, however, suggest that depression may be a stronger risk factor for stroke in mid-aged women than was previously thought,” she said.

Despite the growing body of evidence on depression and risk of stroke, depression is generally not included in guidelines for primary stroke prevention, which appears to be an important omission that should be addressed, Jackson noted.

The report was published May 16 in the journal Stroke.

One expert said this latest finding adds to the growing pile of evidence on the link.

“This large study among Australian women adds further evidence supporting the association between depression and stroke risk,” said Dr. Ralph Sacco, chairman of neurology at the University of Miami Miller School of Medicine.

Other studies have also demonstrated the effects of depression on stroke risk, he added. “Although we are not clear about the mechanisms, depression is frequent and needs to be more readily recognized and appropriately treated,” Sacco said.

To see how much depression influenced the risk of stroke, Jackson and her colleague Gita Mishra, a professor of life course epidemiology at the University of Queensland, collected data on more than 10,000 women aged 47 to 52 who took part in the Australian Longitudinal Study on Women’s Health.

Women in the survey answered questions about both physical and mental health every three years from 1998 to 2010.

Among these women, about 24 percent said they suffered from depression. Over the study period 177 women had a stroke for the first time.

Analysis by Jackson and Mishra found depressed women were 2.4 times more likely to have a stroke than women who weren’t depressed.

After eliminating some of the other factors that increase the risk of stroke, depressed women still were 1.9 times more likely to have a stroke, compared to women who were not depressed, they found.

Risk factors included: age; socioeconomic status; lifestyle habits such as smoking, alcohol and physical activity; and high blood pressure, heart disease, being overweight and diabetes.

WebMD Health

Cellphone Use May Reveal Your ‘Dominant Brain’


People with left-brain dominance tend to listen with right ear, and vice-versa, study finds


WebMD News from HealthDay

By Alan Mozes

HealthDay Reporter

FRIDAY, May 17 (HealthDay News) — New research suggests the dominant side of your brain may make the call on which ear you choose to use while talking on your cellphone.

The dominant side of your brain is where your speech and language center resides. Ninety-five percent of the human population is left-brain dominant, and those people tend to be right-handed. The opposite holds true for people who are right-brain dominant. In this study, scientists found that roughly 70 percent of those surveyed held their cellphone up to the ear that was on the same side as their dominant hand.

This insight into the way people use their cellphones could one day help doctors quickly and safely locate and protect a patient’s language center before beginning a potentially risky brain operation, the researchers said.

“In essence, this could be used as a poor man’s Wada test,” said study author Dr. Michael Seidman, director of the division of otologic/neurotologic surgery at the Henry Ford Health System in West Bloomfield, Mich. “[The Wada test] is the standard test used today to determine exactly where a surgical patient’s language center is located, which is critical information to have if you want to carefully preserve a person’s language abilities.

“The Wada test is, however, invasive and risky,” Seidman said. “But by looking at how a person uses their cellphone, which side they listen in to, you can get shorthand insight into brain dominance. It’s not a foolproof guarantee, but I would say it’s a pretty reliable and safe way of going about it.”

Seidman and his colleagues reported their findings in the May issue of the journal JAMA Otolaryngology — Head & Neck Surgery.

To explore how brain dominance may relate to cellphone handling, the authors sifted through more than 700 online surveys completed by people who were members of a web-based otology (hearing) discussion group, as well as those already undergoing Wada and MRI testing for various purposes.

Respondents were asked to give information regarding their cellphone habits, favored hand for executing various tasks (such as writing, throwing and cellphone handling) and any hearing-loss issues. Any history of brain, head or neck tumors also was noted.

Ninety percent of those polled were right-handed, and 68 percent used their right ear, 25 percent used their left ear and 7 percent used both ears.

The story was similar among the left-handed people: 72 percent used their left ear, 23 percent used their right ear and 5 percent used both ears.

The team concluded that there is an association between cellphone handling habits and brain dominance, with right-ear cellphone use typically indicating left-brain dominance, and vice versa.

“We’re pretty confident in our results,” Seidman said. “Basically, if your speech and language centers are in the left side of the brain — which for most people they are — a cellphone conversation is going to sound better in your right ear.”

WebMD Health

Understanding Calcium: Supplements, Calcium Carbonate, Calcium Citrate, and More


Experts share their advice about what to consider when choosing a calcium supplement.

Are you getting enough calcium in your diet? Maybe not, especially if you’re a woman or a teenage girl. Although Americans have improved at this in recent years, we’re still not getting enough calcium to maintain our bone health.

How much is that? It depends on your age. According to the Institute of Medicine, the recommended daily amount of calcium to get is:

Recommended Related to Osteoporosis

Weight-Bearing Exercise: 8 Workouts for Strong Bones

What are the best ways to exercise and improve your bone health when you have osteoporosis? Try weight-bearing workouts that stress bones and muscles more than your everyday life, says Paul Mystkowski, MD, an endocrinologist at Virginia Mason Medical Center in Seattle and clinical faculty member of the University of Washington in Seattle. Talk to your doctor and make sure the workout you choose is safe for you. Then give these latest trends a try! 1. Tai Chi Tai chi — a form of slow,…

Read the Weight-Bearing Exercise: 8 Workouts for Strong Bones article > >

  • 1-3 years: 700 milligrams daily
  • 4-8 years: 1,000 milligrams daily
  • 9-18 years: 1,300 milligrams daily
  • 19-50 years: 1,000 milligrams daily
  • 51-70 years: 1,200 milligrams daily for women; 1,000 milligrams daily for men
  • 71 and older: 1,200 milligrams daily

The Institute of Medicine says that most in the U.S. get enough calcium, except for girls 9 to 18 years old. Although women’s recommended calcium needs to increase with menopause, postmenopausal woman taking supplements may also be at greater risk of getting too much calcium.

“We know that peak bone mass occurs around age 30, so it’s very important in childhood and adolescence to have a healthy intake of calcium early on,” says Marcy B. Bolster, MD. She is a professor of medicine in the division of rheumatology and immunology at the Medical University of South Carolina and director of the MUSC Center for Osteoporosis and Bone Health.

“After age 30, we start to gradually lose bone, and that loss accelerates for women at the time of menopause. So it’s very important to stave off bone loss with adequate calcium intake.”

Your health care provider may recommend calcium supplements. But with so many choices of calcium supplements, where should you start? Here’s what you need to know.

What kind of calcium supplement should you take?

“I tell my patients to take the kind that they tolerate best and is least expensive,” Bolster says. She says she recommends calcium carbonate because “it’s inexpensive, won’t cause discomfort, and is a good source of calcium.”

Some people’s bodies may have problems making enough stomach acid, or may be taking medications that suppress acid production. For them, says J. Edward Puzas, MD, a calcium citrate supplement might be better because it “dissolves a little better than calcium carbonate for these people.” Puzas is a professor of orthopedics and director of orthopedic research at the University of Rochester Medical Center in New York.

What about other types of supplements, like calcium plus magnesium, coral calcium, and so on? Not necessary, the experts tell WebMD. But they note that supplements that combine calcium with vitamin D — which is essential for the body to appropriately absorb calcium — provide an added benefit.

What calcium supplement dose is best?

The body can absorb only about 500 milligrams of a calcium supplement at any one time, says Puzas, so you can’t just down a 1000-mg supplement first thing in the morning and call it a day.

Instead, split your dose into two or three servings a day. “The best way to take it is with a meal; calcium is absorbed better that way,” Puzas says. If your daily diet includes calcium-containing foods and drinks, you may not need multiple doses.

WebMD Health

Latest Edition of Psychiatry’s ‘Bible’ Launched Amid Controversy


Authors say it defines disorders more concisely; critics say it will lead to over-diagnosis and unnecessary treatments


WebMD News from HealthDay

By Dennis Thompson

HealthDay Reporter

FRIDAY, May 17 (HealthDay News) — As the American Psychiatric Association unveils the latest edition of what is considered the “bible” of modern psychiatry this weekend, the uproar over its many changes continues.

“This is unprecedented, the amount of commentary and debate and criticism,” said Dr. Jeffrey Lieberman, president-elect of the American Psychiatric Association (APA). “It’s been an interesting phenomenon, but the evidence is what it is. You have to evaluate it and then make your own determination of how compelling it is, and what would be best clinical practice.”

The APA believes that changes made in this fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) will allow for more precise diagnoses of mental illnesses in patients, because this edition better characterizes and categorizes disorders.

But it has drawn fire from critics who are concerned that the revised version will lead to the diagnosis of mental illness in people who are simply being challenged by life.

More than 1,500 experts from 39 countries representing a wide variety of medical fields contributed to the new DSM-5, which was more than a decade in the making. Drafts of the manual were made available online as part of three open-comment periods that drew more than 13,000 responses.

One of the most notable naysayers has been Dr. Allen Frances, chairman of the task force that created the DSM-4, the previous version of the guide that has been in use since 1994.

In a commentary released the day of the DSM-5′s release, Frances wrote that this latest revision introduces “several high-prevalence diagnoses at the fuzzy boundary with normality,” and predicted that the changes “will probably lead to substantial false-positive rates and unnecessary treatment.”

“In DSM-5, normal grief becomes a major depressive disorder, temper tantrums become disruptive mood dysregulation disorder, worrying about medical illness becomes somatic symptom disorder, gluttony becomes binge eating disorder and almost everyone will soon qualify for attention-deficit disorder,” Frances said in an interview.

The main points of contention regarding the DSM-5 include:

  • The combination of a number of autism-related disorders into a single category called autism spectrum disorder. Although some clinicians believe that placing autism on a continuum from mild to severe will allow for more accurate diagnoses, others are concerned that high-functioning people with autism will find themselves unable to receive services or treatment. This is particularly true of people with Asperger’s Syndrome, a diagnosis that has been eliminated from the DSM-5, critics of the new version contend.

    “We’re concerned that people who have Asperger’s — who have high-functioning autism — are going to be dismissed as just being different when the majority of adults with Asperger’s will need people to assist them in parts of their lives,” said Karen Rodman, president and founder of Families of Adults Affected With Asperger’s Syndrome.

    “We are very concerned that medicine is going to drop the ball again, and the children who need services won’t get them,” Rodman said. “Fortunately, clinicians and physicians and the public around the world are still going to refer to Asperger’s as Asperger’s. It’s like saying people don’t have a right arm anymore.

    “Many people with Asperger’s are [also] concerned there will be a stigma — that everyone will be considered autistic — and when people think of that they think of a child sitting in a corner and spinning,” Rodman added.

  • Changes made to the diagnostic criteria for attention-deficit/hyperactivity disorder (ADHD). Critics are concerned that changes made to better diagnose ADHD will instead lead to over-diagnosis. In the previous version of the DSM, a person needed to show the onset of symptoms before age 7 to be diagnosed with ADHD. The new version now says 12 is the latest age at which ADHD symptoms can manifest themselves. The DSM-5 also reduces the number of criteria needed to arrive at a diagnoses of adult ADHD from six to five.
  • A new diagnostic category for children who are hostile or acting out. The DSM-5 includes a new category called disruptive mood dysregulation disorder, which would apply to children who have extreme irritability but fall short of the standards for bipolar disorder or depression. The category was created to deal with the upswing in bipolar diagnoses among children, but there is concern that some clinicians will label a simple childhood temper tantrum as a treatable mental illness.
  • Breaking out obsessive-compulsive disorders into their own category. Obsessions such as hoarding, hair-pulling and skin-picking had been considered anxiety disorders, but in the DSM-5 they will have their own category. Critics are concerned that this change has more to do with reality television’s recent focus on hoarders than with the need for a new category of mental illness.

WebMD Health

HIV No Barrier to Getting Liver Transplant, Study Finds


Procedure recommended to treat aggressive liver cancer


WebMD News from HealthDay

By Mary Elizabeth Dallas

HealthDay Reporter

FRIDAY, May 17 (HealthDay News) — Liver transplants to treat a common type of liver cancer are a viable option for people infected with HIV, according to new research.

The Italian study, published May 10 in the journal The Oncologist, found that the AIDS-causing virus doesn’t affect survival rates and cancer recurrence after transplants among HIV patients with this particular type of liver cancer, called hepatocellular carcinoma (HCC). The study’s authors noted, however, that HCC is more aggressive in people with HIV and it is becoming a major cause of death among these patients as antiretroviral treatment prolongs their lives.

“The key message of this study is that liver transplantation is a valid option for HCC treatment in HIV-infected patients,” the study’s authors wrote in a journal news release. “We suggest that HIV-infected patients must be offered the same liver transplant options for HCC treatment currently provided to HIV-uninfected subjects.”

The study involved 30 HIV-positive patients and 125 patients not infected with HIV who received a liver transplant to treat HCC at three different hospitals in northern Italy between 2004 and 2009.

During a follow-up period of roughly 32 months, the researchers found a recurrence of HCC in 6.7 percent of the patients with HIV and 14.4 percent of the patients who were not HIV positive.

The study also revealed that survival was similar for all of the patients one year after surgery and three years post-surgery.

The researchers, led by Dr. Fabrizio Di Benedetto, associate professor of surgery at the University of Modena, said the HIV-positive patients were treated with antiretroviral therapy until they underwent the transplant. The therapy was not resumed until their liver function stabilized after surgery.

None of the HIV-positive patients developed AIDS during the post-surgery follow-up period. The study’s authors suggested that this may be due to timely resumption of HIV therapy following the liver transplant.

New options in antiviral therapy for people with HIV could improve control of the HIV virus as well as outcomes following liver transplant for HCC, the researchers said.

Patients with HIV undergoing liver transplant for HCC would benefit most from a multidisciplinary approach to care, the study authors said, which would involve collaboration among oncologists, radiologists, gastroenterologists, liver surgeons and infectious disease specialists.

WebMD Health