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Obesity Rates Fall for Many Young Kids in Federal Nutrition Program

THURSDAY, Nov. 21, 2019 — Forty-one states and territories have seen drops in obesity rates among young children enrolled in a U.S. nutrition program, a new study shows.

“Improvements in national, state and caregiver guidance around nutrition and physical activity may be contributing to this decline in childhood obesity,” said Dr. Robert Redfield, director of the U.S. Centers for Disease Control and Prevention.

“We are moving in the right direction, and helping parents make healthy choices for their children is reducing the potential for complications posed by childhood obesity later in life,” he added in a CDC news release.

In the study, U.S. federal government researchers analyzed obesity trends from 2010 to 2016 among more than 12.4 million children, aged 2 to 4, in low-income families enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). WIC helps provide supplemental foods and nutrition education.

In 2009, WIC state agencies started providing food packages more in line with the U.S. Dietary Guidelines for Americans and infant feeding practice guidelines of the American Academy of Pediatrics. This led to increased availability of healthier foods and beverages for WIC enrollees.

Between 2010 and 2016, obesity rates fell by more than 3% in seven WIC states and territories (New Jersey, New Mexico, Utah, Virginia, Guam, Northern Mariana Islands, and Puerto Rico).

However, three states had increases in obesity: Alabama (0.5%), North Carolina (0.6%), and West Virginia (2.2%).

The study appears in the Nov. 21 issue of the CDC publication Morbidity and Mortality Weekly Report.

A previous study found that 34 of 56 WIC state/territory agencies had decreases in obesity rates between 2010 and 2014.

Currently, the WIC program also helps establish successful long-term breastfeeding, provides participants with a wider variety of foods, and offers WIC state agencies flexibility in food packages for participants with cultural food preferences.

Despite these declines in obesity among children enrolled in WIC, rates remained high in most states in 2016.

“While we have seen some progress, obesity prevalence among young children remains too high,” said Dr. Ruth Petersen, director of CDC’s Division of Nutrition, Physical Activity, and Obesity.

“We must persist in our efforts to support healthy eating and physical activity for this positive trend to continue,” Petersen said in the release.

More information

Advice on preventing childhood obesity can be found at healthfinder.gov.

© 2019 HealthDay. All rights reserved.

Posted: November 2019

Drugs.com – Daily MedNews

Study Casts Doubt on Angioplasty, Bypass for Many Heart Patients

SUNDAY, Nov. 17, 2019 — Bypass operations, angioplasty and the placement of artery-opening stents: For decades, millions of Americans have undergone these expensive, invasive procedures to help treat clogged vessels.

However, the results of a large and long-awaited clinical trial suggests that, in most cases, these procedures may not have provided any benefit over medications and lifestyle changes.

In fact, people treated with meds and healthy changes in lifestyle wound up about as healthy as those who underwent an invasive procedure to open their hardened arteries, researchers reported Saturday at the American Heart Association (AHA) annual meeting in Philadelphia.

Only a subgroup of patients who suffered from frequent angina appeared to receive any benefit from an invasive procedure, and that benefit was in their quality of life, not in lowering their odds of death or future heart problems.

“Based on the trial results to date, I as a clinician would feel comfortable advising my patient not to undergo the invasive strategy if their angina was absent or controlled or it was tolerated,” said Dr. Alice Jacobs, director of the Cardiac Catheterization Laboratory and Interventional Cardiology at Boston Medical Center. She wasn’t involved in the new research.

Still, doctors are often uncomfortable limiting their treatment of clogged arteries to drugs, diet and exercise alone because they’re worried the patient will wind up suffering a heart attack or other heart-related illness, according to past AHA president Dr. Elliot Antman.

The new findings are expected to give physicians more confidence in saying no to invasive treatments, the experts said.

The study did not focus on people who are admitted to a hospital with a heart attack — these patients often receive bypass, angioplasty or stenting to quickly open a blocked artery.

Instead, the trial focused on patients with stable but severe heart disease.

A typical patient in this group might be a 71-year-old grandmother who has noticed during the past two months some chest heaviness walking from the parking lot to her grandkids’ soccer game, the AHA presenters said. Stress testing and imaging scans could reveal some moderately clogged arteries leading to her heart.

The new trial was very comprehensive, involving nearly 5,200 patients across 37 countries. Half were randomly assigned to undergo an invasive procedure: About three-quarters underwent angioplasty (most receiving a stent as well), while the others had a bypass operation.

The other half of patients were treated with medications and lifestyle changes alone.

Researchers mainly focused on whether the invasive procedure would reduce a patient’s risk of heart-related death, heart attack, hospitalization with unstable angina, heart failure or cardiac arrest.

Overall, an invasive strategy “did not demonstrate a reduced risk over a median 3.3 years” compared with the more conservative, drugs/lifestyle therapy, said trial co-chair Dr. Judith Hochman, a cardiologist and senior associate dean of clinical sciences at NYU Langone Health, in New York City.

However, invasive procedures did have a positive impact on one patient subgroup: People who regularly suffer the chest pain and shortness of breath associated with angina, said co-researcher Dr. John Spertus. He directs health outcomes research at Saint Luke’s Mid-America Heart Institute in Kansas City.

“For a patient who has weekly angina, there would be 15% of them who would be expected to be angina-free with the conservative approach, while 45% would be expected to be angina-free with the invasive approach,” Spertus said. “This is such a large difference that you would only have to treat about three patients with weekly angina for one to be angina-free at three months.”

On the other hand, patients who did not regularly have angina received only minimal quality-of-life or symptom benefits after undergoing an invasive procedure, Spertus added.

A smaller set of trials — this time focused on patients with chronic kidney disease — revealed even less promising results, researchers said. Patients didn’t gain any health benefits and didn’t have any improvement in their quality of life after getting an invasive treatment. Angioplasty might even help put them on dialysis earlier or increase their risk of stroke, the study found.

Dr. Glenn Levine, a professor of cardiology with Baylor College of Medicine in Houston, said that when it comes to kidney patients with clogged arteries, he “will treat them with medical [drug] therapy alone” unless they have marked or uncontrolled angina.

Experts said the main message from these studies is that doctors shouldn’t feel pressured to immediately send patients with clogged arteries into a catheterization lab, especially if they aren’t suffering any symptoms.

That could free up physicians to focus on getting patients to take their medications, Jacobs said. If drug therapy helps relieve their occasional angina or other symptoms, then angioplasty might be avoided in two out of every three patients, she estimated.

The trials were funded by the U.S. National Heart, Lung, and Blood Institute.

For more information:

There’s more on common heart procedures at the American Heart Association.

© 2019 HealthDay. All rights reserved.

Posted: November 2019

Drugs.com – Daily MedNews

Many Cancer Docs Don’t Discuss Costs of Pricey Gene Tests

FRIDAY, Nov. 1, 2019 — Fighting cancer can be a long, hard battle, not to mention expensive. Now, new research shows that a quarter of oncologists don’t discuss the cost of expensive tests with their patients.

Genomic tests on cancer cells can help determine which types of treatment might work, and which ones might not. However, such testing can be expensive, and not all tests and related treatments are covered by health insurance, the researchers noted.

Costs of cancer care are rising, and there are increasing concerns about high patient out-of-pocket costs for cancer treatment.

Discussions with their oncologists can help patients make informed decisions about treatment and prepare for potentially high costs. So, the study authors wanted to find out how often oncologists discuss costs of genomic testing and treatment with patients.

They analyzed data from 1,220 U.S. oncologists who took part in a national survey on precision medicine in cancer care.

Half of them said they often discussed the likely costs of testing and related treatments with patients; 26.3% said they sometimes discussed costs; and 23.7% said they never or rarely discussed costs.

Further investigation showed that oncologists trained in genomic testing or who worked in practices with electronic medical record alerts for genomic tests were about two times more likely to discuss costs with patients sometimes or often.

Other factors associated with being more likely to discuss costs with patients included: treating patients with solid tumors; using next-generation sequencing gene panel tests; having higher patient volume; and working in practices with higher percentages of patients with Medicaid, private insurance or no insurance.

“Initiating a discussion about the expected out-of-pocket costs of genomic testing and related treatment is a necessary first step, but is not sufficient to ensure that patients and their families can make fully informed decisions about treatment options,” said lead researcher Robin Yabroff, from the American Cancer Society.

“In the context of rising costs of cancer care, interventions targeting modifiable physician and practice factors may help increase the frequency of physician-patient cost discussions, contributing to more informed patient decisions and higher-quality cancer care,” the researchers said in a society news release.

The study was published Nov. 1 in the Journal of the National Cancer Institute.

More information

The American Cancer Society has more on the costs of cancer treatment.

© 2019 HealthDay. All rights reserved.

Posted: November 2019

Drugs.com – Daily MedNews

Many Women Are Sharing Breast Milk, and That Has Health Experts Worried

FRIDAY, Oct. 25, 2019 — “Informal” sharing of breast milk may be more common than thought, with too many parents mistakenly thinking it’s risk-free, new research suggests.

In a pair of studies, researchers delved into the issue of donor breast milk, and how parents are choosing to get it. In one, a survey of 655 parents who used donor milk found that only about 36% got it from official “milk banks” that screen and pasteurize donations.

Most said they’d turned to “informal” sharing, where parents get breast milk either from a nursing mom they know or via the internet. It’s a practice discouraged by the American Academy of Pediatrics (AAP) and U.S. Food and Drug Administration due to safety concerns.

There is a risk of dilution, or contamination with viruses or bacteria, particularly with donor milk obtained online, explained Dr. Lori Feldman-Winter, who chairs the AAP’s Section on Breastfeeding.

Certain viruses, such as HIV, can also be transmitted through breast milk.

“If you get breast milk from someone you know, it’s probably a low-risk situation,” said Feldman-Winter.

However, she added, that doesn’t mean there’s no risk.

Study author Dr. Ruth Milanaik, of Cohen Children’s Medical Center/Northwell Health in New York, made the same point. Even when breast milk is given for free, with the best of intentions, she said there could be accidental contamination or temperature instability that causes the milk to spoil.

“The only recommended option for obtaining donor breast milk is through a milk bank,” said Milanaik.

That is easier said than done, however.

Right now, there are 28 nonprofit milk banks across the United States that are part of the Human Milk Banking Association of North America. And most of that milk, Feldman-Winter explained, goes to hospitals for preemies whose mothers cannot yet express their own breast milk.

That means little left over for moms of full-term infants who cannot breastfeed, or for adoptive or male gay parents. And even when it is available, there is a steep cost — around $ 4 an ounce, Milanaik said.

With informal sharing, parents may get breast milk for free — either from a friend or by finding a local donor with the help of social networking. There are also websites that allow women to sell their breast milk — it’s not a cheap option, but the prices are typically lower than those of a milk bank, Milanaik noted.

Breast milk is considered the best nutrition for infants. However, it’s not clear whether, for most babies, donor breast milk is a healthier choice than formula.

There’s proof of the benefits to preemies in the hospital, Feldman-Winter said. But when it comes to healthy, full-term infants, “the science just isn’t there yet,” she said.

So if breastfeeding or banked milk are not options, the AAP recommends formula-feeding.

The new findings will be presented by Milanaik and co-author and Cohen researcher Nikita Sood on Saturday at the AAP’s annual meeting in New Orleans, and are based on two related studies. Such research is considered preliminary until published in a peer-reviewed journal.

In the first study, a survey found that of those who chose informal sharing, 56% said they had no safety concerns, and 78% did not ask for medical information from donors because they “trusted them.” More than half said they opted for informal sharing over milk banks due to costs.

In the other study, the researchers looked at 122 parenting-blog posts on donor breast milk. Most, they found, focused on informal sharing rather than milk banks, and most “lacked important discussion of safety concerns.”

It’s not clear how many parents are choosing informal milk sharing. But the new findings suggest it may be more common than pediatricians realize, Feldman-Winter said.

“Certainly one of the take-home messages here is that doctors should talk about this,” she said. “We’re missing an opportunity, as pediatricians, to open up a dialogue and help clarify misperceptions.”

As for nursing moms who have extra milk they want to donate, Milanaik urged them to give to a milk bank.

More information

The Human Milk Banking Association of North America has more on breast milk donation.

© 2019 HealthDay. All rights reserved.

Posted: October 2019

Drugs.com – Daily MedNews

Poll: Many Young Americans Think Vaping is Safe

FRIDAY, Sept. 27, 2019 (HealthDay News) — Despite an outbreak of severe lung illnesses and deaths linked to vaping, many young Americans consider e-cigarettes harmless, a new poll shows.

More than 20% of 18- to 38-year-olds called vaping harmless and nonaddictive; nearly 30% said flavored e-cigarettes do less damage to the lungs than unflavored ones.

The nationwide poll of more than 4,000 adults, commissioned by the American Society of Clinical Oncology (ASCO), was conducted between July 9 and Aug. 10. Reports of vaping-related respiratory illnesses began in July.

More than 800 cases of severe lung illness have been reported and 12 people in 10 states have died, according to the latest statistics from the U.S. Centers for Disease Control and Prevention.

“There are so many unanswered questions about e-cigarettes,” Dr. Richard Schilsky, ASCO’s chief medical officer, said in a society news release. “We need more research about these products so we can begin to answer these questions and protect the health and safety of the American public through education and, where necessary, regulation.”

Nationwide, about 1 in 5 adults use e-cigarettes, the pollsters found.

Vaping is far more popular with young adults than their older counterparts. More than 21% of 23- to 38-year-olds (Millennials) said they regularly use e-cigarettes, compared with 15% of 39- to 54-year-olds (Generation X) and 5% of 55- to 72-year-olds (Baby Boomers).

Among Boomers, 10% said vaping is safe; 14% said it not addictive; and 12% thought flavored e-cigarettes are less harmful than unflavored ones.

Despite the growing number of teens who use e-cigarettes, 73% of parents said they have warned their children about the dangers of vaping.

The U.S. Surgeon General has warned that e-cigarettes contain addictive and harmful or potentially harmful ingredients, including nicotine, lead and other heavy metals and flavorants, such as diacetyl, a chemical linked to lung disease.

The Trump administration recently announced plans to ban the sale of most flavored e-cigarettes. New York and Michigan are also banning flavored vaping products.

Nearly 7 in 10 adults said they support increasing the legal age to buy e-cigarettes from 18 to 21.

Among the 13% of adults who said they vape regularly, 80% were current or former smokers. Many said they use e-cigarettes as a way to use less tobacco (44%) or to stop smoking entirely (41%).

While quitting is a worthwhile goal, the U.S. Food and Drug Administration has not approved e-cigarettes as a smoking cessation aid.

Most Americans (71%) want the FDA to regulate e-cigarettes; 46% favoring banning sale of flavored e-cigarettes; and 41% support a total ban.

— Steven Reinberg

WebMD News from HealthDay

Sources

 American Society of Clinical Oncology, news release, September 2019

Copyright © 2013-2018 HealthDay. All rights reserved.

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WebMD Health

Americans Are Still Eating Too Many ‘Bad’ Carbs

By Amy Norton
HealthDay Reporter

TUESDAY, Sept. 24, 2019 (HealthDay News) — Decades into the obesity epidemic, Americans are still eating far too much sugar, starch and saturated fat, a new report claims.

Since 1999, Americans have cut down a bit on “low-quality” carbs, like heavily processed grains and snack foods with added sugar. But that amounts to only a 3% drop overall, the researchers found.

And Americans have made little headway in boosting their intake of “high-quality” carbohydrates — like beans, fiber-rich whole grains, fruit and vegetables other than potatoes: Consumption rose by only 1% between 1999 and 2016.

Meanwhile, total fat intake rose by the same amount, but half was from saturated fat — which comes mainly from meat and full-fat dairy products. Americans today typically get 12% of their daily calories from saturated fat, the study found. That’s above the 10% recommended limit.

The study cannot answer any “why” questions, according to senior researcher Dr. Fang Fang Zhang, an associate professor at Tufts University Friedman School of Nutrition Science and Policy, in Boston.

But Americans’ reliance on processed foods and take-out is a likely culprit.

“Our study shows that Americans are eating a lot of low-quality carbohydrates from refined grains and added sugars — 42 percent [of daily calories],” Zhang said.

“That’s a lot of calories without many nutrients,” she added. “It’s reasonable to say that’s partially related to convenience foods.”

The findings, reported in the Sept. 24 issue of the Journal of the American Medical Association, are based on a long-running government nutrition survey. Between 1999 and 2016, nearly 44,000 Americans were interviewed about their eating habits.

Over those years, Zhang’s team found, people reduced their total carb intake from an average of 52.5% of daily calories, to 50.5%. At the same time, protein and fat intake inched up.

But there was not much improvement in the national appetite for healthy carbs. And consumption of plant proteins — like nuts and beans — barely budged, from about 5.4% of calories, to 5.8%, the findings showed.

On balance, Americans still seem to love their meat and potatoes.

Continued

Linda Van Horn, who heads the nutrition division at Northwestern University’s Feinberg School of Medicine, co-authored an editorial published with the study.

She agreed that convenience is a powerful force in the national diet, as is advertising.

“Access to snacks, desserts, sugary beverages, pizza, sandwiches and other grab-and-go foods is far greater and more highly marketed than fruits, vegetables, whole-grain foods, and unsalted nuts and seeds,” Van Horn said.

So the responsibility for eating healthy goes beyond an individual’s “will,” Zhang said — particularly since disadvantaged Americans still have poorer diets than those who are wealthier and more educated.

For example, the study found that people living below the poverty line trimmed their intake of low-quality carbs by around 2%, versus nearly 4% among higher-income people.

That points to a need to make healthier choices more affordable and accessible, according to Zhang.

For now, she pointed to simple changes people can try: “Mind the quality of your carbohydrates. Instead of French fries, go for a piece of fruit. Instead of white bread, go for whole-grain bread with nuts or seeds. Read nutrition labels for added sugars, and select products with more fiber and less sugar.”

Van Horn made another point: Healthy eating is not only about weight control; it can help people avoid chronic disease and disability, and the drugs used to treat those conditions.

Ideally, she noted, everyone should pay attention to diet from the beginning — with pregnant women eating healthfully and parents passing good habits onto their kids.

“Establishing the recommended dietary patterns and lifestyle behaviors early in life is the very best strategy to preserve healthy growth and development in our kids — and reverse the escalating obesity epidemic in our country,” Van Horn said.

WebMD News from HealthDay

Sources

SOURCES: Fang Fang Zhang, M.D., Ph.D., associate professor, Friedman School of Nutrition Science and Policy, Tufts University, Boston; Linda Van Horn, Ph.D., R.D., professor, preventive medicine, and chief, nutrition division, Feinberg School of Medicine, Northwestern University, Chicago; Sept. 24, 2019,Journal of the American Medical Association

Copyright © 2013-2018 HealthDay. All rights reserved.

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Train Tracks Deadly for Kids, But Many Parents Underestimate the Danger

TUESDAY, Sept. 24, 2019 — Think the chances that your kid could be hit by a train are slim to none?

New research suggests you should think again.

Issued to coincide with “Rail Safety Week,” the Sept. 23 report finds that, on average, a child dies of a train-related injury somewhere in the United States every five days. And for every death, another three children are injured.

The finding indicates that many parents may not realize the importance of addressing railroad safety, said Torine Creppy, president of Safe Kids Worldwide.

“In fact, fewer than half of parents we surveyed say they have talked with their children about it, and half of parents admit to taking risks around railroads,” Creppy added.

“We want to help parents get the little-known, but lifesaving information they need to protect themselves and their kids,” she added in a Safe Kids news release.

The Safe Kids Worldwide report highlights two key reasons people get hit by trains: car collisions and trespassing.

The report warns that collisions occur when drivers aren’t paying attention, ignore track safety barriers, or race to cross over the tracks before an oncoming train. The latter is a big mistake, Creppy and her colleagues noted, because even if a conductor spots a problem it’s impossible to stop a hurtling train on a dime. It can take upwards of a mile of advanced warning to bring a moving train to a full stop.

Trespassing on foot alongside tracks is both illegal and dangerous, they added. For one, modern trains aren’t as loud as one might expect. And they’re also considerably wider than the track itself — at least three feet wider on either side — which means being near, but not on, a track is no guarantee of safety.

In concert with Union Pacific Railroad, Safe Kids Worldwide offers some safety tips:

  • Only cross at designated track crossings.
  • Never try to beat a train across the tracks.
  • Always wait for trains to completely clear the crossing.
  • Don’t play, stroll or take photos anywhere near a train track.
  • Avoid distractions, such as cellphones or music, when preparing to cross a railroad track.

More information

There’s more on railroad track safety at Safe Kids Worldwide.

© 2019 HealthDay. All rights reserved.

Posted: September 2019

Drugs.com – Daily MedNews

Purdue Files for Bankruptcy Over Opioid Crisis Suits, With Many States Objecting

MONDAY, Sept. 16, 2019 — OxyContin maker Purdue Pharma has filed for Chapter 11 bankruptcy, touching off what could be a fierce battle by dozens of states hoping to recoup billions spent fighting the opioid crisis.

As reported by The New York Times, there are over 2,600 pending federal and state lawsuits lodged against Purdue, and the pharmaceutical giant has proposed a resolution to most of them as part of its bankruptcy filing. The move was approved Sunday night by Purdue’s board of directors.

However, one group of 26 states has refused to settle with Purdue under the proposed arrangement. That sets the stage for lengthy legal battles between the states, Purdue Pharma and the wealthy Sackler family that owns the company, the Times said.

The first legal fight could occur as early as this week in White Plains, N.Y., the newspaper added.

In a statement, Purdue Chairman Steve Miller said the company’s proposed settlement “will dedicate all of the assets and resources of Purdue for the benefit of the American public. This settlement framework avoids wasting hundreds of millions of dollars and years on protracted litigation, and instead will provide billions of dollars and critical resources to communities across the country trying to cope with the opioid crisis.”

Purdue hopes to restructure following bankruptcy, and in the process trigger an automatic halt to civil litigation against it over the opioid epidemic, the Times said.

The settlement requires the dissolution of Purdue Pharma and the formation of a new “public benefit trust” that would continue to sell OxyContin, the firm’s blockbuster opioid.

Proceeds from the new company would be used to pay the plaintiffs in the lawsuit and combat the opioid epidemic through research and the development of new medicines to treat addiction. Purdue also would donate drugs under development for addiction treatment and overdose reversal.

In its filing, Purdue claims the company is valued at $ 10 billion. However, states opposed to the plan say that number is speculative and could take years to realize. And they add that the Sacklers still plan to run another pharmaceutical business, a British company called Mundipharma, until it is sold off. Finally, the states contend that settling the lawsuits through the continued sale of Oxycontin helps the Sackler family itself avoid any monetary penalty.

In a statement, the Sackler family said it had “deep compassion for the victims of the opioid crisis,” the Times reported. “We are hopeful that in time, those parties who are not yet supportive will ultimately shift their focus to the critical resources that the settlement provides to people and problems that need them.”

The Chapter 11 filing comes just one day after New York Attorney General Letitia James announced evidence of almost a billion dollars in previously undisclosed wire transfers from Purdue to private accounts held by Sackler family members.

In a statement released earlier this month about the proposed bankruptcy settlement, Connecticut Attorney General William Tong said that, “I cannot speak to other states or divulge confidential negotiations, but Connecticut has not agreed to any settlement. The scope and scale of the pain, death and destruction that Purdue and the Sacklers have caused far exceeds anything that has been offered thus far.”

More than 200,000 people have died from prescription opioid overdoses since 1999, according to federal statistics. Another 200,000 have died due to overdoses from illicit opioids such as heroin and fentanyl.

More information

The U.S. Centers for Disease Control and Prevention have more about the opioid epidemic.

© 2019 HealthDay. All rights reserved.

Posted: September 2019

Drugs.com – Daily MedNews

Many Older Americans Aren’t Equipped to Weather Hurricanes Like Dorian

WEDNESDAY, Sept. 4, 2019 — As Hurricane Dorian continues to churn up the east coast of Florida, a new poll shows that many older Americans aren’t fully prepared to cope with natural disasters or severe storms.

The poll of more than 2,200 adults, ages 50 to 80, found that less than one-third have an emergency kit with essential supplies and medicines that can sustain them at home or that they can take with them in an evacuation, and only one-quarter who rely on electrical power to run health-related equipment have a backup power supply.

Less than half have signed up for emergency warning systems offered by their community, which can provide crucial information in a crisis, according to the National Poll on Healthy Aging by the Institute Healthcare Policy and Innovation at the University of Michigan.

“Whether it’s as straightforward as a power outage that lasts a day, or as severe as a hurricane, tornado or earthquake, preparing can make a huge difference,” said poll director Dr. Preeti Malani, a professor in the university’s medical school.

“A bit of time spent now can protect your health, and spare you worry and expense, when something like this does happen,” Malani added in a university news release.

Yet only 40% of respondents have spoken with loved ones about what to do in different types of emergency situations.

The poll did find that 82% of respondents said they have a week’s supply of their medications and 72% said they have a week’s worth of other health supplies. A week’s supply is the minimum recommend by experts.

Just over half said they had the recommended week’s worth of food and water, while fewer had cellphone chargers and radios that didn’t require electricity.

Nearly all the respondents said they had transportation if they needed to evacuate their homes, but 1 in 4 said it would be difficult for them to pay for a place to stay for a week.

“The results of this poll can be used to target efforts to better support older adults to prepare for an emergency,” said Sue Anne Bell, a University of Michigan School of Nursing researcher who studies the health implications of major emergencies and disasters.

“By knowing areas where older adults are well-prepared, and where they are not, programs can work alongside older adults to become fully prepared and ready,” Bell explained.

More information

The U.S. Centers for Disease Control and Prevention has more on disaster preparedness and recovery.

© 2019 HealthDay. All rights reserved.

Posted: September 2019

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Many Parents Would Switch Doctors Over Vaccination Policy, Poll Finds

MONDAY, Aug. 19, 2019 — Forty percent of U.S. parents say they would likely find a new doctor if their child’s primary care provider sees families who refuse childhood vaccines, a nationwide poll finds.

And three in 10 say their child’s primary care provider should not treat youngsters whose parents refuse all vaccines.

Those are key findings of the latest C.S. Mott Children’s Hospital National Poll on Children’s Health from the University of Michigan. The findings, published Aug. 19, are based on responses from 2,032 parents of at least one child aged 18 or younger.

“When a family refuses all childhood vaccines, it puts providers in a challenging position,” poll co-director Sarah Clark said in a university news release announcing the findings.

Not only is an unvaccinated child unprotected against harmful and contagious diseases (such as measles, whooping cough and chickenpox), those who skip vaccines also pose a risk of transmitting diseases to other patients, she pointed out.

“This can be especially risky exposure for vulnerable populations, including infants too young to receive vaccines, elderly patients, patients with weakened immune systems or pregnant women,” Clark added.

But many parents were unaware of their health care provider’s policies, and some were unconcerned.

Thirty-nine percent said their child’s primary care provider requires patients to get all recommended vaccines; 8% said only some vaccines are required; and 15% said their provider has no policy. Almost four in 10 weren’t sure.

But 29% of respondents said they’d be “somewhat likely” to look for another doctor if theirs saw kids whose parents had refused all vaccines. Twelve percent would be “very likely” to switch, the findings showed.

Six percent said their provider doesn’t let unvaccinated kids use the common waiting room; 2% said they are allowed do so if they wear a mask. About one-quarter said their provider had no restrictions.

Many parents favor tighter controls: 17% said unvaccinated kids should be kept out of the waiting room and 27% said any allowed in should have to wear masks. Yet, 28% of parents favored no restrictions.

About 43% said they would want to know if other patients at their child’s primary care practice had received no vaccines, while 33% would not, according to the poll.

Clark said recent measles outbreaks underscore the need for parents and providers to consider policies for unvaccinated children.

“Parents may assume that when they take their child to the doctor, they are in a setting that will not expose their child to diseases,” she said. “Parents may not have considered that there could be another child in the waiting room whose parents have refused all vaccines.”

Clark said providers need to consider whether to adopt policies to prevent exposure to vaccine-preventable diseases and then communicate them to everyone in their practice.

“Any parent — and particularly parents of infants or immunocompromised children — should ask their child’s primary care provider about policies surrounding unvaccinated children,” she advised.

The poll, administered in February to a representative sample of parents, has a margin of error of plus or minus 1 to 3 percentage points.

More information

The American Academy of Pediatrics has more on vaccinations.

© 2019 HealthDay. All rights reserved.

Posted: August 2019

Drugs.com – Daily MedNews

Many Doctors Refusing Care of People Prescribed Opioids

THURSDAY, Aug. 15, 2019 — Folks taking opioids for chronic pain may run into trouble if they need to find a new doctor.

A new “secret shopper” survey of 194 Michigan primary care clinics found that as many as four out of 10 primary care doctors would turn away patients who have been taking the pain-killing medications (such as Percocet) long term. And that’s true even if those physician practices said they are open to taking new patients.

“This is a prevalent problem — more so than we expected,” said study author Dr. Pooja Lagisetty, from the University of Michigan Medical School and the VA Ann Arbor Healthcare System.

For the study, researchers called physician practices, posing as a potential new patient. The “patients” explained that they were taking opioids for chronic pain and said they had either Medicaid or private health insurance.

Lagisetty said she hopes the study gets health care systems thinking about this problem.

“I hope it gets physicians thinking, ‘What can we do better?’ By closing doors on patients, we’re not helping anybody,” she said. “We need to dig into this problem to find out what’s driving it.”

Lagisetty said there are probably multiple reasons that doctors turn certain patients away.

“Stigma is probably a component, and another big component is probably the administrative burden that comes with prescribing opioids. It’s not a trivial amount of work to manage someone on opioids safely. I suspect some clinics may be a little overburdened,” she said.

Dr. Noel Deep, a spokesman for the American College of Physicians, suspects the problem is less about stigma and more about the regulatory burden related to prescribing opioids.

“Physicians have to think twice when prescribing opioids, and if you’re in a small, rural practice, it gets difficult. Physicians can also be targeted for overprescribing,” he said.

Dr. Yili Huang, director of the pain management center at Northwell Phelps Hospital in Sleepy Hollow, N.Y., agreed that opioid regulations might make physicians hesitant to take on a patient who’s using them, even if that patient doesn’t have an issue with addiction.

While people taking opioids are at a very high risk of misuse or abuse, Huang said about three-quarters of people who take them don’t misuse them and about 90% don’t develop an addiction. He did note, however, that many people can have their pain successfully managed without opioids.

But for those who do need them, the increased scrutiny and potential risk to a doctor’s license and livelihood may keep them from taking on these patients.

So, what can happen if people treating chronic pain with opioids can’t find a doctor?

Lagisetty said patients could be left with uncontrolled pain, and may have withdrawal symptoms. If they attempt to see several doctors for opioids, they may be labeled as a “drug-seeker” and have difficulty accessing their pain medications.

For those who are abusing the opioids, in some states they won’t have access to the medication that can reverse an overdose. They also won’t get a referral for addiction treatment.

Deep said, “Patients have to come first. If patients can’t get medications, there can be very bad outcomes.” He noted that patients might end up driving long distances to seek pain relief. Some might even use illicit drugs.

All three experts said there’s a need for increased addiction education, as well as some flexibility in prescribing guidelines.

The news from the study wasn’t all bad, Lagisetty pointed out. While around 40% of doctors turned chronic opioid users away, 60% were willing to see them.

Huang added, “Despite increasing regulatory scrutiny, many providers continue to care for patients on chronic opioids.”

The study found no difference in whether doctors would see patients based on the type of insurance they had.

“This suggests that there may not be any financial or discriminatory incentive behind these actions, and instead [turning these patients away] is driven solely by fear of policy repercussions and lack of education,” Huang explained.

The study was recently published online in JAMA Network Open.

More information

Learn more about pain treatment options from the U.S. National Institute on Aging.

© 2019 HealthDay. All rights reserved.

Posted: August 2019

Drugs.com – Daily MedNews

Dangerous Sesame Allergy Affects Many Americans

FRIDAY, Aug. 2 , 2019 — More than 1.5 million children and adults in the United States have sesame allergy — more than previously believed, a new study finds.

And even though sesame allergy can cause severe reactions, sesame is often not declared on food product labels, the Northwestern University researchers said.

In the United States, sesame labeling is not required by law as it is with eight other allergens: peanut, milk, shellfish, tree nuts, egg, wheat, soy and finfish, along with proteins derived from them.

Also, sesame labeling is often confusing. For example, it may be labeled as tahini, a sesame seed paste. This increases the risk of accidental consumption.

“It is important to advocate for labeling sesame in packaged food. Sesame is in a lot of foods as hidden ingredients. It is very hard to avoid,” study lead author Dr. Ruchi Gupta said in a university news release. She is director of the Center for Food Allergy and Asthma Research at Northwestern’s Feinberg School of Medicine in Chicago.

The study comes as the U.S. Food and Drug Administration is weighing whether to add sesame to the list of food allergens requiring mandatory product labeling. This is something that’s done in the European Union and Australia.

The researchers conducted a telephone and online survey of more than 80,000 children and adults in 50,000 U.S. households. They asked about any suspected food allergies, including specific reaction symptoms and diagnosis of food allergies.

Based on the survey results, the researchers concluded that more than 1.5 million children and adults have a sesame allergy, and more than 1.1 million have either a physician-diagnosed sesame allergy or a history of sesame-allergic reaction symptoms.

The researchers also concluded that many people who report sesame allergies and have potentially severe allergic reactions do not have their allergy diagnosed.

“Clinical confirmation of suspected food allergies is essential to reduce the risk of unnecessary allergen avoidance as well as ensure patients receive essential counseling and prescription of emergency epinephrine,” said study first author Christopher Warren. He’s an investigator with the Center for Food Allergy and Asthma Research.

Sesame allergy affects children and adults at similar rates, unlike milk or egg allergies, which often appear early in life and are no longer present by the teens, the researchers noted.

Also, 4 in 5 people with sesame allergy have at least one other food allergy. More than half have a peanut allergy; a third have tree nut allergy; a quarter have egg allergy, and 1 in 5 have cow’s milk allergy, according to the researchers.

The study was published Aug. 2 in the journal JAMA Network Open.

More information

Food Allergy Research & Education has more on sesame allergy.

© 2019 HealthDay. All rights reserved.

Posted: August 2019

Drugs.com – Daily MedNews

It’s Not Just College Kids: Many Seniors Are Binge Drinking, Too

WEDNESDAY, July 31, 2019 — Binge drinking is often associated with young adults, but according to a new study, more than 10% of people over 65 do it, too.

Among seniors, binges are most common in men and those who use cannabis, researchers found. Experts said the trend is troubling, because older people should actually be cutting back on alcohol.

“Many organizations, such as the U.S. National Institute on Alcohol Abuse and Alcoholism [NIAAA], recommend lower drinking levels as people get older or have more chronic diseases,” said lead researcher Dr. Benjamin Han, an assistant professor of geriatric medicine at NYU Langone Health in New York City.

Other studies have documented increasing alcohol consumption in the United States and worldwide, he said.

Binge drinking is generally defined as consuming five or more alcoholic drinks at a time. NIAAA suggests seniors cap their alcohol intake at three drinks a day.

Because the new study used the higher cutoff, it may actually underestimate how common binge drinking is among U.S. seniors.

Han isn’t sure why binge drinking is on the rise among older people, but he has a theory.

“It is possible,” he said, “that the increase in binge drinking is partly driven by increases by older women.”

Although their male counterparts are more likely to binge, older women are catching up. Binge drinking among older men remained relatively stable between 2005 to 2014.

Han says doctors should screen older adults for “unhealthy alcohol use, including binge drinking, even if it is not frequent.”

For the study, his team collected data on nearly 11,000 U.S. adults 65 and older who took part in the National Survey on Drug Use and Health between 2015 and 2017.

Of those, 10.6% had binged in the past month, the study found. That was up from previous studies. Between 2005 and 2014, between 7.7% and 9% of older Americans were binge drinkers.

Blacks and people with less than a high school education were more likely to do so, the researchers found.

They found no link between binge drinking and mental disorders or a higher incidence of chronic diseases. Among senior binge drinkers, the most common chronic diseases were high blood pressure (41%), heart disease (23%) and diabetes (18%).

Still, researchers warned that excessive drinking can make chronic diseases worse and lead to accidents.

That binge drinking is increasing is worrisome, said Dr. James Garbutt, medical director of the Alcohol and Substance Abuse Program at the University of North Carolina at Chapel Hill.

“By definition, binge drinking means drinking to the point of intoxication,” said Garbutt, who wasn’t involved with the study. “In older adults, that increases risks of falls, other accidents, blackouts, cognitive impairment, depression and suicide.”

Plus, alcohol makes high blood pressure worse and is a significant factor for dementia, he said.

“It seems we need to educate older adults about these risks and encourage them that if they are going to drink alcohol, to limit intake to one to two standard drinks and try not to drink daily,” Garbutt said.

If people find they can’t drink without a binge, they should talk with their doctor or a counselor and consider a period of abstinence to see how they feel, he said.

“Reducing or stopping drinking could be one of the best things they do for their health, and many are surprised at how good they feel,” Garbutt said.

The report was published July 31 in the Journal of the American Geriatrics Society.

More information

For more on binge drinking, head to the U.S. Centers for Disease Control and Prevention.

© 2019 HealthDay. All rights reserved.

Posted: July 2019

Drugs.com – Daily MedNews

Many Pneumonia Patients Get Too Many Antibiotics

By Robert Preidt
HealthDay Reporter

FRIDAY, July 12, 2019 (HealthDay News) — Two-thirds of hospitalized pneumonia patients may be prescribed antibiotics for too long, increasing their risk for potentially harmful side effects, researchers say.

In 93% of cases, overprescription involved the number of antibiotics patients received upon being discharged from the hospital.

Each year in the United States, pneumonia sends 1 million adults to the hospital. The new study examined the medical records of 6,500 pneumonia patients treated at 43 Michigan hospitals. Of those, 60% were interviewed by phone within a month after they left the hospital.

Most patients who received too-long prescriptions for antibiotics got an average of two extra days’ worth of pills, according to a research team led by Dr. Valerie Vaughn of the University of Michigan. As she explained, the more days of antibiotics a patient received beyond the recommended minimum, the higher their risk of experiencing side effects such as upset stomach or yeast infections.

“‘Antibiotic stewardship,’ which includes choosing the right drug and the right duration for each patient, has become a part of most hospitals,” said Vaughn, an assistant professor of internal medicine.

“But these results show us that we need to pay more attention to stewardship at discharge — and suggest that guidelines for prescribers should be clearer about how to calculate an appropriate duration based on a patient’s condition,” she said in a university news release.

Overprescription of antibiotics is also a known contributor to antibiotic resistance, where bacteria find ways to mutate around the drugs.

The study found wide variation among hospitals in the percentage of pneumonia patients who were prescribed antibiotics for too long. In some hospitals less than 50% of patients got too many of the drugs, while other hospitals gave an oversupply to nearly every patient.

Adding to the problem is the fact that national guidelines for treating pneumonia are not precise, Vaughn noted.

She said that determining the amount of antibiotics a pneumonia patient requires depends on their diagnosis, plus how long it took them to stabilize after treatment began. In general, most patients without risk factors need about five days’ worth of antibiotics; while those with risk factors, or pneumonia caused by especially difficult bacteria, need about seven days’ worth, Vaughn said.

The study was published June 8 in the journal Annals of Internal Medicine.

WebMD News from HealthDay

Sources

SOURCE: University of Michigan, news release, July 8, 2019

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WebMD Health

Many Pneumonia Patients Get Too Many Antibiotics

FRIDAY, July 12, 2019 — Two-thirds of hospitalized pneumonia patients may be prescribed antibiotics for too long, increasing their risk for potentially harmful side effects, researchers say.

In 93.2% of cases, overprescription involved the number of antibiotics patients received upon being discharged from the hospital.

Each year in the United States, pneumonia sends 1 million adults to the hospital. The new study examined the medical records of 6,500 pneumonia patients treated at 43 Michigan hospitals. Of those, 60% were interviewed by phone within a month after they left the hospital.

Most patients who received too-long prescriptions for antibiotics got an average of two extra days’ worth of pills, according to a research team led by Dr. Valerie Vaughn of the University of Michigan. As she explained, the more days of antibiotics a patient received beyond the recommended minimum, the higher their risk of experiencing side effects such as upset stomach or yeast infections.

“‘Antibiotic stewardship,’ which includes choosing the right drug and the right duration for each patient, has become a part of most hospitals,” said Vaughn, an assistant professor of internal medicine.

“But these results show us that we need to pay more attention to stewardship at discharge — and suggest that guidelines for prescribers should be clearer about how to calculate an appropriate duration based on a patient’s condition,” she said in a university news release.

Overprescription of antibiotics is also a known contributor to antibiotic resistance, where bacteria find ways to mutate around the drugs.

The study found wide variation among hospitals in the percentage of pneumonia patients who were prescribed antibiotics for too long. In some hospitals, less than 50% of patients got too many of the drugs, while other hospitals gave an oversupply to nearly every patient.

Adding to the problem is the fact that national guidelines for treating pneumonia are not precise, Vaughn noted.

She said that determining the amount of antibiotics a pneumonia patient requires depends on their diagnosis, plus how long it took them to stabilize after treatment began. In general, most patients without risk factors need about five days’ worth of antibiotics; while those with risk factors, or pneumonia caused by especially difficult bacteria, need about seven days’ worth, Vaughn said.

The study was published June 8 in the journal Annals of Internal Medicine.

More information

The U.S. National Heart, Lung, and Blood Institute has more on pneumonia.

© 2019 HealthDay. All rights reserved.

Posted: July 2019

Drugs.com – Daily MedNews