Prescription Medications

Could Taking a Swing at Golf Help Parkinson’s Patients?

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WEDNESDAY, March 3, 2021 — For helping Parkinson’s patients improve their balance and mobility, golf may beat the martial art exercise tai chi, a new, small study reveals.

“Exercise is well-known to treat the symptoms of Parkinson’s disease,” said study author Dr. Anne-Marie Wills, noting it helps to improve gait, balance and fatigue, while offering a measure of depression relief. Several human and animal studies have also raised the prospect that exercise could help slow disease progression as well, she added.

But many Parkinson’s patients fail to engage in therapeutic activities. And “there are almost no randomized trials comparing different types of exercise in PD,” said Wills, an assistant professor of neurology at Harvard Medical School.

To see how golf stacks up against tai chi, her team focused on 20 patients whose disease was characterized as “moderate.” None had previously played golf or practiced tai chi.

Eight were offered a 10-week golf class that met twice weekly for an hour. The other 12 underwent tai chi training for the same amount of time.

Standing and walking tests were conducted before and after the training classes, with each patient timed to see how long it took to rise from a chair, walk 10 feet, return and sit down again. The result: Post-study the tai chi group performed the full exercise about a third of a second slower than at the study’s start. But the golf group was nearly 1 second faster.

Wills said she was not particularly surprised by the finding because, anecdotally, “I had observed that people with Parkinson’s disease who golf regularly seem to have better outcomes.”

The study found a “statistically significant improvement” among the golf group, and also determined that golf was at least as safe and effective as tai chi.

“While both interventions focus on balance, participants in the golf arm seemed to enjoy the exercise more, which may help to explain the greater improvement,” said Wills, who also directs the CurePSP Center of Care at Massachusetts General Hospital in Boston.

Her takeaway: “While this was a small pilot study, we are optimistic that this could be a good exercise option for people with Parkinson’s. It was well-tolerated, safe and seemed to improve balance. We would like to perform a larger study to confirm our findings, but in the meantime, we would encourage people with Parkinson’s disease to practice their golf swing at a driving range for an hour a day, three times a week.”

James Beck is the chief scientific officer at the Parkinson’s Foundation in New York City. “While not a cure for people living with Parkinson’s disease, exercise is like a rising tide that can lift all boats,” he noted.

“For PD, exercise can ease symptoms of stiffness, improve movement, counter apathy and depression, and improve overall function,” said Beck, who wasn’t part of the study.

“Exercise often leads to increased strength and better balance,” he said, stressing that it all helps to minimize falls, a leading cause of death for those with Parkinson’s.

The Parkinson’s Foundation says patients who develop a consistent exercise routine early in the course of their disease are better able to slow declines in quality of life, compared with those who get active later on.

With that in mind, Beck suggested the overriding goal should be “less about finding the ‘right’ exercise and more about getting people to start moving and stay moving.

“The message is not that people should go out and start golfing,” he said. “But it is clear that if these results persist with a larger sample, people living with PD should find the exercise they like and keep doing it.”

The findings will be presented April 17-22 at a virtual meeting of the American Academy of Neurology. Data and conclusions presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.

© 2021 HealthDay. All rights reserved.

Posted: March 2021

Vaping Pot Worse Than Vaping Tobacco for Teens’ Lungs: Study

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WEDNESDAY, March 3, 2021 — Teenagers who vape pot are more likely to wheeze and cough than those who smoke or vape nicotine, new survey data reveals.

Reports from U.S. kids 12 to 17 show they have a higher risk of wheezing, suffering from a dry cough, and having their sleep, speech or exercise impeded by wheezing if they vape marijuana products, according to results from the U.S. federally funded Population Assessment of Tobacco and Health Study.

These are all symptoms strongly related to lung injury, and it’s unclear how long they will last, said lead researcher Carol Boyd, co-director of the University of Michigan’s Center for the Study of Drugs, Alcohol, Smoking and Health.

“We found, and it was something that surprised us a bit, that it was the lifetime vaping cannabis that was associated with a far greater number of symptoms and a higher likelihood of having each of these symptoms than using either e-cigarettes or cigarettes,” Boyd said. “Lifetime” referred to any past use.

Survey responses from nearly 15,000 teens showed that vaping pot increased their risk of wheezing or whistling in the chest by 81%, compared with a 15% increased risk from cigarettes and a 9% increased risk from nicotine e-cigarettes.

Vaping pot also increased teens’ risk of:

  • Sleep disturbed by wheezing by 71%
  • Speech limited due to wheezing by 96%
  • Wheezing during or after exercise by 33%
  • Dry coughing at night by 26%.

Smoking and nicotine e-cigarette use also increased risks for these indications of lung injury, just not by as much, Boyd said.

“I think that industry would probably like to show that vaping e-cigarettes is healthier, that it’s the cannabis vaping causing these respiratory symptoms, not the e-cigarettes. This is not true. E-cigarette vaping also causes symptoms among youth,” Boyd said. “However, in our study, and when we took into account their e-cigarette use, we found higher odds of having these respiratory symptoms among youth who had vaped cannabis.”

The survey was taken between December 2016 and January 2018 — prior to the wave of lung injuries among young people that occurred in 2019. It was given the name EVALI, or e-cigarette or vaping use-associated lung injury.

Boyd thinks some of these lung problems reported in the survey were probably due to EVALI, which has been linked to pot-laced e-liquids and particularly those containing vitamin E acetate.

According to the U.S. Centers for Disease Control and Prevention, 4 out of 5 patients with EVALI had vaped cannabis, versus only about 16% who said they were only vaping nicotine.

In addition, vitamin E acetate was found in the lung fluid of all patients with EVALI, but never in people who weren’t suffering from lung injury related to vaping, Boyd noted.

“It could be a lot of things that cause respiratory symptoms among vapers, including cannabis vapers,” Boyd said. “There are other things in these compounds. But right now, there appears to be a notable association between EVALI and vitamin E acetate.”

Dr. Albert Rizzo, chief medical officer of the American Lung Association, says that vaping products remain largely unregulated, despite promises by the U.S. Food and Drug Administration to enforce product standards among e-cigarette manufacturers.

“The FDA doesn’t make sure that these substances have in them what they say on the label, so you’re always at the mercy of the manufacturer,” Rizzo said. “They’ve really not been taking the action they need to. The dates have gone by when some of the products on the market should have been submitting data to the FDA. They’re not keeping to the timeline they said they would as far as removing products from the market.”

Folks thinking about vaping pot should keep in mind that they could be drawing just about anything into their lungs, Rizzo said.

“Rather than trying to pigeonhole a specific term like EVALI as a concern for some of this cannabis use in electronic devices, I think it’s more important to look at the broader picture of what inhaling any substance like this can do to the airways and the lungs,” Rizzo said.

The study appears in the March 3 Journal of Adolescent Health.

© 2021 HealthDay. All rights reserved.

Posted: March 2021

COVID Vaccines for All American Adults by the End of May: Biden

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WEDNESDAY, March 3, 2021 (Healthday News) — The United States is now poised to have enough COVID-19 vaccines for every American adult by the end of May, President Joe Biden said Tuesday.

The announcement, which came during a brief speech at the White House, accelerates the country’s vaccination goals by two months.

“As a consequence of the stepped-up process that I’ve ordered and just outlined, this country will have enough vaccine supply — I’ll say it again — for every adult in America by the end of May,” Biden said. “By the end of May. That’s progress — important progress.”

How was it possible to speed up the U.S. vaccine rollout?

Biden said his administration provided support to Johnson & Johnson so the company and its partners can make vaccines around the clock, The New York Times reported. In addition to that, the administration brokered a deal in which the pharmaceutical giant Merck & Co. would help manufacture the newly approved Johnson & Johnson single-shot coronavirus vaccine.

Although its own attempt at making a COVID-19 vaccine failed, Merck is the world’s second-largest vaccine manufacturer, according to the Times. White House officials described the partnership between the two competitors as historic and said it harkens back to the wartime manufacturing campaigns that former President Franklin D. Roosevelt put into place.

Biden also said Tuesday that he wanted all teachers to receive at least one shot by the end of this month, the Times reported.

Biden’s announcement came days after the U.S. Food and Drug Administration authorized the emergency use of the Johnson & Johnson vaccine. As of Wednesday, 78.6 million Americans had been vaccinated, with just over 26 million getting their second shot.

Even as vaccinations ramp up, public health officials worry about another surge of coronavirus cases, as new, more infectious variants emerge and states like Texas and Mississippi lift their mask mandates and roll back many of their coronavirus restrictions. Although cases have dropped significantly since January, they are now leveling off, the Times reported.

“We cannot let our guard down now or assure that victory is inevitable,” Biden said Tuesday. “We can’t assume that.”

U.S. will stick with two doses of Pfizer, Moderna vaccines: Fauci

The United States will stick with its plan to give millions of Americans two doses of the Pfizer and Moderna coronavirus vaccines, Dr. Anthony Fauci said Monday.

The nation’s top infectious diseases expert told the Washington Post that shifting to a single-dose strategy for those two vaccines could leave people less protected, allow more contagious variants to spread and make Americans already hesitant to get the shots even more wary.

“We’re telling people [two shots] is what you should do … and then we say, ‘Oops, we changed our mind’?” Fauci said. “I think that would be a messaging challenge, to say the least.”

Fauci said he spoke on Monday with health officials in the United Kingdom, who are delaying second doses to give more people shots more quickly. He said that although he understands the strategy, it wouldn’t make sense in America. “We both agreed that both of our approaches were quite reasonable,” Fauci told the Post.

Some public health experts have asked U.S. policymakers to reconsider whether millions of doses intended as second shots could be distributed as first doses instead — to offer at least some protection to a greater number of people. The issue gained steam after an advisory committee to the U.S. Centers for Disease Control and Prevention on Monday tackled the question while approving Johnson & Johnson’s single-shot coronavirus vaccine.

About 80 percent of adults have yet to get a single dose, according to CDC data.

Fauci told the Post the science shows that a two-shot regimen creates enough protection to fend off more contagious coronavirus variants, while a single shot could leave Americans at risk from these variants. There is insufficient data showing how long the immunity provided by one shot would last. “You don’t know how durable that protection is,” he noted.

Fauci also argued that Pfizer’s and Moderna’s recent commitment to deliver 220 million total doses by the end of March, in addition to Johnson & Johnson’s pledge to deliver nearly 20 million shots this month, should make the issue moot.

“Very quickly the gap between supply and demand is going to be diminished and then overcome in this country,” he said. “The rationale for a single dose — and use all your doses for the single dose — is when you have a very severe gap between supply and demand.”

FDA Approves J&J’s single-dose COVID vaccine

The U.S. Food and Drug Administration on Saturday approved Johnson & Johnson’s single-shot coronavirus vaccine for emergency use after its advisory panel unanimously backed the vaccine a day earlier.

Adding a third vaccine to the country’s arsenal will help boost the nation’s limited supply of the two authorized shots, from Pfizer and Moderna.

Nearly 4 million doses of the newest COVID-19 vaccine were shipped Sunday night, and will begin to be delivered to states for injections starting on Tuesday, the Associated Press reported.

The White House said the entire stockpile of the newly approved single-dose Johnson & Johnson vaccine will go out immediately. J&J will deliver about 16 million more doses by the end of March and 100 million total by the end of June.

Advisory panel members said the J&J approval made sense.

“It’s a relatively easy call; it clearly gets way over the bar, and it’s nice to have a single-dose vaccine,” said Eric Rubin, an infectious diseases specialist at the Harvard T.H. Chan School of Public Health and a member of the FDA advisory panel.

Infectious disease experts also welcomed the approval.

“The addition of a third COVID-19 vaccine substantially reduces the time it takes the U.S. to reach herd immunity — when a high enough proportion of the population is immunized and we can disrupt the spread of this disease,” said Dr. Lisa Lee, a public health expert who specializes in infectious diseases.

“Getting 75-85% of the population vaccinated will be easier with this additional vaccine option, especially because it, unlike the first two, does not require a complex frozen or ultra-frozen transport and storage system, and requires only one shot, instead of the two required by the others,” said Lee, who is associate vice president for research and innovation at Virginia Tech.

FDA briefing documents showed the J&J vaccine had an overall efficacy rate of 72 percent in the United States and 64 percent in South Africa, where a concerning variant emerged in the fall and has since spread to the United States, the Times reported.

The vaccine was particularly effective at preventing severe illness or death: It showed 86 percent efficacy against severe forms of COVID-19 in the United States, and 82 percent against severe disease in South Africa. None of the nearly 22,000 vaccinated people in the trial died of COVID-19.

A global scourge

By Wednesday, the U.S. coronavirus case count passed 28.7 million while the death toll passed 515,700, according to a Times tally. On Wednesday, the top five states for coronavirus infections were: California with nearly 3.6 million cases; Texas with more than 2.6 million cases; Florida with over 1.9 million cases; New York with over 1.6 million cases; and Illinois with nearly 1.2 million cases.

Curbing the spread of the coronavirus in the rest of the world remains challenging.

In India, the coronavirus case count was more than 11.1 million by Wednesday, a Johns Hopkins University tally showed. Brazil had over 10.6 million cases and more than 257,000 deaths as of Wednesday, the Hopkins tally showed.

Worldwide, the number of reported infections passed 114.8 million on Wednesday, with over 2.5 million deaths recorded, according to the Hopkins tally.

© 2021 HealthDay. All rights reserved.

Posted: March 2021

Further Support and Information on COVID-19

Health Highlights: March 3, 2021

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Texas, Mississippi Drop Mask Mandates

Texas has lifted its mask mandate and all businesses can reopen next Wednesday with no seating limits, Gov. Gregg Abbott announced Tuesday.

Abbott’s moves came as federal health officials have cautioned governors against easing restrictions because nationwide progress against the COVID-19 pandemic has plateaued in the last week, The New York Times reported.

“To be clear, COVID has not, like, suddenly disappeared,” Abbott acknowledged. “COVID still exists in Texas and the United States and across the globe.”

However, “state mandates are no longer needed,” because better treatments are now available for COVID-19 patients, the state can conduct large numbers of tests each day and Texans have already received 5.7 million vaccine shots, according to Abbott, theTimes reported.

While saying that most state restrictions would be lifted, Abbott did not specify which mandates would remain in place. He said Texans could decide for themselves what precautionary measures they want to take to limit the spread of the virus and that top elected officials in each county could reimpose restrictions if hospital capacities passed 15 percent, the Times reported.

“At this time, however, people and businesses don’t need the state telling them how to operate,” he said, the Times reported.

Shortly after Abbott’s announcement, Gov. Tate Reeves announced that he would end Mississippi’s statewide mask mandate, effective Wednesday, NBC News reported.

On Monday, CDC Director Rochelle Walensky strongly cautioned against the rollbacks that Abbott and Reeves were about to announce.

“I am really worried about reports that more states are rolling back the exact public health measures we have recommended to protect people from COVID-19,” Walensky said during a White House briefing, NBC News reported.

“Please hear me clearly,” Walensky said. “At this level of cases with variants spreading, we stand to completely lose the hard-earned ground we have gained.”

Dolly Parton Gets Shot of COVID-19 Vaccine She Backed

Dolly Parton has received a shot of the COVID-19 vaccine whose development she helped fund.

The 75-year-old country music star received her first dose of the Moderna vaccine on Tuesday from her friend Dr. Naji Abumrad, CBS News reported.

Parton tweeted a video of herself getting vaccinated, saying she and Abumrad have been “friends forever.”

“I thought it was only appropriate that you should be the one to give me my shot today,” she said.

Tennessee began vaccinating those aged 70 and older at the beginning of February. Parton is 75.

Less than a year ago, Parton donated $1 million to help Abumrad develop the vaccine at Vanderbilt University. When she got vaccinated, Parton said quipped that she “got a shot of her own medicine.”

Parton also had a message for those who may plan on avoiding getting vaccinated.

“I’m old enough to get it and I’m smart enough to get it. …The sooner we get to feeling better, the sooner we are going to get back to being normal,” Parton said during the video. “So I just wanna say to all of you cowards out there, don’t be such a chicken squat, get out there and get your shot.”

“Dolly’s generous support helped fund early research at Vanderbilt Health into what is now a vaccine that’s helping end the pandemic,” the Vanderbilt University Medical Center tweeted.

© 2021 HealthDay. All rights reserved.

Posted: March 2021

How Climate Change Could Put More MS Patients in Danger

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TUESDAY, March 2, 2021 — When temperatures rise, people with multiple sclerosis need to keep cool. Heat sensitivity is a hallmark of the central nervous system disorder.

So, what happens when warm weather spikes become more frequent because of climate change?

More MS patients end up in the emergency room. A new study found that during periods of unusually warm weather, they were more likely to visit the emergency room or require a visit to the doctor.

The relative increase in visits is small — but the effect is meaningful, said study author Holly Elser, an epidemiologist and student at Stanford University School of Medicine in California.

Elser was moved to investigate after a patient at a routine checkup mentioned that her MS symptoms were worse with the heat.

“We know that average temperatures globally continue to rise every year and both weather and temperature patterns are anticipated to become more variable over time,” Elser said, noting that the adverse health effects have been documented in the general population and in some at-risk groups. Those include people with heart and lung diseases, dementia or serious mental illness.

“But when we looked at the literature, there really wasn’t very much on the implications of weather and temperature patterns for individuals living with MS,” Elser said.

Researchers defined unusually warm months as those when the local average temperatures exceeded long-term averages by roughly 2 degrees Fahrenheit.

They looked at data on more than 106,000 Americans with MS and estimated that stretches of unusually warm weather were associated with 592 more ER visits, 1,260 more inpatient visits and 1,960 more outpatient visits.

During those periods, MS patients were 4% more likely to visit the emergency room than during normal weather patterns, the study found. They also had 3% higher odds of having an in-person medical visit and were 1% more likely to have an outpatient visit.

“Many patients with MS, especially those who’ve had the disease for a long time, are prepared for extreme temperatures, but I think our study implies that not-so-extreme but warmer-than-average temperatures may also put patients at risk for worsening of their symptoms,” Elser said.

The findings will be presented April 17-22 at a virtual meeting of the American Academy of Neurology. Research presented at meetings is typically considered preliminary until published in a peer-reviewed journal.

Release of the findings on March 2 dovetailed with news of an Austrian man with a temperature-dependent form of MS who plans to take his government to court.

Lawyers said the aim is to force Austria to do more to combat climate change, according to the Associated Press. The case is expected to be filed next month.

MS is a disease of the central nervous system that affects the brain and spinal cord. It damages myelin, a material that surrounds and insulates the nerves, impeding messages between the brain and the body. Symptoms can range from minimal to severe.

The notion of heat having an impact on MS isn’t new.

In years past, one diagnostic test immersed a patient in very warm water to evaluate its impact on their symptoms, said Kathy Costello, vice president of programs for Can Do Multiple Sclerosis, a Colorado-based organization that provides lifestyle coaching for MS patients and their families.

“For people living with this, it’s really difficult. Hot days, hot rooms, hot bath, hot shower, hot drinks, having a fever — all of these things can make someone’s MS feel horrible,” Costello said. “They can have visual changes. They can have increased fatigue. They can have cognitive changes, weakness, increased numbness, essentially any of the areas that have been already affected by demyelination can suffer when that person’s body temperature is raised.”

And, she added, it doesn’t take a big temperature spike to cause trouble. “Half a degree is enough to have someone with MS experience an increase in their symptoms,” Costello said.

To cope, patients can wear lightweight, loose-fitting, breathable clothing; drink frozen beverages to cool off from the inside; and stay in air-conditioned rooms when it’s hot outdoors.

A variety of cooling products, including vests, neck wraps and bandanas, can enable someone with MS to get outside even if it’s hot. To exercise safely, they can walk before the heat of the day or work out in pools heated to 84 degrees F max.

As temperatures warm, electric company vouchers to help MS patients afford air conditioning might be one way to help, Elser said.

“I think that this is an area where there may be very real discrepancies in how individuals can protect themselves from unexpected weather and temperature based on income,” she said.

As weather patterns change, Elser added that a constant re-examination of health implications will be important, not only for individuals with MS, but also for other vulnerable patients.

© 2021 HealthDay. All rights reserved.

Posted: March 2021

What You Need to Know About the New J&J COVID Vaccine

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TUESDAY, March 2, 2021 — The U.S. Food and Drug Administration has approved the emergency use of Johnson & Johnson’s single-shot coronavirus vaccine, adding a third weapon to the arsenal the United States is building to battle the pandemic.

The overall effectiveness of the J&J vaccine in protecting recipients against any case of COVID-19 (66%) is not as high as that of the Pfizer and Moderna vaccines (95%). But J&J’s single shot was very effective where it really counted: preventing severe illness. The vaccine showed 86 percent efficacy against severe forms of COVID-19 in the United States and 82 percent efficacy against severe disease in South Africa, where a potentially tougher new variant of coronavirus was circulating. None of the nearly 22,000 people who were vaccinated the trial died of COVID-19.

So, experts believe J&J’s vaccine will be a valuable new option for many Americans.

“It’s easy to look at the numbers and assume this vaccine is less effective, but when the race to develop a COVID-19 vaccine began, scientists were hopeful for a 50% efficacy rate. We have managed to knock that out of the park at least three times now, so we epidemiologists are still very excited about the vaccines with a perceived ‘lower’ efficacy rate,” said Katelyn Jetelina, an assistant professor at the UTHealth School of Public Health, in Dallas.

“The bottom line is this, if you’re eligible to receive any COVID-19 vaccine, it’s important that you take the first opportunity you can. All of the vaccines granted authorization in the U.S. are safe and effective, and we are hopeful that vaccines will help stop this pandemic,” Jetelina noted in a university news release.

So, how does the J&J vaccine work and is it right for you?

Here is what you need to know:

The J&J vaccine is based on existing technology that uses an adenovirus that is a common cause of respiratory infections. The DNA in the adenovirus is changed so that it makes a part of the SARS-CoV-2 virus to which the body develops an immune response.

  • How does the J&J vaccine differ from other COVID-19 vaccines?

The Pfizer and Moderna COVID-19 vaccine technology uses genetic material that codes for parts of the SARS-CoV-2 virus. When injected, the vaccine causes people to make pieces of virus to which the body develops immunity. The genetic material breaks down quickly, so it stays in cells for only a short period. That’s why these vaccines have to be kept in very cold temperatures until they are used.

  • How safe and effective is the J&J vaccine?

The vaccine produced antibodies against SARS-CoV-2 in 90% of people who received it after the first dose. According to J&J, one dose was 66% effective in preventing moderate to severe COVID-19 and 100% effective in preventing hospitalization and death from COVID-19. No one given this vaccine developed a severe allergic reaction, and side effects were similar to other vaccines, including fever. The vaccine did not appear to cause any serious complications.

These tips were released March 1 by the Journal of the American Medical Association.

Nearly 4 million doses of the J&J vaccine have already been shipped and will begin to be delivered to states for injections starting on Tuesday, the Associated Press reported. J&J will deliver about 16 million more doses by the end of March and 100 million doses by the end of June.

FDA advisory panel members who gave their blessing to the vaccine on Friday said the J&J approval made sense.

“It’s a relatively easy call; it clearly gets way over the bar, and it’s nice to have a single-dose vaccine,” said Eric Rubin, an infectious diseases specialist at the Harvard T.H. Chan School of Public Health, in Boston, and a member of the FDA advisory panel. He told the Washington Post, “It’s a bit challenging about how to use it clinically right now, but the demand is so large, it clearly has a place.”

Another infectious disease expert also welcomed the approval.

“The addition of a third COVID-19 vaccine substantially reduces the time it takes the U.S. to reach herd immunity — when a high enough proportion of the population is immunized and we can disrupt the spread of this disease,” said Dr. Lisa Lee, a public health expert who specializes in infectious diseases.

“Getting 75% to 85% of the population vaccinated will be easier with this additional vaccine option, especially because it, unlike the first two [from Pfizer and Moderna], does not require a complex frozen or ultra-frozen transport and storage system, and requires only one shot, instead of the two required by the others,” said Lee, who is associate vice president for research and innovation at Virginia Tech.

© 2021 HealthDay. All rights reserved.

Posted: March 2021

Further Support and Information on COVID-19

Skipping Mammograms Raises a Woman’s Odds for Breast Cancer Death

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TUESDAY, March 2, 2021 — Don’t skip your breast cancer screening mammogram.

This is the overarching message of an extended study of more than a half-million Swedish women. Those who missed even one recommended screening mammogram were more likely to die from breast cancer, the study found.

The new findings — which appear March 2 in the journal Radiology — are concerning given the widespread delays and cancellations of preventative cancer screenings that took place during early stages of the COVID-19 pandemic.

“You can save your own life by making sure to get your regular, routine mammogram,” said Dr. Marisa Weiss, founder and chief medical officer of Breastcancer.org and Breasthealth.org in Ardmore, Pa.

“Getting your mammogram won’t increase your risk for COVID,” said Weiss, who was not involved with the new study. “Make the call. Hospitals are safe; your mammogram can save your life.”

When performed regularly, screening mammograms can detect breast cancer in its most treatable and beatable stages.

While experts agree that mammograms are beneficial, there is debate among medical groups about when to start screening and how often to do so.

The U.S. Preventive Services Task Force recommends women who are at average risk for breast cancer get their first mammogram at age 50, and then every two years until age 74.

Meanwhile, the American Cancer Society (ACS) says 40- to 44-year-old women should consider annual mammograms, which are recommended yearly for women between 45 and 54. Older women may get mammograms every other year if they prefer, ACS says.

In the new study, women who had shown up for their two routine screening exams before their breast cancer diagnosis were 50% less likely to die from breast cancer within 10 years than women who avoided mammograms. Women who missed one of their last two recommended screening exams were about 30% less likely to die from breast cancer, the study showed.

The study covered more than 549,000 Swedish women from 1992 to 2016. During that time, 40- to 54-year-olds were advised to have mammograms every 18 months; 55- to 69-year-olds were told to screen every two years.

“For women of screening age, the take-home message is to participate in regular scheduled screens,” said study author Stephen Duffy, professor of cancer screening at Queen Mary University of London. “For providers, the message is to make the screening experience as safe, acceptable and positive as possible, so that women come back for their next screen.”

Screening mammography saves lives, said Dr. Laurie Margolies, chief of breast imaging at Mount Sinai Health System in New York City, who reviewed the findings.

“Once-in-a-while mammography is not sufficient if your goal is to decrease the chances that you will die from breast cancer,” she said. “If you miss even one yearly mammogram, the chances of dying from breast cancer increase.”

Weiss agreed that making sure you get your recommended mammogram is essential: “Don’t let it slip and slide. You don’t want to miss a year.”

If your mammogram was canceled due to the pandemic, reschedule it today, she advised.

If you’ve recently had a COVID-19 vaccination, however, be aware that lymph nodes on the side where the shot was received may swell. Because the swollen lymph nodes may show up on X-ray, the Society of Breast Imaging recently recommended women wait four weeks after vaccination to have their mammogram.

© 2021 HealthDay. All rights reserved.

Posted: March 2021

Could ADHD Raise Odds for More Serious Psychiatric Ills?

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TUESDAY, March 2, 2021 — As if attention-deficit/hyperactivity disorder (ADHD) isn’t already tough on a child, new research suggests the condition might also raise the odds for a psychotic disorder later in life.

But parents should not panic.

“I would say that this finding should not be an alarm for parents and people who have ADHD, because the absolute risk for psychotic disorders remains low,” said psychiatry professor Dr. Gabrielle Shapiro. She is chair of the American Psychiatric Association’s Council on Children, Adolescents and Their Families.

That point was echoed by Dr. Victor Fornari, vice chair of child and adolescent psychiatry with Zucker Hillside Hospital in Glen Oaks, N.Y. “What’s clear is that the vast majority of youth with ADHD do not go on to develop psychosis,” he said.

The new analysis looked at 12 prior studies that included a total of more than 1.8 million participants, of whom just over 124,000 had been diagnosed with ADHD before the age of 18. Roughly 1% to 12.5% of those patients went on to develop a psychotic disorder.

But no more than 4% of those without ADHD met the same fate, with some of the studies citing essentially zero risk. Collectively that translated into a five-times higher psychotic disorder risk among those with a history of ADHD, regardless of gender.

So how much concern should this raise? Both Shapiro and Fornari, who were not involved in the review, suggested that the findings need to be kept in context. They said the far more pressing issue is making sure that children with ADHD get the care they need in the first place.

“Parents should know that they should seek early treatment for their child with ADHD,” Fornari said, “because children who are treated do much better than children who are not treated. And getting them in treatment is the best way to prevent the development of more serious problems.”

And, Shapiro added, that means “making sure that we do everything we can to destigmatize mental illness so that parents don’t hesitate to seek out care for their children with ADHD.”

The new review, led by Dr. Mikaïl Nourredine, of the Service Hospital and University of Pharmacotoxicology of Lyon, France, was published online recently in JAMA Psychiatry.

When looking at a potential connection between ADHD and psychotic disorder risk, Nourredine and colleagues included a wide array of diagnoses, including schizophrenia and delusional disorder. Mood disorders that can give rise to psychotic symptoms — such as depression or bipolar disorder — were not included.

In the end, both Shapiro and Fornari noted that what the research team found was an association between ADHD and elevated risk for future mental illness, rather than definitive proof of a direct cause and effect.

Still, the French investigators offered a number of theories that could explain the link. For example, they suggested that both ADHD and psychotic disorders may source back to similar genetic predispositions. It could also be that they share the same environmental triggers, or that they unfold along similar developmental pathways.

According to Shapiro, “The message of this study is that, as scientists, we must continue to look for correlations to prevent long-term mental illness among our ADHD patients, because the propensity for a child with ADHD to have some sort of other psychiatric diagnosis in the future is definitely real. We know, for example, that kids with ADHD who go untreated have higher instances of depression, anxiety and substance use.”

Fornari said that means that “children being treated for ADHD should certainly be monitored for other mental health symptoms. That kind of tracking should already be part of the treatment plan.”

The best treatment plans, Shapiro said, “look at the entire holistic person. Because that’s the way to try and prevent co-morbid diagnoses down the road. And the good news is that I do see that kids with ADHD who are treated properly do have a lower incidence for additional disorders in the future.”

© 2021 HealthDay. All rights reserved.

Posted: March 2021

AHA News: A New Heart at 18 Put Her on a New Path

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TUESDAY, March 2, 2021 (American Heart Association News) — Jill Hollander was 9 when, during a visit to her cardiologist with her parents, he asked her to step outside so he could speak alone with her parents.

Nonsense, she thought.

“I want to be in the room too,” she told them. “It’s about me, and I have a right to be here.”

Now 40, Hollander vividly remembers that moment. Not because of the news the doctor shared – she doesn’t even recall it – but because it was the first time she spoke up about her care.

“It has been life-sustaining for me to advocate for myself,” Hollander said. “It’s a huge part of who I am. I was born with a fighting spirit and I became an extremely determined individual.”

As a certified life coach and motivational speaker, Hollander’s mission is to lead others to find their own optimistic fighting spirit. She has plenty of experience to share.

Hollander was born with faulty plumbing in her heart. The two main arteries carrying blood away from the heart were reversed. This congenital heart defect is called transposition of the great arteries and requires corrective surgery.

Open-heart surgery at 2 allowed her to have a mostly normal childhood. She remembers no restrictions, only a lot of medical appointments. She also knew she might eventually need another heart surgery.

When Hollander was 14, her father was diagnosed with lung cancer. The two were very close. He died shortly after the diagnosis. A few months later, the still-grieving teen endured an infection in her heart, followed by the diagnosis of a slow heart rate. She had to have a pacemaker implanted to regulate it.

The series of setbacks would be enough to leave anyone distraught. She allowed herself “to feel the upset, the sadness, the ‘no’s.'”

“But also that summer was about me saying ‘yes,'” said Hollander, who recovered from the pacemaker implantation in time to attend the final weeks of summer camp.

At 16, doctors determined she needed a second heart operation. The surgery was supposed to close a hole between her left and right ventricles. It didn’t turn out as hoped. Her heart slowly began to fail.

She was 18 when doctors said she needed a new heart.

“At first, I couldn’t even wrap my head around it,” she said. “I had a pity party, crying, screaming, saying, ‘This is not fair!’ I let it all out.

“After three days, I was sick of my own negative self-talk.”

Hollander was fortunate. She spent only two weeks on the transplant list.

Given a new start, she became determined to make the most of it.

She earned a bachelor’s degree in sociology, then a master’s in speech-language pathology. She worked for years as a speech pathologist before shifting into her new roles.

“I’ve seen Jill successfully get through every obstacle and every health challenge she’s had,” said Randi Nochumson, Hollander’s best friend since elementary school. “She works through every problem, which is one reason she’s so resilient.”

Hollander’s journey had a profound impact on Nochumson. So much so that she became a cardiac nurse.

“Through Jill, I realized how fascinating the heart is, and how much you can do for it, like transplants and pacemakers,” Nochumson said. “In my work in cardiac care and rehab, Jill’s story is one of the most amazing stories I’ve ever seen.”

In 2018, Hollander held a “Celebration of Love & Life.” The event was both her wedding to Daniel Poletick and a commemoration of 20 years with her transplanted heart.

When the pandemic hit, Hollander knew she was in the high-risk category for COVID-19 being severe. The daily medications she takes as a transplant recipient compromise her immune system. Her risk of catching the virus also was elevated because Poletick is an essential worker. To protect her health, they stayed in different parts of their house, seeing each other only outside or via video.

Considering all Hollander has been through, it’s just another hurdle to clear.

“I deal with the fear when it comes up and I live in the present moment, knowing it’s not going to be like this forever,” she said. “I’m proactive and focus on the things that are positive, the things that make me want to say ‘yes’ in the midst of all the ‘no’s.'”

American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. If you have questions or comments about this story, please email editor@heart.org.

By Diane Daniel

© 2021 HealthDay. All rights reserved.

Posted: March 2021

Stressed and Distracted, Kids and Their Teachers Say Virtual Learning Isn’t Working

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TUESDAY, March 2, 2021 — For Morgan Compton, 7, who has attended school remotely for nearly a year, the stress of the pandemic manifests itself in meltdowns.

On one particular day, Morgan “threw a fit and decided to go upstairs,” said her mother, Tracy Compton. Hearing the sound of his daughter’s tears, Compton’s husband, John, who also works from home, got involved.

Meltdowns are familiar to any parent of young children, but when they occur during a school day — with other young siblings trying to learn through a screen and two parents working remotely — chaos ensues.

“Now we’re all yelling, she’s crying more, and I’m trying to encourage her to go back into class because now she’s missing learning,” Tracy Compton said. After 45 minutes of cajoling their tearful child — plus putting in a call to the school’s counselor — they were able to calm her down and get her back to class.

Almost all of the more than 180,000 students in the Fairfax County, Va., school system that Morgan and the Compton’s 9-year-old daughter Lucy attend have been in remote classes since March. Morgan recently joined a pilot program that allows some students to experience in-person instruction for three hours a week. Compton said the program is for “kids who are kind of struggling in remote learning,” which begs the question, how could a 7-year-old not be struggling to stay focused through a computer screen?

Compton, who elaborated on her experiences during a HealthDay Now interview, knows that her daughter’s experience is only a drop in the ocean compared to the upheaval the pandemic has wrought for kids around the United States.

Nearly a year into the COVID-19 pandemic, studies examining the pandemic’s impact on kid’s mental health and well-being are scarce, but troubling.

Sobbing in the middle of class

Based on one recent report from the U.S. Centers for Disease Control and Prevention, children across the United States visited emergency departments for mental health-related issues at higher rates during 2020 compared to the previous year. And another study, published recently in the journal Pediatrics, found that suicide attempts and thoughts of suicide among children and teens were higher during some months of 2020 than they were in 2019.

However, parents and educators don’t need data to tell them what they already know. Millions of kids across the United States are not able to attend physical school, and their parents, teachers and experts in child psychology will tell you that it is affecting more than just their education.

Kids express their stress and anxiety in varied, and sometimes surprising, ways. As they move through developmental stages, these reactions are likely to change, said Shawna Lee, an associate professor at the Michigan School of Social Work, in Ann Arbor, who focuses on parent-child relationships, child abuse and neglect.

While children’s behaviors are highly variable and difficult to predict, toddlers and younger children are more likely to show their stress through temper tantrums, crying and acting out, while older elementary school children may become withdrawn, lethargic or uninterested, Lee said.

Compton recalled the story of a third-grade girl in Monmouth County, N.J., who reportedly began to sob in the middle of a virtual class in December before confessing that she was starving. “If you don’t think that’s happening everywhere,” she sighed, before adding, “I’ve got it good. That’s all I’m saying.”

Students falling behind

Alison Mack, 28, a second-grade teacher in the Northeast area of the Philadelphia School District, sees many tears in her virtual classroom these days. Mack left her classroom in March of 2020 and hasn’t been back since.

Many of Mack’s students do not speak English as a first language, and their families may not speak English at all. Mack used to communicate with parents primarily by giving her students written notes to bring home. When lockdown began, Mack had no structure in place to make sure she had the updated contact information for her students and their families. The school started virtual classes sometime in early April, but Mack estimated that roughly half of her students that semester didn’t sign on after school facilities closed in March.

When she was able to reach them, the parents of absent students would explain that they didn’t have an internet connection or that their child was home with grandparents, siblings or even alone, and lacked adequate supervision to make sure that they attended class.

Mack said she felt guilty that many of her students were not only falling behind in their math or reading skills but also that they lost access to all of the resources, support and personal growth that teachers, schools and their peers offer.

“As a teacher, I’m not just teaching them,” Mack said. “For a lot of these kids, school is like a safe place for them. A lot of these kids count on me for structure. They count on me for love, or they count on us to provide food.”

This school year, most of the 26 kids in Mack’s class sign on every day, often from their beds, a crowded room of kids, or some unknowable location because they don’t turn on their video camera. While she said that many of her students have adapted to online learning, others aren’t able to because of any number of factors, including a distracting environment, family stress, a lack of internet or technological support, or simply because it is difficult for anyone (let alone a second grader) to pay attention to a screen all day.

Signing off, giving up

Like Morgan, many of Mack’s second graders regularly break down in tears during class. “I see some kids sitting there crying, like bawling their eyes out on the other side of the screen,” Mack said. “It’s really hard when you have a student crying because they’re not sure what to do. They’re just so stressed out or having anxiety and saying, ‘Ms. Mack, I don’t even know what this activity is.’ And I read it to them, I show it to them, but I get upset because I don’t know what else I can do through a screen.”

Other times, they shut off their computers, Mack said. “I have some kids who will literally sign off — they’re so frustrated with the situation that they’ll shut off the computer completely and give up.”

On the other side of the country, in Oxnard, Calif., a coastal city north of Los Angeles, many of Kristin Dodge’s 8th graders seem to be giving up on school, too.

Dodge teaches four sections of English Language Arts, along with an 8th-grade college readiness elective called AVID, geared towards kids from under-resourced backgrounds or those whose families never went to college. Her school has been operating remotely since March of 2020.

Dodge estimates that roughly 20% of her students have acclimated to virtual learning and are doing well in their online classes. She suggested that this cohort of kids has a solid foundation in one way or another that has allowed them to make do with the circumstances and even thrive.

“For most of those doing well, home is a happy and safe place,” Dodge explained. “They have a dog or a cat. They have a mom or dad at home. They live in a space mostly free from distraction.”

Some of these students also have a personality or temperament that is well-suited to learning at home, away from the social pressures that middle school is known for, Dodge said. “These are the students who would normally be in my room eating lunch instead of out in the quads. They are more reserved,” she explained.

Unfortunately, the rest of Dodge’s students — a group that she estimated makes up around 80% — are not doing so well. “At least half of this 80% are failing most of their classes,” Dodge said. “They attend Zoom classes sporadically, if at all. They disappear for weeks at a time. They disappear online in the middle of Zoom class. They say they hate learning like this.”

Millions of kids affected

The kids who articulate how they’re feeling and explain why they cannot complete their work typically say that they are too overwhelmed, distracted or both. “They say things like, ‘I start to do something, and then I get confused, and I just give up because it’s too much,’ or ‘I try to do it, but then I get distracted, and I can’t stay focused.’ That seems to be the refrain,” Dodge said.

Then there are the students who are completely closed off. Dodge tries to meet with these students one-on-one in a private Zoom meeting called a breakout room. When her classes meet together as a group, students can elect to mute their microphones and keep their video cameras turned off, even if their teacher discourages them from doing so. Meeting with students in breakout rooms gives Dodge an opportunity to converse with individual students on camera and unmuted, to try to get a sense of what they’re struggling with.

During one of those meetings, when the student unmuted the computer’s microphone, Dodge was immediately struck by the noise. “I realized that the background noise in their house or apartment or garage is like a nightmare. I don’t even know if they can hear me talking when I’m teaching the class. That explains a lot,” Dodge said.

For Dodge, Mack and teachers all around the United States, worrying about their student’s outside stressors has always been part of the job, but COVID-19 has merged school and home into one, making each part of a student’s life more difficult. In most cases, problems that existed in the home or at school have only been magnified.

The concerns about how this year will impact the growth of young people are endless, but Lee said that one of the top priorities for school systems should be to track down those students who have disappeared from school entirely. The estimates are wide-ranging and difficult to pin down, but one recent report from Bellwether Education Partners found that as many as 3 million U.S. students have not received any type of formal education since the pandemic began.

“I think school personnel or school systems need to find those kids and get them reconnected to school, because those are the people who were probably struggling the most before the pandemic and who are going to have the hardest time getting reconnected without some kind of external support,” Lee said. “I think as a society, if we want these kids to be able to recover from this, we need to prioritize their needs.”

SOURCES: Tracy Compton, Fairfax, Va.; Shawna Lee, associate professor, Michigan School of Social Work, Ann Arbor; Alison Mack, 28, second grade teacher, Northeast area, Philadelphia School District; Kristin Dodge, eighth grade teacher, Oxnard, Calif.; Pediatrics, Dec. 15, 2020; Bellwether Education Partners, report, Oct. 21, 2020; Morbidity and Mortality Weekly Report, Oct. 17, 2020

© 2021 HealthDay. All rights reserved.

Posted: March 2021

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