Category Archives: Health

Having My First Tattoo Removed

When I was much younger, I did a lot of crazy things. One of those things included getting a questionable tattoo. Now that I am older and wiser, I realize that it wasn’t a good idea. I decided to look for tattoo removal in Modesto. I finally decided to take the next step and find a doctor who would be able to permanently remove my tattoo with a laser. The center I found online seemed like a really good match. I asked my friend if he had ever heard of them, and he said that he had visited them before. It was reassuring to know that he had a positive experience with them.

My first concern about laser tattoo removal was the pain factor. I had heard things from people regarding a high level of pain associated with removal. When I went in for my consultation, this was one of the first things I asked. The doctor told me that their clinic actually goes above and beyond other clinics in terms of pain management.

Help Ease Chronic Fatigue Syndrome

Patients with chronic fatigue syndrome who participated in programs aimed at helping them overcome their symptoms — a combination of exercise and counseling — improved more than those whose treatment was intended to help them adapt to the limitations of the disease, a large randomized trial found.

Mean fatigue scores among patients treated with graded exercise therapy — a tailored program that gradually increases exercise capacity — were 3.2 points lower than scores in patients who received specialist medical care alone, according to Dr. Peter D. White, of Queen Mary University of London, and colleagues.

Furthermore, fatigue scores were lower by 3.4 points among patients receiving cognitive behavioral therapy, in which a therapist works with the patient to understand the disease, alleviate fears about activity, and help overcome obstacles to functioning.

In contrast, among patients who were treated with a program known as adaptive pacing therapy, which emphasizes energy limitations and avoidance of excess activity, scores differed by only 0.7 points the researchers reported online in The Lancet.

In a press briefing describing the study findings, co-investigator Dr. Trudie Chalder, of King’s College London, said, “We monitored safety very carefully, because we wanted to be sure we weren’t causing harm to any patients.”

“The number of serious adverse events was miniscule,” she added.

Another co-investigator, Dr. Michael Sharpe, of the University of Edinburgh, commented that a difficulty in the management of chronic fatigue syndrome has been ambiguity — about the causes and whether these treatments recommended by NICE actually are effective.

“The evidence up to now has suggested benefit, but this study gives pretty clear-cut evidence of safety and efficacy. So I hope that addresses the ambiguity,” Sharpe said during the press briefing.

4 Ways to Save Energy With Chronic Fatigue Syndrome

However, the investigators conceded that the beneficial effects of these treatments were only moderate, with less than one-third of participants being within normal ranges for fatigue and functioning, and only about 40 percent reporting that their overall health was much better or very much better.

“Our finding that studied treatments were only moderately effective also suggests research into more effective treatments is needed,” they wrote.

In addition, they stated that their finding of efficacy for cognitive behavioral therapy “does not imply that the condition is psychological in nature.”

The importance of cognitive behavioral therapy was further emphasized by Dr. Benjamin H. Natelson, of Albert Einstein College of Medicine in New York.

“This approach of encouragement of activity and discouragement of negative thinking should be a tool in every physician’s armamentarium,” he said.

“We know that cognitive behavioral therapy and gentle physical conditioning help people cope with any chronic disease — even congestive heart failure and multiple sclerosis,” Natelson said in an interview with MedPage Today.

Chronic fatigue syndrome is characterized by persisting or relapsing fatigue for at least six months that cannot be explained by any other physical or psychiatric disorder.

The fatigue is debilitating, and often is accompanied by joint and muscle pain, headaches, and tenderness of the lymph nodes.

In an editorial published with the study, Dr. Gijs Bleijenberg, and Dr. Hans Knoop, of Radboud University in Nijmegen, the Netherlands, explained the differences in these types of treatment for chronic fatigue.

Group Claims Caramel Coloring Is Toxic

The FDA should ban the use of two compounds widely used in food products, including market giants Coke and Pepsi as well as other soft drinks, because they pose a cancer risk, according to a petition filed by a citizen’s group.

But the American Beverage Association denounced the petition, filed Feb. 16, as “nothing more than another attempt to scare consumers” that is not supported by science.

At issue are caramel colorings that contain 2-methylimidazole and 4-methylimidazole.

According to the petition, filed by the Washington-based Center for Science in the Public Interest, both have been found by the National Toxicology Program to cause cancer in animals.

Kick the Soda Habit With These 10 Tasty Alternatives

And last month, California regulators added one of them — 4-methylimidazole — to the list of chemicals “known to the state to cause cancer.” The state said the safe limit for consumption of the chemical is 16 micrograms a day.

However, a recent study suggested that 12 ounces of cola would contain up to 130 micrograms of the substance, according to the petition.

The coloring substances are made by treating sugars with ammonium alone or ammonium and sulfites under high pressure and temperatures; the two compounds are byproducts of the process.

Feeding studies conducted by the National Toxicology Program showed that high doses of the substances led to lung, liver, or thyroid cancer or leukemia in laboratory mice or rats.

The government researchers concluded there was “clear evidence” that 4-methylimidazole caused cancer in mice, although studies in rats were less clear, with significant increases in leukemia in females but no increase in tumor activity in males.

They also concluded that 2-methylimidazole caused cancer in female rats and argued there was “some evidence” the substance caused tumors in male and female mice.

“Carcinogenic colorings have no place in the food supply,” according to Dr. Michael Jacobson, executive director of the citizens’ group.

Top 10 Foods to Fight Cancer

“The FDA should act quickly to revoke its approval of caramel colorings made with ammonia,” Jacobson said in a statement.

The American Beverage Association, however, noted that the National Toxicology Program does not include 4-methylimidazole among compounds on its list of substances “reasonably anticipated to be human carcinogens.”

“No health regulatory agency around the globe, including the Food and Drug Administration, has said that 4-methylimidazole is a human carcinogen,” the association said in a statement.

Have You a Fractured Bone

images-24Any crack or break in a bone is considered to be a fractured bone. Although auto accidents are a common cause of fractured bones, most fractures actually occur inside the home.

The most common fractured bone in children is an arm bone, because kids hold out their arms when they fall. For people over age 65 who fall, the most common fractures are hip, spine, arm, and leg fractures.

Fractured bone symptoms depend on what bone is fractured and the type of break you experience, from a stress fracture in the shin or a compression fracture in the spine. The shin bone is the most commonly broken long bone in the body, but fractured leg symptoms from the shin bone can range from mild swelling to a bone actually sticking out through the skin.

Avoid These Hip-Fracture Risk Factors

Symptoms that may occur with most fractured bones include:

  • A misshapen or deformed bone or joint
  • Bruising and swelling around the fracture
  • Severe pain that is worse with movement
  • Broken skin with visible bone showing
  • Loss of sensation or a tingling
  • Limited or complete loss of movement

Types of Bone Fractures

A bone fracture can range from a tiny crack in one spot to multiple complete breaks. Doctors use different terms to describe these types of fractured bones:

  • Greenstick. A greenstick fracture is a crack on one side of a bone that does not go all the way through.
  • Complete. A complete fracture is one that goes all the way through the bone.
  • Stress. A stress fracture is a hairline crack that occurs from overuse. Minor leg fracture symptoms often occur from stress fractures.
  • Compression. A compression fracture is when a bone collapses. This type of fracture usually occurs in the bones of the spine.
  • Open. An open fracture is a fracture that has broken the skin. These are also called compound fractures.
  • Comminuted. A comminuted fracture means that the bone is broken in more than one place.

Users at Risk for Early Psychosis

unduhan-14Psychotic illness occurs significantly earlier among marijuana users, results of a meta-analysis suggest.

Data on more than 22,000 patients with psychosis showed an onset of symptoms almost three years earlier among users of cannabis compared with patients who had no history of substance use.

The age of onset also was earlier in cannabis users compared with patients in the more broadly characterized category of substance use, investigators reported online in Archives of General Psychiatry.

“The results of this study provide strong evidence that reducing cannabis use could delay or even prevent some cases of psychosis,” Dr. Matthew Large, of the University of New South Wales in Sydney, Australia, and co-authors wrote in conclusion.

“Reducing the use of cannabis could be one of the few ways of altering the outcome of the illness because earlier onset of schizophrenia is associated with a worse prognosis and because other factors associated with age at onset, such as family history and sex, cannot be changed.”

Psychosis has a strong association with substance use. Patients of mental health facilities have a high prevalence of substance use, which also is more common in patients with schizophrenia compared with the general population, the authors wrote.

Several birth cohort and population studies have suggested a potentially causal association between cannabis use and psychosis, and cannabis use has been linked to earlier onset of schizophrenia. However, researchers in the field remain divided over the issue of a causal association, the authors continued.

Attempts to confirm an earlier onset of psychosis among cannabis users have been complicated by individual studies’ variation in methods used to examine the association. The authors sought to resolve some of the uncertainty by means of meta-analysis.

A systematic search of multiple electronic databases yielded 443 potentially relevant publications. The authors whittled the list down to 83 that met their inclusion criteria: All the studies reported age at onset of psychosis among substance users and nonusers.

The studies comprised 8,167 substance-using patients and 14,352 patients who had no history of substance use. Although the studies had a wide range of definitions of substance use, the use was considered “clinically significant” in all 83 studies. None of the studies included tobacco in the definition of substance use.

The studies included a total of 131 patient samples.

Substance use included alcohol in 22 samples, cannabis in 41, and was simply defined as “substance use” in 68 samples.

Alcohol use was not significantly associated with earlier age at onset of psychosis.

On average, substance users were about 2 years younger than nonusers were. The effect of substance use on age at onset was greater in women than in men, but not significantly so. Heavy use was associated with earlier age at onset compared with light use and former use, but also not significantly different, the authors reported.

Pitchers Need Limits on Innings

To prevent serious arm injuries, young baseball pitchers should pitch no more than 100 innings a year, researchers said.

In a 10-year prospective study, boys who pitched more than 100 innings were almost four times more likely to undergo elbow or shoulder surgery or to retire because of injury, according to Dr. Glenn Fleisig, of the American Sports Medicine Institute in Birmingham, Ala., and colleagues.

The cumulative rate of serious injury was 14 percent in those who exceeded that number and 4 percent in those who did not, the researchers reported in the February issue of the American Journal of Sports Medicine.

“On the basis of these findings and review of the literature, we recommend that pitchers in high school and younger pitch no more than 100 innings in competition in any calendar year,” Fleisig and his colleagues wrote.

“Young pitchers who have not developed should be limited to even less, and no pitcher should continue to pitch when fatigued.”

In recent years, researchers have detected an increase in the numbers of younger pitchers who require shoulder and elbow surgery, including ulnar collateral ligament reconstruction, or Tommy John surgery.

Many doctors believe that the trend is related to the growth of year-round baseball leagues and showcases for professional scouts, which reduces the amount of downtime pitchers would normally have in the off-season.

A 1999 study linked the number of pitches thrown to elbow and shoulder pain — assumed to be a predictor of future injury. That and similar studies led youth baseball organizations, including Little League Baseball, to replace innings limits with pitch counts.

But no studies had established a relationship between throwing volume and injury risk.

To explore the risk factors for serious arm injuries — those requiring surgery or those resulting in retirement — Fleisig and his colleagues followed 481 male pitchers ages 9 to 14 for 10 years using annual telephone interviews; about two were still pitching in the final year of the study.

The researchers focused on total innings pitched in the previous year rather than pitch counts because most youth players and their families do not keep track of the numbers of balls thrown.

During the study, three of the boys had elbow surgery, seven had shoulder surgery, and 14 retired because of a throwing injury, resulting in a 10-year rate of serious injury of 5 percent.

The average age at the time of surgery was 17, and two boys underwent surgery before they turned 13.

The only significant risk factor for serious injury was pitching more than 100 innings in a calendar year.

There was a trend toward a greater likelihood of serious injury in boys who played both pitcher and catcher during the study period (11 percent versus 4 percent), but it fell short of statistical significance because of the small sample size, according to Fleisig and his colleagues.

“A baseball player may play multiple positions, but we discourage an individual from playing both pitcher and catcher,” they wrote.

iPad App for MRI

The FDA has moved into the “got an app for that” market by approving the first diagnostic radiology application for the iPhone and the iPad.

In announcing the approval, the FDA said the application can be used to view results of CT, MRI, and PET scans on the mobile devices and use those images to make diagnoses.

But the agency noted that the app was “not intended to replace full workstations and is indicated for use only when there is no access to a workstation.”

“This important mobile technology provides physicians with the ability to immediately view images and make diagnoses without having to be back at the workstation or wait for film,” said William Maisel, MD, MPH, chief scientist and deputy director for science in the FDA’s Center for Devices and Radiological Health in a statement.

The new “device,” which is designed for use with Apple products, is a software program called Mobile MIM, made by Cleveland’s MIM Software.

The software allows radiology images taken in the hospital or physician’s office to be “compressed for secure network transfer then sent to the appropriate portable wireless device,” according to the FDA statement.

The images are then viewed on the iPhone or iPad in a format that “allows the physician to measure distance on the image and image intensity values and display measurement lines, annotations and regions of interest.”

The FDA said it evaluated the app by testing its performance on a number of devices, measuring luminance, resolution, and noise against international standards and guidelines.

The FDA said it, “also reviewed results from demonstration studies with qualified radiologists under different lighting conditions. All participants agreed that the device was sufficient for diagnostic image interpretation under the recommended lighting conditions.”

In announcing the approval, the FDA noted that mobile devices have a wide range of variation in luminance even among the same model devices.

“The Mobile MIM application includes sufficient labeling and safety features to mitigate the risk of poor image display due to improper screen luminance or lighting conditions. The device includes an interactive contrast test in which a small part of the screen is a slightly different shade than the rest of the screen. If the physician can identify and tap this portion of the screen, then the lighting conditions are not interfering with the physician’s ability to discern subtle differences in contrast,” the FDA said.

MIM is including a safety guide within the application.

Jewelry Can Pose Danger

Foreign-made jewelry is a potential source of lead exposure, according to public health officials.

A 1-year-old boy living in New York City had a rapid increase in blood lead levels, and the likely source of the exposure was traced to a Cambodian amulet made from knotted string and metallic beads, according to researchers from the NYC Department of Health and Mental Hygiene and the CDC.

Testing revealed that the beads contained 45 percent lead, the researchers reported in Jan. 28 issue of Morbidity and Mortality Weekly Report.

The boy had worn the amulet — “something to protect him,” his father said — since he was 3 months old, and had been seen putting it in his mouth.

“Healthcare providers and public health workers should consider traditional customs when seeking sources of lead exposure in Southeast Asian populations,” the authors wrote.

Healthcare professionals should ask parents — particularly from Southeast Asian families — about the use of amulets, they added, noting that educational efforts about the risk of lead poisoning from jewelry are needed for immigrant families.

An accompanying editorial note pointed out that the CDC recommends blood lead testing for internationally adopted and refugee children and that the New York City health department recommends testing all children with recent travel to foreign countries.

Although the most common source of lead exposure in young children is paint, other sources have been increasingly identified.

That is particularly true in immigrant communities because of the use of lead-containing products from their country of origin, such as spices, food, candy, cosmetics, health remedies, ceramics or pottery, and jewelry.

For the case of the 1-year-old boy, routine lead testing showed an elevated blood lead level of 10 micrograms/dL.

According to the National Institutes of Health lead concentrations in blood should be less than 10 micrograms/dL in children and less than 20 micrograms/dL in adults.

Because he lived in a household with a cousin who had had lead poisoning, he had also been tested at 6 months. His blood lead level was just 1 microgram/dL then.

A risk assessor from the Environmental Protection Agency visited the home to look for potential sources of the lead exposure. The boy’s father denied using any imported products, and the assessor failed to find any potential sources of exposure.

Three months later, the boy’s blood level doubled to 20 micrograms/dL.

The boy’s father again denied that the child wore jewelry or charms, but eventually admitted that the child had worn an amulet acquired at a Cambodian market since he was 3 months old.

A second home inspection identified one area of paint with an elevated lead level, as well as imported spices and rice. Testing revealed that the food products did not have elevated lead content.

Within eight days of the amulet being removed from the home, the boy’s blood lead level decreased to 14 micrograms/dL.

About five weeks later — after the lead paint was reported to be removed — the boy’s blood lead level was 10 micrograms/dL, and five months after the amulet was removed, the level was down to 5 micrograms/dL.

“Although other factors might have contributed to the child’s overall lead burden,” the researchers wrote, “the most likely source identified was the amulet, based on its high lead content, statements that the child had been observed mouthing it, and the rapid decrease in the child’s blood lead level after its removal.”

Healthcare Reform Law

A federal judge in Florida has ruled that the healthcare reform law is unconstitutional, siding with the 26 states that sued to block enforcement of the law.

The lawsuit, filed by 26 states that sued to block the Affordable Care Act (ACA), is considered likely to go all the way to the Supreme Court.

Judge Roger Vinson, of the U.S. District Court in Pensacola, Fla., stopped short of directing the federal government to stop implementing the law. Still, the ruling is the harshest legal action yet against the ACA.

Unlike a ruling last month by a judge in Richmond, Va., stating that the individual mandate portion of the ACA violates the Constitution, Vinson ruled the entire law “void” because the individual mandate provision can’t be separated out from the rest of the law.

Congress “exceeded the bounds of its authority in passing the Act with the individual mandate,” Vinson wrote in his 78-page ruling, which was released Monday afternoon. The mandate requires all citizens to have health insurance by 2014 or else pay a penalty.

“Because the individual mandate is unconstitutional and not severable, the entire Act must be declared void,” he concluded.

He did contend that Congress has the power to address the “problems and inequities in our health care system,” but that Congress overstepped its power in passing the ACA.

“There is widespread sentiment for positive improvements that will reduce costs, improve the quality of care, and expand availability in a way that the nation can afford,” Vinson wrote. “This is obviously a very difficult task. Regardless of how laudable its attempts may have been to accomplish these goals in passing the Act, Congress must operate within the bounds established by the Constitution.”

While it was widely expected that Vinson would side with the states, it comes as somewhat of a surprise that he declared the entire law “void.”

The original lawsuit — which filed just hours after Obama signed the ACA into law on March 23, 2010 — alleged that the “individual mandate” in the law exceeded Congress’ authority under the Commerce Clause of the Constitution, but didn’t argue that the whole of the law is unconstitutional. The Commerce Clause permits the federal government to regulate interstate commerce.

In October, when Vinson ruled the case could proceed, he said the states “had a plausible claim” in their argument that the law’s individual mandate violated the Commerce Clause.

The states argued that the government cannot force individuals to participate in the stream of commerce — in this case, the health insurance market.

The federal government responded that at some point, every U.S. citizen will seek medical care, and if that person chooses to not have insurance, the cost of his or her medical care is passed on to those with insurance. Thus, a choice to not participate in the commerce of healthcare doesn’t actually exist.

Two other judges have rejected challenges to the law, ruling that the ACA’s individual mandate provision is constitutional.

Other states that have joined the lawsuit are: Alabama, Alaska, Arizona, Colorado, Georgia, Indiana, Idaho, Iowa, Kansas, Louisiana, Maine, Michigan, Mississippi, Nebraska, Nevada, North Dakota, Ohio, Pennsylvania, South Carolina, South Dakota, Texas, Utah, Washington, Wisconsin and Wyoming.

Heart and Brain

Regular aerobic exercise such as walking may protect the memory center in the brain, while stretching exercise may cause the center — called the hippocampus — to shrink, researchers reported.

In a randomized study involving men and women in their mid-60s, walking three times a week for a year led to increases in the volume of the hippocampus, which plays an important role in memory, according to Dr. Arthur Kramer, of the University of Illinois Urbana-Champaign in Urbana, Ill., and colleagues.

On the other hand, control participants who took stretching classes saw drops in the volume of the hippocampus, Kramer and colleagues reported online in the Proceedings of the National Academy of Sciences.

The findings suggest that it’s possible to overcome the age-related decline in hippocampal volume with only moderate exercise, Kramer told MedPage Today, leading to better fitness and perhaps to better spatial memory. “I don’t see a down side to it,” he said.

The volume of the hippocampus is known to fall with age by between 1 percent and 2 percent a year, the researchers noted, leading to impaired memory and increased risk for dementia.

But animal research suggests that exercise reduces the loss of volume and preserves memory, they added.

To test the effect on humans, they enrolled 120 men and women in their mid-sixties and randomly assigned 60 of them to a program of aerobic walking three times a week for a year. The remaining 60 were given stretch classes three times a week and served as a control group.

Their fitness and memory were tested before the intervention, again after six months, and for a last time after a year. Magnetic resonance images of their brains were taken at the same times in order to measure the effect on the hippocampal volume.

The study showed that overall the walkers had a 2 percent increase in the volume of the hippocampus, compared with an average loss of about 1.4% in the control participants.

The researchers also found, improvements in fitness, measured by exercise testing on a treadmill, were significantly associated with increases in the volume of the hippocampus.

On the other hand, the study fell short of demonstrating a group effect on memory – both groups showed significant improvements both in accuracy and speed on a standard test. The apparent lack of effect, Kramer told MedPage Today, is probably a statistical artifact that results from large individual differences within the groups.

Analyses showed that that higher aerobic fitness levels at baseline and after the one-year intervention were associated with better spatial memory performance, the researchers reported.

But change in aerobic fitness was not related to improvements in memory for either the entire sample or either group separately, they found.

On the other hand, larger hippocampi at baseline and after the intervention were associated with better memory performance, they reported.

The results “clearly indicate that aerobic exercise is neuroprotective and that starting an exercise regimen later in life is not futile for either enhancing cognition or augmenting brain volume,” the researchers argued.