How to Keep a Spring in Your Step with Daylight Saving Time

THURSDAY, March 9, 2017 (HealthDay News) -- Clocks will spring ahead one hour with the time change on Sunday morning, but medical experts have plenty of advice on how to weather that lost hour of sleep.

"'Gaining' an hour in the fall is much easier for our bodies than 'losing' an hour in the spring," said Dr. Praveen Rudraraju, medical director of the Center for Sleep Medicine at Northern Westchester Hospital in Mount Kisco, N.Y.

Starting a few days before the time change, people can prepare themselves by going to bed 15 or 20 minutes earlier each night, according to the American Academy of Sleep Medicine.

But it can still be hard to adjust to the switch afterwards, sleep specialists said.

"In fact, it may take some people up to a week to get used to the new time change," Rudraraju said. "Though it may be tempting to stay up an extra hour, one of the best ways to fight the effects of daylight saving time is to go to bed at your usual time."

Another sleep expert likened the time change to a slight case of jet lag.

"It's like flying from Chicago to New York," said Saul Rothenberg, a behavioral sleep medicine specialist at Northwell Health in Great Neck, N.Y. "Good sleepers may not even notice a difference."

But if you're sensitive to time changes or sleep disruptions, you could have trouble falling asleep at night or waking up in the morning, at least for the first few days, he said.

For those folks, Rothenberg offered some tips for countering the effects of the time change: Don't sleep in on Sunday morning; don't nap Sunday afternoon; and don't fret, because worrying will just make it harder for you to sleep.

However, Rothenberg recommended you should get some morning light, and listen to your body if you can't fall asleep at your regular bedtime the first few nights.

Rudraraju offered some advice of his own.

For the first few weeks, try to wake up five or 10 minutes earlier every two to three days, he suggested. And exercise for 30 to 40 minutes in bright light each day, but do it before 5 p.m.

Don't drink caffeinated beverages, Rudraraju added, and eat dinner at least three to five hours before bedtime. At dinner, don't have more than one alcoholic drink. Stop all computer activity an hour before bedtime, and stay out of the bedroom until it's bedtime, he said.

If you still have trouble falling asleep, try taking a melatonin pill two hours before you want to go to sleep, said Rudraraju, who noted the pills are available without a prescription.

Another sleep expert had bedroom-specific advice for handling the time change.

Robert Oexman, director of the Sleep to Live Institute in Mebane, N.C., said keeping the bedroom cool, dark and quiet will help you sleep through the time change. Beyond that, a good mattress and pillows always help, and you should consider separate blankets if you sleep with a partner. That way, you won't be disturbed during the night by your partner hogging the covers, he said.

SOURCES: Praveen Rudraraju, M.D., medical director, Center for Sleep Medicine, Northern Westchester Hospital, Mount Kisco, N.Y.; Saul Rothenberg, Ph.D., behavioral sleep medicine specialist, Northwell Health, Great Neck, N.Y.; Robert Oexman, D.C., director, Sleep to Live Institute, Mebane, N.C.

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Your DNA May Determine How You Handle the Time Change

SATURDAY, March 11, 2017 (HealthDay News) -- Some people have more trouble adjusting to daylight saving time than others and genes may be the reason why, says an expert on sleep/wake patterns.

The time change occurs 2 a.m. Sunday morning when clocks "spring ahead" one hour.

"It is likely that advancing our clocks in the spring would more affect owls, those individuals who tend to stay awake later at night and consequently wake up later in the morning," said Dr. Joseph Takahashi.

"Less affected are the larks, those individuals who tend to wake up early and go to sleep earlier," he added. Takahashi is chairman of neuroscience at UT Southwestern Medical Center in Dallas.

"Since being an owl or a lark is in large part genetically influenced, the best way to deal with daylight saving time is to be self-aware of your chronotype (early versus late awakening and sleeping) and to realize that advancing your clock will be harder if you are an owl and easier if you are a lark," he advised in a medical center news release.

To check your chronotype, you can take a simple online test called the Munich Chronotype, Takahashi suggested.

Because some studies have found a spike in traffic crashes after the time change, Takahashi said it's a good idea to "go to sleep slightly ahead of your normal bedtime." Then, in the morning, he added, "have an extra coffee and be vigilant on the road."

Research also indicates that more heart attacks occur after daylight saving time starts.

"It is now well established that the incidence of heart attacks is highest in the morning. Since waking up one hour earlier adds to stress and sleep deprivation, these might contribute to the increase," Takahashi said.

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7 in 10 U.S. Workplaces Hit by Opioid Abuse: Survey

FRIDAY, March 10, 2017 (HealthDay News) -- Prescription drug abuse has seeped into the American workplace, with 70 percent of businesses saying it affects their workers, a new survey reveals.

The National Safety Council report also found that while 71 percent of employers believe that abuse of opioid prescription painkillers is a disease that requires treatment, 65 percent also consider it a justifiable reason to fire a worker.

"Employers must understand that the most dangerously misused drug today may be sitting in employees' medicine cabinets," said Deborah Hersman, president and CEO of the safety council.

"Even when they are taken as prescribed, prescription drugs and opioids can impair workers and create hazards on the job. We hope these findings prompt employers to take the lead on this emerging issue so that workplaces can be as safe as possible," she added in a safety council news release.

But the survey findings showed that employers have a long way to go on this front.

Only 19 percent of employers said they felt "extremely prepared" to deal with prescription drug abuse in their workplace, only 13 percent were "very confident" that workers could spot signs of misuse, and 76 percent do not offer training on the topic.

Fifty-seven percent of employers said all employees underwent drug testing. Of those who conduct drug testing, 41 percent do not test for synthetic opioids such as oxycodone, hydrocodone, and fentanyl, the findings showed.

The survey also found that 81 percent of employers' policies lack at least one major element of an effective drug-free workplace program.

While 88 percent of employers said they would be interested in having their insurer cover alternative pain relief treatments so workers could avoid taking narcotic painkillers, 30 percent of those employers said they would not act on that interest.

On a positive note, 70 percent of employers did say they would help workers struggling with prescription drug abuse return to their jobs after completing treatment.

The survey was released online March 9 by the National Safety Council.

The United States is currently in the throes of an unprecedented opioid epidemic. More than six out of 10 overdose deaths involve opioid drugs, and 91 Americans die every day from prescription opioids or heroin, according to the U.S. Centers for Disease Control and Prevention.

Deaths from prescription painkillers -- such as oxycodone (Oxycontin) -- as well as heroin and methadone have more than quadrupled since 1999, according to the CDC.

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Heart Disease Kicks in Earlier for Obese People

THURSDAY, March 9, 2017 (HealthDay News) -- Overweight and obese people tend to develop heart disease at an earlier age, living with chronic illness for much longer than those of a healthy weight, a new study shows.

People carrying excess pounds do tend to live similar or only slightly shorter life spans compared to folks with normal body weight, the researchers found.

But heart disease begins 1.8 years earlier in overweight middle-aged women compared with normal-weight women, and 4.3 years earlier for those who are obese, they added.

Meanwhile, obese middle-aged men suffer heart disease 3.1 years earlier than normal-weight men. However, overweight men tended to develop heart disease at about the same rate and live about as long as normal-weight men.

These findings show that even though some may benefit from an "obesity paradox" -- where people with excess weight live longer than those of normal weight -- those extra years of life could be filled with illness and misery, said lead researcher Dr. Sadiya Khan, an instructor at Northwestern University's Feinberg School of Medicine in Chicago.

"Individuals in the overweight category really live about the same amount of time," Khan said. "It was really the difference about how long they lived with cardiovascular disease because they developed the disease earlier in life."

For this study, Khan and her colleagues pooled together participants from 10 different research projects, coming up with a group of almost 73,000 middle-aged people with an average age of 55. All participants were healthy and free of cardiovascular disease when they enrolled in the study.

Average body mass index or BMI (a measure of body fat based on weight and height) was 27.4 for men and 27.1 for women. A BMI above 25 is considered overweight, and above 30 obese, according to the U.S. Centers for Disease Control and Prevention.

During years of follow-up, just over 13,450 people suffered a heart health event, defined as either heart failure, a stroke or a diagnosis of heart disease.

Compared to people with normal BMI, lifetime risks for developing heart disease were higher in overweight and obese adults, the researchers found.

For example, overweight middle-aged women were 32 percent more likely to develop heart disease in their lifetime compared to women of normal weight, while overweight men were 21 percent more likely to develop heart disease. Obese men and women were 67 percent and 85 percent more likely to develop heart disease, respectively.

On average, people with normal BMI also tended to enjoy more years free of heart disease.

The overweight and obese people "developed [heart disease] at a younger age and lived longer with [heart disease], with a higher risk of conditions like coronary artery disease and heart failure," Khan said.

People with excess weight likely benefit from a heart health event, in that their heart attack or stroke forces their doctor to step up their medical care, said Dr. Robert Eckel, chair of atherosclerosis at the University of Colorado Denver Anschutz Medical Campus. He was not involved with the study.

"If you're obese or overweight, your years of survival after you have a cardiovascular disease event may be a bit higher, but I think that's because these people are more aggressively treated for risk factors," said Eckel, who is also director of the Lipid Clinic at the University of Colorado Hospital.

Khan was to present the findings at the an American Heart Association meeting in Portland, Ore. Research presented at meetings is considered preliminary until published in a peer-reviewed journal.

SOURCES: Sadiya Khan, M.D., instructor, medicine, Northwestern University's Feinberg School of Medicine, Chicago; Robert Eckel, M.D., chair, atherosclerosis, University of Colorado Denver Anschutz Medical Campus, and director, Lipid Clinic, University of Colorado Hospital; March 9, 2017, presentation, American Heart Association meeting, Portland, Ore.

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Most Women Stop Drinking After Positive Pregnancy Test, Study Finds

THURSDAY, March 9, 2017 (HealthDay News) -- When they learn they're pregnant, most American women stop drinking alcohol, a new study shows.

Researchers analyzed data from more than 5,000 newly pregnant women in eight U.S. cities. They found that the vast majority stopped or reduced their drinking after their positive pregnancy test.

"Our study was not focused on whether or not alcohol is safe in the early conception window," said study senior author Dr. Katherine Hartmann.

"We wanted to see what actual women were currently doing. And we were pleasantly surprised about how promptly people changed their alcohol use," said Hartmann, a professor of obstetrics and gynecology at Vanderbilt University Medical Center in Nashville, Tenn.

Most quit completely, while about 6 percent of women continued to consume some alcohol, almost all of them at very low levels, she said.

The U.S. Centers for Disease Control and Prevention recommends that women who are pregnant or could become pregnant avoid alcohol use.

The fact that many women understand the risks of alcohol use during pregnancy and change their drinking habits is encouraging, but doing so is most effective the earlier women know they're pregnant, Hartmann added.

"Women were already self-regulating their alcohol use. Our findings suggested that promoting early pregnancy awareness could prove to be more effective than promoting abstinence from alcohol among all who could conceive," she said in a university news release.

The study will appear in the April issue of the journal Obstetrics and Gynecology.

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Biomarker in Blood May Help Predict Recovery Time for Sports Concussions

Monday, January 9, 2017

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Researchers at the National Institutes of Health found that the blood protein tau could be an important new clinical biomarker to better identify athletes who need more recovery time before safely returning to play after a sports-related concussion. The study, supported by the National Institute of Nursing Research (NINR) with additional funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), published online in the Jan. 6, 2017 issue of Neurology, the medical journal of the American Academy of Neurology.

Despite the millions of sports-related concussions that occur annually in the United States, there is no reliable blood-based test to predict recovery and an athlete's readiness to return to play. The new study shows that measuring tau levels could potentially be an unbiased tool to help prevent athletes from returning to action too soon and risking further neurological injury.

"Keeping athletes safer from long-term consequences of concussions is important to players, coaches, parents and fans. In the future, this research may help to develop a reliable and fast clinical lab test that can identify athletes at higher risk for chronic post-concussion symptoms," said NINR Director Patricia A. Grady Ph.D., R.N.

Athletes who return to play before full recovery are at high risk for long-term symptoms like headaches, dizziness, and cognitive deficits with subsequent concussions. About half of college athletes see their post-concussive symptoms resolve within 10 days, but in others, the symptoms become chronic. 

Tau is also connected to development of Alzheimer's and Parkinson's diseases, and is a marker of neuronal injury following severe traumatic brain injuries.

In the study, led by Dr. Jessica Gill, NIH Lasker Clinical Research Scholar and chief of the NINR Division of Intramural Research's Brain Injury Unit, researchers evaluated changes in tau following a sports-related concussion in male and female collegiate athletes to determine if higher levels of tau relate to longer recovery durations.

"Incorporating objective biomarkers like tau into return-to-play decisions could ultimately reduce the neurological risks related to multiple concussions in athletes," said Gill.

To measure tau levels, a group of 632 soccer, football, basketball, hockey, and lacrosse athletes from the University of Rochester first underwent pre-season blood plasma sampling and cognitive testing to establish a baseline. They were then followed during the season for any diagnosis of a concussion, with 43 of them developing concussions during the study. For comparison, a control group of 37 teammate athletes without concussions was also included in the study, as well as a group of 21 healthy non-athletes.

Following a sports-related concussion, blood was sampled from both the concussed and control athletes at six hours, 24 hours, 72 hours, and seven days post-concussion.

Concussed athletes who needed a longer amount of recovery time before returning to play, (more than 10 days post-concussion) had higher tau concentrations overall at six, 24, and 72-hours post-concussion compared to athletes who were able to return to play in 10 days or less. These observed changes in tau levels occurred in both male and female athletes, as well as across the various sports studied.

Together, these findings indicate that changes in tau measured in as short a time as within six hours of a sports-related concussion may provide objective clinical information to better inform athletes, trainers, and team physicians' decision-making about predicted recovery times and safe return to play. 

Further research will test additional protein biomarkers and examine other post-concussion outcomes.

###

About the National Institute of Nursing Research (NINR): NINR supports basic and clinical research that develops the knowledge to build the scientific foundation for clinical practice, prevent disease and disability, manage and eliminate symptoms caused by illness, and enhance end-of-life and palliative care. For more information about NINR, visit the website at www.ninr.nih.gov.

About the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): NICHD conducts and supports research in the United States and throughout the world on fetal, infant and child development; maternal, child and family health; reproductive biology and population issues; and medical rehabilitation. For more information, visit NICHD's website.

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

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Eye Exam Might Help Spot Poor Circulation in Legs

WEDNESDAY, March 8, 2017 (HealthDay News) -- Could a routine eye exam some day point to trouble with circulation in the legs? New research suggests it might be possible.

Researchers at Johns Hopkins University in Baltimore said changes in the eye's retina may help spot people at risk for a narrowing of the large blood vessels in the legs -- a condition called peripheral artery disease (PAD).

"PAD is estimated to affect approximately 8.5 million Americans above the age of 40 years and is associated with significant morbidity, mortality and quality of life impairment," noted one heart specialist, Dr. Samy Selim. He's an interventional cardiologist at Northwell Health's Southside Hospital in Bay Shore, N.Y.

And while the disability from PAD is serious and widespread, "physician screening for PAD is not satisfactory, to say the least," Selim said.

The new study was led by Hopkins researcher Chao Yang and is slated for presentation Wednesday at a meeting of the American Heart Association in Portland, Ore.

Yang's team investigated almost 9,400 adults who were tracked for 19 years. During that time, more than 300 developed PAD that required hospitalization or a procedure to open their narrowed leg arteries.

Ninety-two of the patients had the most severe form of PAD, called critical limb ischemia. As the researchers explained, this condition can cause ulcers to form on the leg, and result in gangrene or even amputation.

After adjusting for common PAD risk factors such as diabetes, the researchers found that people with abnormalities in the tiny blood vessels of the retina had more than double the odds of developing PAD, and nearly 3.5 times the odds of developing its more severe form.

These telltale abnormalities included bleeding, yellow spots from the breakdown of lipids and areas of blood protruding from vessels in the back of the eye, Yang's group said.

The link between retinal problems and PAD was strongest among people with diabetes, the researchers added.

Why the link? According to the investigators, abnormalities in tiny blood vessels -- as evidenced in the retina -- may point to bigger problems in the legs.

In the lower limbs, damage to small vessels could impede wound healing or the creation of new routes for blood to flow around narrowed leg vessels, Yang and colleagues explained. And that could lead to more severe PAD.

Selim agreed that the notion of spotting small-vessel trouble in routine eye exams has merit.

"Looking at the back of the eye's retina can be done in primary care offices as part of a routine clinical exam," he said. "Hopefully one day, a look at the eye will hold clues to the future of the legs -- which will be an alert to the heart outcome and a signal to start effective prevention and treatment."

Dr. James Catanese is chief of cardiology at Northern Westchester Hospital in Mount Kisco, N.Y. He agreed that PAD can be a "silent" condition that's tough to spot early. But "this study confirms that retinal evaluation and imaging can find this disease when it is in a silent, but treatable phase," he said.

"If more patients had regular eye examinations and atherosclerosis was found, early treatment could save their lives," Catanese said.

Because the findings were presented at a medical meeting, they should be considered preliminary until published in a peer-reviewed journal.

SOURCES: Samy Selim, MBBCh, interventional cardiology and endovascular specialist, Northwell Health's Southside Hospital, Bay Shore, N.Y.; James Catanese, M.D., chief of cardiology, Northern Westchester Hospital, Mount Kisco, N.Y.; Epidemiology and Prevention | Lifestyle and Cardiometabolic Health, news release, March 8, 2017

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Gleevec Keeps a Leukemia in Check for More Than a Decade: Study

WEDNESDAY, March 8, 2017 (HealthDay News) -- The cancer drug Gleevec appears to keep chronic myeloid leukemia at bay a decade into treatment -- with no signs of additional safety risks, a new study finds.

Gleevec -- known generically as imatinib -- was hailed as a "wonder drug" when it was introduced in 2001 for treating chronic myeloid leukemia (CML).

CML is a type of blood cancer that strikes about 5,000 Americans each year, according to the U.S. National Cancer Institute (NCI).

Before Gleevec, a CML diagnosis "amounted to a death sentence," the institute said. Now, most cases can be controlled, with either Gleevec or related drugs that have been developed since then.

The new findings offer more evidence that the early "hype" around Gleevec was correct, said lead researcher Dr. Andreas Hochhaus, of Jena University Hospital in Germany.

Of more than 500 CML patients given Gleevec as their initial therapy, slightly more 83 percent were alive 10 years later, the study found.

Essentially, their life expectancy was "almost normal," Hochhaus said.

In addition, the study found no evidence of any new, long-range risks from the drug.

In the early days, Hochhaus explained, there was concern that Gleevec could eventually raise the odds of other health conditions, such as heart disease.

So the new safety data should be reassuring for patients, according to Hochhaus.

He and his colleagues report the findings in the March 9 New England Journal of Medicine. Novartis Pharmaceuticals, which makes Gleevec, funded the research.

The study offers some valuable information, said Dr. Michael Mauro, a leukemia specialist at Memorial Sloan Kettering Cancer Center in New York City.

With CML, he said, "we're in a unique situation where we now expect patients to survive for a long time."

So it's important to have studies that track patients' long-range outlook -- including any unexpected complications, according to Mauro.

"What we're seeing is, imatinib has stood the test of the time," Mauro said. "It's served patients well."

Dr. Henry Fung is vice chair of hematology and oncology at the Fox Chase Cancer Center in Philadelphia. He expressed sentiments similar to Mauro's.

"Back in 2000s when imatinib was first approved for treatment of CML, many of us believed that the response would not be durable," Fung said, adding that the new study's authors "have clearly demonstrated that we are absolutely wrong."

Before 2001, fewer than one-third of CML patients were still alive five years after their diagnosis, according to the NCI.

Gleevec changed the picture because unlike traditional cancer drugs, it was developed as a "targeted therapy."

With CML, researchers took advantage of the fact that a specific abnormal gene -- called BCR-ABL -- fuels the cancer's growth. Gleevec inhibits the protein made by that gene.

Almost all CML patients respond to the drug -- and usually for years, according to the American Cancer Society. But most people have to stay on treatment indefinitely, which typically means a daily pill.

The common side effects include nausea, muscle pain, fatigue and itchy skin rashes.

In the new study, 9 percent of Gleevec patients had a side effect considered "serious" -- most often abdominal pain. Those problems were most common during the first year of treatment, then declined over time, according to Hochhaus.

Gleevec is not the only drug of its kind: It was the first in a class of medications known as tyrosine kinase inhibitors, or TKIs. Since 2001, so-called "second-generation" TKIs -- including the drugs dasatinib (Sprycel) and nilotinib (Tasigna) -- have been approved for chronic myeloid leukemia.

According to Mauro, patients' overall survival appears to be similar regardless of which TKI they take. But side effects vary somewhat, he said, so that's one factor in choosing which drug to use.

Patients on the newer drugs seem to have a better chance of a "deep molecular response," Hochhaus said. And that might allow them to try coming off the drug after a few years.

But, Mauro said, researchers are still studying whether the newer drugs offer a better shot at treatment-free remission.

One difference between Gleevec and the newer drugs is clear: The patent on Gleevec expired last year, and it's starting to become available in generic form.

TKIs are very expensive, costing thousands of dollars per month. Fung said many patients may not be able to afford these treatments.

The generic form of Gleevec may help. A study last year estimated that five years of treatment with generic imatinib would cost $100,000 less than treatment with Gleevec.

There are targeted drugs for certain other cancers, too, Hochhaus pointed out. They include some cases of melanoma and lung cancer where researchers have discovered specific gene mutations that drive the tumors' growth.

Gleevec stands as a "model" for such targeted therapies, Hochhaus and his colleagues said.

SOURCES: Andreas Hochhaus, M.D., chair, general internal medicine, hematology/oncology, Jena University Hospital, Jena, Germany; Michael Mauro, M.D., clinical director, leukemia service, Memorial Sloan Kettering Cancer Center, New York City; Henry Fung, M.D., vice chair, hematology and oncology, Fox Chase Cancer Center, and director, Fox Chase Cancer Center-Temple University Hospital Bone Marrow Transplant Program, Philadelphia; March 9, 2017, New England Journal of Medicine

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'Pokemon Go' Players Add 2,000 Steps a Day

WEDNESDAY, March 8, 2017 (HealthDay News) -- People playing Pokemon Go on their smartphone receive an unintended dose of physical activity during their quest to capture virtual critters, a new study finds.

Pokemon Go players were twice as likely to walk 10,000 steps a day than they were before taking up the game, researchers reported.

Overweight or sedentary people appeared to benefit most from the game, in which players walk to various physical locations in the real world to catch virtual Pokemon they can "see" through their smartphone cameras, said lead researcher Hanzhang Xu.

"For example, individuals with the lowest physical activity level at baseline walked nearly 3,000 additional steps per day after playing Pokemon Go," said Xu. She is a graduate student at Duke University School of Nursing in Durham, N.C.

Similarly, overweight or obese players took around 3,000 extra steps daily, "almost double their physical activity from the baseline," Xu said.

Pokemon Go became one of last summer's hottest fads following its release in July. Some health experts surmised the game could prove a boon to players' health, since it requires walking around to find the virtual creatures, Xu said.

To test this, Xu's team recruited 167 iPhone users playing Pokemon Go. The participants were asked to report their daily steps as tracked by the iPhone Health app between June 15 and July 31, 2016.

Before taking up Pokemon Go, participants walked an average of 5,678 steps a day. Their daily steps increased to 7,654 after starting the game, an average increase of nearly 2,000 steps each day, the findings showed.

"While 2,000 steps might seem small, previous studies showed that an increase of 2,000 steps decreases the risk of having a heart attack or stroke by 8 percent in high-risk individuals," Xu said.

"Considering the low level of physical activity in the United States, doing some physical activity is always better than sitting on the couch," she added.

The percentage of days upon which players met their 10,000 daily step goal nearly doubled after they began playing Pokemon Go, increasing from about 15 percent to more than 27 percent, the researchers added.

The success of Pokemon Go shows that such "augmented reality" games could be key in making physical activity fun for those not normally inclined to exercise, Xu concluded.

"Lack of enjoyment and lack of time are the most common reasons for not being physically active," Xu said. Mobile games incorporating physical activity may provide an alternative way to promote physical activity, she suggested.

Still unknown, however, is whether the added movement reported in this brief study is sustainable.

"The initial interest may decline over time," Xu acknowledged. "Therefore, we would like to see whether playing Pokemon Go has long-term health benefits for players." Proven long-term benefits -- as well as interesting new game features -- could help keep players motivated and active, she noted.

New York City cardiologist Dr. Nieca Goldberg has observed the allure of Pokemon Go firsthand. A friend she shops with on Saturdays always takes time to walk by areas where Pokemon are plentiful, or locations where she can get extra points in the game.

"This is a great way for people to engage their friends in competition, and for families to exercise together," said Goldberg, medical director of NYU Langone's Tisch Center for Women's Health.

Even though Pokemon Go players aren't working up a good sweat, observers shouldn't make light of the physical activity involved in the game, she added.

"Walking makes a big difference. It's a great aerobic exercise," Goldberg said. "People need to get away from the notion that you have to do some Olympic-level feat to maintain your heart health."

Xu presented the study Wednesday at a meeting of the American Heart Association in Portland, Ore. The findings should be viewed as preliminary until published in a peer-reviewed journal. The study was self-funded by the Duke Clinical Research Institute.

SOURCES: Hanzhang Xu, graduate student, Duke University School of Nursing, Durham, N.C.; Nieca Goldberg, M.D., medical director, NYU Langone Tisch Center for Women's Health, New York City; March 8, 2017, abstract for presentation, American Heart Association meeting, Portland, Ore.

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1 in 4 U.S. Adults Disabled by Arthritis: CDC

TUESDAY, March 7, 2017 (HealthDay News) -- Arthritis is expanding its grip on Americans, with 24 million adults limited in their everyday activities because of the debilitating joint disease, U.S. health officials say.

Overall, 54 million adults -- or one in four -- report an arthritis diagnosis. And the number of people disabled by it has jumped 20 percent since 2002, the U.S. Centers for Disease Control and Prevention reported Tuesday.

"Arthritis symptoms keep millions of Americans from going about their daily routines," CDC acting director Dr. Anne Schuchat said in an agency news release.

The joint aches, stiffness and swelling of arthritis can make holding a glass, carrying a grocery bag, or walking a short distance difficult or even impossible, the agency said.

Why so many Americans have arthritis isn't clear, and can't be attributed solely to an aging population. Almost two of five adults with arthritis are of working age -- 18 to 64 years old, the CDC said.

The most common types are osteoarthritis, which is age-related wear and tear; rheumatoid arthritis; gout; lupus; and fibromyalgia, the CDC reported.

Arthritis costs at least $81 billion in direct medical costs annually, the agency said.

Although narcotic painkillers are often prescribed for arthritis, other options are safer, the CDC added.

Instead of opioids, doctors and loved ones can encourage people with arthritis to exercise and watch their weight. "Physical activity is a proven strategy to ease pain and reduce symptoms among people with arthritis," Schuchat said.

Exercise -- such as walking, swimming or biking -- can reduce symptoms by as much as 40 percent. Yet, about one-third of adults with arthritis aren't active, the CDC noted in its March 7 Vital Signs.

Self-management education is another important arthritis tool that doctors need to recommend, the report co-author said.

Along with physical activity, "it is just as important for them [doctors] to motivate their patients to attend workshops to learn how to better manage their arthritis," said epidemiologist Kamil Barbour, of the CDC's National Center for Chronic Disease Prevention and Health Promotion.

People are more likely to attend an education program if a health care provider recommends it. But to date, only 1 in 10 Americans has participated in this type of program, the CDC reported.

The report also found that arthritis frequently occurs with other health conditions, namely heart disease, diabetes or obesity. These conditions become harder to manage with arthritis, the agency said.

SOURCE: Vital Signs, U.S. Centers for Disease Control and Prevention, March 7, 2017

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Study Casts Doubt on A Brain Cancer's Link to Herpes

TUESDAY, March 7, 2017 (HealthDay News) -- There's no link between a common type of herpes virus and aggressive brain cancers, according to a new study that refutes earlier reports.

Johns Hopkins researchers analyzed tumor tissue from 125 patients with aggressive brain cancers called gliomas. Ninety-nine of the samples were from adults. Twenty-six were from children. The researchers found no evidence of cytomegalovirus (CMV), a type of herpes virus, in the tumor tissue.

Further studies are needed to rule out any role for CMV in these brain cancers. But the new findings suggest little likelihood of any connection, the researchers said.

"We have found no evidence of CMV in these tissues, and if there is no virus, targeting that virus to affect cancer using antiviral drugs or tailored vaccines doesn't make biological sense," said Dr. Angelo De Marzo, a professor of pathology, oncology and urology at Johns Hopkins Kimmel Cancer Center in Baltimore.

CMV is a very common virus. It infects more than half of all adults by age 40, according to the U.S. Centers for Disease Control and Prevention.

Several earlier studies reported finding CMV in tumor cells from patients with aggressive glioma brain cancers. This led to speculation that therapies targeting CMV could improve outcomes for people with gliomas.

"Significant resources have already gone into this field of study, making it very important to definitively answer the question of whether there's an association between CMV and gliomas or not," Dr. Matthias Holdhoff said in a Hopkins news release. He's an associate professor of oncology and neurosurgery at the Kimmel Cancer Center.

He noted that other laboratories have also found no evidence of CMV in glioma tumors.

The study was published recently in the journal Clinical Cancer Research.

SOURCE: Johns Hopkins, news release, Feb. 28, 2017

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Study: Gene Test Needed Before Using Alzheimer's Drug 'Off-Label'

TUESDAY, March 7, 2017 (HealthDay News) -- A drug used to treat Alzheimer's disease should not be prescribed to people with milder mental impairment without first giving them a genetic test, a new study urges.

The drug is donepezil (brand name: Aricept).

Donepezil could speed mental decline in someone with mild cognitive impairment who has a specific genetic variation, according to Sophie Sokolow, an associate professor at the UCLA School of Nursing.

She and her colleagues found that patients with the K-variant of the butyrylcholinesterase (BChE) gene who took donepezil deteriorated faster than those who took a placebo.

Donepezil is approved in the United States to treat Alzheimer's disease but not mild cognitive impairment -- the stage between normal age-related decline and dementia. However, doctors often prescribe it "off-label" for patients with mild cognitive impairment, the study authors said.

For this study, the researchers examined data from a U.S. government-funded study published in 2005 that assessed donepezil as a possible treatment for mild cognitive impairment.

The findings reinforce the importance of physicians discussing the possible benefits and risks of donepezil with their patients, the researchers said in a university news release.

The study was published recently in the Journal of Alzheimer's Disease. Funding was provide by the U.S. National Institute on Aging.

SOURCE: UCLA School of Nursing, news release, Feb. 24, 2017

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Kidney Transplant Survival Up Among Babies, Kids

MONDAY, March 6, 2017 (HealthDay News) -- Survival rates for children who get kidney transplants have improved significantly over the last half-century, a new study finds.

"The outlook for infants and children with end-stage kidney disease was once dismal, with poor survival rates after transplant. There has been great progress in pediatric kidney transplantation, and now the patient survival rate is almost 100 percent," said the study's principal investigator, Dr. Srinath Chinnakotla.

Chinnakotla is an associate professor of surgery at the University of Minnesota Masonic Children's Hospital in Minneapolis, where the study was done.

Since 2002, 97 percent of children who had kidney transplants at the hospital were alive a year later. That compares to 85 percent 40 to 50 years ago, the study showed.

Long-term outcomes have also improved. Only 42 percent of kids who got a new kidney between 1963 and 1983 still had a functioning transplant 10 years later. That compares to 58 percent who had transplants between 1984 and 2001, and 70 percent since then, the researchers found.

The study was recently published online in the Journal of the American College of Surgeons.

"Thanks to advances in immunosuppressive [anti-rejection] medications including steroid-free drugs, better surgical technique, and improved management of infections after kidney transplant, children ages 10 years and younger now have the best long-term graft survival of all ages," Chinnakotla said.

Kidney transplant is far less common in infants and children than in adults, he noted. Fewer than 720 of the nearly 18,600 kidney transplants performed in the United States in 2015 were in patients under age 18, according to the Organ Procurement and Transplant Network.

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Would You Feel Safe in A Driverless Ambulance?

MONDAY, March 6, 2017 (HealthDay News) -- Automated, driver-free cars and trucks may be the wave of the future. But new research suggests many Americans aren't sold on the idea of a ride in a driverless ambulance.

This new technology does have one potential advantage over current emergency vehicles. Right now, a patient in an ambulance gets medical attention only from one paramedic, while the other crew member drives the vehicle.

But "an automated ambulance would allow patients to get to the hospital much more quickly and smoothly while receiving care from two providers instead of one," said study co-author Joseph Keebler.

"Automation could be especially important in many regions where emergency medical services are insufficiently funded," added Keebler, who is an assistant professor of human factors at Embry-Riddle Aeronautical University in Daytona Beach, Fla.

And with prototype driverless cars and trucks already being tested, "it is likely that automated emergency response vehicles may soon be a reality," he and co-author Stephen Rice wrote in the study.

But how would today's public react to ambulances with computers instead of people in the driver's seat?

To find out, the researchers conducted online studies involving more than 1,000 U.S. adults. In one study, people were asked to imagine they had placed a 911 call and one of two scenarios followed: A conventional ambulance arrived with a driver and one attending paramedic, or a driverless ambulance arrived with two paramedics free to help the patient.

That study, involving adults with an average age of 36, found most still preferred getting driven to an ER in a conventional ambulance.

Fewer women than men would be willing to ride in a driverless ambulance, the study found, even if told they would receive care from two paramedics instead of one.

Subsequent research found that people who judged themselves as more "emotional" were less apt to embrace the idea of a driver-free ambulance, the Florida research team said.

"Our results showed that consumers were fairly positive toward the idea of the traditional ambulance configuration, while they had mixed feelings about the autopilot configuration," said Rice, an associate professor of human factors at Embry-Riddle.

But he also wondered if, over time, people might not warm to the idea of a computer-driven ambulance.

"The novelty of the concept likely heightened people's emotional responses to it because ambulances on autopilot aren't a part of our everyday lives at this point," Rice said in a university news release.

Still, in a medical emergency, predictability can be important to patients.

"If you're having a heart attack and all of a sudden a driverless vehicle shows up, that would be an unexpected event, which could cause you additional stress," study co-author Scott Winter said in the news release. He's an assistant professor of aviation science at Florida Institute of Technology in Melbourne, Fla.

The study was to be presented Monday at the International Symposium on Human Factors and Ergonomics in Health Care conference, in New Orleans. Research presented at scientific meetings is typically considered preliminary until published in a peer-reviewed journal.

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Rheumatoid Arthritis Drug May Not Ease Chronic Fatigue Syndrome After All

MONDAY, March 6, 2017 (HealthDay News) -- A small-scale clinical trial has cast doubt upon the potential usefulness of an anti-inflammatory drug to treat chronic fatigue syndrome.

Doctors had hoped that anakinra (Kineret) -- a medication for rheumatoid arthritis -- also could be used to relieve symptoms of chronic fatigue syndrome.

But after a month of daily anakinra injections, a group of 25 women reported chronic fatigue symptoms as severe as those experienced by a control group receiving placebo shots, researchers reported.

"In this carefully and well-controlled study, we were unable to show a beneficial effect," said senior researcher Dr. Jos Van der Meer.

"Of course, this is a disappointment," added Van der Meer, chair of internal medicine at Radboud University Nijmegen Medical Center in the Netherlands.

Anakinra treats rheumatoid arthritis by blocking interleukin-1, a biochemical produced by the immune system to create inflammation.

Patients with chronic fatigue syndrome have been found to have increased levels of interleukin-1 in their bloodstream. This has fueled suspicion that the mysterious disorder might be linked in some way to inflammation, the researchers said in background notes.

In addition, previous studies have shown that arthritis patients treated with anakinra experience a dramatic decline in their fatigue levels, said Dr. Kevin Fleming, a geriatric specialist with the Mayo Clinic in Rochester, Minn. He wasn't involved in the study.

Chronic fatigue syndrome is generally diagnosed as six months or more of extreme fatigue that doesn't improve with bed rest. It generally spikes after activities requiring physical or mental energy, according to the U.S. Office on Women's Health.

The debilitating disorder has no known cause, the women's health office says, but reports have linked its onset in some to mononucleosis, flu-like illness, or a period of intense physical stress.

To test anakinra's potential as a treatment, the researchers randomly assigned 25 women with chronic fatigue to receive daily 100-milligram injections of the drug. Another 25 women received a placebo.

After one month, there was no meaningful difference between the two groups in fatigue severity.

Other symptoms -- including pain, distress, and physical and social functioning -- were not appreciably different, either, according to the study authors.

"This was a potential drug that had a lot of hope, but it didn't work in this small trial," said Dr. Houman Danesh, director of integrative pain management at the Mount Sinai Hospital in New York City.

Van der Meer suspects that anakinra didn't work because the body couldn't effectively deliver the drug into the brain.

"Hence, we are looking for another safe and selective [anti-inflammatory] drug, preferably a small molecule that can be taken orally and that is able to reach the brain in sufficient concentrations," he said.

But neither Danesh nor Fleming are ready to close the door on anakinra's usefulness. Danesh, who wasn't involved in the research, said larger trials are needed to completely rule out anakinra as a treatment.

Meanwhile, Fleming noted that the women in this study had been long-time chronic fatigue sufferers. Perhaps anakinra could head off the onset of chronic fatigue syndrome in people who just suffered serious infection or physical stress and are at risk for developing the disorder, he said.

"It could be there's a subgroup where if you intervene early, they might actually not develop it," Fleming said.

Currently, no drugs have U.S. Food and Drug Administration approval for chronic fatigue syndrome, according to the Office on Women's Health.

The two leading therapies for the condition are physical exercise and a type of talk therapy called cognitive behavioral therapy, Danesh and Fleming said.

"What I do recommend for most of my patients with chronic fatigue is daily exercise, even if it's as little as 5 to 10 minutes," Danesh said. "That seems to have the best evidence for treatment."

Cognitive behavioral therapy can help by teaching patients to recognize patterns that lead to feelings of fatigue, and training them to counter those feelings, Fleming said.

"You need to recognize your brain is actually telling you things that aren't true," Fleming said. "They feel horrible, but nothing horrible is happening. You can train them to recognize this."

The study was published March 6 in the Annals of Internal Medicine.

SOURCES: Jos Van der Meer, M.D., Ph.D., chair, internal medicine, Radboud University Nijmegen Medical Center, the Netherlands; Kevin Fleming, M.D., geriatric specialist, Mayo Clinic, Rochester, Minn.; Houman Danesh, M.D., director, integrative pain management, Mount Sinai Hospital, New York City; Annals of Internal Medicine, March 6, 2017

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Can Mom's Vitamin E Head Off Child's Asthma Risk?

SATURDAY, March 4, 2017 (HealthDay News) -- Kids born to moms with low levels of vitamin E might be more likely to develop asthma, new research suggests.

When moms had low levels of a specific type of vitamin E measured right after birth, their children were more likely to develop wheezing and to have been treated with asthma medications in their first two years of life, the study found.

"The major sources of vitamin E are oils" such as sunflower, safflower, corn, soy and canola oils, study lead author Dr. Cosby Stone said in a news release from the American Academy of Allergy, Asthma & Immunology (AAAAI).

Stone said his team's previous research in mice had suggested the link between vitamin E and asthma. Stone is with Vanderbilt University Medical Center in Nashville.

"We hypothesized that maternal vitamin E levels, reflecting levels that the fetus encounters during pregnancy," would affect how kids breathe, he said.

The study tracked the health of more than 650 children and their mothers for the children's first two years of life. The researchers also asked moms specifically about whether their kids had trouble breathing or used asthma medications.

The researchers found that kids who wheezed or needed asthma medications were more likely to have mothers who had lower levels vitamin E just after birth.

Specifically, they had lower levels of a substance found in vitamin E called alpha-tocopherol. Sunflower and safflower oils provide the highest levels of this substance, Stone said.

The study only found an association between vitamin E levels and asthma symptoms, however. It didn't show a cause-and-effect relationship.

The findings were scheduled to be presented Saturday at the AAAAI annual meeting, in Atlanta, and published simultaneously in a supplement of The Journal of Allergy and Clinical Immunology.

SOURCE: American Academy of Allergy, Asthma & Immunology, news release, March 4, 2017

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Longer Addiction Treatment Is Better, Study Confirms

FRIDAY, March 3, 2017 (HealthDay News) -- The longer patients receive treatment for addiction, the greater their chances of success, a new study finds.

The study included 72 people, with an average age of 30 years. The participants were being treated for a variety of addictions, including alcohol and drugs such as opioids, amphetamines and benzodiazepines.

The only significant factor in treatment success was the length of treatment. After one year, the treatment success rate was about 55 percent for those who underwent a standard 30-day treatment program. But the success rate was about 84 percent for those in treatment programs that lasted more than 30 days, the investigators found.

The findings are important because most government and private health insurance programs only reimburse patients for 30 days of addiction treatment, said study leader Dr. Akikur Mohammad, of the University of Southern California, and colleagues.

Mohammad is a psychiatrist, an addiction medicine specialist and the founder and CEO of Inspire Malibu, a drug addiction treatment center.

"Aftercare is crucial once an individual has completed drug or alcohol treatment and is in recovery. There is a continuity of care that should be followed once initial treatment is completed," Mohammad said.

"This usually involves a lower level of treatment, such as outpatient care and a sober living environment. Our study shows that the absence of such treatment after 30 days significantly reduces the chances of the patient maintaining their sobriety," Mohammad said in a university news release.

The study was published recently in the Open Journal of Psychiatry.

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More Teens Turning Their Backs on Tanning Beds: CDC

FRIDAY, March 3, 2017 (HealthDay News) -- The number of U.S. teens who use indoor tanning has dropped by half in recent years, a new government study reveals.

Only about 7 percent of high school students said they used indoor tanning in 2015, down from almost 16 percent of students in 2009, according to results from a U.S. Centers for Disease Control and Prevention survey.

But that still leaves more than 1 million teens putting themselves at increased risk of skin cancer, including the most severe form, melanoma, by going to a tanning salon, said study lead author Gery Guy Jr.

Worse, their use of indoor tanning appears to give them a false sense of security when they step outdoors into real sunlight, said Guy, a health economist with the CDC's division of cancer prevention and control.

"We also found that among the 1.2 million high school students who are continuing to indoor tan, 82 percent of them experienced a sunburn in the past year," Guy said. That increases the danger, he added.

Just one blistering sunburn during childhood or adolescence can nearly double your lifetime risk of melanoma, according to the American Academy of Dermatology.

Teens likely believe the myth that indoor tanning provides a "base tan" that will protect them against sunburn, Guy said.

"There is no base tan. Tanned skin is damaged skin," Guy said. "Individuals may think a base tan will protect them, when in reality it doesn't."

The CDC's Youth Risk Behavior Survey of thousands of high school students focuses on risky behaviors that could pose a hazard to kids' health and safety.

As part of the survey, teens were asked how often they'd used an indoor tanning device (such as sunlamp, sunbed or tanning booth) during the previous 12 months. They were also asked how many times they'd been sunburned.

Indoor tanning is most popular among white girls. But even that group experienced a large decrease in trips to the tanning salon -- dropping from more than 37 percent in 2009 to just over 15 percent in 2015, the findings showed.

Unfortunately, white girls' interest in indoor tanning appears to increase with age, and the study found that about one out of every four girls 17 or older was still using tanning beds.

Dr. Len Lichtenfeld is deputy chief medical officer of the American Cancer Society. He said, "The reality that one-quarter of women 17 and older are using indoor tanning is still very disturbing. It basically says there's a huge market for indoor tanning, and young people are still taking advantage of that opportunity."

A wave of state laws restricting teens' use of tanning beds likely has been the major driver in the observed decline, said Guy and Dr. Henry Lim, a dermatologist with Henry Ford Hospital in Detroit.

Only five states had laws restricting indoor tanning in 2009, but by 2015 such laws had been enacted in 42 states, according to the report.

"Most of them are not bans, but restrictions that you have to get parental consent to go to a tanning booth," said Lim, who co-authored an editorial accompanying the study. "I think it is a sort of deterrent."

The U.S. Food and Drug Administration had proposed a federal rule restricting access to tanning beds for kids under 18, but it remains just that -- a proposal, Lichtenfeld said.

The World Health Organization has classified indoor tanning devices as cancer-causing. And, Guy said, in 2014 the U.S. Surgeon General's Office listed limiting indoor tanning as one of its strategic goals for skin cancer prevention.

Unfortunately, U.S. schools do not seem to promote sun safety, according to a second CDC study. Both were published online March 3 in the journal JAMA Dermatology.

Researchers found that sun-safety practices are not common among schools, particularly in high schools.

For example, only about 37 percent of high schools required teachers to give students time to apply sunscreen, compared to about half of elementary and middle schools.

Even then, kids who didn't bring their own sunscreen were mostly out of luck. Just over 13 percent of schools said they provide sunscreen for kids' use.

Lim believes that restrictions on indoor tanning and continued public education will continue to decrease the number of teens hitting the tanning salon.

"I think we're on the right track, and we need to keep going," Lim said. "It's similar to smoking. It takes a concerted effort to get people to change their behavior."

SOURCES: Gery Guy Jr., Ph.D., MPH, health economist, division of cancer prevention and control, U.S. Centers for Disease Control and Prevention; Henry Lim, M.D., dermatologist, Henry Ford Hospital, Detroit; Len Lichtenfeld, M.D., deputy chief medical officer, American Cancer Society; March 3, 2017, JAMA Dermatology, online

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DIY Teeth-Straightening: Don't Try This at Home

THURSDAY, March 2, 2017 (HealthDay News) -- An orthodontist recalled a patient who devised her own means of straightening two wayward teeth.

"The patient tried to close a gap between her lower incisors by wrapping string around the two teeth," the orthodontist explained.

But the do-it-yourself method brought only trouble.

"I was horrified to see the string deep in the gum and the severe mobility in the two teeth," the unnamed orthodontist said.

Examples of people attempting to straighten their own teeth -- often using dubious "how-to" guides accessed on the Internet -- is on the rise, according to a survey by the American Association of Orthodontists (AAO).

People are resorting to the use of potentially dangerous objects such as rubber bands, string, paper clips and fake retainers to circumvent the orthodontists' office, the AAO said.

But this type of jerry-rigged orthodontics can lead to permanent damage, the group warns.

"What most people don't understand is that moving teeth is a biological process that involves bone that dissolves and rebuilds as teeth are moved into their new positions," AAO president DeWayne McCamish said in a news release from the organization.

"Moving teeth is best done under the direct supervision of an orthodontist after an in-person assessment, including complete diagnostic records," he said.

Social media has played a significant role in the dangerous do-it-yourself orthodontics trend, McCamish added. "There are literally hundreds of videos on YouTube alone, with 'tutorials' on how to straighten your own teeth," he said.

In the new survey, AAO members were queried on their experiences with patients who attempt to straighten their own teeth.

The survey found that nearly 13 percent of the orthodontists said they'd had patients -- ranging from the age of 8 to over 60 -- who tried to fix their own teeth by pushing on their teeth, biting on pencils or using a variety of household items, including paper clips.

In some cases, those who tried to straighten their teeth caused irreversible problems, the survey authors noted.

"It's really a shame when someone comes in after attempting DIY orthodontic treatment and we determine that the damage they've done to their teeth is so extensive that teeth cannot be saved," McCamish said.

"By the time a lay person recognizes something is wrong with their teeth, it may not be reversible, even with professional help," he said.

"The cost of dealing with replacing a lost tooth can easily exceed $20,000 over a lifetime and certainly be much less than ideal," McCamish said. "You have to remember that the goal of good orthodontic treatment is obtaining a healthy, beautiful smile for a lifetime -- shortcuts can be disastrous."

Of the orthodontists who said they'd had patients who tried to straighten their own teeth, 39 percent said they had to then provide treatment to correct damage that had been done as a result.

Most of the orthodontists polled believed that their patients would actually have saved time and money if they had gotten professional help to straighten their teeth.

"If it's a matter of economics, many orthodontists do an initial consultation at no cost and with no obligation," McCamish explained. "It's an opportunity to get the expert's opinion about your problem, options to resolve it and, in so doing, avoid the unintended harmful consequences that could result from DIY treatment."

SOURCE: American Association of Orthodontists, news release, Feb. 23, 2017

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Keep an Eye Out for Eating Disorders in Loved Ones

THURSDAY, March 2, 2017 (HealthDay News) -- Millions of Americans have eating disorders, but it can be difficult for family and friends to detect these problems in loved ones, a doctor warns.

For example, many people with anorexia are skillful at hiding their weight loss by doing things such as wearing loose clothing to mask their size or being very involved in meal preparation, according to Dr. Martha Levine of Penn State Children's Hospital.

But there are signs that loved ones can look for, said Levine, who is director of the partial hospitalization program, in the division of eating disorders and adolescent medicine.

People with anorexia are often cold and may develop a fine layer of hair on their bodies in reaction to the loss of body fat. In females, menstruation tends to stop, she noted.

In the case of those with bulimia, watch for the person visiting the bathroom right after meals. Dentists can detect the disorder because of the damage stomach acid causes to teeth. Other signs of bulimia or a binge-eating disorder include large amounts of food vanishing.

If you notice signs of an eating disorder, raise your concerns with that person when you have enough time and space to have a good conversation, Levine advised.

"Individuals who struggle with eating disorders feel a lot of shame about their illness. They can also be perfectionistic and are usually eager to make others around them happy, so if they feel criticized or shamed, they will take that very much to heart," Levine said in a Penn State news release.

"You don't want to ignore it, but if you try to push too much, it can lead to more control issues," she said. "The key is to be accepting and not critical."

Levine also suggested making an appointment with an eating disorder specialist, because they can help a person delve into the emotional causes of the problem.

An estimated 20 million females and 10 million males in the United States will have an eating disorder during their lifetime. Death rates from anorexia nervosa and bulimia nervosa are estimated to be around 4 percent to 5 percent, the National Eating Disorders Association says.

Anorexia is characterized as self-starvation leading to severe weight loss, while bulimia involves frequent cycles of binge-eating and purging.

SOURCE: Penn State, news release, Feb. 23, 2017

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Exercise Helps Counter Cancer-Linked Fatigue

THURSDAY, March 2, 2017 (HealthDay News) -- Whether from the disease itself or the treatment, cancer can be exhausting, but a new review says there are ways to beat back cancer-related fatigue.

The review included a look at 113 past studies that included more than 11,000 adult cancer patients. The researchers found that exercise and/or behavioral and educational therapy seemed to be more effective than prescription drugs for dealing with fatigue.

"Exercise and psychological treatment, and the combination of these two interventions, work the best for treating cancer-related fatigue -- better than any pharmaceuticals we have tested," noted study lead author Karen Mustian. She's an associate professor with the University of Rochester Medical Center's Wilmot Cancer Institute in Rochester, N.Y.

The upshot, said Mustian, is that doctors should consider exercise and psychological interventions as the "first-line therapy" instead of more medications when it comes to tackling cancer-related fatigue.

The study team noted that cancer-related fatigue is a very common problem among cancer patients, both during and following treatment.

The American Cancer Society describes the phenomenon as distinct from routine tiredness. Even if you get rest, you're still tired. Your arms and legs may feel heavy. You may feel too tired to do even the simplest tasks, such as eating a meal, according to the ACS.

Beyond affecting overall quality of life, cancer-related fatigue can also interfere with a patient's ability to continue cancer treatment itself. That may result in a poorer prognosis and, in some cases, a reduced chance for long-term survival, the study authors said.

For the study, Mustian and colleagues looked at cancer-related fatigue triggered by the onset of cancer itself, rather than as a side effect of treatment.

Almost half of the patients included in the review were women battling breast cancer. Ten studies focused solely on male patients. In all, almost 80 percent of study participants were women. Their average age was 54.

The analysis excluded studies that looked at so-called complementary therapies, with an exception made for alternative exercise treatments, such as yoga or tai chi.

In addition, the research team didn't include studies that had assessed drug treatments involving erythropoietin medications (such as epoetin alpha, brand names Procrit and Epogen). These drugs are designed to stimulate red blood cell production, and are "used primarily for treating anemia and are not recommended as a stand-alone treatment for [cancer-related fatigue] due to adverse effects," the study authors stated.

Studies included looked at the impact of four different treatment approaches: exercise alone (including aerobic, such as walking or swimming or anaerobic, such as weight-lifting); mental health interventions aimed at providing information and/or helping patients understand and adapt to their current situation; a combination of both exercise and psychological treatment; and prescription drugs, including stimulant medications (such as modafinil, brand name Provigil) and ADHD meds (such as methylphenidate, brand name Ritalin).

All four interventions led to improvement in fatigue. But the researchers found that exercise therapy led to the best outcomes.

But psychological therapies produced similarly positive results, as did treatments that integrated exercise with mental health efforts.

The team concluded that when it came to controlling cancer-related fatigue, the exercise and/or psychological therapy approaches appeared to outperform prescription drugs.

Colleen Doyle is managing director of nutrition and physical activity for the ACS. She said exercise has many benefits, not just helping to ease fatigue.

"But because many people undergoing treatment do experience fatigue, it's nice to know that there is something an individual can do to help reduce that fatigue and gain some of the many other benefits of exercise [both during and after treatment]: reduced stress, less anxiety, [and] benefits to physical functioning," Doyle said.

But can the typical cancer patient actually handle an exercise regime? Mustian says yes.

"These are not your elite athletes or fitness buffs," she said. Almost all of the studies focused on people who had been sedentary and were placed on a low-to-moderate intensity exercise regimen, involving activities such as yoga or resistance training.

"So they are normal people who were not regular exercisers, and who were able to complete these interventions and have relief from their fatigue," Mustian said.

Doyle said that for patients who weren't previously active, it's important to start slowly.

"Our recommendation for survivors is essentially avoid inactivity as best you can. There will be days when you feel like not doing much of anything, and that's okay, but strive to do something. Even if it is gentle stretching exercises, or a five-minute walk down the block," she advised.

Mustian stressed that relatively few studies looked at combining exercise and psychological therapy.

"So it is not as clear what the best way to combine them would be," she noted. The researchers said more studies need to be done to explore the ideal way to integrate exercise and psychological interventions.

The study was published March 2 in JAMA Oncology.

SOURCES: Karen M. Mustian, Ph.D., M.P.H., associate professor, Wilmot Cancer Institute, department of surgery, University of Rochester Medical Center, Rochester, N.Y.; Colleen Doyle, M.S., R.D., managing director, Nutrition and Physical Activity, American Cancer Society; March 2, 2017, JAMA Oncology

News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services.

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Immune Disorders Such as MS, Psoriasis May Be Tied to Dementia Risk

WEDNESDAY, March 1, 2017 (HealthDay News) -- People with autoimmune diseases -- conditions that cause a person's immune system to turn against the body -- appear to have an increased risk of developing dementia, a new British study suggests.

Researchers found that 18 out of 25 different autoimmune diseases, such as lupus, psoriasis or multiple sclerosis, "showed a statistically significant association with dementia," said study co-author Dr. Michael Goldacre. He's a professor of public health at the University of Oxford.

But Goldacre and other experts stressed that the study didn't prove that autoimmune diseases cause dementia. The research only showed that these conditions are associated with a higher risk of dementia.

Specifically, the study found that people with multiple sclerosis appeared to have nearly double the risk of dementia. Psoriasis was associated with a 29 percent increased risk of dementia. Lupus was linked to a 46 percent increased risk, and rheumatoid arthritis with a 13 percent increased risk. Crohn's disease was associated with a 10 percent increased risk.

"How do [autoimmune diseases] affect the brain? We don't know, although others have suggested that chronic inflammation, possibly autoimmune effects, or possibly both, may have a role in Alzheimer's," Goldacre said.

For this study, the researchers reviewed information from more than 1.8 million people in England. All had been admitted to a hospital with an autoimmune disease between 1998 and 2012.

Compared with people admitted for other causes, patients admitted for treatment of an autoimmune disorder were 20 percent more likely to wind up back at the hospital later with dementia, the researchers found.

However, when researchers broke down their findings by type of dementia, they found that autoimmune diseases only increased the risk of Alzheimer's disease by about 6 percent.

The autoimmune diseases had a much stronger impact on the risk of vascular dementia. The risk of vascular dementia was 28 percent higher in people with autoimmune diseases. People with vascular dementia experience a decline in their thinking skills due to conditions that block or reduce blood flow to the brain, starving brain cells of oxygen and nutrients.

This apparent increased risk for vascular dementia could be caused by the effect of autoimmune diseases on the circulatory system, the researchers said. The study also found that people with an autoimmune disease were 53 percent more likely to be hospitalized for heart disease. Those with an autoimmune disease were also 46 percent more likely to have a stroke.

The link between vascular dementia and autoimmune diseases is "something new," said James Hendrix. He's the director of global science initiatives for the Alzheimer's Association, based in Chicago.

This link could implicate chronic inflammation as a potential cause of progressive dementia, he said.

Hendrix explained that a person with a sprained ankle experiences inflammation and swelling as the immune system responds to their injury. If the inflammation continues for an extended period, that person could wind up with joint damage and arthritis.

"We are starting to think neuron inflammation is similar," Hendrix said.

Both Hendrix and Goldacre noted that the study is observational, so it couldn't prove a direct cause-and-effect link. In addition, Goldacre said the size of the associations they found was small, and should be taken "more as a message for interested researchers than for interested patients."

Dr. Walter Rocca is a professor of epidemiology and neurology with the Mayo Clinic in Rochester, Minn. He said the findings are "important" but may be limited by the fact that the researchers focused solely on people admitted to the hospital with an autoimmune disorder.

"The concern is that many persons affected by an autoimmune disease may never need to be admitted to a hospital, and many persons affected by dementia may not need to be hospitalized," Rocca said.

"This incomplete capture [of information] may cause a distortion of the findings," he added.

Rocca also pointed out that the 25 autoimmune diseases considered in the study are very different from each other. For example, some attack the joints or the endocrine glands, while others -- like multiple sclerosis -- may directly affect the brain.

Findings from the study were published March 1 in the Journal of Epidemiology & Community Health.

SOURCES: Michael Goldacre, BM, BCh, F.F.P.H., F.R.C.P., professor, public health, University of Oxford, United Kingdom; James Hendrix, Ph.D., director, global science initiatives, Alzheimer's Association, Chicago; Walter Rocca, M.D., professor, epidemiology and neurology, Mayo Clinic, Rochester, Minn.; March 1, 2017, Journal of Epidemiology & Community Health

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Gene Therapy: a Breakthrough for Sickle Cell Anemia?

WEDNESDAY, March 1, 2017 (HealthDay News) -- Researchers are reporting early success using gene therapy to treat, or even potentially cure, sickle cell anemia.

The findings come from just one patient, a teenage boy in France. But more than 15 months after receiving the treatment, he remained free of symptoms and his usual medications.

That's a big change from his situation before the gene therapy, according to his doctors at Necker Children's Hospital in Paris.

For years, the boy had been suffering bouts of severe pain, as well as other sickle cell complications that affected his lungs, bones and spleen.

Medical experts stressed, however, that much more research lies ahead before gene therapy can become an option for sickle cell anemia.

It's not clear how long the benefits will last, they said. And the approach obviously has to be tested in more patients.

"This is not right around the corner," said Dr. George Buchanan, a professor emeritus of pediatrics at the University of Texas Southwestern Medical Center in Dallas.

That said, Buchanan called the results a "breakthrough" against a disease that can be debilitating and difficult to treat.

Buchanan, who wasn't involved in the research, helped craft the current treatment guidelines for sickle cell.

"This is what people have been wanting and waiting for," he said. "So it's exciting."

Sickle cell anemia is an inherited disease that mainly affects people of African, South American or Mediterranean descent. In the United States, about 1 in 365 black children is born with the condition, according to the U.S. National Heart, Lung, and Blood Institute.

It arises when a person inherits two copies of an abnormal hemoglobin gene -- one from each parent. Hemoglobin is an oxygen-carrying protein in the body's red blood cells.

When red blood cells contain "sickle" hemoglobin, they become crescent-shaped, rather than disc-shaped. Those abnormal cells tend to be sticky and can block blood flow -- causing symptoms such pain, fatigue and shortness of breath. Over time, the disease can damage organs throughout the body.

There are treatments for sickle cell, such as some cancer drugs, Buchanan pointed out, but they can be difficult to manage and have side effects.

There is one potential cure for sickle cell, Buchanan said: a bone marrow transplant.

In that procedure, doctors use chemotherapy drugs to wipe out the patient's existing bone marrow stem cells -- which are producing the faulty red blood cells. They are then replaced with bone marrow cells from a healthy donor.

A major problem, Buchanan said, is that the donor typically has to be a sibling who is genetically compatible -- and free of sickle cell disease.

"We've known for a long time that bone marrow transplants can work," Buchanan said. "But most patients don't have a donor."

That's where gene therapy could fit in. Essentially, the aim is to genetically alter patients' own blood stem cells so they don't produce abnormal hemoglobin.

In this case, the French team, led by Dr. Marina Cavazzana, of Necker Children's Hospital's biotherapy department, focused on a gene called beta globin. In sickle cell anemia, beta globin is mutated.

First, the researchers extracted a stem cell supply from their teen patient's bone marrow, before using chemotherapy to wipe out the remaining stem cells.

Then they used a modified virus to deliver an "anti-sickling" version of the beta globin gene into the stem cells they'd removed pre-chemo. The modified stem cells were infused back into the patient.

Over the next few months, the boy showed a growing number of new blood cells bearing the mark of the anti-sickling gene. The result was that roughly half of his hemoglobin was no longer abnormal.

In essence, Buchanan explained, the therapy "converted" the patient to sickle-cell trait -- that is, a person who carries only one copy of the abnormal hemoglobin gene. Those individuals don't develop sickle cell disease.

"This is encouraging," said Dr. David Williams, president of the Dana-Farber/Boston Children's Cancer and Blood Disorders Center.

But, he cautioned, "the caveat is, this is one patient, and 15 months is a short follow-up."

Williams and his colleagues are studying a different approach to sickle cell gene therapy. It aims to restart the body's production of healthy fetal hemoglobin -- to replace the abnormal "adult" hemoglobin seen in sickle cell.

The hope, Williams said, is that gene therapy will ultimately offer a one-time treatment that cures sickle cell. But no one knows yet whether that will happen.

According to Williams, two key questions are: What's the long-term safety? And will the altered stem cells last for a patient's lifetime?

If gene therapy is proven to work, there will no doubt be practical obstacles to its widespread use, according to Buchanan. It's a high-tech treatment, and many sickle cell patients are low-income and far from a major medical center, he said.

But, Buchanan said, the new findings have now "opened a door."

The study was partly funded by Bluebird Bio, the company developing the therapy.

The results were published March 1 in the New England Journal of Medicine.

SOURCES: George Buchanan, M.D., professor emeritus, pediatrics, University of Texas Southwestern Medical Center, Dallas; David Williams, M.D., president, Dana-Farber/Boston Children's Cancer and Blood Disorders Center; March 1, 2017, New England Journal of Medicine

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Mildly Low Thyroid Function in Pregnancy Not a Threat

WEDNESDAY, March 1, 2017 (HealthDay News) -- There's no benefit to treating pregnant women who have mildly low thyroid function, researchers report.

Very low thyroid function during pregnancy is associated with impaired fetal brain development and increased risk of preterm birth and miscarriage. Some studies have suggested that even mildly low thyroid function (so-called subclinical hypothyroidism) during pregnancy could also pose a threat to a newborn.

This new study of more than 97,000 pregnant women across the United States found no evidence of that. Researchers saw no differences in brain development between children born to mothers with low thyroid function who did or did not receive medication during pregnancy.

There were also no differences between the groups in rates of preterm birth, stillbirth, miscarriage and gestational diabetes, according to the study, conducted by a U.S. National Institutes of Health (NIH) research network.

"Our results do not support routine thyroid screening in pregnancy since treatment did not improve maternal or infant outcomes," study author Dr. Uma Reddy said in an NIH news release.

Reddy is with the U.S. National Institute of Child Health and Human Development's pregnancy and perinatology branch.

Thyroid hormones help regulate energy levels and other vital bodily functions. For the study, Reddy and her colleagues tested thyroid hormone levels of more than 97,000 women before the 20th week of pregnancy.

The researchers randomly assigned about 500 women with mildly low thyroid function to receive either treatment with the drug levothyroxine (Synthroid) or a placebo.

After birth, all of their children underwent IQ testing and developmental testing each year until 5 years of age.

The new findings confirm the results of an earlier study that included about 22,000 women and followed their children until age 3, the researchers said.

The study results were published March 1 in the New England Journal of Medicine.

SOURCE: U.S. National Institutes of Health, news release, March 1, 2017

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Concussions More Likely in Female Athletes

TUESDAY, Feb. 28, 2017 (HealthDay News) -- Female athletes appear to be more likely than men to suffer concussions during their careers on the field, a new study suggests.

The findings add to the existing evidence that female athletes may be more susceptible to concussions, even as attention has tended to focus on the risk to male football players.

"The more we look at concussion, the more we realize that women are at high risk," said study co-author Dr. James Noble. He's an assistant professor of neurology at Columbia University Medical Center in New York City.

Once a concussion occurs, however, the gender gap dwindles, the researchers found.

"For the most part, men and women experience concussion in about the same way," Noble said, "although men were more likely to report forgetfulness and women more likely to report sleep problems."

Concussions, especially among football players from high school to professional levels, have gotten intense attention in recent years.

Last year, a study suggested that concussion diagnoses more than doubled from 2007 to 2014, with especially big jumps among children and teens. It's not clear, though, how much of the increase is due to increased awareness of concussions or a higher number of injured young people.

In the new study, the researchers tracked more than 1,200 athletes from Columbia University from 2000 to 2014. More than 800 were male, and almost 400 were female.

The athletes all played sports believed to pose a higher risk of concussions.

For women, the sports included field hockey, soccer, basketball, softball and lacrosse, said study lead author Cecilia Davis-Hayes, a medical student at Columbia.

For men, the sports initially included just football but then also included wrestling, basketball and soccer, Davis-Hayes said.

Twenty-three percent of the women and 17 percent of the men had at least one concussion during their college careers over the time of the study.

The difference "doesn't sound like much, but it's almost 50 percent more, meaning it's 50 percent more likely for women to get a concussion than men," Noble said.

Concussions in sports typically happen when athletes run into each other or hit the ground, Noble said. According to Davis-Hayes, lacrosse and soccer are especially physical sports for women with "a lot of contact on every play."

Levels of most concussion symptoms were similar among the men and women, although forgetfulness was more common for men (44 percent reported it, compared to 31 percent of the women). Women were more likely to experience insomnia (42 percent, compared to 29 percent of men).

The researchers found that it took an average of almost two weeks for the athletes to return to play, although Davis-Hayes said that's skewed because some players took especially long -- months -- to recover. The study didn't look at how the athletes were treated for their concussions.

The study also didn't take into account how long athletes played each sport. That means researchers don't know if the women or men were on the field for longer periods, potentially boosting their risk of concussion.

Why might women face a higher risk? It's not clear, Noble said, although he thinks it could be due to a variety of factors, such as differences in the bodies of men and women.

"Is there something about how the head moves in a woman versus a man?" he said.

Steven Broglio, director of the NeuroTrauma Research Laboratory at the University of Michigan, said the findings fit with other research.

"There are a multitude of studies that have shown that women participating in similar sports as men -- like soccer, basketball, baseball/softball -- report concussions at a higher rate. Concussions are not just a football or male injury," he said.

Broglio also noted that the new study results suggest men and women recovered at the same speed. "Historically, we believed women took longer to recover from injury," he said, "but there is growing evidence suggesting this may not be the case."

The study authors said larger studies could offer more insight into the differences between the genders when it comes to concussion.

The study was to be presented Tuesday at the annual meeting of the American Academy of Neurology, in Boston. Studies released at medical conferences are typically considered preliminary until published in peer-reviewed journals.

SOURCES: James Noble, M.D., assistant professor, neurology, and Cecilia Davis-Hayes, medical student, Columbia University Medical Center, New York City; Steven Broglio, Ph.D., director, NeuroTrauma Research Laboratory, and concussion lead, University of Michigan Injury Center, Ann Arbor; Feb. 28, 2017, American Academy of Neurology meeting, Boston

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Concussions More Likely in Female Athletes