Medical News Today: ADHD and Schizophrenia: Similarities and Differences

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Medical News Today: STIs: The perils of pubic preening investigated

As fashions ebb and flow, the free pubic growth of the 1970s has fallen from favor. Today sees many more individuals grooming and shaving their pubic region than ever before; new research asks whether this is a healthful shift in habits.
[Hands during sex]
With pubic grooming on the rise, could we see a spike in STIs?



Worldwide, pubic hair removal is becoming more prevalent in both men and women.


This shift appears to be due to perceptions of attractiveness, feelings of masculinity and femininity, and cleanliness.


Some smaller studies have shown a link between pubic grooming and sexually transmitted infections (STIs), but nothing has been carried out on a large scale.


Researchers from a number of American universities recently set out to better understand the effect, if any, that pubic grooming has on an individual’s susceptibility to STIs.


The team asked a nationally representative sample of American adults about their intimate grooming habits and their history of STIs. The results are published today in the journal Sexually Transmitted Infections.

Data on intimate grooming


In total, more than 14,000 people aged 18-65 were polled (56 percent were men). The questionnaire asked about the intensity of grooming – whether it was a trim or complete removal, and frequency – on a scale from daily to annually. They also asked about the types of tools used – wet shave or electric razor, for instance.


People who removed all of their pubic hair more than 11 times each year were classified as “extreme” groomers, and those who trimmed their pubic hair daily or weekly were classed as “high frequency” groomers.


The questionnaires also asked participants about their sexual history – 7,470 of the respondents had had at least one sexual partner.


In total, 74 percent of participants had groomed their hair (84 percent women, 66 percent men). Of the 74 percent, 17 percent were classified as “extreme,” and 22 percent were “high frequency.” Ten percent of groomers fell into both categories.




Groomers, in general, tended to be younger, more sexually active, and have had more sexual partners throughout their lives.


Most commonly, an electric razor was the tool of choice among men (42 percent), and a manual razor was most common among women (61 percent). Roughly 20 percent of women and men used scissors.


At least one STI was reported by 943 respondents (13 percent). The STIs that were quantified included molluscum (a viral infection affecting the skin), syphilis, HPV, chlamydia, gonorrhea, and pubic lice.

Examining the effects of private grooming


The investigators controlled for age and number of sexual partners to observe whether the act of grooming itself would have a significant effect on STI infection. Once they had controlled for these variables, they found that any type of grooming was associated with an 80 percent increase in the risk of having one STI, compared with no grooming.


Beyond this, intensity and frequency appeared to play a part. For high frequency and extreme groomers, there was a 3.5- to 4-fold increase in risk. This risk was particularly pronounced for infections that require skin-to-skin contact, such as herpes and HPV.


The researchers theorize that, during grooming, small tears in the skin might occur that could allow bacteria and viruses to enter the body with more ease.


On the other side of the fence, low-intensity and low-frequency grooming were associated with a doubling in the risk of lice infestation. It seems a reasonable conclusion to draw that grooming might make it more difficult for lice to breed.


Because the study is observational, it is not possible to prove cause and effect. However, because the act of shaving pubic hair is sometimes considered a way to prepare for a sexual encounter, whether the link is causal or statistical, the findings may be useful for building strategies to reduce STI rates.


As the authors write:

“Irrespective of the ultimate underlying mechanisms, we believe that a better understanding of the relation between grooming and STIs may be useful for STI risk reduction. For instance, if our positive findings reflect a statistical correlation between grooming and STI acquisition, this information could be used to target STI risk prevention.”


There are a number of other details that could not be picked out of the data; for instance, the questionnaire did not gather information regarding safe sex practices and risky sexual behaviors.


Although further work is necessary, the large sample used in the current trial gives validity to the findings.


More studies will be needed to fill in the blanks as far as pubic topiary is concerned. For now, clinicians who spot signs of grooming may begin to recommend safer sex practices and delaying sex until skin has healed.


Learn how men’s sex drive could be boosted with light therapy.

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Medical News Today: Is smoking ever safe? Study investigates

Most people would agree that smoking is harmful, but many of us think smoking just a little bit is not that dangerous. New research suggests there is no such thing as safe smoking, with low-intensity smoking significantly increasing the risk of premature death.
[cigarette in ashtray]
New study investigates the harm in smoking as little as one cigarette a day.



With the help of public awareness campaigns, the negative health effects of smoking have become widely acknowledged.



Smoking causes a variety of diseases affecting almost every organ in the human body, making it the leading cause of death worldwide.



The Centers for Disease Control and Prevention (CDC) report that every year almost 6 million people die from a smoking-related disease, and in the United States alone, smoking accounts for 480,000 yearly deaths.



While most people will be convinced of the harmful effects of heavy smoking, not as many are aware that even an average of one cigarette a day may cause significant damage to our health.



A new study investigates the health risks involved in low-intensity smoking.



Studying the risk of early death in low-intensity smokers




Researchers from the National Cancer Institute (NCI) analyzed over 290,000 adults in the NIH-AARP Diet and Health Study.


The team – led by Maki Inoue-Choi, Ph.D., Division of Cancer Epidemiology and Genetics from the NCI – defined low-intensity smoking as 10 or fewer cigarettes per day. Study participants were between 59 and 82 years old at the beginning of the study.



Participants were asked to report on their lifetime smoking patterns. Questions were divided over nine periods of the participants’ life, ranging from before their 15th birthday to after the age of 70.



Of those who were current smokers, 159 reported smoking less than one cigarette per day throughout their smoking years. Almost 1,500 said they smoked between one and 10 cigarettes every day.



The results of the study were published in the journal JAMA Internal Medicine.



One cigarette a day or less increases death risk by 64 percent




The study revealed that even low-intensity smoking could pose serious health risks.



People who consistently smoked as little as one cigarette a day throughout their lives were still 64 percent more likely to die earlier than never smokers.



Those who smoked between one and 10 cigarettes a day had an 87 percent higher risk of dying earlier than never smokers.



Among former smokers, the risk of dying earlier was lower among those who used to be low-intensity smokers compared with those who were still smokers. The risk of premature death also decreased proportionally with the age when these smokers quit.



The research also revealed some interesting trends in specific causes of death. Researchers noticed a strong association with lung cancer.



Those who smoked an average of less than one cigarette per day over their lifetime were nine times more likely to die from lung cancer than non-smokers.


Additionally, those who smoked between one and 10 cigarettes a day had a 12 times higher risk of dying from lung cancer than never smokers.



Low-intensity smokers had a six times higher risk of developing respiratory diseases such as emphysema than never smokers. They were also almost one and a half times likelier to die of cardiovascular disease than non-smokers.




Study reinforces ‘no safe level of smoking’ health warnings



The overall negative health effects of smoking are well known, and public awareness of the risks has led to a ban on smoking in public places.



A historical analysis of public awareness reveals that between 1949 and 1981, the proportion of smokers who believe smoking to be harmful rose from 0.52 in 1949 to 0.81 in 1981.



However, many smokers continue to think that smoking a small number of cigarettes every day does not pose any health risks at all.


In fact, a recent study of over 1,600 French smokers and non-smokers revealed that over 34 percent of the respondents think up to 10 cigarettes a day does not increase the risk of lung cancer.



In this context, the NCI study is a much-needed reminder that even smoking a small number of cigarettes is significantly harmful to one’s health.



“The results of this study support health warnings that there is no safe level of exposure to tobacco smoke. Together, these findings indicate that smoking even a small number of cigarettes per day has substantial negative health effects and provide further evidence that smoking cessation benefits all smokers, regardless of how few cigarettes they smoke.”

Maki Inoue-Choi, lead author of the study






Strengths and limitations of the study




As the study relied on the participants’ ability to self-report, the findings are more susceptible to recall bias, making the results less certain.


Additionally, while the study sample was in itself large, the actual number of low-intensity smokers who had been consistent over their lifetime was small.



Also, participants were predominantly white and in their 60s and 70s, which limits the findings to a particular age and racial group of Americans.



The authors point out that historically, low-intensity smoking has been associated with minorities in the U.S., so future studies would need to focus on other racial and ethnic groups, as well as on younger participants.


The scientists also lacked data on more detailed smoking patterns, such as the smoking frequency among low-intensity smokers. Therefore, they could not examine whether smoking every other day, every few days, or weekly had a significant impact on health risks.

Learn how the heart attack risk is over eight times higher for younger smokers.

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Medical News Today: Brain thinks yo-yo dieting is a famine, causing weight gain


We are in the height of holiday season, when chocolate, cakes, and calorie-laden foods are in abundance. But after the feast has commenced, you may want to think twice before going on a low-calorie diet. According to new research, the brain interprets repeated dieting as short famines, prompting the body to store more fat for future food shortages – resulting in weight gain.
[Scales]
Yo-yo dieting may trick the brain into thinking it is in the midst of famine, prompting the body to store fat and, ultimately, gain weight.


The study, published in the journal Evolution, Medicine and Public Health, was led by Prof. Andrew Higginson, from the University of Exeter, and Prof. John McNamara, of the University of Bristol, both in the United Kingdom.


Keeping weight in check is a health benefit; compared with people of a healthy weight, people who are obese are at increased risk for many diseases.


For instance, the risk of high blood pressure, type 2 diabetes, coronary heart disease, and stroke are all higher in the obese population.


More than one-third of adults in the United States are obese, so keeping weight at a healthy level is a major priority from a public health perspective.


Although shedding holiday pounds may be a popular focus for many of us in January, the Centers for Disease Control and Prevention (CDC), say that people who lose weight gradually – about 1-2 pounds per week – are more successful at keeping the weight off.

‘Weight gain for dieters greater than for non-dieters’


Previous studies have investigated the negative health effects of yo-yo dieting. One study recently presented by the American Heart Association suggested that yo-yo dieting increases the risk of heart disease death.


For the latest study on yo-yo dieting, the researchers utilized a mathematical model of animals – such as birds – that knows when food is in abundance or is scarce but does not know when the situation will change.


The researchers note that animals respond to food shortages by storing energy and gaining weight.


Their model demonstrates that when food is in short supply – much like during a phase of dieting – an efficient animal will gain excess weight between periods of food shortage.


“Surprisingly,” says Prof. Higginson, “our model predicts that the average weight gain for dieters will actually be greater than those who never diet. This happens because non-dieters learn that the food supply is reliable so there is less need for the insurance of fat stores.”


Prof. McNamara adds that their model “shows that weight gain does not mean people’s physiology is malfunctioning or that they are being overwhelmed by unnaturally sweet tastes.”


It could be that their brain is working normally, “but uncertainty about the food supply triggers the evolved response to gain weight,” he adds.

‘Best thing for weight loss is to take it steady’


The researchers say their model shows that the desire to eat increases as a diet continues, and this desire will not go away as weight is gained. This is because the brain thinks that further famines are likely.


The model may explain why many people get into a cycle of weight gain in the wake of increasingly restrictive diets; it only serves to communicate to the brain that it must store fat.


For those of us who over-indulge during the holiday season, however, what is the best way to lose weight?


“The best thing for weight loss is to take it steady. Our work suggests that eating only slightly less than you should, all the time, and doing physical exercise is much more likely to help you reach a healthy weight than going on low-calorie diets.”

Prof. Andrew Higginson, University of Exeter


The CDC offer some good advice for healthy weight loss. Because 1 pound equals 3,500 calories, they recommend reducing caloric intake by 500-1,000 calories per day to lose 1-2 pounds per week.


Once a healthy weight is achieved, the CDC say to rely on healthful eating and physical activity most days of the week to keep the weight off over the long term.


Even a modest weight loss will confer health benefits, such as improvements in blood pressure, blood cholesterol, and blood sugars, the organization adds.


Read how yo-yo dieting may be caused by altered gut microbes.

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Medical News Today: Cancer: Molecular insights into anti-tumor effects of diabetes drug

Researchers have uncovered a previously unknown molecular mechanism that works at the cell level to help protect the epithelial tissue that lines various body cavities and organs in the body. The discovery may help explain why the widely prescribed diabetes drug metformin appears to preserve the epithelial barrier’s ability to ward off infection, resist inflammation, and suppress tumors.
tumor
The researchers suggest their findings help explain how the diabetes drug metformin helps suppress tumor formation in epithelium tissue.


The team – from the University of California-San Diego School of Medicine – reports the findings in the journal eLife.


The study concerns cells of the epithelium, one of the four main tissue types of the human body – the others are connective, muscle, and nerve tissue. The epithelium lines various cavities and organs and covers flat surfaces.


There is a feature common to nearly all cells called polarity – the asymmetric organization of internal components and shape.


Without this “knowing which way is up” feature, epithelial cells cannot carry out specialized functions, such as maintaining a protective barrier against toxins, disease-causing agents, and triggers of inflammation.


Loss of epithelial cell polarity can cause a breach in the barrier that leads to organ dysfunction and development of tumors.


The new study identifies a previously unknown mechanism that helps strengthen the structure and tight junctions between epithelial cells so they can maintain the barrier.


Metformin activates LKB1-AMPK stress-polarity pathway


Previous studies have shown that the widely prescribed diabetes drug metformin helps preserve the epithelial barrier’s ability to resist stressors such as inflammation, sepsis, low oxygen (hypoxia), and harmful microbes. It also appears to help the barrier suppress tumors.


Other studies published some 10 years ago also uncovered a “stress-polarity” pathway that is only activated when the epithelial cells come under stress.


The pathway is switched on when an enzyme called AMPK – that protects cellular polarity under conditions of stress – is triggered by a tumor suppressor molecule called LKB1.


Senior author Pradipta Ghosh, professor in the departments of Medicine and Cellular and Molecular Medicine, describes LKB1 as a “bona fide tumor suppressor,” mutations in which have been linked to cancers and loss of cell polarity.


For the past 10 years, the question of how the energy-sensing LKB1-AMPK pathway maintains cell polarity during stress has remained unanswered.


However, in the meantime, it has come to light that metformin – a front-line treatment for type 2 diabetes – is an activator of the LKB1-AMPK pathway.


Metformin acts via GIV phosphorylation


In their new study, Prof. Ghosh and colleagues investigated the mechanisms involved in the tumor-suppressive effect of metformin on the LKB1-AMPK pathway.


They discovered that the pathway depends on a key effector – a triggering molecule – of AMPK, a protein called GIV/Girdin.


GIV/Girdin is itself activated by a process called “phosphorylating” (the chemical addition of a phosphate group).


Using cultured polarized epithelial cells, the team showed much of the beneficial effect of metformin on AMPK occurred via phosphorylating GIV and directing it to the tight junctions of the epithelial layer.


In another set of experiments, the researchers found the beneficial effects of metformin activating AMPK virtually disappeared in the absence of GIV phosphorylation. This also resulted in a “leaky” epithelial barrier that eventually collapsed.


Finally, the researchers showed that mutant forms of GIV found in colon cancer that prevent its phosphorylation by AMPK led to tumor cell growth.




“In summary, by identifying GIV/Girdin as a key layer within the stress-polarity pathway we’ve peeled another layer of the proverbial onion. In the process, we’ve provided new insights into the epithelium-protecting and tumor-suppressive actions of one of the most widely prescribed drugs, metformin, which may inspire a fresh look and better designed studies to fully evaluate the benefits of this relatively cheap medication.”

Prof. Pradipta Ghosh




Discover how targeting a protein may reverse insulin resistance.




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Medical News Today: What Does a Psoriasis Rash Look Like?

MNT Knowledge Center

Psoriasis is a life-long skin disorder that causes rashes. While not contagious, psoriasis rashes are frequently itchy and painful. The most common type, plaque psoriasis, starts out as small red bumps that grow larger and form a scale.


Scratching the rash can pull scales off the skin and cause bleeding. As the rash spreads, bumpy red and silvery-scaled patches on the skin can develop.


Psoriasis can take hold anywhere on the body where there is skin. It is most often found on the knees and elbows, or on the scalp.



Types of psoriasis


There are several different types of psoriasis.

[plaque psoriasis]
Plaque psoriasis is the most common type of psoriasis.

Plaque psoriasis


This is the most common form. According to the American Academy of Dermatology, 80 percent of the 7.5 million Americans with psoriasis have this form.


It usually produces red patches of plaque, with a silvery-white coating of scale. It commonly appears on the scalp, the lower back, the elbows, and the knees. The patches can be sore and itchy, and they can get thicker if scratched.


Finger and toenails may also develop pits, or they may crumble or fall off.

Pustular psoriasis


Pustular psoriasis gives rise to painful, pus-filled bumps that are usually found on the palms of the hands and the soles of the feet. The skin surrounding the bumps is swollen and red.


When the bumps dry, they leave behind brown spots that may be covered with scale. Individuals with this condition may also develop a fever, chills, weak muscles, little appetite, extensive itching, and tiredness.

Inverse psoriasis


This form only appears in areas where skin is in contact with skin, or skin folds, including the armpits, behind the knees, the groin, the buttocks, the genitals, and under the breasts. The skin is very red, shiny, raw, and sore.

Guttate psoriasis


This form often develops after an illness, like strep throat.


Guttate psoriasis is identified by small red spots that form all over the body, most often on the chest, legs, and arms.


Found in about 10 percent of people with psoriasis, according to the National Psoriasis Foundation, guttate psoriasis can affect children and young adults, as well as those somewhat older.

Erythrodermic psoriasis


Erythrodermic psoriasis is a rare and very serious condition. Individuals who develop symptoms should seek medical treatment immediately.


With the skin turning red, this condition looks like a burn over most or all the body. It is accompanied by intense pain and itching and a very rapid heartbeat.


Individuals may feel very hot or very cold, because it is not possible for the body to maintain a stable temperature.


Symptoms and complications


Psoriasis affects individuals in different ways, and it can take multiple forms, but people with all types of psoriasis typically have at least one of the following symptoms:

[guttate psoriasis]
Guttate psoriasis can occur after a strep infection.

  • Itchy, sore, or burning patches on the skin
  • Red patches of skin, with silvery spots
  • Small red spots on the skin
  • Dry, cracked skin
  • Changes in the nails
  • Swollen joints.


Most forms of psoriasis typically go through phases. Symptoms may become more severe for an extended period of time, and then improve or disappear.


The following factors can trigger a flare-up of psoriasis:

  • Skin injury
  • Infections
  • Medications such as lithium, beta-blockers, iodides, and antimalarials
  • Stress
  • Cold temperatures
  • Exposure to smoke
  • Heavy use of alcohol.


Psoriasis is a life-long condition, but it can usually be managed effectively with over-the-counter treatments and medication.


However, it is also linked to the following complications:

  • Psoriatic arthritis can develop in about 30 percent of people with psoriasis, and it often affects the joints closest to the fingernails and toenails
  • Cardiovascular disease may be linked to severe cases of psoriasis
  • Onychomycosis is a fungal infection experienced by around one third of those with psoriasis. It makes the nails grow thicker.


Psoriasis also seems to increase the risk of developing other serious health conditions. These include other autoimmune diseases, depression, kidney problems, and Parkinson’s disease.


How can rashes differ in severity and in different areas?


Psoriasis on the face can be challenging. The skin is very sensitive in this area, as are the eyes, so great care should be taken with treatment, even with mild cortisone creams.


Psoriasis may also develop on the eyes, in the ears, and around the mouth and nose.


When the hands and feet are affected, swelling, blisters, and cracking may follow. Prompt and cautious treatment is recommended. Phototherapy, combined with medication, may be an effective treatment.


With more severe cases, such as those involving pustular psoriasis, a biologic drug may be used.


About half of all individuals with psoriasis develop problems with their nails.

[nail psoriasis]
Nail psoriasis can cause the fingernails or toenails to crumble and break off.


These can include:

  • Changes in the shape or color
  • Thickening or developing holes
  • Separation of the nail from the nail bed.


Psoriasis on the scalp ranges from the mild to the severe. Plaque lesions may grow beyond the boundary of the hairline to reach the ears, forehead, and the neck.


The National Psoriasis Foundation report that close to 50 percent of individuals living with psoriasis develop sores at this location.


Psoriasis in the genital area affects some of the body’s most sensitive skin, so particular care needs to be taken with treatment.


This is usually caused by the inverse variety of psoriasis, so it is not scaly but it can result in tender, sensitive skin.


How to tell a psoriasis rash from different kinds of rash


Eczema, another skin disorder that causes itching and discomfort, can be mistaken for psoriasis, but in a biopsy, skin affected by psoriasis will look thicker and redder than skin affected by eczema.


Shingles, a rash caused by the same virus that causes chicken pox, forms itchy, painful blisters on one side of the body. One notable difference with psoriasis is that the area where the rash develops will often feel uncomfortable before the rash appears.


Heat rash can cause itchy red blisters in skin folds. It may at times be confused with psoriasis. Physicians can make an appropriate diagnosis with a simple examination.

Other conditions that cause similar-looking rashes


The following conditions also resemble psoriasis:

  • Lichen planus can appear on the skin as reddish bumps, or as white dots in the mouth
  • Pityriasis rosea starts with a “herald patch” on the trunk, with smaller itchy patches spreading across the body in a shape frequently described as resembling a pine tree
  • Ringworm, caused by a fungus, forms a circle-shaped itchy red rash
  • Seborrheic dermatitis is an itchy, red skin condition usually found on the scalp and other oily areas of the body.

When to see a doctor


People should see a doctor if a skin rash lasts longer than a few days, if it interferes with their quality of life, or if there are other symptoms, such as a fever.


Treatments and home remedies


Various treatments are available for psoriasis. Treatment decisions are based on the form of psoriasis, the location of the rash, the severity, and its impact on the individual.


The most common approaches include:

  • Exposure to sunlight
  • Soaking with bath oils or tar solutions
  • Using moisturizers to keep the skin from cracking
  • Covering rash areas
  • Rest
  • Lotions and creams, such as coal tar ointments, topical steroids, and compounds based on vitamin D or vitamin A
  • Light therapy
  • Oral medications
  • Injected medications.


Individuals sometimes use superglue to manage deep cracks in the feet due to psoriasis. Patients should check with a doctor first, to make sure this action would be safe, and that the patient is not allergic.





Causes of psoriasis


While work on identifying the specific cause of psoriasis is ongoing, researchers believe it is linked to autoimmune problems. These are where the body’s signals get confused and the body starts attacking itself.


Typically, in a process called turnover, skin cells move up to the surface to mature over a 30-day period. For people with psoriasis, this process only takes a few days. This results in immature skin cells piling up on the surface of the skin.


The National Psoriasis Foundation report that 1 in 3 people who have psoriasis also have a family member with the condition, which suggests the condition is linked to genetics. However, not everyone related to someone with psoriasis will develop it.

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Medical News Today: Back pain may raise risk of mental health problems

A study, involving almost 200,000 participants, finds that individuals who have back pain are more likely to also experience a range of mental health issues. Knowing about these links could form a more successful treatment plan for both sets of conditions.
[Man with back pain illustration]
According to recent findings, back pain and mental health are deeply linked.



Back pain is a leading cause of disability across the globe. In fact, it causes more global disability than any other condition.


According to the Global Burden of Disease study, lower back pain affects almost 1 in 10 people.


There is also a wealth of evidence that back pain negatively impacts quality of life and heightens the risk of other physical health problems. Additionally, it comes with substantial healthcare cost.


One earlier study of note used data from the World Mental Health Survey and found that chronic back or neck pain was associated with increased risk for mood disorders, alcohol abuse, and anxiety disorders.


Despite its high prevalence, little work has been done to investigate back pain’s links with mental health outcomes in low- and middle-income countries (LMICs).

The largest back pain-mental health study to date


The latest and largest study to investigate the connections between back pain and psychological illness in LMICs was published this week in the journal General Hospital Psychiatry.


The research team – headed up by Prof. Patricia Schofield and Dr. Brendon Stubbs from Anglia Ruskin University in the United Kingdom – took data from 190,595 individuals aged 18 or older across 43 countries, making it the largest study of its type. Of the 43 countries, 19 were low-income and 24 were middle-income.


The team used data from the World Health Survey 2002-2004, a project set up by the World Health Organization (WHO) to “generate information on the health of adult populations and health systems.”


Overall, in LMICs, back pain affected 35.1 percent of the population, and 6.9 percent reported chronic back pain. Of the countries investigated, China’s levels of back pain were lowest, at 13.7 percent.


In some countries, more than half of respondents reported back pain; Nepal was highest with 57.1 percent. Similarly, 53.1 percent of Bangladeshis reported back pain, as well as 52 percent of people from Brazil.

Back pain and mental health


The analysis of the questionnaire data showed that, when compared with people without back pain, those who did experience back pain were more than twice as likely to experience one of five mental health conditions – anxiety, depression, psychosis, stress, and sleep deprivation.


People with chronic back pain were also three times more likely to experience a depressive episode and 2.6 times more likely to experience psychosis.


Interestingly, the results were relatively similar across all 43 LMICs, regardless of their standing on the socioeconomic ladder.

“Our data shows that both back pain and chronic back pain are associated with an increased likelihood of depression, psychosis, anxiety, stress, and sleep disturbances.


This suggests that back pain has important mental health implications which may make recovery from back pain more challenging. The exact reasons for this are yet to be established.”

Dr. Stubbs


Because the study used such a large group of people across a section of populations, the findings can be considered highly reliable. As back pain is so prevalent in LMICs (and the world at large), any connection to mental health needs to be thoroughly understood.


As Dr. Stubbs says:


“Further research is required to find out more about the links between these problems and to ensure effective treatments can be developed. It is also important that healthcare professionals are made aware of this link to refer patients to other services if necessary.”


Learn how motor control exercise may help lower back pain.

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Medical News Today: Tai Chi may benefit veterans with PTSD

Around 7 to 8 percent of Americans will experience post-traumatic stress disorder in their lifetime, and the condition is even more common among veterans, affecting around 23 percent of those involved in recent conflicts. According to a new study, the ancient Chinese exercise Tai Chi could help veterans manage symptoms of post-traumatic stress.
[Adults practicing Tai Chi]
Researchers say Tai Chi may be beneficial for veterans who have PTSD.


Study co-author Barbara Niles, Ph.D., assistant professor of psychiatry at Boston University School of Medicine in Massachusetts, and colleagues recently reported their findings in BMJ Open.


Post-traumatic stress disorder (PTSD) is a mental health condition that can arise after experiencing or witnessing a shocking or frightening event.


Because veterans have been exposed to highly traumatic events more often than the general population, their rates of PTSD are much higher. According to the U.S. Department of Veterans Affairs, around 30 percent of veterans who served in the Vietnam War have experienced PTSD at some point in their lives.


Symptoms of PTSD include flashbacks of the traumatic event, nightmares, negative emotions, and avoidance of situations that trigger memories of the event. Some individuals may also experience anxiety, depression, physical symptoms – such as chronic pain – and alcohol or drug abuse.


Treatment for PTSD often includes a combination of medication and behavioral therapy. However, these treatments are not always effective.


Now, Niles and colleagues say Tai Chi has the potential to offer significant benefits for veterans with PTSD.

Veterans enrolled to four weekly Tai Chi sessions


Originating from China, Tai Chi is a gentle form of exercise that incorporates slow movements, breathing, and meditation.


Previous studies have documented the numerous health benefits of Tai Chi, which include improved muscle strength, increased energy, reduced inflammation, and better heart health.


Research has also associated Tai Chi with better mental health, such as reduced anxiety and depression.


According to Niles and team, few studies have investigated whether Tai Chi might help individuals with PTSD, although research has demonstrated the benefits of other mind-body practices – such as yoga – for the disorder.


With this in mind, the researchers enrolled 17 veterans – 11 males and 6 females – with symptoms of PTSD to take part in an introductory Tai Chi program, which involved four once-weekly sessions over 4 weeks.


Each session involved a warm-up – including a self-massage and a review of Tai Chi principles – Tai Chi movement, and breathing and relaxation. During the 4-week period, subjects were also encouraged to practice Tai Chi at home for at least 30 minutes daily.


After the final Tai Chi session, each veteran completed a questionnaire that asked them how satisfied they were with the Tai Chi program, whether they would like to take part in future Tai Chi programs, and whether they felt it helped manage their issues.

Positive findings should spur additional research


The vast majority of veterans – 93.8 percent – said they were mostly or very satisfied with the introductory Tai Chi program and would rate the program as “excellent” or “good.”


Importantly, 68.8 percent of the veterans said that the Tai Chi program “helped them deal more effectively with their problems,” and all subjects said they would take part in Tai Chi again if offered.


The researchers note that the study sample size was small, and some of the participants only reported mild symptoms of PTSD, meaning their results may not apply to larger populations of veterans with the disorder.


Still, the team says the results provide “evidence for the feasibility of enrolling and engaging veterans with symptoms of PTSD in a Tai Chi exercise program,” adding:

“Veterans were very satisfied with their Tai Chi experience and they indicated both willingness and a preference for additional sessions. Given these positive findings, additional research is needed to empirically evaluate Tai Chi as a treatment for symptoms of PTSD.”


Read how Tai Chi may boost health and well-being for people with cardiovascular disease.

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Medical News Today: Erythroblastosis Fetalis: Causes, Symptoms, and Treatment

MNT Knowledge Center

Erythroblastosis fetalis, also known as hemolytic anemia, is a serious medical condition that most commonly results from maternal-fetal blood type (Rh factor) incompatibility.


Rh factor is an inherited protein, found on the surface of red blood cells. Not everyone has this protein.


If a person has the protein, they are Rh positive. Those who do not have the Rh protein are Rh negative.


Rh factor positivity is very common. If a woman who is Rh negative and a father who is Rh positive conceive a child, the fetus may be Rh positive. This can lead to Rh incompatibility and pregnancy complications.


The first pregnancy is not normally affected, but future pregnancies may be compromised.




When can incompatibility cause problems?


Sometimes, the blood supply from the mother mixes with the blood of the fetus during pregnancy. Even if small amounts of the mother’s blood are mixed with the blood of the fetus, problems can arise.

[blood vessel]
Rhesus incompatibility between parents can lead to complications in offspring.


The blood could mix as a result of:

  • The placenta becoming detached from the wall of the uterus wall during delivery
  • Bleeding during pregnancy
  • Manual rotation of a breech baby
  • Abortion
  • Ectopic pregnancy
  • Miscarriage
  • A fall, blunt trauma, or invasive prenatal testing.


Prenatal tests, such as an amniocentesis or chorionic villus sampling, may place a mother with Rh-negative blood at risk for mixing her baby’s potentially Rh-positive blood with her own.


If this happens, an immune response known as Rh sensitization may occur in the mother.


This means that the mother will recognize future Rh-positive cells as foreign and her immune system will attack them.


Her body will produce antibodies to fight future exposure to Rh factor, including the blood of her fetus. This can result in the fetus’ red blood cells being destroyed.


The antibodies can also be produced after Rh positive blood needle contamination or a blood transfusion with Rh-positive blood.

Erythroblastosis fetalis destroys red blood cells


The result is red blood cell destruction, known as erythroblastosis fetalis during pregnancy.


Destruction of the red blood cells in the fetus can be rapid. As a result, the fetus will not receive enough oxygen. Illness or death may result.


The anemic fetus’ body will attempt to produce red blood cells rapidly. This can result in liver and spleen enlargement. In addition, these rapidly-produced red blood cells are often immature. They are not yet able to function properly.


When this condition is present in the newborn, it is called hemolytic disease of the newborn. It can lead to the inability to break down and excrete the red blood cells.


As a result, there will be high levels of bilirubin, a by-product of red blood cell breakdown. The excess circulating bilirubin will lead to jaundice, and the infant will appear yellow in color.


Rh incompatibility is the most common cause of the condition, but it is not the only cause. Other causes include other antigen system incompatibilities.


Caucasian infants are more likely to develop erythroblastosis fetalis than African-American infants. The risk is also higher in pregnancies if Rh sensitization has already taken place during a first pregnancy.



It is important to note that having a different blood type than the fetus is not a cause of erythroblastosis fetalis or hemolytic anemia in the newborn.


Symptoms of erythroblastosis fetalis


During pregnancy, the fetus may display certain symptoms.


These include:

  • Yellow amniotic fluid with the presence of bilirubin, seen on an amniocentesis
  • An enlarged liver, spleen, or heart
  • Buildup of fluid in the abdomen, lungs, or scalp, detectable through an ultrasound scan during pregnancy.


Newborns born with the condition may display symptoms such as:

  • Pale skin
  • Yellow amniotic fluid, umbilical cord, skin, or eyes, either at birth or within 24 to 36 hours following delivery
  • Spleen or liver enlargement
  • Hydrops fetalis, marked by breathing difficulties and full body fluid buildup.

Complications


Complications experienced by the fetus may include:

  • Mild to severe anemia
  • Raised bilirubin levels
  • Jaundice, or yellowing of the skin
  • Severe anemia accompanied by liver and spleen enlargement.


Excessive fluid can accumulate in fetal tissues and organs as a result of heart failure. This is referred to as hydrops fetalis, and it is a life-threatening condition. Infants with this condition may be stillborn.


Complications in the newborn may include:

  • Severely high levels of bilirubin, with accompanying jaundice
  • Anemia
  • Liver enlargement.


Excessive buildup of bilirubin in the brain can lead to seizures, brain damage, deafness, or death. This is referred to as kernicterus.



Diagnosis and treatment


The first step in diagnosing erythroblastosis fetalis is to determine if there is Rh incompatibility and maternal antibody titers.

[blood testing]
Rhesus factor testing for parents can indicate a potential risk.


This is done by using an antibody screening test in the first trimester. It may be repeated at 28 weeks of gestation. Paternal Rh factor testing may be recommended.


To diagnose the condition, it is important to know if there is Rh incompatibility, specifically during pregnancy.


Testing for the fetus may include ultrasound, amniocentesis, fetal middle cerebral artery blood flow measurement, and fetal umbilical cord blood testing.


In the newborn, blood tests can be carried out to check for hemolytic anemia.


These will include an evaluation of the:

  • Blood group and Rh factor
  • Red blood cell count
  • Antibodies and bilirubin levels.


Treatment of erythroblastosis fetalis during pregnancy may include a fetal blood transfusion and delivery of the fetus between 32 and 37 weeks gestation.


Treatment options for newborns with the condition include:

  • Blood transfusion
  • Intravenous fluids
  • Management of respiratory difficulties
  • Use of intravenous immunoglobulin (IVIG).


The goal of IVIG antibody therapy is to reduce red blood cell breakdown and levels of circulating bilirubin.


Sometimes, an exchange transfusion is necessary. This type of transfusion requires small amounts of the newborn’s blood to be removed and replaced by fresh blood. The goal is to increase the presence and number of red blood cells and to lower bilirubin levels.






Prevention of erythroblastosis fetalis


Rh sensitization can be prevented by giving a medication called Rh immunoglobulin (RhIg), also known as RhoGAM, before a woman becomes sensitized.


This medication prevents the mother from developing antibodies. However, it is not beneficial to women who have already experienced Rh sensitization.


It is recommended that women at risk for Rh sensitization be given RhoGAM at certain times during their pregnancy and after delivery.


These include:

  • At 28 weeks of gestation
  • At 72 hours following delivery, if the newborn is confirmed to be Rh positive
  • Within 72 hours of a miscarriage, abortion, or ectopic pregnancy
  • Following an invasive prenatal test such as an amniocentesis or chorionic villus sampling
  • Following any vaginal bleeding.


If a woman carries beyond 40 weeks of gestation, an additional dose of RhoGAM may be recommended.

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Medical News Today: Why you should never go to sleep on an argument

 Never go to bed on an argument,” so the saying goes. And according to a new study, we should take note of this age-old advice. Researchers have found that going to sleep while still holding on to negative memories can make it harder to suppress them.
[A couple in bed after an argument]
It might be best not to go to sleep on an argument; it could make those bad memories harder to suppress.


Study co-author Yunzhe Liu, of the Institute for Brain Research at Beijing Normal University in China, and colleagues report their findings in the journal Nature Communications.


In recent years, neuroscientists have learned just how important sleep is for learning and memory.


A study reported by Medical News Today earlier this year, for example, uncovered evidence that rapid eye movement (REM) sleep – the cycle of sleep in which dreams occur – is essential for memory consolidation, the process by which information is transferred from short-term to long-term memory.


However, there are some memories we would rather not hold on to, such as those of a traumatic event. While bad memories may never be fully eradicated, studies suggest we are able to voluntarily suppress them to some extent in order to cope with trauma.


“A failure to suppress unwanted memories has been linked to symptoms in a number of psychiatric disorders including the ruminative state found in depression and intrusive memories in post-traumatic stress disorder (PTSD),” note Liu and colleagues.


They add that over time, emotional memories can become increasingly resistant to suppression, which they speculate is down to memory consolidation during sleep.


“However, it remains unknown how consolidation impacts the effectiveness of voluntary suppression of unwanted emotional memories,” say the authors.


With a view to finding out, Liu and colleagues enrolled 73 male college students and asked them to take part in a number of memory suppression tasks over 2 days.

Bad memories harder to suppress after sleep


First, subjects were required to learn associations between faces and aversive images, so that when they were reintroduced to each face, memories of the aversive image would arise.


Participants were presented with the faces again – both 30 minutes and 24 hours after learning the associations – and told to suppress any negative memories that came to mind.


During this experiment – called the “Think/No Think” task – participants’ brain activity was monitored using functional magnetic resonance imaging (fMRI).


The researchers found that when presented with the faces 24 hours after the learning task – after having had a good night’s sleep in between – subjects were more likely to remember the aversive images than when they were presented with the faces 30 minutes after the learning task.


Subjects’ brain activity during the tasks may shed light on why it was easier to remember the aversive images after sleeping.


The team found that 30 minutes after the learning task, neural circuits involved in memory suppression were more active in the hippocampus – the brain region linked to learning and memory – while 24 hours after, this activity became widely distributed in the cortex, making bad memories harder to repress.


The authors explain:

“Our findings point towards a neurobiological model through which overnight consolidation assimilates aversive memories into more distributed neocortical representations, and makes these memories more resistant to suppression through the prefrontal-hippocampal inhibitory pathway.


Our study underlines the importance of memory consolidation in understanding the resistance to suppression of emotional memories, which is a cardinal feature of affective disorders.”


They add that information on how brain changes impact memory suppression could give physicians a better understanding of PTSD and other psychological disorders associated with bad memories.


All in all, Liu and colleagues believe there is some substance to the theory that one should not go to bed on an argument.


Talking to The Guardian, the researchers say: “We would suggest to first resolve [an] argument before going to bed; don’t sleep on your anger.”


Read how retrieval practice could help protect memory in stressful scenarios.

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