Category: Health

PARIS: Even if marriage is sometimes more a bed of nails than roses, living into old age with a partner may help ward off heart disease and stroke, researchers said Tuesday.

A sweeping survey of research conducted over the last two decades covering more than two million people aged 42 to 77 found that being hitched significantly reduced the risk of both maladies, they reported in the medical journal Heart.

The study examined ethnically varied populations in Europe, North America, the Middle East and Asia, adding weight to the results.

Compared to people living in spousal union, the divorced, widowed or never married were 42 per cent more likely to develop cardiovascular disease and 16 per cent more likely to have coronary heart disease, the study found.

The risk of dying was likewise elevated for the non-married, by 42 per cent from coronary heart disease and by 55 per cent from stroke.

The results were nearly the same for men and women, except for stroke, to which men were more susceptible.

“These findings may suggest that marital status should be considered in the risk assessment for cardiovascular disease,” concluded a team led by Chun Wai Wong, a researcher at Royal Stoke Hospital’s department of cardiology, in Stoke-on-Trent in Britain.

Four-fifths of all cardiovascular disease can be attributed to a proven set of “risk factors”: advanced age, being a man, high-blood pressure, high cholesterol, smoking, and diabetes.

Marriage, in other words, could be an important share of the missing 20 per cent.

More precisely, living together – with or without a wedding band – is probably the operative factor, if indeed conjugal status has any impact at all.

But most of the 34 studies reviewed by Wong and colleagues did not identify couples out of wedlock or same-sex unions, so it was not possible to know whether, statistically, such arrangements were the equivalent of being wed.

Because the study was observational rather than based on a controlled experiment – something scientists can do with mice but not humans – no clear conclusions could be drawn as to cause-and-effect.

That leaves open the question of why marriages may be “protective”.

“There are various theories,” the researchers said in a statement.

Having someone around to take care of one’s health problems and keep track of one’s meds is probably a plus, as are two incomes or pensions instead of one.

More intangibly, not living alone is thought to be good for morale, and for neural stimulation. People living in couples, earlier research has shown, also have lower rates of dementia. (AFP)

(Reuters) Many parents will have thought it for a long time, but they now have a new argument to limit their children’s ‘screen time’ — addiction to video games has been recognized by World Health Organization (WHO) as a mental health disorder.

The WHO’s latest reference bible of recognised and diagnosable diseases describes addiction to digital and video gaming as “a pattern of persistent or recurrent gaming behaviour” that becomes so extensive that it “takes precedence over other life interests”.

The International Classification of Diseases (ICD), which has been updated over the past 10 years, now covers 55,000 injuries, diseases and causes of death.

It forms a basis for the WHO and other experts to see and respond to trends in health.

“It enables us to understand so much about what makes people get sick and die, and to take action to prevent suffering and save lives,” WHO Director-General Tedros Adhanom Ghebreyesus said in a statement as the ICD was published.

The ICD is also used by health insurers whose reimbursements depend on ICD classifications.

This latest version — known as ICD-11 — is completely electronic for the first time, in an effort to make it more accessible to doctors and other health workers around the world.

ICD-11 also includes changes to sexual health classifications.

Previous editions had categorised sexual dysfunction and gender in-congruence, for example, under mental health conditions, while in ICD-11 these move to the sexual health section.

The latest edition also has a new chapter on traditional medicine.

The updated ICD is scheduled to be presented to WHO member states at their annual World Health Assembly in May 2019 for adoption in January 2022, the WHO said in a statement.

Monitoring Desk

More than 11 million Americans could be inadvertently taking the wrong heart medication. The trend reveals an even more problematic issue within American healthcare.

New research published this month in Annals of Internal Medicine found that risk calculations of people being assessed for atherosclerotic cardiovascular disease were off by, on average, 20 percent.

Black men in particular were at risk of being misestimated.

That means a significant number of patients could be over- or undertreated. This can be dangerous.

Overtreated people could be taking medication unnecessarily, subjecting themselves to potential side effects as well as throwing money away.

On the other hand, undertreated people are likely not receiving the proper treatment they actually need to prevent things like heart attack and stroke.

In the case of heart disease, there’s a sliding scale of treatment options, including aspirin, blood pressure medication, and statins. Researchers found that because a significant number of patients were considered to be at high risk through miscalculations, the number of people being recommended one or all of these therapies should likely be reduced.

The widespread use of statins among Americans is a hotly debated issue in particular. As researchers in the BMJ point out, the benefits of statins for people with a high risk of cardiovascular disease are undisputed. But for those with a lower risk, statin therapy could be unnecessary, even dangerous.

The problem, say researchers, lies in how risk is calculated for disease.

Risk calculators are commonplace in healthcare. They give doctors a simple measurement of health to help guide the risks and benefits of a medication therapy.

In fact, these calculators are now so easy to find, universities like Harvard even have them available on the internet for people at home to use. They work by feeding variable data into an equation — in this case, a Pooled Cohort Equation (PCE) — to assess a patient’s risk for a given outcome. Here, it’s heart disease.

Common variables for calculating risk of heart disease would include a person’s age, race, sex, height, weight, and health factors including family history, diabetes, and smoking.

Generally, risk calculators are a valuable tool for healthcare. But researchers found that when the data and the statistical analysis becomes outdated, risk estimates can be skewed, resulting in suboptimal care.

“The big message from [this research] is that the way we do these things needs to continue to evolve, and we need to continue to collect better data and do better calculations so that we can continue to improve the level of care,” said Dr. Charles Dinerstein, a senior fellow at the American Council on Science and Health.

Dinerstein compares the practice of keeping PCE and risk assessment guidelines up to date like any other infrastructure project.

“If we don’t do it, we’re going to wind up having a medical system that resembles our bridges that are in various levels of decay,” he said.

Current PCE guidelines were last updated in 2013. They’re updated by the National Institutes of Health, specifically the National Heart, Lung and Blood Institute.

However, what researchers discovered was that some of the data used even in these current guidelines was more than 60 years old.

According to senior author Dr. Sanjay Basu of Stanford University, one of the data sets used was based on people between the ages of 30 and 62 in 1948.

“A lot has changed in terms of diets, environments, and medical treatment since the 1940s,” Basu said in a statement. “So, relying on our grandparents’ data to make our treatment choices is probably not the best idea.”

Basu and his team found that by updating both the data sets and the PCE, risk estimates had improved accuracy.

Their research also found that if certain groups aren’t well represented in a data set, their risk assessment will likely be off.

In older data sets, African-Americans weren’t well represented, resulting in risk of heart attack and stroke being underestimated.

“So while many Americans were being recommended aggressive treatments that they may not have needed according to current guidelines, some Americans — particularly African-Americans — may have been given false reassurance and probably need to start treatment given our findings,” Basu said.

Women and other minority groups may also not be represented well in key data sets.

“Women present with heart attacks differently,” Dinerstein said. “For a long time, they were not part of any of the studies for a variety of reasons. So, their heart disease was largely ignored, because no one thought it was there.”

“If you’re not well represented in the study, there’s going to be some bias in the results,” he said.

Risk calculators serve as guidance to a doctor, but don’t dictate standard of care. Because they’re based on groups — and can be miscalculated, as illustrated by this new research — speaking with your doctor about your own individual needs is of utmost importance.

“As long as you have a conversation with your physician and can find out whether he’s working with the guidelines that are there and whether he agrees or disagrees with how you’re being treated within it, I think your needs are met,” Dinerstein said.

“The most personalized medicine you can get is having a conversation with your doctor.”

 

 

Monitoring Desk

NEW YORK: If you take Prilosec or Zantac for acid reflux, a beta blocker for high blood pressure, or Xanax for anxiety, you may be increasing your risk of depression.

More than 200 common medications sold in the U.S. include depression as a potential side effect. Sometimes, the risk stems from taking several drugs at the same time. Now, a new study finds people who take these medicines are, in fact, more likely to be depressed.

The list includes a wide range of commonly taken medications. Among them are certain types of proton pump inhibitors (PPIs) (used to treat acid reflux), beta blockers, anxiety drugs, painkillers including ibuprofen, ACE inhibitors (used to treat high blood pressure), and anti-convulsant drugs.

“The more of these medications you’re taking, the more likely you are to report depression,” says study author Mark Olfson, a professor of psychiatry at Columbia University.

The study, which was published Tuesday in the Journal of the American Medical Association, included 26,192 adults who participated in a federal survey, the National Health and Nutrition Examination Survey. All of the participants listed the medications they were taking at the time of the survey. In addition, they each completed a depression screening, the Patient Health Questionnaire (PHQ-9), which asks about sleep, mood and appetite.

More than a third of the people who took the survey were taking medications known to have depression or suicidal thoughts as potential side effects. Olfson and his collaborators wanted to determine whether those participants were more or less likely to be depressed, compared to participants who didn’t take any of these medications.

“What we found is that, in fact, they’re more likely,” Olfson says. And they found that people who took three or more of the medications were three times as likely to be depressed.

About 15 percent of participants who simultaneously used three or more of these drugs were depressed. By comparison, among participants who didn’t use any of the medications, just 5 percent were depressed. Even those who used just one of these medications were at slightly higher risk of depression: About 7 percent were depressed.

Olfson says the study does not prove that the medications caused the depression. “We’re just showing that if you’re already taking them, you are more likely to be depressed,” he says. To determine causation, he says, researchers would need to follow people over time — beginning at the time they start taking the medications — to see if they’re more likely to develop depression.

Nonetheless, Olfson says, he was surprised by the “strength of the association between the number of medications and the likelihood of being depressed.”

These findings may motivate people to ask their health care providers more questions. “People should always be ready to ask, ‘What are the risks and the benefits of me taking this medication?’ “says Don Mordecai, a psychiatrist with Kaiser Permanente in San Jose, Calif. And he says doctors should be ready to have these conversations, too.

Mordecai says, if you start a new medicine it can be helpful to keep track of changes in how you feel.

“People who don’t have a history of depression and then, suddenly, start to have symptoms of depression should be concerned that it’s potentially due to a side effect, or potentially, an interaction,” Mordecai says.

It’s also worth having a conversation with your doctor about whether you might be able to stop a medication, Mordecai says. For instance, it may be possible to go off — or reduce — a medication for high blood pressure if you make other changes “such as changing your diet, limiting salt intake, or increasing exercise.”

Use of medications with depression or suicidal thoughts as potential side effects has been on the rise, according to the study’s lead author, Dima Mazen Qato, an assistant professor at the College of Pharmacy of the University of Illinois, Chicago.

“People are not only increasingly using these medicines alone, but are increasingly using them simultaneously, yet very few of these drugs have warning labels, so until we have public or system-level solutions, it is left up to patients and health care professionals to be aware of the risks,” Qato wrote in a release about the study findings.

Qato says physicians may want to consider including evaluations of medications when they screen for depression.

“With depression as one of the leading causes of disability and increasing national suicide rates, we need to think innovatively about depression as a public health issue,” Qato writes. She suggests that one strategy to reduce depression rates might be for health care providers to give more thought to the role these medications might play in depression risk.

 

Monitoring Desk

ISLAMABAD:  Good teeth and gum care is an important part of maintaining overall health. Poor oral health is significantly associated with major chronic diseases, can cause disability, and contribute to low self-esteem.

Proper teeth and gum care does not require excessive time or expensive oral hygiene instruments. Avoiding simple sugars, and implementing daily gentle tooth brushing and flossing is the basic foundation.

Additionally, not smoking, drinking plenty of water, and getting regular dental cleanings and checkups are needed to keep gums healthy and teeth cavity free.

Fast facts on tooth and gum care:

• A tooth is primarily composed of minerals.
• Plaque is a sticky, colorless film of bacteria that sticks to teeth.
  • When bacteria consume sugar, they produce acids, which eat away at the tooth’s enamel.
• Tobacco use is one of the most significant risk factors associated with the development of gum disease.

Brushing teeth with fluoridated toothpaste is the best method of reducing plaque. The American Dental Hygienists’ Association (ADHA) recommends brushing for 2 minutes, twice daily.

Proper brushing technique cleans teeth and gums effectively. Keep the following tips in mind:

• Use a soft bristled toothbrush – to prevent damage to the enamel, only use a soft-bristle toothbrush.
  • Brush at a 45-degree angle – the angle of the brush is important, the toothbrush should be placed against the teeth at a 45-degree angle to the gum line.
  • Motion correctly – using short gentle back, forth, and small circular motions, all tooth surfaces will be gently brushed, avoid a sawing or scrubbing motion.
  • Brush the tongue – use your toothbrush to do a light brushing of the tongue.
  • Keep the mouth clean after brushing – avoid eating for 30 minutes after brushing.

A toothbrush should be replaced at least every 3 months, as well as after any illness.

Flossing

Flossing is a good way to remove plaque. Daily flossing is necessary for removing plaque and food particles that your toothbrush cannot reach.

The area just beneath the gum line and the tight spaces between teeth are vulnerable areas where plaque can build up and turn to tartar.

If you do not floss regularly, the build-up of plaque and tartar can lead to cavities, as well as gum disease.

Foods to eat and avoid

There is overwhelming evidence that sugars are the biggest dietary contributor to dental disease. Specifically, it is the amount and frequency of free sugars consumed that determines the severity of decay.

Food and drink to avoid

Sugar and candy intake should be limited; this is because the bacteria in the mouth need sugar to produce the acids that weaken enamel and damage teeth. Each time teeth are exposed to sugar, the demineralization process begins, and it can take up to an hour for the mouth to return to normal, non-acidic pH conditions.

Specifically try to avoid:

• Sodas
• Candy
• Sweets and sugary snacks
• Chocolate
• Cookies
• Fast food, which is known to contain sugars

Other fermentable carbohydrates are also involved:

• Bread
• Crackers
• Bananas
• Breakfast cereals

Studies show that consumption of starchy staple foods and fresh fruit are associated with lower levels of dental caries, so the risk is not as high as sugar.

Consuming a variety of foods rich in nutrients and avoiding those that contain sugars and starches is important for keeping teeth and gums healthy.

Crunchy fruit and vegetables such as apples, pears, celery, and carrots are good in between meals as the chewing activity increases the production of saliva, and saliva helps protect teeth.

Water should be consumed liberally, and any soft drink or fruit juice beverage (diet and regular), should be consumed with caution.

Most soft drinks contain phosphoric acid, which interferes with the body’s ability to absorb calcium. Fruit juices will also bathe the teeth in damaging sugar. Drinking these beverages through a straw can help minimize the time the teeth are exposed to the acid. Chewing sugarless gum for 10 minutes after meals and snacks can also help reduce decay.

Dental decay affects people of all ages, but the severity of the disease increases with age. Dental decay is comprised primarily of:

• Cavities – these are permanently damaged areas in the hard surface of the teeth that develop into tiny openings or holes. Cavities are also called tooth decay or caries.
• Tooth decay – this requires exposure to sugar, but also depends on the susceptibility of the tooth, the bacterial profile of the mouth, the quantity and quality of the saliva, and the amount of time the tooth is exposed to sugars.

Cavities and tooth decay are among the world’s most common health problems. They are especially common in children, teenagers, and older adults. But anyone who has teeth can get cavities, including infants.

The best way to care for teeth and gums is to follow good eating habits, brush, and floss daily, and have regular dental cleanings and exams.

Regular checkups are important to prevent tooth and gum decay. Brushing and flossing help get rid of most plaque, but some plaque is more difficult to remove and will harden and form tartar. Only cleaning by a dental professional can remove tartar.

Unremoved plaque and tartar will not only cause decay, but also work its way under the gums and lead to serious gum disease. Eventually, the disease process could become so advanced the only treatment is the extraction of the tooth.

Proper care of the teeth and gums requires minimal time commitment. A healthy diet, a consistent oral home hygiene program, and regular professional cleanings and checkups will keep teeth and gums in excellent shape, and leave you with a beautiful, healthy smile.

 

 

Monitoring Desk

WASHINGTON: Global warming is expected to make vegetables significantly scarcer around the world, unless new growing practices and resilient crop varieties are adopted, researchers warned.

By the end of this century, less water and hotter air will combine to cut average yields of vegetables — which are crucial to a healthy diet — by nearly one-third, said the report in the Proceedings of the National Academy of Sciences.

A 7.2 Fahrenheit (4 Celsius) increase in temperature, which scientists expect by 2100 if global warming continues on its current trajectory, reduces average yields by 31.5 percent, said the report.

“Our study shows that environmental changes such as increased temperature and water scarcity may pose a real threat to global agricultural production, with likely further impacts on food security and population health,” said lead author Pauline Scheelbeek of the London School of Hygiene and Tropical Medicine.

Southern Europe, large parts of Africa and South Asia may be particularly affected.

The findings are based on a systematic review of 174 studies examining the impact of environmental exposures on yield and nutritional content of vegetables and legumes since 1975.

Some previous research has pointed to a likely increase in crop yields as carbon dioxide rises, but the current review found that any such boost would be cancelled out by higher greenhouse gases, reduced water availability for irrigation and rising temperatures.

“We have brought together all the available evidence on the impact of environmental change on yields and quality of vegetables and legumes for the first time,” said senior author Alan Dangour, also of LSHTM.

‘Urgent action’ needed

“Our analysis suggests that if we take a ‘business as usual’ approach, environmental changes will substantially reduce the global availability of these important foods,” he added.

“Urgent action needs to be taken, including working to support the agriculture sector to increase its resilience to environmental changes and this must be a priority for governments across the world.”

A second study in PNAS found that rising temperatures will increase the volatility of corn, the most widely grown crop on the planet.

Researchers confirmed prior studies that showed global warming would likely cut back on corn growth.

They also showed that heat waves may boost inconsistency and volatility across various regions from year to year, leading to price hikes and global shortages.

“Previous studies have often focused on just climate and plants, but here we look at climate, food and international markets,” said lead author Michelle Tigchelaar, a University of Washington postdoctoral researcher in atmospheric sciences.

“We find that as the planet warms, it becomes more likely for different countries to simultaneously experience major crop losses, which has big implications for food prices and food security.”

The vast majority of the global corn exports come from the United States, Brazil, Argentina and Ukraine.

“Under 4 degrees Celsius warming, which the world is on track to reach by the end of the century if current greenhouse gas emissions rates continue, there’s an 86 percent chance that all four maize-exporting countries would simultaneously suffer a bad year,” said the report.

 

 

 

Monitoring Desk

KINSHASA: The director general of the World Health Organization said he believed a swift end could be put to the outbreak of Ebola in northwestern DR Congo, some 21 days which has left 27 people dead over the past month.

“I am cautiously optimistic that we shall be able to bring it to an end soon,” Doctor Tedros Adhanom Ghebreyesus told reporters at Kinshasa airport.

Earlier, he had tweeted that “it’s far too early to declare victory in the #Ebola outbreak. But the signals are positive and we are cautiously optimistic.”

His comments come after the WHO and NGOs since May 21 began helping the Democratic Republic of Congo immunize front-line workers with a vaccine that has shown to be highly effective in trials, though it still awaits regulatory approval.

A total of 1,369 people have received the experimental vaccine since May 21, the ministry said last Wednesday.

Tedros is on an “evaluation” visit to the country as the WHO monitors the progress of surveillance teams of epidemiologists working to assess the situation after local authorities declared the outbreak in a remote part of the province of Equateur on May 8.

On Thursday the WHO gave a total of 59 confirmed, probable and suspected Ebola cases, of which 27 people had died with one new case confirmed on June 6.

But Tedros said the situation was improving with the last case in the town of Mbandaka diagnosed on May 20 and in the town of Bikoro, which saw the first case confirmed on May 17, with another confirmed on June 2 at nearby Iboko.

Tedros noted the cases were in “places which are not very accessible” and that the epidemiologists were going from village to village as they battled the logistical difficulties of covering ground as swiftly as they could.

Bikoro is some 100 kilometers (62.5 miles) from regional centre Mbandaka and 600 km from Kinshasa), near the border with Congo-Brazzaville.

The outbreak is DR Congo’s ninth since the first in 1976.