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Could a Little Drinking Help Those With Heart Failure?

FRIDAY, Dec. 28, 2018 (HealthDay News) — A new study suggests that an occasional drink won’t harm, and might even help seniors with heart failure.

Heart failure patients who drank in moderation — a drink a day for women, two for men — had an average survival that was a year longer than nondrinkers, the researchers found.

“My patients who are newly diagnosed with heart failure often ask me if they should stop having that glass of wine every night,” said senior study author Dr. David Brown, a cardiologist and professor of medicine at Washington University in St. Louis. “And until now, I didn’t have a good answer for them.”

But one cardiologist who wasn’t involved in the study pushed back hard against any recommendation that drinking is “healthy” for people with heart failure.

“We know with certainty that alcohol is a cause of heart failure,” said Dr. David Majure, who help directs cardiovascular care at Northwell Health’s Sandra Atlas Bass Heart Hospital in Manhasset, N.Y.

“This research can be added to the long history of observational studies that will delight the alcohol industry and confuse the public,” Majure said. “In no way should one conclude from this study that alcohol consumption of any quantity is safe or can prolong life after a diagnosis of heart failure.”

Brown and his colleagues agreed that the study couldn’t prove that moderate alcohol intake caused the benefit in longevity. It’s possible that other factors among drinkers might be responsible, they said.

In the study, the St. Louis team collected data on nearly 5,900 Medicare recipients who took part in a major U.S. heart health study from 1989 to 1993. Among the participants, nearly 400 developed heart failure.

Heart failure is a condition in which the heart loses the ability to pump sufficient blood to the body. It can be caused by a heart attack, or by chronic conditions such as diabetes or kidney disease.

After taking into account factors such as age, sex, race, education, income, smoking and blood pressure, the researchers found that moderate drinkers (seven or fewer drinks per week) lived an average of 383 days longer than nondrinkers.

For purposes of the study, “one drink” was defined as a 12-ounce beer, a 6-ounce glass of wine or a 1.5-ounce shot of liquor.

Dr. Eugenia Gianos directs the Women’s Heart Health program at Lenox Hill Hospital in New York City. She agreed that the study population was “small,” so “I would be very hesitant to draw conclusions” about drinking from the research.

“It’s also possible that other factors that go along with drinking alcohol — having a social network, positive outlook, good coping mechanisms, optimal diet or active lifestyle — are at play” in boosting drinkers’ longevity, Gianos said.

Brown stressed that certainly, “People who develop heart failure at an older age and never drank shouldn’t start drinking.”

Still, “our study suggests people who have had a daily drink or two before their diagnosis of heart failure can continue to do so without concern that it’s causing harm,” he said in a university news release.

But even then, “that decision should always be made in consultation with their doctors,” Brown added.

The report was published online Dec. 28 the journal JAMA Network Open.

More information

For more on heart failure, visit the American Heart Association.

Ring in the New Year Resolved to Improve Your Health

FRIDAY, Dec. 28, 2018 (HealthDay News) — If you’re thinking about making some health-related resolutions for 2019, the American Medical Association (AMA) has some suggestions.

“This is the perfect time of year for each of us to consider our personal goals, and how we can make positive health choices in the coming year,” said AMA President Dr. Barbara McAneny.

“We encourage everyone to prioritize their long-term health by making small lifestyle changes now that can have a lasting effect in improving their health,” she added in an AMA news release.

The association offers some tips that can make a big difference in your health:

  • Learn your risk for type 2 diabetes: Take a self-screening test at DoIHavePrediabetes.org. If you’re at risk, the website lists steps that can help you prevent or delay development of the blood sugar disease.
  • Get regular exercise: Adults should get at least 150 minutes a week of moderate-intensity activity, or 75 minutes a week of vigorous-intensity activity.
  • Know your blood pressure: Get high blood pressure under control to help prevent heart attack or stroke.
  • Eat a healthy diet: Cut down on processed foods, especially those with added salt and sugar, as well as sugar-sweetened beverages. Drink more water.
  • Help prevent antibiotic resistance: If you’re prescribed antibiotics, take them exactly as directed. Remember: Antibiotics aren’t effective against viruses, including those that cause colds and flu.
  • Limit alcohol and tobacco: If you drink alcohol, do so in moderation — no more than one drink a day for women and two for men. If you use tobacco, talk to your doctor about quitting.
  • Be careful with painkillers: If you’re prescribed opioid pain medications, follow your doctor’s instructions, store them safely, and properly dispose of unused pills to prevent misuse or theft.
  • Immunize: Be sure everyone in your family is up to date on vaccinations, including the annual flu shot for everyone 6 months or older.
  • Control stress: Healthy eating and regular exercise can help maintain good mental health, but seek help from a friend or professional if you need it.

More information

The U.S. Centers for Disease Control and Prevention has more on healthy living.

Kidney Disease Risk Tied to Sugar-Sweetened Drinks

THURSDAY, Dec. 27, 2018 (HealthDay News) — People who drink lots of sugar-sweetened drinks may be putting themselves at a heightened risk for kidney disease, a new study suggests.

The study of more than 3,000 black men and women in Mississippi found that those who consumed the most soda, sweetened fruit drinks and water had a 61 percent increased risk of developing chronic kidney disease.

That water was included in the increased risk surprised the researchers. It’s possible, however, that participants reported drinking a variety of types of water, including flavored and sweetened water. Unfortunately, that information was not included in the Jackson Heart Study, which was used for the project.

Specifically, the researchers looked at beverage consumption as reported in a questionnaire given at the start of the study in 2000 to 2004. Participants were followed from 2009 to 2013.

“There is a lack of comprehensive information on the health implications of the wide range of beverage options that are available in the food supply,” said lead study author Casey Rebholz.

Rebholz is an epidemiologist at the Johns Hopkins Bloomberg School of Public Health in Baltimore.

“In particular, there is limited information on which types of beverages and patterns of beverages are associated with kidney disease risk in particular,” she added.

And while the study found an association between sugary drink consumption and kidney disease, it couldn’t prove a cause-and-effect relationship.

The study findings were published online Dec. 27 in the Clinical Journal of the American Society of Nephrology.

In an accompanying journal editorial, Dr. Holly Kramer and David Shoham of Loyola University in Chicago said the findings have public health implications.

Although a few U.S. cities have reduced consumption of sugar-sweetened beverages by imposing taxes on them, others have resisted these efforts, the editorial noted.

“This cultural resistance to reducing sugar-sweetened beverage consumption can be compared to the cultural resistance to smoking cessation during the 1960s after the Surgeon General report was released. During the 1960s, tobacco use was viewed as a social choice and not a medical or social public health problem,” Kramer and Shoham wrote.

In another editorial, a kidney disease patient, Duane Sunwold, said he changed his eating and drinking habits to put his disease in remission. He’s a chef who offers recommendations to other kidney disease patients who are seeking to cut back on sugar-sweetened drinks.

More information

To learn more about kidney disease, visit the National Kidney Foundation.

PTSD Drug May Do More Harm Than Good

THURSDAY, Dec. 27, 2018 (HealthDay News) — A drug used to treat post-traumatic stress disorder (PTSD) may actually be harmful, a new study suggests.

The high blood pressure drug prazosin is sometimes used to treat PTSD-related nightmares and insomnia that can increase suicide risk. But this small study suggests the drug may make nightmares and insomnia worse and not reduce suicidal thoughts in PTSD patients.

“I think we have to view this as not the final word on this, but it raises questions,” said study author Dr. W. Vaughn McCall. He’s chairman of psychiatry and health behavior at the Medical College of Georgia.

The study included 20 PTSD patients, including two military veterans and several civilian women who had been sexually assaulted. All had active suicidal thoughts, some had previously attempted suicide, and most were taking antidepressants and/or had them prescribed for the study.

For eight weeks, participants took prazosin at bedtime with an aim of preventing nightmares and suicidal thoughts. They were assessed weekly for severity of suicidal thoughts, nightmares, insomnia, depression and PTSD.

The drug “did not seem to do much for suicidal ideation and that was somewhat disappointing, but the thing what was mind-blowing was that it actually worsened nightmares,” McCall said in a university news release. “Maybe it’s not for everybody.”

The unexpected increase in nightmares and insomnia might owe to the severity of a patient’s PTSD or the once-a-day dose of prazosin, he said.

PTSD patients’ nightmares often focus on the trauma that caused their PTSD, he said.

Two patients required emergency inpatient psychiatric care, but there were no suicide attempts or deaths during the study, which was published recently in the Journal of Clinical Psychopharmacology.

Prazosin may help some PSTD patients, but may not be a good choice when suicide is an active concern, according to McCall, who is now seeking input from PTSD experts across the United States

Two larger studies in active and retired military personnel yielded mixed results as well, he noted.

“We need to reconcile how is it that we had 10 years of data saying prazosin is good for nightmares in PTSD, a big study this February indicating it has essentially no [effect] and now a smaller study showing it can worsen some aspects,” McCall said. “We need to know what it all means.”

The antidepressants sertraline (Zoloft) and paroxetine (Paxil) are the only U.S. Food and Drug Administration-approved PTSD drug therapies, he said, adding that neither is widely effective.

More information

The U.S. National Institute of Mental Health has more on PTSD.

Is Your State a Hotspot for Obesity-Linked Cancers?

THURSDAY, Dec. 27, 2018 (HealthDay News) — What state you call home may have a great deal to do with your chances of developing an obesity-related cancer, a new report suggests.

A nearly twofold difference exists between U.S. states with the highest and lowest proportion of obesity-related cancers, American Cancer Society researchers have found.

The highest is in the District of Columbia, at 8 percent, and the lowest in Hawaii, at nearly 6 percent. Being obese or overweight has been tied to 13 types of cancer.

“The proportion of cancers attributable to [excess body weight] varies among states, but [excess body weight] accounts for at least one in 17 of all incident cancers in each state,” the researchers reported.

For the study, a team led by Dr. Farhad Islami calculated the proportion of cancer among obese or overweight people. Islami is the cancer society’s scientific director of surveillance research.

Participants in the study were aged 30 and older between 2011 and 2015, and lived in all 50 states plus the District of Columbia.

Among men, the investigators found a range of cancer attributable to excess weight from nearly 4 percent in Montana to 6 percent in Texas.

For women, the risk of cancers linked to excess weight was about twice as high as in men. It ranged from 7 percent in Hawaii to 11 percent in the District of Columbia, the findings showed.

States in the South and Midwest had the largest proportion of people with weight-related cancers, as well as Alaska and the District of Columbia, the researchers found.

Cancers linked to weight were at different levels across the country. For example, cases of endometrial cancer ranged from about 37 percent in Hawaii to 55 percent in Mississippi, and reached 50 percent or more in 19 states.

“Broad implementation of known community- and individual-level interventions is needed to reduce access to and marketing of unhealthy foods (e.g., through a tax on sugary drinks) and to promote and increase access to healthy foods and physical activity, as well as preventive care,” Islami’s team concluded in a cancer society news release.

The report was published online Dec. 27 in the journal JAMA Oncology.

More information

For more on weight and cancer, visit the American Cancer Society.

Are You Overdoing Antibiotics?

THURSDAY, Dec. 27, 2018 (HealthDay News) — Antibiotics are life-savers. But they’re being overprescribed and overused, leading to antibiotic-resistant germs stronger than the drugs available to treat them.

This is also creating more drug side effects, allergic reactions and serious infections.

According to the U.S. Centers for Disease Control and Prevention, in one year alone, more than 262 million courses of antibiotics were prescribed on an outpatient basis — that’s 842 prescriptions for every 1,000 adults. For children up to age 9 and adults 65 and older, the rate was greater than one to one, meaning that many took more than one prescription over the course of a year.

Urgent care centers, in particular, are prescribing antibiotics to walk-in patients at a very high rate, often because patients are demanding them, even when they’re not necessary.

As a consequence, people are experiencing a growing number of infections caused by bacteria resistant to various antibiotics. These include MRSA, E. coli and strains of pneumonia.

Antibiotics Overuse 411:

  • The most commonly prescribed antibiotic among children and teens is amoxicillin; among adults, it’s azithromycin.
  • Women are almost twice as likely as men to receive antibiotics.
  • Antibiotic prescribing rates are higher in the South than other parts of the United States.
  • Dermatologists, family practitioners and pediatricians prescribe more antibiotics than other types of doctors.

Sometimes you do need an antibiotic, but other times you don’t.

Follow these best practices to avoid antibiotic resistance:

  • If you get sick, ask your doctor what tests you can have to make sure the right antibiotic is prescribed, should you need one.
  • Take antibiotics exactly as your doctor prescribes — complete the course of treatment, even after you start feeling better.
  • Only take antibiotics prescribed for you. Don’t share antibiotics — if you take the wrong medicine, you may not treat the problem correctly and allow bacteria to multiply.
  • Don’t “save” antibiotics for a future illness.
  • Don’t ask for antibiotics when your doctor thinks you don’t need them.
  • Prevent infections with thorough hand washing and getting all recommended vaccines.

Take steps to limit your exposure to antibiotics so that they’ll work for you when you really need them.

More information

The U.S. Centers for Disease Control and Prevention has detailed information on antibiotic resistance to help you stay safe.

One Woman's Case Gives New Hope Against Disfiguring Sarcoidosis

WEDNESDAY, Dec. 26, 2018 (HealthDay News) — In very preliminary findings, an existing rheumatoid arthritis drug appeared to cure one woman of a rare but potentially life-threatening condition known as sarcoidosis.

After 10 months of use, tofacitinib (Xeljanz) appeared to eliminate all symptoms for the woman, who’d tried numerous standard treatments to no avail.

Sarcoidosis is an inflammatory disease that affects multiple organs. While some patients recover without treatment, others suffer damage to lungs, heart, lymph nodes, skin and other organs. On the skin, it can cause disfiguring lesions.

The disease “alters the immune system which, in turn, leads to increased inflammation in the body,” explained Dr. Anup Singh, a pulmonologist at Lenox Hill Hospital in New York City.

“This increased inflammation may cause non-specific symptoms like cough, weight loss, rash, joint pain and swelling, palpitations, difficulty in breathing, headache or loss of vision,” said Singh, who wasn’t involved in the new study.

The new research was led by Dr. Nkiruka Emeagwali, a clinical fellow at Yale Medical School. She said current treatments for sarcoidosis include steroids or the anti-inflammatory drug known as methotrexate. Neither are reliably effective, however, and both can cause serious side effects, the researchers noted.

The Yale team suspected — based on data from earlier trials — that the rheumatoid arthritis drug Xeljanz might help. It belongs to a class of medicines called JAK inhibitors, because the drugs act on a specific biochemical pathway called Jak-STAT.

Researchers had already used this class of drug to successfully treat other chronic skin diseases such as vitiligo, alopecia areata and eczema.

In the new study, a 48-year-old woman with sarcoidosis took Xeljanz twice a day over several months. Over that time, her skin lesions nearly disappeared, the Yale team reported in the Dec. 27 issue of the New England Journal of Medicine.

“During treatment, not only does her skin disease go away, but there is no activation of the pathway,” researcher Dr. Nkiruka Emeagwali, a clinical fellow at Yale Medical School, said in a Yale news release.

In addition, the researchers looked at genetic data from another patient before and during treatment, which proved that the Jak-STAT pathway was involved.

“We plan to evaluate the activation of the Jak-STAT pathway in the lung fluid and blood of over 200 patients with pulmonary and multiorgan sarcoidosis,” she said.

The findings are being tested further in a clinical trial. If confirmed, they could represent a breakthrough for sarcoidosis patients, the researchers said.

“A frequently awful disease, which to date has no reliably effective therapy, may now be targeted with Jak inhibitors,” said lead researcher Dr. Brett King, an associate professor of dermatology at Yale. “We have a relatively safe medicine that works.”

Singh noted that the patient had exhausted many avenues for treatment.

She “had been treated with multiple anti-inflammatory drugs including oral steroids and methotrexate for eight years — without any improvement of symptoms,” he said.

Her success in eliminating sarcoidosis symptoms while taking Xeljanz “suggests that there is a different pathway of our immune system which is also involved in inflammation seen in patients of sarcoidosis,” Singh said.

But he stressed that more study is crucial before the drug becomes a first-line treatment.

“This case report has given us hope for a newer treatment alternative in the form of tofacitinib,” Singh said, but the drug “will remain an investigational option, until results of future studies are available.”

More information

For more information on sarcoidosis, visit the U.S. National Heart, Lung, and Blood Institute.

Short People Fare Worse in ICUs: Study

WEDNESDAY, Dec. 26, 2018 (HealthDay News) — Shorter patients in hospital intensive care units (ICUs) are more likely to die during treatment than taller ones, a new study suggests.

Among more than 400,000 critically ill adults, the shortest patients (4 feet, 6 inches) were 29 percent (men) and 24 percent (women) more likely to die in the hospital than the tallest — 6 feet, 6 inches, the study found.

Among the tallest, the risk of dying in the hospital ranged from 21 percent for men and 17 percent for women.

The study does not prove height was totally responsible for the increase in deaths, only that the two appear to be linked.

The study was launched because ICUs tend to base treatment on an ideal patient of average weight and height, said lead researcher Dr. Hannah Wunsch, a critical care doctor at Sunnybrook Hospital in Toronto.

“There are often devices and tubes that are put into people that come in one size or can’t easily be varied to accommodate different size individuals,” she said.

Wunsch’s team thought that these constraints might affect patient care.

“Sure enough, we found that even after we accounted for other factors that we know account for someone dying in the hospital, there was a pretty strong relationship between the height of an individual and their mortality,” Wunsch said.

“We can’t say for sure why this is happening,” she said. “It’s speculative that all the things we do to people might in some way be harmful to patients who are smaller.”

For doctors, Wunsch said both height and weight may be worth taking into account when treating patients.

“There is limited ability to change things right now,” she said. “It opens up a new avenue for awareness and future research.”

For the study, Wunsch and her colleagues collected data on patients in 210 ICUs in the United Kingdom between 2009 and 2015. The data included about 233,000 men and 184,000 women.

Of those patients, 45 percent had their height measured.

Increases in height were linked to decreases in deaths, the study found. Researchers also found that height predicted leaving the hospital for home.

Though differences in treatment might account for the findings, no difference in deaths was seen among patients on mechanical ventilators. These breathing devices must be adjusted to a patient’s height.

The researchers couldn’t determine if height was influenced by childhood disease, such as cancer, which can affect life expectancy. Nor could they account for differences in care in individual ICUs that might affect outcomes.

Dr. Mark Astiz, chairman of critical care medicine at Lenox Hill Hospital in New York City, said these findings aren’t conclusive enough to change clinical practice.

“The results of this study need to be confirmed,” said Astiz, who wasn’t involved with the research. “Also, investigation into the patient characteristics that may be contributing to these differences needs to be done.”

The report was published Dec. 23 in the journal Intensive Care Medicine.

More information

The U.S. National Library of Medicine has more about critical care.

Justice Ruth Bader Ginsburg Released From Hospital After Lung Surgery

WEDNESDAY, Dec. 26, 2018 (HealthDay News) — U.S. Supreme Court Justice Ruth Bader Ginsburg has been discharged from the hospital following surgery for lung cancer last week.

“Justice Ginsburg was discharged from the hospital yesterday and is recuperating at home,” said Kathleen Arberg, public information officer for the Supreme Court, in an email to reporters on Wednesday.

Ginsburg, who is 85, had two cancerous nodules removed from her left lung at Memorial Sloan Kettering Cancer Center in New York City on Friday.

“Two nodules in the lower lobe of her left lung were discovered incidentally during tests performed at George Washington University Hospital to diagnose and treat rib fractures sustained in a fall on November 7,” Arberg said in a statement last week.

According to thoracic surgeon Dr. Valerie Rusch, both nodules removed during surgery were found to be malignant.

However, “post-surgery, there was no evidence of any remaining disease. Scans performed before surgery indicated no evidence of disease elsewhere in the body. Currently, no further treatment is planned,” Arberg said.

The Supreme Court does not reconvene for official business until Jan. 4.

Neither injuries nor cancer have stopped Ginsburg from working in the past. After breaking two ribs in 2012, she never missed a day of work. That same year, she returned to work quickly after having a heart procedure performed, according to The New York Times.

Not only that, she was diagnosed with pancreatic cancer in 2009 and returned to work less than three weeks after having the tumor removed, ABC News reported at the time.

One doctor unconnected to the case said that, based on what has been communicated so far, Ginsburg’s prognosis looks “great.”

“She has no evidence of disease anywhere else and appears to be grossly cancer free,” said Dr. Raja Flores, chair and professor of thoracic surgery at Mount Sinai Health System in New York City.

“If this is spread from the pancreas then this appears to be very slowly moving, since her pancreatic surgery was a decade ago. She should do fine,” he said. “She should be back at work soon.”

A history of bouncing back from setbacks hasn’t eased the nerves of liberals who worry about how much longer Ginsburg can serve, as the balance of the Supreme Court shifts to the right with President Donald Trump’s two recent appointees, Brett Kavanaugh and Neil Gorsuch.

Ginsburg was first appointed to the Supreme Court in 1993 by former President Bill Clinton. She is the oldest justice on the court.

Ginsburg has consistently fought for women’s rights. In 1971, she helped launch the Women’s Rights Project of the American Civil Liberties Union (ACLU). She served as the ACLU’s general counsel from 1973 to 1980.

In recent years, Ginsburg gained social media popularity with her own nickname, “Notorious R.B.G.” She was also the subject of a recent documentary, and a movie has been made about her life.

Ginsburg was born in Brooklyn, N.Y., in 1933, according to the U.S. Supreme Court website. She married Martin Ginsburg, and together they had a daughter and a son. She received her undergraduate degree from Cornell University, and attended Harvard and Columbia law schools.

More information

Visit the American Cancer Society for more on lung cancer.

Follow the Mediterranean Diet for Weight Loss, Too

WEDNESDAY, Dec. 26, 2018 (HealthDay News) — When the 2015 U.S. Dietary Guidelines were released, they included details for following the Mediterranean-style diet. That’s the way of eating in countries that border the Mediterranean Sea and has been associated with many health benefits, from a sharper mind to a healthier heart.

The eating plan includes more fruit and seafood and less dairy than traditional healthful diets. And this way of eating is as tasty as it is healthy and easy to follow.

The first guideline of the Mediterranean diet is to eat mostly plant-based foods — a wide variety of fruits and vegetables, whole grains, legumes and nuts. Next, is to replace butter with healthy fats, such as olive oil. Also, use herbs and spices instead of salt, eat fish and poultry at least twice a week, and limit red meat to just a few times a month.

In terms of exact portions, for a daily diet of 1,200 calories, start with 1.5 cups of vegetables and increase from there. Over the course of every week, get a mix of dark green, red and orange veggies for their range of micronutrients, and include some legumes, great sources of fiber and some protein as well as carbs.

Other amounts of daily foods to include are 1 cup of fruit; 4 ounces of grains — at least half of which are whole grain; 2.5 cups of dairy, like nonfat milk or yogurt; 3 ounces of protein such as seafood, poultry, eggs or nuts and seeds; and about 1 tablespoon of oil.

You can adjust these portions depending on your caloric needs and how rapidly you’d like to lose weight. Another great feature of this diet is that it can become a way of life — no need to “go off” it when you reach your desired weight, just increase your portions to maintain it.

More information

Get guidelines for following the Mediterranean diet for caloric intakes between 1,000 and 2,000 calories a day from Health.gov.