Category Archives: Health

Federal program cuts disparities in HIV/AIDS care

When Gina Brown was diagnosed with HIV in 1994, she considered it a death sentence, but nearly 23 years later, she’s living a full life in New Orleans, thanks largely to the federally funded Ryan White HIV/AIDS Program.

In 2014, the safety-net program provided drugs, medical care and support services to more than 268,000 people in the U.S. living with human immunodeficiency virus (HIV) infections. Now a study shows that in 82 percent of them, including Brown, HIV is no longer detectable in their blood – a state known as “viral suppression.”

Those who are virally suppressed take antiretroviral medications that allow them to expect to live a nearly average lifespan. In addition, the drugs can virtually eliminate the possibility of transmitting the virus to others.

The number of Ryan White program participants who achieved viral suppression rose 12 percent from 2010 until 2014, researchers found. The study considered only those who used the program for medical care and were at least 13 years old.

Senior author Dr. Laura Cheever hailed the increase as a “huge improvement.” She is the associate administrator of the federal Health Resource and Service Administration’s HIV/AIDS Bureau in Rockville, Maryland.

Named for a boy who was expelled from school at age 13 following a 1984 diagnosis with HIV, the Ryan White program has offered healthcare and other services – from drugs to temporary housing to counseling, substance-abuse treatment and rides to medical appointments – to HIV-positive people since 1990.

The program cost $2.3 billion this fiscal year and is expected to serve more than 500,000 people, about half the number of Americans diagnosed with HIV, Cheever said.

The viral suppression rate rose even higher for program participants who received medical care in 2015 – to more than 83 percent, Cheever said in a phone interview. Some participants receive just support services, not medical care, and were not included in the viral suppression number.

From 2010 to 2014, disparities between suppression rates for those in vulnerable groups shrank, the report in Health Affairs found.

The gap in viral suppression rates for blacks narrowed in comparison to whites; the gap for adolescents and youth adults narrowed in comparison to those for older adults; and the gap for HIV-positive people living in the South narrowed in comparison to people in other regions of the U.S.

Disparities persisted, but were significantly reduced for every group except homeless and transgender people, Cheever said.

Brown, 51, a black woman living in the South, has been a beneficiary of the program’s equal access, and she sees it as her salvation.

“The Ryan White program allows us to live,” she said in a phone interview.

The program enabled Brown to earn a master’s degree in social work, and she now works in the HIV testing and prevention program at the Institute of Women and Ethnic Studies in New Orleans.

Most importantly, Brown said, the program has introduced her to other HIV-positive people. “You can hang out with women just like you and not feel stigmatized and not feel so alone,” she said.

The Ryan White program reduces disparities for vulnerable groups that persist for other diseases throughout the U.S., Cheever said.

“The paper demonstrates that by taking a public health approach to a complicated medical condition, we can really serve the people in this country who have limited access to care,” she said.

Dr. Michael Saag directs the University of Alabama at Birmingham AIDS Center and was not involved in the new research. The study’s findings mirror what he’s seen in his clinic and present “evidence that when you give people ready and equal access to care, healthcare disparities disappear,” Saag said in a phone interview.

“Why is it that health disparities are substantially less with HIV? The answer is it’s because of the Ryan White Care Act,” he said. “These are the healthcare disparities we’re so used to, that we expect. And that’s a tragedy.”

Under the Ryan White program, financial status no longer limits access to care because the program fills whatever holes people with HIV have in their healthcare coverage and in their related needs.

“You could almost think of it as an experiment in single payer because it creates relatively equal access to all people, regardless of their station in life,” Saag said. Because people who are virally suppressed don’t transmit HIV, he said, the program benefits not only individuals but the general public.

Before the Affordable Care Act was enacted, only about 13 percent of HIV-positive people in the U.S. had private health insurance, and 24 percent had no coverage at all, according to the Department of Health and Human Services.

Ryan White died at age 18, just months before Congress passed the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act.

Why You Need a Health Emergency Fund

Even with good health insurance, a health emergency or a prolonged illness can be a financial disaster. Health insurance deductibles, co-payments, emergency room costs, and other costs of illness can add up in a hurry.

A health savings account (HSA) is one way you can put aside tax-free money for a health emergency. HSAs were established in 2003. If you are covered by a type of insurance known as a high-deductible insurance plan, you can make tax-deductible contributions to an HSA. Your employer may also make tax-deductible contributions.

“An HSA account is very different from having a general emergency fund account,” says Joseph J. Porco, managing member of the Financial Security Group, LLC, in Newtown, Conn. “An emergency fund is about more than just out-of-pocket medical expenses. If possible, it’s a good idea to have both.”

How Much of an Emergency Fund Do You Need?

For an older adult, a health emergency might result in the need for long-term care, possibly for the rest of the senior’s life. For a young adult supporting a family, a medical emergency might be much more than just the cost of illness. Your health emergency could cause a disability that results in loss of income over an extended period. That means you should save enough to cover all your expenses.

“Most advisers would say you should have enough emergency funds saved to cover your family expenses for three to six months. I would recommend trying to put enough aside to cover all your expenses, not just health expenses, for 6 to 12 months,” says Porco.

How much you need for a health emergency and how much you can actually put into an emergency fund will depend on your family size, your income, your health status, and your age. But your first step is to understand your health insurance situation.

“The best way to start is to sit down with a financial adviser and figure out what your insurance actually covers and what it doesn’t cover. What are your insurance limits? What kind of medical bills might arise that you would be responsible for? Get some expert advice on how best to cover your actual needs,” advises Porco.

What Insurance May Not Cover

How much insurance companies actually pay for accidents, cancer treatment, or surgery depends on what kind of insurance you have, but there are usually limits. Here are some facts to consider:

  • Cost of illness. Most insurance companies have a cap on how much they will pay for a long-term illness. A recent survey found that 10 percent of people with cancer have hit their lifetime cap and are no longer covered by insurance. Looking forward, however, the new health care reform law will eliminate caps on lifetime insurance by 2014.
  • Emergency room cost. If you have an accident that requires emergency treatment and you end up in an emergency room outside your insurance network, you may not be covered. One study found that HMOs in California denied one out of every six claims for emergency room costs.
  • Surgical coverage. You may be surprised at what your insurance company considers non-covered surgery. There can be a big gray area between covered “reconstructive” surgery and uncovered “cosmetic” surgery. Even when surgery is covered, your deductible may be $500 or more, and you may still be responsible for up to 25 percent or more of surgical costs, depending on the specifics of your plan.

How to Save for a Health Emergency

Once you know what your insurance actually covers and how much you need to put away for an emergency, the next question is where to put it. “Money that you put aside for a health emergency needs to be liquid and secure,” says Porco. “That means you need to be able to get it when you need it.”

And your money needs to remain liquid. “Those who fail to set up an emergency fund may find themselves running up credit card debts to cover their expenses. The last thing you need is to be paying interest on your emergency,” warns Porco.

Examples of places to put your emergency fund include an interest-bearing checking or savings account, money market fund, or bond fund. Don’t tie your money up in anything that would penalize you for early withdrawals or any investment or account that has the potential for loss.

Practical Ways to Save

There are many different ways to approach starting — and adding to — your health emergency savings. “You can take advantage of a health savings account if this is offered at your job, but start a general emergency fund also,” suggests Porco.

Here are more health savings tips:

  • Put any money you get from a tax refund or earned income credit into your health savings fund.
  • Ask your bank or credit union to automatically transfer funds into your emergency account.
  • Explain the importance of an emergency fund to your family and get everyone involved in cutting back on unnecessary expenditures.

Human rotavirus manipulates immune

This and other human viruses of the digestive system have been difficult to study because they do not grow well in experimental animals or in cell cultures in the laboratory,” said Dr. Mary Estes, Cullen Endowed Professor of human and molecular virology and microbiology at Baylor and emeritus founding director of the Texas Medical Center Digestive Diseases Center. “This has changed since the development of the human intestinal enteroids (HIEs), a laboratory model of the human gut that recapitulates many of the biological and physiological properties of the human small intestine.”

Using a laboratory model of the human gut, Estes and colleagues have revealed a strategy human rotavirus uses to evade the attempts of the human body to eradicate it. They found that although the virus does not succeed at preventing initial steps of the defense response, it is able to minimize subsequent steps that could stop its growth. Using a model of the live human gut, the scientists also showed cellular strategies to counter the viral response.

Studying anti-viral defenses in a living model of the human gut

“In this study we used the HIE model of the gut, which included epithelial cells, to study what happens when these cells encounter the virus and how the virus responds to IFNs,” said Estes.

The researchers developed HIEs from a number of patients to compare the responses of different individuals. Their results show that each culture from an individual patient exhibits diversity in basal gene expression, yet after viral infection, all the cultures responded in a very similar manner.

When the researchers added human rotavirus to the HIE cultures in the laboratory, the epithelial cells activated type III IFN genes, which in turn activated other genes involved in the anti-viral response. However, this activation did not reduce viral reproduction. Unexpectedly, almost no type I IFN was activated.

The scientists then looked at whether activation of IFN genes had produced the desired IFN proteins, which are the molecules that ultimately carry out the job of inhibiting the virus. They found that when they added live rotavirus to the cultures, type III IFN genes were active but did not go through the process of efficiently translating their instructions into IFN proteins. On the other hand, when the scientists added inactivated rotavirus, which can enter the cells but not replicate, the epithelial cells responded by both activating the type III IFN genes and producing IFN proteins.

“These experiments showed us that in the HIE cultures, the active rotavirus is able to suppress the production of most of the IFN proteins aimed at controlling virus reproduction,” Estes said. “Adding type I IFN to the HIE cultures with live rotavirus reduced viral replication more efficiently than adding type III IFN. This suggests that type I IFN may be more critical to limiting the growth of the virus and this IFN may be made from a source different from epithelial cells.” The HIE model system of the human gut is a valuable tool to assess how people respond to viruses and other microorganisms that cause intestinal diseases and how those microorganisms counter bodily defenses. This is the first step toward designing treatments to prevent or control these deadly diseases.

New Target for Treating Glioblastoma

“These findings change our fundamental understanding of the molecular basis of glioblastoma, and how to treat it,” said co-senior author Dr. Robert Bachoo, Associate Professor of Neurology and Neurotherapeutics, Internal Medicine, and with the Annette G. Strauss Center for Neuro-Oncology at UT Southwestern Medical Center. “We may have identified a set of critical genes we can target with drugs that are shared across nearly all glioblastomas.”

The study, published in Cell Reports, represents research from UT Southwestern’s precision medicine campaign in neuro-oncology.

For the past decade, patients diagnosed with glioblastoma have been treated with the current standard of care regimen: surgery followed by chemotherapy and radiation. This regimen improves median survival by an average of four to six months, followed by recurrence of the tumor. There are currently no successful therapies available to treat glioblastoma patients when the tumor recurs. Five-year survival rates are around 5 percent.

Faced with these prospects, the brain tumor research and clinical communities turned to genetic studies to guide possible treatment strategies.

“Our work shows that the gene mutations which the pharmaceutical industry and clinicians have been focusing on are essential only for starting tumor growth. Once the tumor has advanced to the stage where patients seek treatment, these mutations are no longer required for continued tumor growth; they are in effect redundant,” said Dr. Bachoo, a member of the Simmons Cancer Center and O’Donnell Brain Institute, who holds the Miller Family Professorship in Neuro?Oncology. Previously, proteins called receptor tyrosine kinase were considered the drivers of glioblastoma; however, drugs that inhibit these proteins have not been effective in treating this type of cancer.

“We learned that, instead, it is neurodevelopmental transcription factors (master proteins that regulate the activity of hundreds of genes during normal brain development), which are reactivated to drive the growth of glioblastoma. We can inhibit these transcription factors and prevent further tumor growth with the chemotherapy drug mithramycin, a drug that has not been in clinical use for years due to its side effects,” said co-senior author Dr. Ralf Kittler, Assistant Professor of Pharmacology in the Eugene McDermott Center for Human Growth and Development. “Our discovery has the potential for the development of a new therapy that may increase survival time for glioblastoma patients.”

The researchers caution that repurposing mithramycin, which is known to cause liver toxicity in some patients, with safer and more effective treatments for brain tumor patients may take years.

Risk-taking behaviour in adolescents

Reckless driving, binge drinking, drug taking — it is well known that adolescents are more likely than adults to engage in risky and impulsive behavior. A study conducted at the Max Planck Institute for Human Development provides new insights into these risky decisions. The findings show that, relative to children and adults, adolescents are less interested in information that would help them to gauge the risks of their behavior. They are less motivated to seek out such information and better able to tolerate a lack of knowledge. “It’s not that they are cognitively incapable of processing the issues. They are simply driven to seek new experiences and try out new things,” says lead author Wouter van den Bos, researcher in the Center for Adaptive Rationality at the Max Planck Institute for Human Development.

The patterns of adolescent risk-taking behaviors observed in previous experimental studies deviate sharply from those seen in real life. In these earlier laboratory experiments, participants were often given all the information they needed to make a decision. When adolescents test their luck by experimenting with drugs or having unprotected sex, however, they may have only a vague idea of the possible consequences of their actions and the likelihoods of those consequences. But they often have the opportunity to learn more about those consequences before making a decision — metaphorically speaking, they can look before they leap. “Ours was the first developmental study to use experimental tasks that afforded decision makers this opportunity to reduce uncertainty by searching for more information,” adds van den Bos.

In the study, 105 children, adolescents, and young adults aged 8-22 years old played various lotteries, each offering a chance of winning a certain amount of money. Players either had full information on the value of the prize and the probability of winning it (choices under risk), or they were told the value of the prize but had incomplete information on its probability (choices under ambiguity), or they were not told the value of the prize or its probability but had the opportunity to access further information (choices under uncertainty). Additionally, participants were asked about their real-life risk-taking behavior.

It emerged that teenagers were more ready to accept ambiguity and also searched for less information in the context of uncertainty. This tolerance of the unknown peaked around age 13-15 years. Unlike adolescents’ choices in the context of full information, their behavior under ambiguity and uncertainty also correlated with their self-reported risk-taking in the real world.

The study findings could also explain why information campaigns designed to educate young people about the risks of certain behaviors — such as drug abuse — often fall on deaf ears. Even when information is easily available to young people, they show little motivation to engage with it. “If we really want to get through to young people, we need to take these insights into account when designing interventions,” says coauthor Ralph Hertwig, Director of the Center for Adaptive Rationality at the Max Planck Institute for Human Development. “A promising alternative to information campaigns would be to give adolescents the opportunity to experience the consequences of their risky behavior

Serum micoRNAs may serve as biomarkers

MicroRNAs are small RNA molecules that influence basic cellular processes and have been proposed as biomarkers for the diagnosis, progression and treatment of multiple sclerosis. In a new study conducted at the Ann Romney Center of Neurologic Diseases at Brigham and Women’s Hospital, researchers have found that serum microRNAs are linked to MRI findings in the brain and spinal cord in patients with MS. These findings suggest that microRNAs could serve as promising biomarkers for monitoring the progression of MS and could help to identify distinct underlying disease processes, such as inflammation and tissue destruction.

The study was published on January 23, 2017 in JAMA Neurology.

In a large study, researchers examined the connection between serum microRNAs and MRI measures to evaluate the severity of MS, which included looking at lesions and atrophy, a measure of degeneration of the cells, in the central nervous system. Among the findings, the researchers identified that the expression of certain microRNAs were linked to MRI measures. The authors showed that these associations could be protective or harmful to patients (depending upon the function of the microRNA). They also found that different mechanisms were linked to different locations of MS changes, such as in the brain or spinal cord. Additionally, the study suggested certain sets of microRNAs were linked to lesions, while others were linked to atrophy, which is known to cause more devastating effects to MS patients.

“These findings tell us the disease is heterogeneous. There’s a complex set of mechanisms at play, and it may vary from patient to patient,” says senior co-author Rohit Bakshi, MD, MA. “Another implication of this research is that it could eventually lead to us having a blood test to identify the subtype of MS in a patient, to help guide therapeutic decisions and prognosis,” says Bakshi, also a neurologist at BWH.

“MicroRNAs could serve as biomarkers of the underlying MS disease processes, once validated and standardized for clinical settings. In addition, these markers have the potential to provide novel treatment targets,” says Roopali Gandhi, PhD, senior co-author and an assistant professor at BWH.

Can You Really Have a Lip Balm Addiction?

lip balm is a fall and winter rite of passage with which many of us are all too familiar. With cold weather comes dry, chapped lips, making that little tube or pot a seasonal staple, whether it’s a newer brand or an old standby like ChapStick (invented in the 1880s) or Carmex (manufactured since 1936). In fact, in 2010, Americans spent about $417 million on lip care (including balms and cold-soreproducts), according to market research firm SymphonyIRI.

But could a lip balm addiction really be driving these blockbuster sales numbers? Many people swear they need to slather their lips with balm many times a day. Referring to themselves as lip balm addicts, these “junkies” gather on Facebook in groups with names like “I forgot my lip balm, my life is over!” There’s even a Web site devoted to helping people break their dependency on balm, called (what else?)LipBalmAnonymous.com. Started in 1995 by “Kevin C.,” a self-described “suffering ChapStick addict,” the site offers tongue-in-cheek information and guidance based on the classic 12-step model of addiction therapy. There’s even a self-evaluation with questions like “Do you feel depressed, guilty, or remorseful after you use lip balm?”

So what’s the real story about lip balm addiction? “The truth is that you cannot get addicted to lip balm in the same way you can get addicted to drugs like alcohol or nicotine,” says Perry Romanowski, a cosmetic chemist and author of the book Can You Get Hooked on Lip Balm?

There’s no denying, though, that people feel they can’t do without the stuff, and here’s why: Because your lips have no oil glands, they tend to dry out very easily. As a result, people slather on balm to relieve the dryness, which “makes them feel immediately better,” Romanowski says. But the balm can actually slow down your lips’ production of fresh new skin cells. “So when the lip balm wears off, as it inevitably does, your lips will feel more dry.”

What’s more, some common ingredients found in lip balms (like menthol and salicylic acid) may irritate your lips, leading you to re-apply in an attempt to soothe the irritation. Repeated often enough, this dryness-balm-more dryness cycle becomes a habit, which some describe as a psychological “addiction.” Romanowski notes, “It’s similar to someone biting their nails.”

But the conspiracy theories still linger. In fact, the rumors that lip balm manufacturers put certain ingredients in their wares in a sinister attempt to get people hooked are so pervasive that Carmex and ChapStick even address the issues on their official Web sites. Romanowski says there’s no truth to this, either. There are no physically addictive substances in balms. So if you think you’re addicted to lip balm, you’ve just got a bad habit.

If you want to wean yourself off lip balm, try these other tips from the American Academy of Dermatology to keep chapped, dry lips at bay this winter:

  • Use a humidifier to keep the air moist in your home.
  • Avoid licking your lips.
  • On cold, blustery winter days, cover your mouth with a scarf or face mask.

And if you’re not willing to part with your trusty ChapStick, don’t worry, says Romanowski: “Having a ‘lip balm addiction’ may be annoying, but it isn’t harmful.”

12 One-Minute Tricks That’ll Boost Your Health

1. Drink Before You Eat

One-minute trick: Guzzle two glasses of water a half-hour before mealtime. Aside from keeping you hydrated, keeping you “regular,” and keeping other bodily functions running smoothly, simply downing 16 ounces of water 30 minutes before each meal may prevent overeating and help with weight loss. Too easy to be true? Nope — not according to a study published in August 2015 in the journal Obesity. Researchers found that participants who “preloaded” with two glasses of water half an hour before meals lost more weight (nearly 3 pounds in 12 weeks, on average) than participants who didn’t preload with water. Bottoms up!

2. Power Up With Protein

One-minute trick:  Scramble an egg. Not only are eggs a classic on the breakfast menu, they’re a source of high-quality protein and nutrients. “Having protein with breakfast helps fill you up and keeps you feeling satisfied for longer,” says Everyday Health nutritionist Kelly Kennedy, RD. She recommends an egg on toast with avocado or another quick, protein-packed breakfast option like a yogurt-based smoothie. Just remember, not all protein is created equal. Skip the fatty bacon, pork sausages, and whole milk, and go for leaner proteins like turkey-based or vegetarian breakfast “meats,” smoked salmon, and low- or fat-free dairy.

3. Get Ready, Set, Stretch!

One-minute trick:  Start with a morning stretch, and take stretch breaks. Starting the day off with at least one minute of stretching can help get your blood flowing, ease morning muscle and joint stiffness, and invigorate you before you pour that first cup of coffee. Doing it on a regular basis throughout the day can also help increase your flexibility; improve balance, posture, and range of motion; lower your risk for muscle and joint injuries; and reduce joint and back pain. Warm up with static stretches: Stretch your arms out to the sides and up toward the ceiling, roll your shoulders, or lift up your knees. Then try dynamic stretching in which you hold the stretch for 10 to 30 seconds and repeat 2 to 4 times. Dynamic stretches include seated rotation and standing hamstring stretches as well as yoga poses like downward dog and child’s pose.

4. Practice Good Hand Hygiene

One-minute trick:  Wash your hands. An apple a day isn’t the only trick for keeping the doctor away. Frequently washing your hands can help, too. Handwashing is one of the easiest and most effective ways to keep from catching — and spreading — colds, the flu, and other illnesses and infections, say experts at the Centers for Disease Control and Prevention (CDC). If soap and water aren’t readily available, the CDC recommends using a hand sanitizer that contains at least 60 percent alcohol.

5. Take Your Grains To-Go

One-minute trick:  Get your fiber fix from portable whole grains in cups. Similar to the instant soup concept, whole grain cups, like Q Cups, can be transformed into a snack or side dish in a matter of minutes with a little boiling water. These organic cups of quinoa are high in fiber, protein, and other nutrients. “Q Cups can also be the base of a meal,” says culinary nutrition expert, Jessica Fishman Levinson, RDN. “Add some protein and lunch is done.” She points out that you can do the same in the morning with a cup of instant rolled oats in a to-go cup. “Add berries and nuts and it makes a quick, easy, healthy breakfast to help get you out the door,” she says.

6. Kick Croutons to the Carb Curb

One-minute trick:  Add nuts or seeds to salad instead of croutons. Since most croutons are not made with whole grains, swapping out croutons for nuts or seeds is an easy way to cut down on your consumption of simple carbs and boost your nutrient intake. “Healthy fat and a little protein add that crunch you’re looking for without the refined carbs,” says Levinson.

7. Go All Out With Exercise (for Just 60 Seconds!)

One-minute trick:  Do a really short high-intensity workout. “People are so concerned about making the time to get to the gym for an hour and a half, but if you compare someone who goes to the gym and works out in a steady state for a long time to someone who works out super hard for a short time, intensity will always trump duration,” says Los Angeles-based celebrity fitness coach, Andrea Orbeck. High Intensity Interval Training (HIIT) workouts are known to yield big results in short periods of time, she says. Additionally, a recent study published in PLOS One in April 2016 found that the same is true for Sprint Interval Training (SIT) — which yields results in even shorter bursts. The study showed that just one minute of intense exercise offered similar benefits as a 45-minute moderate-intensity workout. We’re not saying to ditch your regular exercise routine, but when you have a spare minute here and there (and if your doctor approves high-intensity activity), take 60 seconds and alternate walking or jogging in place with doing short, fast bursts of jumping jacks, squats, lunges, or sit-ups.

8. Pull Your Own Weight — Literally!

One-minute trick:  Use your body weight to get in some quick strength training. Goodbye, dumbbells. Hello, extra pounds left over from the holidays! Believe it or not, your own body weight can be an ideal tool for resistance. “Body weight exercise is cheap, adaptable, simple, and doesn’t require much space,” says Avigdor Dori Arad, RD, a certified exercise physiologist at Mount Sinai St. Luke’s hospital in New York City. “Body weight workouts can help you become lean, active, and strong.” In one minute, you can do push-ups, sit-ups, or squats, or combine them into a circuit.

9. Plan Your Snack Attack

One-minute trick:  Schedule quick-and-easy snacks between meals. Healthy snacking between meals (and before/after intense workouts) can help you achieve your weight goals in 2017. “It’s a good way to keep from feeling famished when you sit down to your next meal,” says Kennedy. Plus, healthy snacks give a boost to your metabolism, balance your blood sugar, and help prevent overeating. Kennedy suggests boiling some eggs and keeping them in the fridge for a grab-and-go snack; having some hummus and veggie sticks on hand; or slicing up an apple and smearing the pieces with 1 tablespoon of peanut butter.

10. Think Outside the Burrito

One-minute trick:  Use avocado instead of mayo. While Americans commonly associate avocados with Mexican food, this fruit (that’s right: fruit not vegetable) is quite versatile. We often see it used in salads, sushi rolls, and smoothies, too. Like nuts and olive oil, avocados are considered a healthy fat. High in monounsaturated fat and packed with nutrients, creamy avocado makes a more health-conscious condiment than mayonnaise. Next time you’re dressing up a burger or sandwich, Levinson suggests holding the mayo and spreading on a little avocado instead.

11. Give Yourself a Time-Out

One-minute trick:  Do a one-minute meditation. Although we hope you have a stress-free new year, we also know that stress creeps into everyone’s lives from time to time. Not all stress is bad. In fact, it can be motivational — and even lifesaving — in certain situations, but some kinds of stress can also wreak havoc on your health. One practical way to regain your sense of calm and balance, manage stress, and help prevent its harmful effects is to meditate. It can be as easy as closing your eyes and breathing deeply, practicing deep breathing on a walk, repeating a mantra, or praying.

12. Keep Happy Hour Happy

One-minute trick: Swap your mixed cocktail for a glass of red wine. Cocktails can be a fun and relaxing way to mark the end of a workday, but many cocktails contain sugary and fatty ingredients so your glass of cheer may also end up being a calorie bomb. Instead, Levinson suggests celebrating with a glass of red wine. “It can help you save 200 or more calories,” she says. “Plus you get the antioxidant benefit from resveratrol.” Resveratrol, one of the polyphenols in red wine, may help prevent damage to blood vessels, lower “bad” LDL cholesterol, and reduce risks of blood clots. Not a fan of red wine? Go for lower calorie cocktails that don’t contain sugary mixers, simple syrup, or full-fat dairy or coconut milk, like champagne with fresh-squeezed juice, a vodka soda, gin and tonic, or a classic martini.

Many on Medical Guideline Panels Have Conflicts

More than half of panel members who gather to write clinical practice guidelines on diabetes and high cholesterol have conflicts of interest, new research suggests. Please use Obat Pembesar Penis for your vitality

“The concern is that compensation by industry on some of these panels can pose a potential risk of industry influence on the guideline recommendations,” said Dr. Jennifer Neuman, lead author of a paper published online Oct. 11 in the BMJ.

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In the United States and Canada, most organizations (including nonprofit and governmental bodies) have their own protocol for divulging conflicts of interest.

And recently, the Institute of Medicine (IOM) published recommendations on how organizations should manage conflicts of interest when drawing up guidelines. Among other things, the institute advocated excluding individuals with financial ties to thedrug industry.

The authors of this paper looked at conflicts of interest, both reported and unreported, among members of 14 different guideline panels in the United States and Canada over the past decade. They focused on two categories only: high cholesterol and diabetes, which account for a lion’s share of drug expenditures. read more about Obat Pembesar Alat Vital Pria

Organizations included the American Heart Association, the American Diabetes Association and the U.S. Preventive Services Task Force (USPSTF).

Five of the organizations did not require conflict-of-interest disclosures from panel members, the investigators found.

Among a total of 288 panel members, conflicts of interest were found among 52 percent, overall.

And 11 percent of those who claimed no conflicts actually did have conflicts, though, to be fair, Neuman said, most fell within the range of their particular organization’s cut-off point for declaration, albeit not within the cut-off established by these authors.

In addition, half of panel chairs had conflicts, the authors said.

On the other hand, only 16 percent of panel members from government-sponsored guidelines such as the USPSTF declared conflicts, versus 69 percent of non-governmental entities.

The authors noted that unless a particular journal publishing guidelines requires it, USPSTF divulges conflicts of interest only after a Freedom of Information Act request has been filed.

“The difference between the degree of conflict found on government and non-government panels was very surprising to us,” said Neuman, who is an instructor of preventive medicine at the Mount Sinai School of Medicine in New York City. “It is possible to convene guideline panels that do not have very much conflict.”

In a written comment, the American Heart Association stated that the association “has long had strict policies for preventing any undue influence of industry. In 2010, we refined our policies to require even more stringent management of relationships with industry, to align with the Council of Medical Specialty Societies. Thus, the conclusions drawn by the British Medical Journal article do not reflect the reality of the guidelines development process today, when, for example, all Chairs of our guideline writing groups are free of relationships with industry and we assure that more than 50 percent of each writing group are also free of such relationships. . . . The association believes that our policies control the potential for inappropriate bias to influence guidelines development.”

Dr. Sue Kirkman, senior vice president of medical affairs and community information at the American Diabetes Association, said that the association was “moving towards meeting the standards in the IOM report.” One of the changes it’s making is to try to weed out people with conflicts before appointing them to a panel. The current guidelines, though, she added, are in the best medical interest.

“In general, most people on guideline panels are interested in doing the right thing and promoting evidence-based data but it’s really important to follow . . . recommendations from the IOM towards increased transparency to prevent any potential biases from coming in,” Neuman said.

New Bacteria Linked to Tattoo Infections

An investigation into skin lesions that two people developed after getting tattoos has concluded that both were infected with a bacteria not previously linked to the practice.

The infections involved Mycobacterium haemophilum, which usually only strikes individuals whose immune system are compromised. In this instance, however, the patients, both from Seattle, developed rashing despite the fact that both had normal immune systems, a report on the investigation found.

“Two people developed chronic skin infections after receiving tattoos at the same parlor,” explained study lead author Dr. Meagan K. Kay from the U.S. Centers for Disease Control and Prevention. “The patrons were thought to have been exposed through use of tap water during rinsing and diluting of inks.”

Kay, an epidemic intelligence service officer with the CDC, and her team report their findings in the September issue of the CDC’s journal Emerging Infectious Diseases.

The authors pointed out that tattooing is not considered a sterile procedure, is not regulated at the federal level and can be risky. And while the specific inks and colorings (pigments) commonly used to apply tattoos are regulated by the U.S. Food and Drug Administration, the rules usually apply only when cosmetics or color additives are involved.

The latest concern about associated infection risk arose in 2009 when a 44-year-old man and a 35-year-old man sought care for skin infections that had developed at the site of tattoos acquired at a facility in the Seattle region.

Lesion cultures and lab testing revealed that M. haemophilum was the culprit in the case of the first patient. Skin evaluations and patient interviews led the researchers to conclude that the second man most probably also suffered from the same sort of bacterial infection, although they technically classified his situation as a “suspected case.”

A follow-up investigation of the tattoo parlor revealed that municipal water had been used to dilute the ink during the tattooing process.

Water is considered to be a source for M. haemophilum. And though the facility was cleared of any safety violations, and no M. haemophilum bacteria was found in analyzed water samples, the tattoo operators were told to use sterile water for all future tattoo applications.

“It is important to remember that tattooing is not a sterile procedure and infections can occur after tattoo receipt,” Kay said. “Measures should be taken by tattoo artists to prevent infections, including proper training, use of sterile equipment, and maintaining a clean facility. Use of tap water during any part of the tattoo procedure should be avoided,” she explained.

“Those who suspect an infection in their tattoo should consult with their doctors,” she added. “Common infections can present as increased redness, warmth, swelling, pain and discharge.”

Myrna L. Armstrong, professor emeritus at the school of nursing at Texas Tech University’s Health Sciences Center in Lubbock, said the investigation serves to highlight the general risks of getting a tattoo.

“This is an invasive procedure. And there’s basically no regulation in force. Or very sporadic regulation. So as someone who’s been looking into tattoos and body piercing for more than 20 years, I would say that it’s really not very surprising that this can happen,” Armstrong said.

“So while I’m not being negative to the industry, I do think that the customer does need to be aware of the situation he or she is getting into,” she added. “Shop around, review people’s techniques, and make sure [you] really want to have this done.”