Should You Pop a Zit?

Tempted to pop that annoying zit? See what happens when you do, and why your best bet is to leave it be.

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WHO Says Childhood Obesity Among Most Serious Health Challenges this Century

The World Health Organization made this assertion in an assessment published March of 2012.  Childhood obesity is certainly a growing epidemic in the United States. According to the CDC, it affects more than 30 percent of children, making it the most common chronic health concern for the young. This number has more than tripled in the US since the 1970’s, and, if current trends continue, more than half of all children in the US today will be characterized as obese as an adult.

Obesity can harm nearly every system in a developing body – heart and lungs, muscles and bones, kidneys and digestive tract, as well as the hormones that control blood sugar and puberty.  It can also take a heavy social and emotional toll that is incalculable.   Medical experts say youth who are overweight or obese have substantially higher odds of remaining so into adulthood, increasing their risk of disease and disability later in life.

WARNING:  Those with patterns of disordered eating may be triggered by this article, and there are certainly strong opinions associated with the word obesity and anyone being characterized as “obese”.

Childhood Obesity Statistics

Globally, an estimated 43 million preschool children (under age 5) were overweight or obese in 2010, a 60 percent increase since 1990. The problem affects countries rich and poor, and by sheer numbers, places the greatest burden on the poorest.  Of the world’s 43 million overweight and obese preschoolers, 35 million live in developing countries. By 2020, if the current epidemic continues unabated, 9 percent of all preschoolers will be overweight or obese – nearly 60 million children.

Here in the United States, childhood obesity has increased nearly 3-fold since 1980, and today, the country has some of the highest obesity rates in the world. One out of six children is obese, and one out of three is overweight or obese. Though the overall U.S. child obesity rate has held steady since 2008, some groups have continued to see increases, and some groups have higher rates of obesity than others.  For children and adolescents aged 2-19 years:

  • The prevalence of obesity was 18.5% and affected about 13.7 million children and adolescents.
  • Obesity prevalence was 13.9% among 2- to 5-year-olds, 18.4% among 6- to 11-year-olds, and 20.6% among 12- to 19-year-olds. Childhood obesity is also more common among certain populations.
  • Hispanics (25.8%) and non-Hispanic blacks (22.0%) had higher obesity prevalence than non-Hispanic whites (14.1%).
  • Non-Hispanic Asians (11.0%) had lower obesity prevalence than non-Hispanic blacks and Hispanics.
  • The prevalence of obesity decreased with increasing level of education of the household head among children and adolescents aged 2-19 years.
  • Obesity prevalence was 18.9% among children and adolescents aged 2-19 years in the lowest income group, 19.9% among those in the middle income group, and 10.9% among those in the highest income group.
  • Obesity prevalence was lower in the highest income group among non-Hispanic Asian and Hispanic boys.
  • Obesity prevalence was lower in the highest income group among non-Hispanic white, non-Hispanic Asian, and Hispanic girls. Obesity prevalence did not differ by income among non-Hispanic black girls.

How Childhood Obesity is Measured

A child is described as “affected by obesity” if their body mass index-for-age (or BMI-for-age) percentile is greater than 95 percent. A child is described as “overweight” if their BMI-for-age percentile is greater than 85 percent and less than 95 percent.

Measuring Weight Status

Obesity in children is determined by using BMI-for-age percentiles. BMI-for-age percentiles have emerged as the favored method to measure weight status in children. This method calculates your child’s weight category based on age and BMI, which is a calculation of weight and height. However, it should be kept in mind that this method, among other methods, should be used as a tool, and only a physician can best determine and diagnose weight status in your child.

Measuring Growth in Children

You may have heard your pediatrician refer to your child’s weight in terms of a percentile. To measure growth in your child based on their weight, doctors most commonly use weight-for-age percentiles. Weight-for-age percentiles are used to measure your child’s weight based strictly on age. It does not take into account the height of a child. This is not a method to determine obesity (or overweight) in children, but simply an indicator of growth as compared to children of the same age.

For example, if your child is in the 95th percentile, this means that their weight is greater than 95 percent of children of the same age.

About Body Mass Index (BMI)

BMI is the most common method to measure adult obesity. However, BMI is now becoming a popular tool, which is combined with BMI-for-age percentiles, used to measure obesity in children. BMI is a number calculated by dividing a person’s weight in kilograms by his or her height in meters squared.

It should be noted, again, BMI is one simple measure that may or may not correlate with true health.  Other measures, such as actual metabolic scores and grip strength may be better indicators of overall health.

Risks Associated with Childhood Obesity

Children who are considered affected by obesity are 70 percent more likely to continue being affected by obesity into adulthood. In addition, they are at greater risk for serious medical issues such as:

  • Heart disease
  • High cholesterol
  • High blood pressure
  • Diabetes
  • Sleep Apnea
  • Cancer

Aside from the clinical perspective, children who are affected by obesity face social discrimination, leading to low self-esteem and depression.

Causes of Childhood Obesity

Although the causes of childhood obesity are widespread, certain factors are targeted as major contributors to this epidemic. Causes include:

  • Environment
  • Microbiome
  • Lack of physical activity
  • Heredity and Family
  • Dietary Patterns
  • Socioeconomic status

Environment

Today’s environment plays a major role in shaping the habits and perceptions of children and adolescents. The prevalence of television commercials promoting unhealthy foods and eating habits is a large contributor. In addition, children are surrounded by environmental influences that demote the importance of physical activity.

Today, it is estimated that approximately 40 to 50 percent of every dollar that is spent on food is spent on food outside the home in restaurants, cafeterias, sporting events, etc. In addition, as portion sizes have increased, when people eat out they tend to eat a larger quantity of food (calories) than when they eat at home.

Beverages such as soda and juice boxes also greatly contribute to the childhood obesity epidemic. It is not uncommon for a 32-ounce soda to be marketed toward children, which contains approximately 400 calories. The consumption of soda by children has increased throughout the last 20 years by 300 percent. Scientific studies have documented a 60 percent increase risk of obesity for every regular soda consumed per day. Box drinks, juice, fruit drinks and sports drinks present another significant problem. These beverages contain a significant number of calories and it is estimated that 20 percent of children who are currently overweight are overweight due to excessive caloric intake from beverages.

Microbiome

Recent studies indicate weight gain trajectories in early childhood are related to the composition of oral bacteria of two-year-old children, suggesting this understudied aspect of a child’s microbiota –  the collection of microorganisms, including beneficial bacteria, residing in the mouth –  could serve as an early indicator for childhood obesity. A study describing the results appears September 19 in the journal Scientific Reports. [1]

Lack of Physical Activity

Children in today’s society show a decrease in overall physical activity. The growing use of computers, increased time watching television and decreased physical education in schools, all contribute to children and adolescents living a more sedentary lifestyle.

Another major factor contributing to the childhood obesity epidemic is the increased sedentary lifestyle of children. School-aged children spend most of their day in school where their only activity comes during recess or physical education classes. In the past, physical education was required on a daily basis. Currently, only 8 percent of elementary schools and less than 7 percent of middle schools and high schools have daily physical education requirements in the U.S.

Heredity and Family

Science shows that genetics play a role in obesity. It has been proven that children with parents affected by obesity are more likely to be affected as well. Estimates say that heredity contributes between 5 to 25 percent of the risk for obesity.

However, genes alone do not always dictate whether a child is affected by excess weight or obesity. Learned behaviors from parents are a major contributor. Parents, especially of those whose children are at risk for obesity at a young age, should promote healthy food and lifestyle choices early in their development.

Dietary Patterns

Over the past few decades, dietary patterns have changed significantly. The average amount of calories consumed per day by has dramatically increased. Furthermore, the increase in caloric intake has also decreased the nutrients needed for a healthy diet.

Food portions also play an important role in the unhealthy diet patterns that have evolved. The prevalence of “super size” options and “all you can eat” buffets create a trend in overeating. Combined with a lack of physical activity, children are consuming more and burning off less.

Socioeconomic Status

Children and adolescents that come from lower-income homes are at greater risk of being affected by obesity. This is a result of several factors that influence behaviors and activities.

Lower-income children cannot always afford to partake in extracurricular activities, resulting in a decrease in physical activity. In addition, families who struggle to pay bills and make a living often opt for convenience foods, which are higher in calories, fat and sugar.

Educational levels also contribute to the socioeconomic issue associated with obesity. Parents with little to no education have not been exposed to information about proper nutrition and healthy food choices. This makes it difficult to instill those important values in their children.

What to do about Treating Childhood Obesity

Treating obesity in children and adolescents differs from treatment in adults. Involving the family in a child’s weight management program is a key element to treatment. As a support system, family is integral in ensuring all health goals, not just weight, are met.

It is important to talk with your physician about options for treating childhood obesity. The various treatments of obesity in children and adolescents include:

  • Diet therapy
  • Physical activity
  • Behavior Modification
  • Surgery

Diet Therapy

When treating a child or adolescent affected by obesity, it is often recommended they have a consultation with a nutritionist that specializes in children’s needs. Nutritionists can best help children understand healthy eating habits and how to implement them in their long-term diet.

In some cases, nutritionists do not always recommend restricting caloric intake for children. Education on how to read food labels, cut back on portions, understand the food pyramid and eat smaller bites at a smaller pace is generally the information given to change a child’s eating habits.

The goal should be to enjoy a balanced and nutritious diet and have an appropriate level of physical activity to promote overall health and well-being.

Physical Activity

Another form of treatment of obesity in children is increasing physical activity. Physical activity is an important long-term ingredient for children, as studies indicate that inactivity in childhood has been linked to a sedentary adult lifestyle.

Increasing physical activity can decrease, or at least slow the increase, in fatty tissues in children affected by obesity. The US Surgeon General recommends that children get at least 60 minutes of physical activity each day. Individualized programs are available and possible for those children or adolescents that are not able to meet minimum expectations.

Behavior Modification

Lifestyles and behaviors are established at an early age. It is important for parents and children to remain educated and focused on making long-term healthy lifestyle choices.

There are several ways that children and adolescents can modify their behavior for healthier outcomes, such as: changing eating habits, increasing physical activity, becoming educated about the body and how to nourish it appropriately, engaging in a support group or extracurricular activity and setting realistic weight management goals.

Surgery

While surgery has been performed on adolescents in extreme cases to treat obesity, it is only considered for those with severe medical conditions that can only be improved through such intervention.

Get Connected

Everyday, you can find physicians in your area who are looking for new and unique ways to connect and collaborate with you on your care and the wellness of your family.  You might find them in HealthLynked – the first of its kind social ecosystem designed to truly allow patients and physicians to engage online in ways never before possible.

If you have a loved one facing the challenges of Childhood Obesity, or any other health concern, find help by getting Lynked.  Go to HealthLynked.com to sign up for free and start taking control of your family’s health.

 

Adapted from:

ObesityAction.org

Harvard.edu

CDC.gov

References:

[1]  Sarah J. C. Craig, Daniel Blankenberg, Alice Carla Luisa Parodi, Ian M. Paul, Leann L. Birch, Jennifer S. Savage, Michele E. Marini, Jennifer L. Stokes, Anton Nekrutenko, Matthew Reimherr, Francesca Chiaromonte, Kateryna D. Makova. Child Weight Gain Trajectories Linked To Oral Microbiota CompositionScientific Reports, 2018; 8 (1) DOI: 10.1038/s41598-018-31866-9

 

Type B Thoracic Aortic Dissection: When to Intervene

In this roundtable discussion originally posted on Medscape Cardiology, Mayo Clinic Cardiology, Cardiac Surgery, and Vascular Surgery specialists Robert D. McBane, M.D., Randall R. De Martino M.D., Thomas C. Bower, M.D., and Alberto Pochettino, M.D., discuss when to intervene in Type B thoracic aortic dissection cases.

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Stroke Facts | cdc.gov

 

Stroke mortality map.The country’s highest death rates from stroke are in the southeastern United States.2

Find facts and statistics about stroke in the United States.

Stroke Statistics

  • Stroke kills about 140,000 Americans each year—that’s 1 out of every 20 deaths.1
  • Someone in the United States has a stroke every 40 seconds. Every 4 minutes, someone dies of stroke.2
  • Every year, more than 795,000 people in the United States have a stroke. About 610,000 of these are first or new strokes.2
  • About 185,00 strokes—nearly 1 of 4—are in people who have had a previous stroke.2
  • About 87% of all strokes are ischemic strokes, in which blood flow to the brain is blocked.2
  • Stroke costs the United States an estimated $34 billion each year.2 This total includes the cost of health care services, medicines to treat stroke, and missed days of work.
  • Stroke is a leading cause of serious long-term disability.2 Stroke reduces mobility in more than half of stroke survivors age 65 and over.2

Stroke Statistics by Race and Ethnicity

  • Stroke is the fifth leading cause of death for Americans, but the risk of having a stroke varies with race and ethnicity.
  • Risk of having a first stroke is nearly twice as high for blacks as for whites,2 and blacks have the highest rate of death due to stroke.1
  • Though stroke death rates have declined for decades among all race/ethnicities, Hispanics have seen an increase in death rates since 2013.1

Stroke Risk Varies by Age

  • Stroke risk increases with age, but strokes can—and do—occur at any age.
  • In 2009, 34%of people hospitalized for stroke were less than 65 years old.3

Early Action Is Important for Stroke

Know the warning signs and symptoms of stroke so that you can act fast if you or someone you know might be having a stroke. The chances of survival are greater when emergency treatment begins quickly.

  • In one survey, most respondents—93%—recognized sudden numbness on one side as a symptom of stroke. Only 38% were aware of all major symptoms and knew to call 9-1-1 when someone was having a stroke.4
  • Patients who arrive at the emergency room within 3 hours of their first symptoms often have less disability 3 months after a stroke than those who received delayed care.4

Americans at Risk for Stroke

High blood pressure, high cholesterol, smoking, obesity, and diabetes are leading causes of stroke. 1 in 3 US adults has at least one of these conditions or habits.

You can take steps to prevent stroke.

More Information

From CDC:

From other organizations:

References

  1. Vital Signs: Recent trends in stroke death rates – United States, 2000-2015. MMWR 2017;66.
  2. Benjamin EJ, Blaha MJ, Chiuve SE, et al. on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2017 update: a report from the American Heart Association. Circulation. 2017;135:e229-e445.
  3. Hall MJ, Levant S, DeFrances CJ. Hospitalization for stroke in U.S. hospitals, 1989–2009. NCHS data brief, No. 95. Hyattsville, MD: National Center for Health Statistics; 2012.
  4. Fang J, Keenan NL, Ayala C, Dai S, Merritt R, Denny CH. Awareness of stroke warning symptoms—13 states and the District of Columbia, 2005. MMWR 2008;57:481–5.

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Top Shaving Tips for Women

Have you nailed down a shaving strategy? Or are you still searching for ways to get a smoother, closer shave? Sharpen up your routine with these tips.

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Differentiating Childhood Apraxia of Speech (CAS) from other types of speech sound disorders

Dr. Edythe Strand, Emeritus Professor and Consultant, division of Speech Pathology, Department of Neurology, Mayo Clinic, compares and contrasts CAS with other types of speech disorders, including phonological impairment and dysarthria.

For more information, visit http://mayocl.in/2ifnYX3

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Farsightedness – Genetics Home Reference

 

Farsightedness, also known as hyperopia, is an eye condition that causes blurry near vision. People who are farsighted have more trouble seeing things that are close up (such as when reading or using a computer) than things that are far away (such as when driving).

For normal vision, light passes through the clear cornea at the front of the and is focused by the lens onto the surface of the , which is the lining of the back of the eye that contains light-sensing cells. Some people who are farsighted have eyeballs that are too short from front to back. Others have a cornea or lens that is abnormally shaped. These changes cause light entering the eye to be focused too far back, behind the retina instead of on its surface. It is this difference that causes nearby objects to appear blurry. In a person with this condition, one eye may be more farsighted than the other.

If it is not treated with corrective lenses or surgery, farsightedness can lead to eye strain, excess tearing, squinting, frequent blinking, headaches, difficulty reading, and problems with hand-eye coordination. However, some children with the eye changes characteristic of farsightedness do not notice any blurring of their vision or related signs and symptoms early in life. Other parts of the visual system are able to compensate, at least temporarily, for the changes that would otherwise cause light to be focused in the wrong place.

Most infants are born with a mild degree of farsightedness, which goes away on its own as the eyes grow. In some children, farsightedness persists or is more severe. Children with a severe degree of farsightedness, described as high hyperopia, are at an increased risk of developing other eye conditions, particularly “lazy eye” (amblyopia) and eyes that do not look in the same direction (strabismus). These conditions can cause significant visual impairment.

In general, older adults also have difficulty seeing things close up; this condition is known as . Presbyopia develops as the lens of the eye becomes thicker and less flexible with age and the muscles surrounding the lens weaken. Although it is sometimes described as “farsightedness,” presbyopia is caused by a different mechanism than hyperopia and is considered a separate condition.

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What is Idiopathic Thrombocytopenic Purpura ?

Our six year old came in from playing on a warm summer’s day.  She seemed her normal, happy and carefree self, but when she jumped into my lap, I noticed dime sized bruises all over her legs, evenly spaced.  It looked odd to say the least, and she couldn’t say anything had happened, so we called the clinic to discuss with the on duty nurse.

“So, you have an active 6 year old with bruises on her legs; doesn’t seem like a big deal to me,” was her response.  After sharing with the nurse I didn’t think she quite understood, which she agreed – at least she couldn’t understand the worry in my voice – she asked we bring her in….

We found out she had Henoch-Schonlein purpura (HEN-awk SHURN-line PUR-pu-ruh) – a disorder that causes inflammation and bleeding in the small blood vessels in your skin, joints, intestines and kidneys.  While this is not ITP, it was our introduction to the words purpura, platelets and thrombocytopenia.

September is National ITP Awareness Month

Chronic ITP and platelet function disorders are perhaps the most common bleeding disorder. It affects both sexes and all ages and races. While we don’t know for sure, there are an estimated 120,000 persons with ITP in the United States. That’s more than 10 times the number of people with Hemophilia!

The purpose of ITP awareness month is to increase the public’s awareness and understanding of ITP and to let patients and families know that there are resources and support available to help them have the best possible outcomes. Patients and families are not alone.

What is ITP?

Platelets are relatively small, irregularly shaped components of our blood. They are required to support the integrity of our blood vessel walls and for blood to clot. Without enough platelets, a person is subject to spontaneous bleeding or bruising.

Idiopathic thrombocytopenic purpura (ITP) is a disorder that can lead to easy or excessive bruising and bleeding. The bleeding results from unusually low levels of platelets — the cells that help blood clot.

Idiopathic thrombocytopenic purpura, which is also called immune thrombocytopenia, affects children and adults. Children often develop ITP after a viral infection and usually recover fully without treatment. In adults, the disorder is often long term.

If you don’t have signs of bleeding and your platelet count isn’t too low, you may not need any treatment. In rare cases, the number of platelets may be so low that dangerous internal bleeding occurs. Treatment options are available.

Symptoms

Idiopathic thrombocytopenic purpura (ITP) may have no signs and symptoms. When they do occur, they may include:

  • Easy or excessive bruising (purpura)
  • Superficial bleeding into the skin that appears as a rash of pinpoint-sized reddish-purple spots (petechiae), usually on the lower legs
  • Bleeding from the gums or nose
  • Blood in urine or stools
  • Unusually heavy menstrual flow

Causes

In some people thrombocytopenia is caused by the immune system mistakenly attacking and destroying platelets. If the cause of this immune reaction is unknown, the condition is called idiopathic thrombocytopenic purpura. Idiopathic means “of unknown cause.”

In most children with ITP, the disorder follows a viral illness, such as the mumps or the flu. It may be that the infection triggers the immune system malfunction.

Increased breakdown of platelets

In people with ITP, antibodies produced by the immune system attach themselves to the platelets, marking the platelets for destruction. The spleen, which helps your body fight infection, recognizes the antibodies and removes the platelets from your system. The result of this case of mistaken identity is a lower number of circulating platelets than is normal.

A normal platelet count is generally between 150,000 and 450,000 platelets per microliter of circulating blood. People with ITP often have platelet counts below 20,000. Because platelets help the blood clot, as their number decreases, your risk of bleeding increases. The greatest risk is when your platelet count falls very low — below 10,000 platelets per microliter. At this point, internal bleeding may occur even without any injury.

Risk factors

Idiopathic thrombocytopenic purpura can occur in anyone at almost any age, but these factors increase the risk:

  • Your sex. Women are two to three times more likely to develop ITP than men are.
  • Recent viral infection. Many children with ITP develop the disorder after a viral illness, such as mumps, measles or a respiratory infection.

Complications

Spontaneous bleeding can also occur in mucous membranes inside the mouth or in the gastrointestinal tract. ITP is often accompanied by fatigue and sometimes depression.

A rare complication of idiopathic thrombocytopenic purpura is bleeding into the brain, or disruptive bleeding into internal organs, which can be fatal.

Pregnancy

In pregnant women with ITP, the condition doesn’t usually affect the baby. But the baby’s platelet count should be tested soon after birth.

If you’re pregnant and your platelet count is very low, or you have bleeding, you have a greater risk of heavy bleeding during delivery. In such cases, you and your doctor may discuss treatment to maintain a stable platelet count, taking into account the effects on your baby.

When to see a doctor

Make an appointment with your doctor if you or your child develop symptoms that worry you.

Bleeding that won’t stop is a medical emergency. Seek immediate help if you or your child experiences bleeding that can’t be controlled by the usual first-aid techniques, such as applying pressure to the area.

The best way to find a physician to talk to you about abnormal bleeding or bruising is to search online through the large data base at HealthLynked.  We are connecting physicians and patients in new ways so they can more closely collaborate on care and wellness.

Ready to get Lynked?  Go to HealthLynked.com to get started, today, for free!

 

 

WebMD Animation: White House Garden

From the WebMD Archives:

First Lady Michelle Obama describes the White House garden to a young girl in the audience at WebMD’s town hall, “Simple Tips for Healthy Families.” Watch the garden come to life in this fun animated short for families to enjoy!

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