July is Sarcoma Awareness Month – Raise Awareness for this “Forgotten Cancer”

If you see yellow ribbons around your community during the month of July, it may mean something different than the usual “Support Our Troops” many think of when first sighted. Instead, they could be displayed in honor of Sarcoma Awareness Month, observed each July.

Sarcoma is a soft-tissue cancer that may occur in a variety of the body’s soft tissues, including the nerves, muscles, joints, blood vessels, fat and more. Sarcoma may also occur in the bones.  Although rare in adults, making up just ONE percent of adult cancers, sarcoma is relatively common in children, accounting for fifteen percent of childhood cancer cases.  Bone and joint cancer is most frequently diagnosed among teenagers, while soft tissue cancers typically affect those 55 years or older.

Sarcoma is most often found in the arms and legs, where the majority of connective tissues are located, but it can occur virtually anywhere. Because the disease often starts deep in the body, it may not be noticeable until a large lump or bump appears — and at this point the cancer may be difficult to treat.

The Sarcoma Foundation of America (SFA) estimates that about 20 percent of sarcoma cases are curable by surgery while another 30 percent may be effectively treated with surgery, chemotherapy and/or radiation. However, in about half of cases, the disease is resistant to all form of treatments, highlighting an urgent need for new therapies.

Soft tissue sarcomas form in cartilage, fat, muscle, blood vessels, tendons, nerves, and around joints. Osteosarcomas develop in bone; liposarcomas form in fat; rhabdomyosarcomas form in muscle; and Ewing sarcomas form in bone and soft tissue.

In 2018, over 13,000 cases of soft tissue sarcoma and 3,400 cases of bone sarcomas are expected to be diagnosed in the United States, according to data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program (SEER). Approximately 5,100 and 1,590 people are expected to die from soft tissue and bone sarcomas, respectively. The five-year survival rate for soft tissue sarcomas is 50 percent, while the survival rate is 66 percent for bone sarcomas.

Because sarcomas are difficult to distinguish from other cancers when they are found within organs, their incidence is probably underestimated, according to the National Cancer Institute.

 Fast facts on sarcoma

  • There are over 50 types of soft tissue sarcoma.
  • Symptoms may not be apparent; often, the only sign of sarcoma is a lump.
  • Pain may occur depending on where the tumor is located, or if it presses on nearby nerves.
  • Treatment, as for other forms of cancer, can include surgery, radiation therapy, and chemotherapy.

Symptoms of soft tissue sarcoma

People with soft tissue sarcomas often have no symptoms. There may be no signs until the lump grows to a large size and can be felt; however, even this may go unnoticed. The main symptoms are:

  • Pain – the most obvious symptom. Once the tumor affects local tissues, nerves, or muscles, it can be felt as pain in the general area.
  • Inflammation – the tumor grows and eventually affects the area with inflammation and swelling.
  • Location specific symptoms – inability to move limbs properly (if the sarcoma is on the arms or legs for example) and other impairments depending on the location.

Specific symptoms may reflect the particular type of sarcoma. For instance, tumors in the gastrointestinal system may bleed, so these sarcomas might produce symptoms like blood in the stool, or a stool that has a black, tarry appearance.

Types of sarcoma

Types of soft tissue sarcoma are defined by the specific tissue or location affected; they include:

  • Undifferentiated pleomorphic sarcoma – previously known as malignant fibrous histiocytoma – this tumor is most often found in the arms or legs but sometimes at the back of the abdomen.
  • Gastrointestinal stromal tumor (GIST) – this affects specialized neuromuscular cells of the gut.
  • Liposarcoma – sarcoma of fat tissue.
  • Leiomyosarcoma – affects smooth muscle in organ walls.
  • Synovial sarcomas – these are usually found around a joint in the arms or legs.
  • Malignant peripheral nerve sheath tumor – also known as neurofibrosarcoma, it affects the protective lining of the nerves.
  • Rhabdomyosarcoma – this forms in muscle and is a childhood cancer. While rare overall, it is a relatively common tumor in children.
  • Angiosarcomas – these develop in the cells of the blood or lymph vessels.
  • Fibrosarcomas – sarcomas that usually form in the limbs or on the trunk, forming from fibroblasts, the most common cell type in connective tissue.
  • Kaposi’s sarcoma – a sarcoma that affects the skin and is caused by a virus. The most common form of Kaposi’s sarcoma is related to AIDS.  Kaposi’s tumors often produce distinctive skin lesions but also affect other soft tissues.  Kaposi’s sarcoma is caused by the human herpesvirus 8.
  • Further examples – these include dermatofibrosarcoma protuberans, a skin lesion; epithelioid sarcoma, which often affects young adults’ hands or feet; myxoma, which affects older adults, usually in the arms and legs; mesenchymomas, which are rare and combine elements of other sarcomas and can be found in any part of the body; vascular sarcomas, containing many blood vessels; and malignant neurilemmoma (also known as schwannoma).  Sarcoma of the bone includes osteosarcoma, Ewing sarcoma, and chondrosarcoma.

Causes of sarcoma

The causes behind sarcoma are unknown, but there are some known risk factors. In adults, for instance, exposure to phenoxy acetic acid in herbicides or chlorophenols in wood preservatives may increase the risk. High doses of radiation are also known to cause sarcomas in some people, as are certain rare genetic alterations. The following inherited diseases are also associated with an increase sarcoma risk, according to SFA:

  • Li-Fraumeni syndrome, which is associated with alterations in the p53 gene
  • Von Recklinghausen’s disease (neurofibromatosis), which is associated with alterations in the NF1 gene

Having certain inherited disorders can increase the risk for other soft tissue sarcomas, including retinoblastoma, tuberous sclerosis, Werner syndrome, and nevoid basal cell carcinoma syndrome. Other risk factors for soft tissue sarcoma include past treatment with radiation therapy for certain cancers; exposure to certain chemicals, such as thorium dioxide, vinyl chloride, or arsenic; and long-term lymphedema in the arms or legs.

Past treatment with radiation can increase the risk of osteosarcoma and other types of bone cancers. Other risk factors for osteosarcoma include treatment with anticancer drugs called alkylating agents, having a certain change in the retinoblastoma gene, and having certain conditions including Paget disease, Diamond-Blackfan anemia, and Werner syndrome.

Tests and diagnosis of sarcoma

After understanding a patient’s medical history and completing a medical examination, medical imaging scans will help to inform a diagnosis, which will need to be confirmed through laboratory analysis of a tumor sample.

The following physical features should prompt a doctor to investigate:

  1. larger than 2 inches in diameter or growing in size
  2. fixed, immovable, or deep
  3. painful
  4. return of tumor previously removed

Medical imaging helps to locate, characterize, and give further information about a tumor to guide diagnosis. It may also be used to gauge the success of treatment or to look for spread of cancer.

Imaging techniques include X-rays, CT scan (computed tomography), MRI(magnetic resonance imaging), ultrasound, and PET (positron emission tomography).

Treatments for soft tissue sarcoma

The following treatment options can be used for sarcomas:

  • Surgery – the most common sarcoma treatment. It aims to remove the tumor and even some of the normal surrounding tissue. A biopsy sample is often taken at the same time to confirm the exact type of tumor.
  • Radiation therapy – this destroys cancer cells and may be done in addition to surgery, before or after the operation.
  • Chemotherapy – this could also be used in addition to surgery, though less often than radiation therapy.

Some soft tissue sarcomas have other available treatments, such as specific drug treatments, gene-targeted therapies, or biological therapies such as immunotherapy.

Treatment choice and intensity are also guided by the stage and grade of cancer, by the size of the tumor, and extent of any spread.

Prevention of sarcoma

Sarcoma is not typically preventable. Radiation therapy is a risk factor, so reducing exposure to it may be preventive, although a need for radiation therapy usually outweighs any subsequent sarcoma risk.

Observing Sarcoma Awareness Month

Sarcoma is still considered to be the “forgotten cancer.”  Efforts to encourage research and drug development are made more challenging due to a lack of awareness and understanding.  How as a community do we raise funds for vital research if people don’t know that this cancer exists?

Though the Sarcoma Foundation of America works tirelessly every day to raise awareness, during Sarcoma Awareness Month, they aim to further highlight the extraordinary challenges sarcoma patients face and the need for more sarcoma research and better sarcoma therapies.  Please join in efforts and pledge to bring awareness to your community.  Here are a few ways you can help highlight the need for ongoing research on sarcoma:

  • This July, take a moment to share a message via social media or speak with your friends and family about this relatively unknown condition.
  • Join sarcoma patients, survivors and their loved ones for the Steps to Cure Sarcoma.  Every dollar raised will be used to fund research, patient advocacy and education.
  • Take a moment to listen to a Sarcoma Awareness Month Public Service Announcement campaign. Share it online to raise awareness.
  • Get together with others in the sarcoma community and donate today!

Getting Help

Since sarcoma is a rare cancer, many people are unfamiliar with the disease and have not been affected personally. However, many children’s lives have been altered because of this disease, and advances in early detection and treatment could help save lives.

A number of clinical trails are underway for people with sarcoma. If you’ve been recently diagnosed, ask your doctor if a clinical trial, which could give you access to novel treatment options, is right for you.

Trying to find the right doctor to determine if that lump or new pain is something more than just a little annoying is made easy at HealthLynked.  We are the first ever social ecosystem designed to connect physicians and patients in a truly collaborative platform to Improve HealthCare.

Ready to get Lynked?  Sign up for free today and take control of your wellness!

Sources:

Han, MD, Seunggu.  “Sarcoma: Symptoms, types, treatments, and causes.” Medical News Today.  23 May 2017.

Sarcoma Awareness Month

https://www.aacrfoundation.org/Pages/sarcoma_awareness_month.aspx

https://www.gatewaycr.org/gateway-blog/posts/2017/july/july-is-sarcoma-awareness-month-what-is-sarcoma/

To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Muscle Loss and Aging

Mayo Clinic Dr. Nathan LeBrasseur discusses muscle loss during the aging process and also looks at strategies and therapies to maintain muscle health.

source

To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Your Baby’s Growth in the First Trimester

From a fertilized egg to a garlic-bulb-sized baby, here’s how your growing little one develops week-to-week through the first trimester.

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To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Facts | Stillbirth | NCBDDD

The loss of a baby due to stillbirth remains a sad reality for many families and takes a serious toll on families’ health and well-being. Learn more about stillbirth below.

What is stillbirth?

A stillbirth is the death or loss of a baby before or during delivery. Both miscarriage and stillbirth describe pregnancy loss, but they differ according to when the loss occurs. In the United States, a miscarriage is usually defined as loss of a baby before the 20th week of pregnancy, and a stillbirth is loss of a baby after 20 weeks of pregnancy.

Stillbirth is further classified as either early, late, or term.

  • An early stillbirth is a fetal death occurring between 20 and 27 completed weeks of pregnancy.
  • A late stillbirth occurs between 28 and 36 completed pregnancy weeks.
  • A term stillbirth occurs between 37 or more completed pregnancy weeks..

How Many Babies Are Stillborn?

Stillbirth effects about 1% of all pregnancies, and each year about 24,000 babies are stillborn in the United States.1 That is about the same number of babies that die during the first year of life and it is more than 10 times as many deaths as the number that occur from Sudden Infant Death Syndrome (SIDS).2

Because of advances in medical technology over the last 30 years, prenatal care (medical care during pregnancy) has improved, which has dramatically reduced the number of late and term stillbirth.3 However, the rate of early stillbirth has remained about the same over time.3

What Increases the Risk of Stillbirth?

The causes of many stillbirths are unknown. Therefore, families are often left grieving without answers to their questions. Stillbirth is not a cause of death, but rather a term that means a baby’s death during the pregnancy. Some women blame themselves, but rarely are these deaths caused by something a woman did or did not do. Known contributors to stillbirth generally fall into one of three broad categories:

  • Problems with the baby (birth defects or genetic problems)
  • Problems with the placenta or umbilical cord (this is where the mother and baby exchange oxygen and nutrients)
  • Certain conditions in the mother (for example, uncontrolled diabetes, high blood pressure, or obesity)

Stillbirth with an unknown cause is called “unexplained stillbirth.” Having an unexplained stillbirth is more likely to occur the further along a woman is in her pregnancy.

Although stillbirth occurs in families of all races, ethnicities, and income levels, and to women of all ages, some women are at higher risk for having a stillbirth. Some of the factors that increase the risk for a stillbirth include the mother:

  • being of black race
  • being a teenager
  • being 35 years of age or older
  • being unmarried
  • being obese
  • smoking cigarettes during pregnancy
  • having certain medical conditions, such as high blood pressure or diabetes
  • having multiple pregnancies
  • having had a previous pregnancy loss

These factors are also associated with other poor pregnancy outcomes, such as preterm birth.

State laws require the reporting of fetal deaths, and federal law supports national collection and publication of fetal death data. The National Vital Statistics System (NVSS) released the first ever report on cause of fetal death using national data in 2016.

What can be done?

CDC works to learn more about who might have a stillbirth and why. CDC does this by tracking how often stillbirth occurs and researching what causes stillbirth and how to prevent it. Knowledge about the potential causes of stillbirth can be used to develop recommendations, policies, and services to help prevent stillbirth. While we continue to learn more about stillbirth, much work remains.

References

  1. Macdorman MF, Gregory ECW. Fetal and perinatal mortality, United States, 2013. National vital statistics reports; vol 64 no 8. Hyattsville, MD: National Center for Health Statistics. 2015.
  2. Xu JQ, Kochanek KD, Murphy SL, Arias E. Mortality in the United States, 2012. NCHS data brief, no 168. Hyattsville, MD: National Center for Health Statistics. 2014.
  3. MacDorman MF, Kirmeyer SE, Wilson EC. Fetal and perinatal mortality, United States, 2006. National vital statistics reports; vol 60 no 8. Hyattsville, MD: National Center for Health Statistics. 2012.

Source

To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Emergency 101

At what point does a fever or stomachache become a medical emergency? If you slice your finger with a knife, or you are having the worst headache you’ve ever had, should you seek emergency care? How do you know?

The following is advice for how to handle common emergency medical conditions. This section does not contain all the signs or symptoms of medical emergencies, and the advice is not intended to be a substitute for consulting with a medical professional. If you think you are experiencing a medical emergency, seek immediate medical attention.

Abdominal or belly pain can have many causes. It may be due to food poisoning, an intestinal or gall bladder obstruction, an infection or inflammation. It could also be appendicitis, a kidney stone or peptic ulcer disease.

Many drugs cause side effects, and certain medicines can trigger life threatening reactions allergic and non allergic in some people. Some medicines also interact with other medications and cause adverse drug reactions.

Anaphylaxis is a severe, life threatening, multisystemic allergic reaction that is triggered by common substances, such as foods, insect stings, medications and latex.

Although asthma and allergies are two separate conditions asthma is a chronic disease of the bronchial airtubes, whereas allergies involve an overreaction of the body’s disease fighting immune system the two conditions can be intertwined and often overlap.

Acute back problems may be experienced by almost everyone at some point in their lives. There are many causes of back pain, including accidents, muscle strains, sports injuries; acquired nerve, disc or muscle disorders; mechanical problems involving the spine; and infections and tumors.

Most bites and stings are easily treatable and non threatening. However, some insects, snakes, jellyfish and even humans can bite or break the skin and potentially introduce disease into your body.

Broken bones (also called fractures) are a common injury for adults and children. They may be caused by falls, motor vehicle crashes, direct blows and even intentional injuries, such as violence and child abuse.

About 4,000 people die each year in the United States from fire and burn injuries. Burns are one of the leading causes of childhood injury. They can be caused by scalding from hot liquids or cooking oils, contact with flames, or from overexposure to the sun.

Emergency physicians used a patient’s personal activity tracker and smartphone to identify the time his heart arrhythmia started, which allowed them to treat his new-onset atrial fibrillation with electrical cardioversion and discharge him home.

The recent and sudden deaths of several well-known celebrities from heart-related issues should focus everyone’s attention on the dangers of heart disease and knowing the symptoms of a serious problem.

ACEP recommends that the Heimlich Maneuver be employed only when a person is choking and his or her life is endangered by a windpipe obstruction.

Most cuts are minor, but it’s still important to care for them. Most can be treated by cleaning with soap and water and applying a clean bandage.

It is estimated that more than 20 million people in the United States have diabetes, with an estimated six million people being unaware they have it.

Earaches and ear infections can have a variety of causes – viral, bacterial and fungal – and can affect different parts of the ear.

Causes of electrical injury and shock include accidental exposure to household or appliance wiring, arcs from power lines, the severing of an electrical cord or sticking of foreign objects into an outlet (typically in the case of a young child).

Eye wounds and emergencies can include cuts and scratches, traumatic injuries from foreign objects, burns and chemical exposure (e.g., cleaning solutions, garden chemicals). Any of these conditions can potentially lead to vision loss if left untreated. Always wear eye protection.

Fainting is a loss of consciousness caused when the blood supply to the brain is momentarily interrupted. While typically sudden and alarming, it usually is not harmful (unless the person suffers fainting related injuries), and consciousness is typically regained quickly.

Fever by itself is not an illness, but a symptom for a range of medical conditions. It also can be a side effect of some medications. Fever is one of the most common reasons that parents visit an emergency department with a child.

In the United States approximately 10,000 people die each year from food poisoning, and many more become ill and require medical attention.

Young children, especially those under age five, sometimes put items, such as marbles, beads, dried beans, tiny button-shaped batteries or small toys in their ears, noses and mouths. It’s important to seek immediate medical attention to remove them, if they are not easily removable.

Head injuries can be caused by falls, motor vehicle crashes and even violence. It’s important to prevent injuries by buckling your seat belt in your car and wearing safety equipment, such as helmets, while biking or playing sports.

Headaches have a variety of causes. Some are caused by stress and muscle tension, while others may be caused by lack of sleep, a delayed meal, an injury or even foods (e.g., lack of caffeine, alcohol, chocolate, cheeses, nuts, food).

Heat related illness can be caused by overexposure to the sun or any situation that involves extreme heat. Young children and the elderly are most at risk, but anyone can be affected.

Hypothermia is a potentially life-threatening condition caused by overexposure to cold air or cold water. Although most people typically are not at risk of developing hypothermia, the condition can strike anyone, depending on their individual circumstances, weather conditions and level of exposure in a cold or wet environment.

Medical emergencies can be frightening and stressful. But knowing what to do in an emergency can help you effectively deal with the situation. Here you can find information about emergencies.

Source

To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

How is Excess Body Fat Priming Our Brains for Mental Decline?

As today marks the 81st birthday of Krispy Kreme – an American doughnut company and coffeehouse chain based in Winston-Salem, North Carolina built off an ancient, secret cajun recipe – it seems a fitting day to talk about obesity, fat, and its effect on the brain.  Let’s start with “skinny fat”.

Sarcopenia, which is the loss of muscle mass, tends to happen naturally with age. So, in older people with sarcopenia, excess body fat may not be readily visible. But hidden fat, paired with muscle mass loss later in life, could predict Alzheimer’s risk, researchers warn, and Sarcopenic obesity may exacerbate the risk of other cognitive decline later in life.

A recent study — the results of which have been published in the journal Clinical Interventions in Aging — has found that sarcopenia and obesity (independently, but especially when occurring together) can heighten the risk of cognitive function impairments later in life.

The research was conducted by scientists at the Comprehensive Center for Brain Health at the Charles E. Schmidt College of Medicine of Florida Atlantic University in Boca Raton.

“Sarcopenia,” explains senior study author Dr. James Galvin, “has been linked to global cognitive impairment and dysfunction in specific cognitive skills including memory, speed, and executive functions.”

“Understanding the mechanisms through which this syndrome may affect cognition is important as it may inform efforts to prevent cognitive decline in later life by targeting at-risk groups with an imbalance between lean and fat mass.”

Dr. James Galvin

“They may benefit from programs addressing loss of cognitive function by maintaining and improving strength and preventing obesity,” he adds.

Beware sarcopenic obesity

The scientists analyzed health-related data collected from 353 participants — aged 69, on average — all of whom registered to take part in community-based studies on aging and memory.

To establish whether or not there was a link between sarcopenic obesity — that is, the presence of excess body fat in conjunction with muscle mass loss — and cognitive decline, the team assessed participants’ performance on tests evaluating cognitive function, including the Montreal Cognitive Assessment and animal-naming exercises.

Also, the participants’ muscle strength and mass were evaluated through grip strength tests and chair stands, and they also underwent body compositions assessments, which looked at muscle mass, body mass index (BMI), and the amount of body fat.

The researchers discovered that the participants with sarcopenic obesity had the poorest performance on cognition-related tests.  The next poorest performance on cognition tests was seen in people with sarcopenia alone, followed by participants who only had obesity.

Both when occurring independently and when occurring in concert, obesity and loss of muscle mass were linked with impaired working memory — which is the type of memory we use when making spontaneous decisions on a daily basis — as well as less mental flexibility, poorer orientation, and worse self-control.

Keep changes in body composition in check

The scientists explain that obesity could exacerbate the risk of cognitive decline through biological mechanisms that influence vascular health, metabolism, and inflammation.

Moreover, they warn that in people who already face impaired executive functioning, obesity might also impact energy resources through poor self-control that affects nutrition.

As for sarcopenia, the researchers note that it could influence brain mechanisms related to conflict resolution skills and selective attention.

Based on the study’s findings, Dr. Galvin and his colleagues are particularly concerned that a mix of sarcopenia and excess body fat in older adults could become a serious public health issue, so they believe that any significant changes in body mass composition should be closely monitored to prevent negative health outcomes.

“Sarcopenia either alone or in the presence of obesity, can be used in clinical practice to estimate potential risk of cognitive impairment,” notes study co-author Magdalena Tolea.

But such health issues can be kept under control, and the risks associated with them averted, she suggests.

“Testing grip strength by dynamometry can be easily administered within the time constraints of a clinic visit, and body mass index is usually collected as part of annual wellness visits,” concludes Tolea.

How Aging and Obesity Prime the Brain for Alzheimer’s

According to another new study, the effects of natural aging processes, combined with those of obesity and a poor diet, affect certain brain mechanisms, thereby boosting the risk of Alzheimer’s. The new study, conducted on mice, uncovered how a high-fat, high-sugar diet renders the aging brain more vulnerable to Alzheimer’s.

Alzheimer’s disease is a neurodegenerative condition that is characterized primarily by memory loss and impaired cognition.  Some risk factors for the development of this disease are aging and metabolic conditions such as obesity and diabetes.  However, many of the biological mechanisms underlying the onset and progression of this disease remain unknown.

This is despite the fact that our understanding of the predisposing risk factors is growing all the time.  Now, Rebecca MacPherson, Bradley Baranowski, and Kirsten Bott — of Brock University in Ontario, Canada — have conducted a study that has allowed them to uncover some more of the mechanics at play in the development of this type of dementia.

The team worked with aging mice to investigate how a high-fat, high-sugar (HFS) diet that fueled obesity might also prime the brain for neurodegeneration in this sample.  Their findings are described in a paper now published in the journal Physiological Reports.

How unhealthful diets impact the brain

Specifically, the researchers examined how an HFS diet, in conjunction with the effects of normal biological aging, would affect insulin signaling, which helps to regulate the amount of glucose (simple sugar) absorbed by muscles and different organs.

They also looked at how this obesity-inducing diet might alter biomarkers relating to inflammation and cellular stress.

To understand the impact of an HFS diet on aging mice, the research team put some mice on a regular type diet, while others were given food that had a high fat and sugar content.

After the mice had been fed their respective diets for a period of 13 weeks, the team looked for signs of inflammation and measured cellular stress levels in two brain areas associated with memory and cognitive behavior: the hippocampus and the prefrontal cortex.

The researchers also compared the effects of an HFS diet on the brains of aging rodents’ baseline measurements effected on the brains of younger mice.

They found older mice on an obesity-inducing diet had high levels of brain inflammation and cellular stress, as well as insulin resistance in parts of the hippocampus linked to the development of Alzheimer’s disease.

Although more markers of insulin resistance were observed in the prefrontal cortices of mice that had been on an HFS diet, inflammation status and cellular stress markers remained the same.

The study authors hypothesize that “region-specific differences between the prefrontal cortex and hippocampus in response to aging with an HFS diet [suggest] that the disease pathology is not uniform throughout the brain.”

Obesity boosts aging’s negative effect

Notably, the researchers also found that brain inflammation levels had also increased in the mice that had been on a regular diet, compared with baseline measurements.

The researchers note that this could be taken as evidence of aging’s role as an independent risk factor in Alzheimer’s. Obesity, they add, boosts the risk by affecting key mechanisms in the brain.

“This study,” they claim, “provides novel information in relation to the mechanistic link between obesity and the transition from adulthood to middle age and signaling cascades that may be related to [Alzheimer’s] pathology later in life.”

“These results add to our basic understanding of the pathways involved in the early progression of [Alzheimer’s] pathogenesis and demonstrate the negative effects of an HFS diet on both the prefrontal cortex and hippocampal regions.”

To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Adapted from:

Cohut, Maria. ”Skinny fat’ linked to cognitive decline, study warns.” Medical News Today, Friday 6 July 2018

Cohut, Maria. ”Aging, obesity may prime the brain for Alzheimer’s.” Medical News Today, Monday 2 July 2018

Dealing with grief after the death of your baby

What is grief?

Grief is all the feelings you have when someone close to you dies. You may find it hard to believe that your baby died. You may want to shout or scream or cry. You may want to blame someone. Or you may want to hide under the covers and never come out. At times, your feelings may seem more than you can handle. You may feel sad, depressed, angry or guilty. You may get sick easily with colds and stomach aches and have trouble concentrating. All of these are part of grief.

When your baby dies from miscarriage, stillbirth or at or after birth, your hope of being a parent dies, too. Miscarriage is when a baby dies in the womb before 20 weeks of pregnancy; stillbirth is when a baby dies in the womb after 20 weeks of pregnancy. The dreams you had of holding your baby and watching him grow are gone. So much of what you wanted and planned for are lost. This can leave a large, empty space inside you. It may take a long time to heal this space.

The death of a baby is one of the most painful things that can happen to a family. You may never really get over your baby’s death. But you can move through your grief to healing. As time passes, your pain eases. You can make a place in your heart and mind for the memories of your baby. You may grieve for your baby for a long time, maybe even your whole life. There’s no right amount of time to grieve. It takes as long as it takes for you. Over time, you can find peace and become ready to think about the future.

How do men and women grieve?

Everyone grieves in his own way. Men and women often show grief in different ways. Even if you and your partner agree on lots of things, you may feel and show your grief differently.

Different ways of dealing with grief may cause problems for you and your partner. For example, you may think your partner isn’t as upset about your baby’s death as you are. You may think he doesn’t care as much. This may make you angry. At the same time, your partner may feel that you’re too emotional. He may not want to hear about your feelings so often, and he may think you’ll never get over your grief. He also may feel left out of all the support you’re getting. Everyone may ask him how you’re doing but forget to ask how he’s doing.

You have a special bond with your baby during pregnancy. Your baby is very real to you. You may feel a strong attachment to your baby. Your partner may not feel as close to your baby during pregnancy. He doesn’t carry the baby in his body, so the baby may seem less real to him. He may become more attached to the baby later in pregnancy when he feels the baby kick or sees the baby on an ultrasound. Your partner may be more attached to your baby if she dies after birth.

In general, here’s how you may show your grief:

  • You may want to talk about the death of your baby often and with many people.
  • You may show your feelings more often. You may cry or get angry a lot.
  • You may be more likely to ask your partner, family or friends for help. Or you may go to your place of worship or to a support group.

In general, here’s how your partner may show his grief:

  • He may grieve by himself. He may not want to talk about his loss. He may spend more time at work or do things away from home to keep his mind off the loss.
  • He may feel like he’s supposed to be strong and tough and protect his family. He may not know how to show his feelings. He may think that talking about his feelings makes him seem weak.
  • He may try to work through his grief on his own rather than ask for help.

Showing grief doesn’t have any rules or instructions. Men and women often may show grief in these ways. But there’s really no right or wrong way for you or your partner to grieve or share your feelings. It’s OK to show your pain and grief in different ways. Be patient and caring with each other. Try to talk about your thoughts and feelings and how you want to remember your baby.

How do children grieve?

Children of all ages grieve. If you have older children, they may be afraid, act out or need special attention after your baby’s death. They may think they’re going to die, too, or that they’re to blame for the death of their brother or sister. Children can cope better with grief when you explain things and so they know what’s happening.

Here are some ways you can help them better understand the baby’s death:

  • Use simple, honest words when you talk to them about the baby’s death. You can say things like, “The baby didn’t grow,” or “The baby was born very tiny.” Don’t say things that may confuse them like, “The baby is sleeping,” or “Mommy lost the baby.”
  • Read them stories that talk about death and loss. A funeral home, library or school may have children’s books to help them understand death.
  • Encourage them to tell you how they feel about the baby’s death. Let them ask questions about what happened to the baby and how you’re doing.
  • Ask them to help you find ways to remember the baby. Ask them to draw a picture or make something that you can keep.
  • Tell them they’re not going to die and that no one is to blame for the baby’s death.

Just like you, children may feel hurt, confused and angry as they grieve. Younger children may be clingy or cranky and act in ways that they haven’t for a long time. Older children may be extra worried about things outside of home, like school, friends or sports. Or they may show no reaction at all to the baby’s death or ask questions that you think are rude or uncaring. If your children act out, be patient and loving.

It may be helpful for your older children to see a grief counselor. This is a person who’s trained to help people deal with grief. A grief counselor who works with children can recommend resources, like bereavement groups just for kids. A bereavement group is a group of people who meet together to heal from grief. To find a grief counselor for your children or to help you with your children, ask your provider, your child’s provider or a social worker at the hospital.

Who can help you and your family deal with grief?

Talking about your baby and your feelings can be helpful and comforting. Of course you can talk to your partner, your friends and your family. But talking to someone who’s trained to help you deal with grief may be useful. For example:

  • Your provider. Your provider may be able to help you understand what happened to cause your baby’s death. She also can help you find people to help you through your grief, like a social worker or grief counselor. And if you’re ready, she can help you get ready to get pregnant again. If you feel intense sadness for a long time, your provider can help you get treatment for depression.
  • A social worker. This is a mental health professional who helps people solve problems and make their lives better. A social worker can help you deal with your grief, and she can also help with things like medical, insurance and funeral bills. Your hospital may have a social worker on staff.
  • A grief counselor. This is someone who’s trained to help people deal with grief.
  • Your religious or spiritual leader. Your religious and spiritual beliefs may be a comfort to you as you grieve.

You may want to join a support or bereavement group. A support group is a group of people who have the same kind of concerns. They meet to share their feelings and try to help each other. There are support and bereavement groups just for parents and families who have lost a baby. Group members understand what you’re going through and can help you feel like you’re not alone. Your provider, social worker or grief counselor can help you find a group, or your hospital may have a group as part of a loss and grief program for families. You can find groups online, too, like Share Your Story, the March of Dimes online community where families who have lost a baby can talk to and comfort each other. We also offer the free booklet From hurt to healing that has information and resources for grieving parents.

How can you take care of yourself as you grieve?

Your body needs time to recover after pregnancy. You may need more time depending on how far along you are when your pregnancy ends. Here’s what you can do to take care of yourself:

  • Eat healthy food, like fruits and vegetables, whole-grain breads and pastas, and low-fat chicken and meats. Stay away from junk food and too many sweets.
  • Do something active every day.
  • Try to stick to a sleep schedule. Get up and go to bed at your usual times.
  • Don’t drink alcohol (beer, wine, wine coolers and liquor) and drinks with caffeine in them, like coffee, sports drinks, tea and soda. Chocolate and some medicines also contain caffeine. Alcohol and caffeine can make you feel bad and make it hard for you to sleep. Instead, drink water or juice.
  • Don’t smoke and stay away from secondhand and thirdhand smoke. Secondhand smoke is smoke you breathe in from someone else’s cigarette, cigar or pipe. Thirdhand smoke is what you smell on things that been in or around smoke.
  • Talk to your provider if you have bleeding from your vagina or if your breasts have milk
  • Tell your provider if you have intense feelings of sadness that last more than 2 weeks that prevent you from leading your normal life. If so, you may need treatment for depression. Treatment can help you feel better. If you’re thinking about suicide or death, call 911.

You need time to recover emotionally, too. Certain things, like hearing names you were thinking of for your baby or seeing the baby’s nursery at home, may be painful reminders of your loss. Your body’s physical recovery also may remind you of your baby, like if your breast milk comes in after a stillbirth. A counselor, social worker or support group can help you learn how to deal with these situations and the feelings they create.

How can you handle family and friends while you’re grieving?

Your baby’s death affects your friends and family, too. It may be hard dealing with others as you’re grieving yourself. Here are some things you can do to help you handle others as you grieve. Do only what feels right for you:

  • Tell them that their calls and visits are important to you.
  • Decide if it’s OK for them to ask questions about what happened to your baby. If not, tell them you’re not ready to talk about it.
  • Tell them it’s OK if they don’t know exactly what to say. Tell them that hearing honest words like, “I just don’t know what to say,” or “I want to help but I don’t know how,” can be comforting. People may say things that aren’t helpful to you like, “It’s for the best,” or “You can always have another baby.” Try to remember that they’re doing their best to support you, even if what they say is hurtful.
  • Tell them exactly what you need. Do you just want them to spend time with you at home? Do you need someone to bring you a meal, shop for groceries, take your older children out or do your laundry? Tell them specific things they can do for you.
  • If you want them to, ask them to use your baby’s name and to remember your baby. Tell them that even if you have other children, you won’t forget the baby who died.
  • Thank them for their patience and support.

Some people may expect you to limit your grief or get over it in a certain amount of time. Take as long as you need to cope with your loss. Support from others may lessen over time. This doesn’t mean that they’ve forgotten about your baby or that they don’t care. You may need to tell them that you’re still grieving and that you still need their support.

What if you lose a multiple?

Any parent who loses a baby feels grief. But losing one, two or a whole set of multiples can create its own set of feelings. Multiples means being pregnant with more than one baby, like twins, triplets or more. If you lost a multiple, you may feel:

  • Sad about not having time to grieve for your baby who died. If you lose a baby and have one who lives, it may be hard to find time to grieve while you’re caring for your living baby.
  • Scared. If your living baby is sick, you may be scared that he will die, too. You may not want to hold him, get close to him or care too much for him. It may be hard for you to go to the newborn intensive care unit (also called NICU) to care for your living baby if your other baby died there. The NICU is a nursery in a hospital where sick newborns get medical care.
  • Confused. Even if only one baby lives, you’re still the parent of multiples. But others may not see you this way. Your family and friends may not want to talk about the baby who died. They may think remembering the baby you lost will make you sad.
  • Happy and sad about bringing your baby home. You may feel happy about the baby you bring home from the hospital and sad about the baby you lost.
  • Worried. The most common complication of being pregnant with multiples is premature birth (before 37 weeks of pregnancy). Premature birth can cause health problems for babies. If your baby was born prematurely, you may be worried about her health.
  • Always reminded of the baby you lost. You may wonder what it would have been like if your baby had lived. It may be hard for you to celebrate birthdays and holidays if you’re thinking about the baby who died.

What can you do to remember your baby?

You can do special things to remember your baby, even if didn’t have a chance to see, touch or hold him. Remember your baby in ways that are special to you. You may want to:

  • Collect things that remind you of your baby, like ultrasound pictures, footprints, a lock of hair, a hospital bracelet, photos, clothes, blankets or toys. Put them in a special box or scrapbook. Keepsakes like these can help you remember your baby.
  • Have a service for your baby, like a memorial service or a funeral. A service can give you a chance to say goodbye to your baby and share your grief with family and friends. Your hospital may have a service each year to remember babies who have died.
  • Write your thoughts and feelings in a journal, or write letters or poems to your baby. Tell your baby how you feel and how much you miss her. Or paint a picture for her.
  • Light a candle or say a prayer in honor of your baby on holidays or special days, like his birthday or the day he died. Do something on your own or bring family and friends together to remember your baby. Read books and poems or listen to music that you like and find comforting.
  • Plant a tree or a small garden in honor of your baby.
  • Have a piece of jewelry made with your baby’s initials or her birthstone.
  • Donate to or volunteer for a charity in your baby’s name, or give something to a child in need who’s about the same age as your baby would be. Dedicate a project to your baby, like raising money to build a swing set in a park.

We grieve with you.  Every day, there are physicians in the HealthLynked system ready to help those living with such loss. To find a physician who can help or join or create  a group to discuss your pain, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Last reviewed: October, 2017

Talking About 13 Reasons Why & Teen Suicide: Tips for Parents

When the Netflix series “13 Reasons Why” premiered in March 2017, it quickly became one of the most watched—and most controversial—shows of the year. It was no surprise that the news of Season 2’s May 2018 release continued to get a lot of attention.

The drama-mystery centers on a high school student who commits suicide and leaves behind 13 audiotapes for people she blames for her action. Season 2 picks up as the community tries to deal with emotional and legal fallout from the suicide.

Raising Awareness–and Risk?

Fans of the series say it increases much-needed awareness about teen suicide, which is currently the second leading cause of death for children and young people 10 to 24 years old.  In addition to graphic portrayal of suicide, the show also focuses on bullying and cyberbullying, underage drinking, sexual assault, guns in the home, and other topics that can serve a tool to start discussions.

But some experts warn the show may do more harm than good. Although the series is fictional, teens can be impulsive and emotional. Watching a character decide suicide is the best option might trigger them to do the same. Researchers found a significant spike in internet searches using terms such as “how to commit suicide” and “how to kill yourself” for 19 days following the release of season 1 of “13 Reasons Why.”

Medical and mental health professionals also report teens listing their own 13 reasons why they wanted to kill themselves. Some families say they believe the show triggered their children to actually take their lives.

Critics of the show point to research that suggests exposure to a peer’s suicide can have a “contagious” effect—especially among 12- to 13-year-olds. There is specific public health recommendations for reporting on suicide in the media that this series goes against:

  • Presenting suicide as a tool for accomplishing certain ends, such as revenge or recognition.
  • Glorifying suicide or persons who commit suicide.

Who’s Watching?

The series is rated TV-MA (Mature Audience), appropriate for ages 17 and up, for its graphic violence, explicit sexual activity and crude language. But school officials and pediatricians say they’re learning of children as young as elementary-school age who are binge watching the show—sometimes without parents knowing, because it can be streamed privately on their phones, tablets, and computers. Parents are often surprised to find out their child has watched the series.

“It has come up quite a bit when I’ve been talking to my patients, especially those who’ve been depressed or anxious,” said Cora Breuner, MD, MPH, FAAP, a pediatrician and chair the American Academy of Pediatrics (AAP) Committee on Adolescence. “Quite a few of them already watched ’13 Reasons Why’—without the knowledge of their parents,” Dr. Breuner said. “It’s usually a major aha moment in my office, when the parents look at their kids and say, `Wait a minute, you watched that?'”

As a parent, it is your job to counsel your children and teens about smart and safe media use. Dr. Breuner said she also asks her patients (and their parents) how much time they spend on screens and what shows they watch.

Even if your child hasn’t watched…

Parents should be aware that their child may hear friends talking about the show at school or on social media—even if they haven’t seen it themselves. Regardless, Dr. Breuner said the series is “absolutely inappropriate” for children under age 13.

If you haven’t watched the show, look up episode summaries and be prepared talk with your child about the ways fictional shows don’t always reflect reality. Use the show as an opportunity to talk with your child about the very real situations teens face—and how your child can come to you with anything he or she may face in the future.

How to Help Teens Process the Show in a Safe & Healthy Way:

Despite concerns about ’13 Reasons Why,’ the show can serve as a powerful teaching tool with informed, adult guidance from parents, teachers, spiritual leaders, and others who work with teens.

What parents can do:

  • Co-view. The AAP media use guidelines encourage parents to co-viewing programs with their children and discuss values. This is especially important for shows such as ’13 Reasons Why’ with themes difficult to process and easy to misinterpret. Watching the show together lets parents pause and point out instances of cyberbullying, for example. Then parents can ask if their child has seen it happen at school, how he or she reacted, and what to do if it happens again. ​
    • Children in groups at a higher risk for suicidal thoughts and actions should not watch the show alone, Dr. Breuner said. This includes kids with a family history of suicide, a history of physical or sexual abuse, mood disorders, and drug and alcohol use, and/or those who identify as lesbian, gay, bisexual, transgender or questioning.
  • Discuss reality vs. fiction. Explain that the show gives an unrealistic view of the help available for teens who may feel suicidal. In particular, the lack of effective mental health care provided to lead character, Hannah Baker, is both troubling and unrealistic. Statistics show that a large majority of the time, teens with suicidal thoughts and behaviors are in the grips of treatable mental illnesses, such as depression. In the show, Hannah voices clear suicidal warning signs to her school guidance counselor. Yet, the counselor failed to connect her with other professionals and resources for help and told her simply to “move on.” Critics say this sends a dangerous message that adults can’t help.
  • Play it safe. If your teen does watch the show, make an extra effort to watch him or her a little more closely afterwards—in a mindful, nurturing way. Know the signs of depression, such as withdrawing from friends or family, eating or sleeping less or more, or losing interest in activities.
    • If you have a gun in your home, make sure it is stored unloaded and locked up separately from ammunition. Studies have found the risk of suicide is 4 to 10 times higher in homes with guns than in those without. And although Hannah Baker uses a different method to end her life, suicide by firearms is now the second leading cause of death among teens 15-19. More than 80% of guns used in teen suicide attempts were kept in the home of the victim, a relative, or a friend.
  • Provide access to help. Give your child su​​​ggestions for whom he or she can turn to in times of need—including you, as well as other trusted adults. Your pediatrician can also help. The American Academy of Pediatrics recently recommended all children over age 12 be screened for depression at their annual wellness exams. For any immediate concerns about your child, call the National Suicide Prevention Lifeline is 1-800-TALK, or text START to 741741.

Keep in Mind:

It may feel uncomfortable to talk with your teen about some of the difficult issues raised in “13 Reasons Why,” but talking about tough topics with teens is every bit as important as making sure a baby’s bath water isn’t too hot. Remember to talk with your child’s pediatrician if you have additional questions or concerns about your child’s media use or mental health.

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Youths Treated for Non-Suicidal Self Harm at Increased Risk of Suicide Within a Year

New research in the April 2018 Pediatrics found that youths treated for deliberate but non-suicidal self-harm, such as cutting, were more than 25 times as likely than demographically matched peers to die from suicide within the following year.

The study, “Suicide Following Deliberate Self-Harm in Adolescents and Young Adults” (published online March 19), followed 32,395 patients between ages 12 and 24 who were enrolled in Medicaid between 2001 and 2007. The risk of suicide within a year of self-harm varied considerably by age, race and other factors. It was more than four times higher for males (338.8 per 100,000) than for females (80.2 per 100,000). In addition, the risk was markedly higher for American Indians/Alaskan Natives than for non-Hispanic white patients, and for patients who patients who used more violent methods of self-harm, especially firearms.

The study also revealed differences among adolescents and young adults who were treated for the initial self-harm. Although depression and anxiety diagnoses were common in both age groups, for example, adolescents with self-harm were far more likely to have been recently diagnosed with attention deficit hyperactivity disorder (ADHD) and other disruptive behaviors, while young adults more commonly had substance use and personality disorder diagnoses.

Authors of the study said their findings underscore the importance of follow-up care for youths treated for self-harm to help ensure their safety.

Source

To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Will We Soon Reverse Diabetes and Obesity with Gene Therapy?

New research shows that gene therapy can completely reverse markers of Type 2 diabetes and obesity in rodents.  If the theory holds, small alterations to our genes could soon repair metabolic disorders such as obesity and Type 2 diabetes in humans.

The prevalence of diabetes, or the total number of existing cases, is on the rise in the United States and globally.  According to recent estimates, over 30 million U.S. adults had diabetes in 2015.

Although the number has been relatively steady in the past few years, rates of newly diagnosed cases among children and teenagers have increased sharply.  And, worldwide, the situation is even more alarming; the number of people with diabetes almost quadrupled between 1980 and 2014, according to the World Health Organization (WHO).

Now, new research brings much-needed hope of curing this metabolic disorder.  Scientists led by Fatima Bosch, a professor at the Universitat Autònoma de Barcelona (UAB) in Catalunya, Spain, have successfully reversed the disorder in rodents.  Prof. Bosch and her colleagues achieved this using gene therapy, a technique that introduces new genetic material into cells to create beneficial proteins or to offset the effects of malfunctioning genes.  The findings were published in the journal EMBO Molecular Medicine.

Using the FGF21 gene to reverse diabetes

Prof. Bosch and team designed two mouse models of obesity and type 2 diabetes. One was diet-induced, and the other one was genetically modified.  Using an adeno-associated viral vector as “transport,” the team delivered the fibroblast growth factor 21 (FGF21) gene.

This gene is responsible for encoding the FGF21 protein, which is seen as a “major metabolic regulator” that stimulates the absorption of blood sugar in adipose tissue.  By delivering this gene, the researchers stimulated the production of the protein, which caused the rodents to lose weight and lowered their insulin resistance — a major risk factor for type 2 diabetes. Additionally, the mice lost weight and the treatment reduced the fat and inflammation in their adipose tissue.

The fat content, inflammation, and fibrosis of the rodents’ livers were completely reversed, with no side effects. In turn, these improvements increased insulin sensitivity.  These beneficial effects were noted in both murine models. Also, the team found that administering FGF21 to healthy mice prevented age-related weight gain and led to healthy aging.

Gene therapy was used to alter three tissue types: liver tissue, adipose tissue, and skeletal muscle.  “This gives a great flexibility to the therapy,” explains Prof. Bosch, “since it allows [us] to select each time the most appropriate tissue, and in case some complication prevents manipulating any of the tissues, it can be applied to any of the others.”

“When a tissue produces FGF21 protein and secretes it into the bloodstream, it will be distributed throughout the body,” adds Prof. Bosch.

First reversion of obesity, insulin resistance

Study co-author and UAB researcher Claudia Jambrina explains that their findings are particularly significant given that “the prevalence of type 2 diabetes and obesity is growing at alarming rates around the world.”

The team also says that delivering FGF21 as a conventional drug would not yield the same benefits as gene therapy; firstly, the drug would have to be administered periodically for long-term benefits, and secondly, its toxicity would be high.  Using gene therapy, however, is free of side effects, and a single administration is enough to make the mice produce the protein naturally for several years.

“This is the first time that long-term reversion of obesity and insulin resistance have been achieved upon a one-time administration of a gene therapy, in an animal model that resembles obesity and type 2 diabetes in humans.”

First study author Veronica Jimenez, a UAB researcher

“The results demonstrate that it is a safe and effective therapy,” she adds. The next steps will be to “test this therapy in larger animals before moving to clinical trials with patients,” notes Prof. Bosch.  “[The] therapy described in this study,” she concludes, “constitutes the basis for the future clinical translation of FGF21 gene transfer to treat type 2 diabetes, obesity, and related comorbidities.”

Statistics and facts about type 2 diabetes

Diabetes mellitus, or diabetes, is a disease that causes high blood sugar. It occurs when there is a problem with insulin.

Insulin is a hormone that takes sugar from foods and moves it to the body’s cells. If the body does not make enough insulin or does not use insulin well, the sugar from food stays in the blood, resulting in high blood sugar.

Diabetes is a key health concern worldwide. In the United States, the rate of new cases rose sharply from the 1990s, but it fell between 2008 and 2015, and it continues to fall, according to the Centers for Disease Control and Prevention’s (CDC) National Diabetes Report, 2017. Meanwhile, the number of adults living with diabetes continues to rise.

The most common of diabetes is type 2. According to the CDC, 90 to 95 percent of people with diabetes in the United States have type 2. Just 5 percent of people have type 1.

Key facts

Diabetes is at an all-time high in the U.S. The CDC’s Division of Diabetes Translation states that 1 percent of the population, which is about a half of a million people, had diagnosed diabetes in 1958.

In 2015, around 9.4 percent of the population in the U.S. had diabetes, including 30.2 million adults aged 18 years and over. Nearly a quarter of those with the condition do not know they have it.

Between 1990 and 2010, the number of people living with diabetes more than tripled, and the number of new cases doubled every year.

Figures suggest that the incidence is levelling off and may even be falling, but it remains unclear whether this will continue as other factors come into play, such as the aging population.

The risk of developing diabetes increases with age.

The CDC report that 4.0 percent of people aged 18 to 44 years are living with diabetes, 17 percent of those aged 45 to 64 years, and 25.2 percent of those aged over 65 years.

Causes

Type 2 diabetes is thought to result from a combination of genetic and lifestyle factors.

The exact cause is unknown, but risk factors appear to include:

  • excess body fat
  • high blood pressure or cholesterol
  • having a close family member with the condition
  • a history of gestational diabetes
  • higher age

As obesity has become more prevalent over the past few decades, so too has the rate of type 2 diabetes. In 2013, more than 1 in 3 people in the U.S. were considered to have obesity, and over 2 in 3 were either overweight or had obesity.

In 1995, obesity affected 15.3 percent of Americans, and in 2008, the figure was 25.6 percent. From 1998 to 2008, the incidence of diabetes increased by 90 percent.

Although the link between obesity and diabetes is well known, the reasons they are connected remain unclear. A report in the Journal of Clinical Endocrinology and Metabolism asks why obesity does not always lead to diabetes, given the established link between the two conditions.

The same report notes that the location of body fat appears to play a role. People with more fat in the upper body area and around the waist are more likely to get diabetes than those who carry their body fat around the hips and lower body.

Diabetes and ethnicity

Rates of diabetes vary between ethnic groups.

There may be a combination of factors, including:

  • genetics
  • health conditions
  • lifestyle
  • finances
  • environment
  • access to healthcare

The CDC’s National Diabetes Statistics Report, 2017, found that, among people aged 20 years and over, diabetes affects:

  • 7.4 percent of Non-Hispanic whites
  • 8.0 percent of Asian Americans
  • 12.1 percent of Hispanics
  • 12.7 percent of Non-Hispanic Blacks
  • 15.1 percent of American Indians and Alaska Natives

Why diabetes is serious

Diabetes can have serious health consequences.

The ADA report that more Americans die from diabetes every year than from AIDS and breast cancer combined.

According to the CDC, 79,535 deaths occur each year due to diabetes. The number of fatalities related to diabetes may be underreported.

Why and how does diabetes damage the body and cause complications?

The ADA says:

  • Adults with diabetes are significantly more likely to die from a heart attack or stroke.
  • More than a quarter of all Americans with diabetes have diabetic retinopathy, which can cause vision loss and blindness.
  • Each year, nearly 50,000 Americans begin treatment for kidney failure due to diabetes. Diabetes accounts for 44 percent of all new cases of kidney failure.
  • Each year, diabetes causes about 73,000 lower limb amputations, which accounts for 60 percent of all lower limb amputations (not including amputations due to trauma).

Costs

Because of its high prevalence and link to numerous health problems, diabetes has a significant impact on healthcare costs.

The productivity loss for reduced performance at work due to diabetes in 2012 was 113 million days, or $20.8 billion, according to the ADA.

Diabetes cost the U.S. $327 billion in 2017, including $237 billion in medical costs and $90 billion in reduced productivity.

However, this number does not include:

  • the millions of people who have diabetes but are undiagnosed
  • the cost of prevention programs for people with diabetes, which are not counted under standard medical costs
  • over-the-counter medications for eye and dental problems, which are more common in people with diabetes.
  • administrative costs for insurance claims
  • the cost of reduced quality of life, lost productivity of family members, and other factors that cannot be measured directly

Because diabetes affects various parts of the body, the medical costs span different areas of specialty. The ADA report that:

  • 30 percent of medical costs associated with diabetes are for circulation problems that reduce blood flow to the limbs
  • 29 percent of medical costs associated with diabetes are for kidney conditions
  • 28 percent of medical costs associated with diabetes are for nervous system conditions

Despite its complications, people can manage their diabetes with a comprehensive plan that includes lifestyle changes and proper medical care. If they control their blood sugar levels well, many people with diabetes can lead full, active lives.

Difference between types 1 and 2

In type 1 diabetes, the immune system attacks the cells in the pancreas that make insulin. As a result, the body does not produce insulin, and people with this condition must take insulin by injection or pump every day.

Type 1 diabetes usually develops in children or young adults, but it can occur at any age. There is no known way to prevent type 1 diabetes, and there is no cure.

In 2011-2012, around 17,900 children under the age of 18 years received a diagnosis of type 1 diabetes in the U.S., or around 49 children each day. Type 1 diabetes affects around 1.25 million American adults and children.

People with type 2 diabetes may still have insulin in their bodies, but not enough for proper blood sugar control. Or, the body may not be able to use the insulin it has properly. As a result, blood sugar levels can become too high.

Typically, adults are diagnosed with type 2 diabetes, but children can get it too. Certain factors increase a person’s risk of getting type 2 diabetes, including:

  • obesity
  • older age
  • a family history of diabetes
  • lack of exercise
  • problems with glucose metabolism

The annual relative increase for type 1 diabetes in 2002-2012 in the U.S. was 1.8 percent, but the annual increase for type 2 diabetes was 4.8 percent.

If diabetes or any other medical concern has you running a little slow, join our ecosystem designed to support your well being.  HealthLynked is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.

Adapted from:

[1]  Murrell MD, Daniel.  “Statistics and facts about type 2 diabetes.” Medical News Today. 12 June 2018

[2]  Sandoiu, Ana. “Type 2 diabetes, obesity may soon be reversed with gene therapy.”  Medical News Today, 12 July 2018

Changing U.S. Incidence of Lower Stomach Cancer

January

18, 2018, by NCI Staff

The incidence of noncardia gastric cancers—those occurring in the lower part of the stomach—has been increasing for Americans under age 50.

Credit: National Cancer Institute

A type of cancer that occurs in the lower stomach has been increasing among some Americans under the age of 50, even though in the general population the incidence of all stomach cancers has been declining for decades, according to a new NCI-led study.

The study tracked the incidence in the United States of cancer of the lower stomach, known as noncardia gastric cancer.

Between 1995 and 2003, the incidence of noncardia gastric cancer in the general population declined by about 2.3% per year, researchers reported January 18 in the Journal of the National Cancer Institute. But when they analyzed the data by birth year, they identified two distinct trends.

Among Americans over age 50, incidence rates fell by 2.6% per year; for those under age 50, however, the rates increased 1.3% per year.

“These results were surprising,” said M. Constanza Camargo, Ph.D., of NCI’s Division of Cancer Epidemiology and Genetics, who led the study. The general decrease in incidence rates for noncardia gastric cancer initially masked the divergence between older and younger individuals, she added.

Risk Factors and Shifting Incidence Rates

Two of the main causes of noncardia gastric cancer are infection by the bacterium Helicobacter pylori and autoimmune gastritis, which occurs when a person’s immune system attacks the lining of the stomach.

The prevalence of H. pylori infection has clearly decreased in the United States over the past century, whereas autoimmune gastritis may have become more common in recent decades.

To assess possible impact of these trends on the incidence of noncardia gastric cancer, the researchers analyzed data from the North American Association of Central Cancer Registries. These registries cover 45 states, or roughly 80% of the US population.

The increased incidence of noncardia gastric cancer among individuals under age 50 was most pronounced among non-Hispanic whites, particularly among women.

There was also a modest increase in incidence among young Hispanic whites during the time period of the study. However, there was no increase among non-Hispanic blacks or other races.

A New Type of Stomach Cancer?

Taken together, the findings suggest that there is “a new [type of] gastric cancer among us,”—one that occurs primarily in the gastric corpus region of the stomach, especially in women younger than age 50, wrote Martin Blaser, M.D., and Yu Chen, M.D., Ph.D., of the New York University School of Medicine, in an accompanying editorial. The corpus is the main body of the stomach.

Drs. Blaser and Chen cited three lines of evidence to support the idea that these tumors represent a new type of stomach cancer: the age-specific effect (increasing incidence among younger generations); the location of the tumors in the stomach (primarily in the gastric corpus and adjacent areas); and the strong sex effect.

“The rapid increases in younger women are especially alarming,” the editorialists wrote. More research is critically needed to truly understand the roots of this cancer, they added.

Increased Incidence: Do Antibiotics Play a Role?

Although the new study was not designed to identify the causes of the increased incidence rates, the study authors noted that trends in incidence rates began to change around the time that antibiotic medications began to see widespread use in the 1950s.

“We are seeing an increasing risk of this cancer in people born after 1950, and that coincides with the introduction of antibiotics,” said Dr. Camargo. “The increase in noncardia gastric cancer rates is more pronounced in females than males, and we know that females take more antibiotics than males.”

The use of antibiotics can disrupt the stomach’s collection of microbes, or microbiome, Dr. Camargo noted. In theory, she added, these changes, including the loss of H. pylori, may lead to autoimmune gastritis, which increases the risk of noncardia gastric cancer.

Noting that more studies are needed to determine the potential effect of antibiotics on the risk of stomach cancer, Dr. Camargo stressed that these drugs save lives and should be used when medically necessary.

Predicting a Reversal of Current Incidence Trends

In addition to gaining a better understanding of the biology of this cancer, researchers need to develop strategies for diagnosing the disease. Gastric cancer is often diagnosed in its later stages, when the disease may be more difficult to treat.

“We need to learn more about the molecular characteristics of these tumors,” said Dr. Camargo. “And we’re trying to identify people who are at high risk of developing noncardia gastric cancer.”

Based on their results, the researchers predict two major changes related to this cancer in the United States. First, around 2025, its incidence will be higher in women than men, which would reverse the current pattern. Second, by 2030, the overall incidence of noncardia gastric cancer will be increasing rather than decreasing.

In their editorial, Drs. Blaser and Chen agreed that such changes were possible and congratulated the researchers “for their keen observations that sound a warning about a growing menace.”

Source

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The Facts on Tampons—and How to Use Them Safely

Tampons—shown within an applicator on the left and outside of an applicator on the right—are regulated by the U.S. Food and Drug Administration as medical devices.

If you use tampons during your period (also called a “menstrual cycle”), it’s important to know the basics for how to use them safely. Consider this important information from the U.S. Food and Drug Administration—and please share it with friends and loved ones who may use these products.

What are tampons—and what are they made of?

You may be surprised to know that the FDA regulates tampons as medical devices. Tampons are inserted into the vagina to absorb menstrual flow when people have their periods. They are cylindrical in shape and made of cotton, rayon, or a blend of the two. Tampons are either designed to be inserted using a plastic or cardboard applicator or to be directly inserted, without an applicator.

What should you know about different types of tampons? And are tampons safe?

Tampons are available in “organic” and standard varieties. Tampons are also available in “scented” and “unscented” options. But before any tampons can be sold, they must go through FDA review to determine whether they are substantially equivalent to, including as safe and effective as, a legally marketed tampon.

As part of this FDA review, manufacturers submit, among other information, the results of testing to evaluate the safety of the materials used to make tampons and applicators (if present); tampons’ absorbency, strength, and integrity; and whether tampons enhance the growth of certain harmful bacteria or alter normal bacterial growth in the vagina.

Tampons sold today are made with a chlorine-free bleaching process, which also prevents products from having dangerous levels of dioxin (a type of pollutant found in the environment).

The bottom line: The FDA views any marketed tampons that comply with FDA requirements, including FDA premarket review, to be safe and effective when used as directed.

What do consumers need to know in order to use tampons safely?

You may want to ask your health care provider if you have questions about whether tampons—or other FDA-regulated products such as menstrual pads or cups—are right for you. If you decide to use tampons, consider the following general advice.

  1. Follow all labeled directions. Even if you’ve used tampons before, refresh yourself on best practices, including any information on washing your hands before and after use. (Note: A tampon cannot get “lost” in your body when used as directed.)
  2. Only use tampons when you have your period—and only use them as directed. Tampons are not intended to be used at any other time.
  3. Change each tampon every 4 to 8 hours. Never wear a single tampon for more than 8 hours at a time.
  4. Use the lowest absorbency tampon that you need. Consider how heavy or light your period is and how often you need to change your tampon. If you can wear one tampon up to eight hours without changing it, the absorbency may be too high.
  5. Consider which period products are best for different activities. For example, if you need coverage for longer than 8 hours, such as when sleeping, choose a pad instead.
  6. Beware of pain or other unusual symptoms. Tell your health care provider if you ever have discomfort, pain, or other unusual symptoms like unusual discharge when trying to insert or wear a tampon. (Note: You shouldn’t feel a tampon when it is inserted properly.) These symptoms may mean that you need to take a break from using tampons. Symptoms such as a sudden fever (usually 102°F or more) and vomiting, diarrhea, fainting or feeling like you are going to faint when standing up, dizziness, or a rash that looks like a sunburn may be signs of toxic shock syndrome (TSS). If you have any of these symptoms during your period, remove the tampon and seek medical attention immediately. And if you have these symptoms soon after your period, seek medical attention immediately. If you ever have an allergic reaction or irritation from using tampons, stop using tampons and talk with your health care provider.

Finally, if you ever have a problem with a tampon, consider also reporting it to MedWatch, the FDA’s safety information and adverse event reporting program.

What should you know about toxic shock syndrome (TSS)?

One safety issue associated with using tampons is toxic shock syndrome, a rare disease caused by a toxic substance that is produced by certain kinds of bacteria. The toxic substance can cause organ damage (including kidney, heart, and liver failure), shock, and even death.

Rates of reported TSS cases associated with tampons have declined significantly over the past 20 years. One reason is that, as part of the premarket review, the FDA evaluates whether a tampon enhances the growth of the bacteria that causes TSS before deciding whether the product can be marketed. The FDA also believes that more informative tampon labeling, as well as educational efforts by the FDA and manufacturers, have contributed to this major reduction in TSS cases.

While TSS is rare today, the risk is higher if you:

  • use more absorbent tampons than needed, or
  • wear a tampon for longer than recommended.

So remember to follow the safety instructions on the tampon labeling and consider the advice outlined above.

Source

To find a healthcare professional, use HealthLynked. It is a first of its kind medical network built as a social ecosystem with a higher purpose – improving healthcare. Go to HealthLynked.com to learn more, sign up for free, connect with your doctor, find a new doctor, and securely store and share your health information. Download our HealthLynked app available on Apple and Android devices.