The Truth About Enamel Shaping

'The Truth About Enamel Shaping'

If you’ve got a small chip on your tooth or a rough spot that irritates your tongue, enamel shaping may be a great choice for you. It’s a quick and inexpensive method that’s done in your dentist’s office.

Enamel is the outer covering of the tooth. It’s a tough shell that protects the softer part inside.

“Enamel shaping is used when a tooth needs very fine adjustments — when the surface is a little rough, for instance, or one tooth is a little squarer than a matching tooth,” says Kellee Kattleman Stanton, DDS, spokeswoman for the American Academy of Cosmetic Dentistry.

How It’s Done

You may hear your dentist refer to the procedure as re-contouring. He uses the same kind of tools that polish your teeth during a routine cleaning. The goal is to remove a very small amount of the surface to create a smoother look. It’s usually done without numbing your mouth.

The opposite of enamel reshaping is bonding. Your dentist adds a small amount of tooth-colored resin material to fill holes or small gaps in teeth. Then he’ll use a polishing tool to smooth out the surface.

Together, these procedures are simple ways to improve your smile.

New Guidelines Would Greatly Boost Number of Young People on Statins

'New Guidelines Would Greatly Boost Number of Young People on Statins'

Guidelines Would Boost Number of Youth on Statins

Analysis finds 483,500 people aged 17 to 21 would get a cholesterol drug, based on NIH advisory

WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

MONDAY, April 6, 2015 (HealthDay News) — If all doctors followed new cholesterol^[1] guidelines aimed at children, almost half a million Americans aged 17 to 21 would be prescribed a cholesterol-lowering statin^[2] drug, a new study predicts.

In 2011, the U.S. National Heart, Lung, and Blood Institute (NHLBI) issued new guidelines on reducing heart disease^[3] in adolescents and young adults. Those guidelines recommended that all people aged 17 to 21 get their blood levels of cholesterol^[4] checked, and statin treatment be initiated if cholesterol was at a certain level.

In contrast, the American College of Cardiology (ACC) and American Heart Association (AHA) are sticking by adult-focused guidelines that more tightly restrict the use of statins^[5] for those under 40 years age.

In the new study, researchers led by Dr. Holly Gooding of Boston Children’s Hospital looked at data from more than 6,300 participants, aged 17 to 21, tracked in federal government health surveys between 1999 and 2012.

Gooding’s team found that 2.5 percent of those with elevated levels of “bad” low-density lipoprotein (LDL^[6]) cholesterol would qualify for statin treatment under the NHLBI cholesterol guidelines for children, compared with only 0.4 percent under the ACC/AHA adult guidelines.

That means that 483,500 people in that age group would qualify for statin treatment under the NHLBI guidelines, compared with 78,200 under adult guidelines, the researchers reported.

Compared with those who met the adult guidelines, those who met the children’s guidelines had lower average LDL cholesterol levels^[7], but higher rates of other heart disease^[8] risk factors, such as high blood pressure^[9], obesity^[10] and smoking^[11].

The study was published online April 6 in the journal JAMA Pediatrics.

It’s common for abnormal cholesterol levels^[12] and other heart disease^[13] risk factors to start appearing when people are teens, but the two sets of recommendations offer doctors conflicting advice, the researchers said.

For now, they recommend that physicians and patients “engage in shared decision making around the potential benefits, harms, and patient preferences for treatment,” the study authors wrote.

References

1. ^{^} cholesterol (www.webmd.com)
2. ^{^} statin (www.webmd.com)
3. ^{^} heart disease (www.webmd.com)
4. ^{^} cholesterol (www.webmd.com)
5. ^{^} statins (www.webmd.com)
6. ^{^} LDL (www.webmd.com)
7. ^{^} cholesterol levels (www.webmd.com)
8. ^{^} heart disease (www.webmd.com)
9. ^{^} high blood pressure (www.webmd.com)
10. ^{^} obesity (www.webmd.com)
11. ^{^} smoking (www.webmd.com)
12. ^{^} cholesterol levels (www.webmd.com)
13. ^{^} heart disease (www.webmd.com)

Cooling After Cardiac Arrest May Help Preserve Brain Function

'Cooling After Cardiac Arrest May Help Preserve Brain Function'

Cooling After Cardiac Arrest and Brain Function

Study finds reducing body temperature slightly tied to good mental outcomes

WebMD News from HealthDay

By Steven Reinberg

HealthDay Reporter

MONDAY, April 6, 2015 (HealthDay News) — Cooling the body might help prevent or lessen brain damage^[1] caused by cardiac arrest, a new study suggests.

People who received what is called targeted body temperature management after cardiac arrest — when the heart stops beating — had good outcomes in terms of quality of life and mental function, researchers said. Body temperatures were lowered between 2 and 7 degrees Fahrenheit.

“Among unconscious patients with cardiac arrest treated with targeted body temperature management, more than 90 percent returned home and a significant number were gainfully employed,” said Dr. Venkatesh Aiyagari, professor of neurological surgery and neurology and neurotherapeutics at the University of Texas Southwestern Medical Center in Dallas.

Aiyagari was not involved in the current research, but co-authored an editorial accompanying the study in the April 6 online edition of JAMA Neurology.

Lowering brain temperature is thought to protect brain^[2] cells, he said. “The precise mechanisms are still under investigation. Broadly speaking, cooling decreases the need for energy by brain cells that have been injured by decreased blood supply to the brain, decreases inflammation, and inhibits release of toxins that could lead to cell death,” Aiyagari said.

Despite the apparent benefits of lowering patients’ temperatures, it’s rarely done in the United States, Aiyagari added.

A previous study found that, on average, just over 1 percent of cardiac arrest patients were treated with temperature lowering in the United States, Aiyagari said.

“However, the good news is that this percentage increased from 0.34 percent in 2007 to 2.49 percent in 2010,” he said. He added that the proportion of hospitals using temperature lowering was almost 14 percent.

For the current study, a team led by Dr. Niklas Nielsen of Lund University and Helsingborg Hospital in Sweden compared two targeted temperatures on more than 900 adults in cardiac arrest. The patients came from 36 intensive care units in Europe or Australia. They were treated between late 2010 to early 2013.

The researchers randomly assigned patients to have their body temperature lowered. One group was lowered to 91.4 degrees Fahrenheit; the other to 96.8 degrees Fahrenheit, the study authors reported. Normal body temperature is 98.6 degrees Fahrenheit.

References

1. ^{^} brain damage (www.webmd.com)
2. ^{^} brain (www.webmd.com)

Regular, Vigorous Exercise May Lengthen Your Life: Study

'Regular, Vigorous Exercise May Lengthen Your Life: Study'

Intense workouts seem more beneficial than less-intense ones, researchers say

By Mary Elizabeth Dallas

HealthDay Reporter

MONDAY, April 6, 2015 (HealthDay News) — Although any amount of exercise^[1] offers health benefits, a new study suggests that rigorous physical activity^[2] may be key to boosting longevity.

Australian researchers found that middle-aged or older people who get at least some high-intensity exercise that makes them sweaty and winded may reduce their chances of dying early by up to 13 percent.

The researchers concluded that doctors’ recommendations and public health guidelines should encourage participation in some vigorous types of exercise^[3].

The study involved more than 204,000 people aged 45 or older who were followed for more than six years. Researchers compared those who engaged in only moderate activities — like gentle swimming^[4], social tennis or household chores — with people who got some amount of vigorous activity — such as jogging^[5], aerobics^[6] or competitive tennis.

The participants were divided into three groups based on their levels of physical activity: those who didn’t engage in any vigorous activity, those who said up to 30 percent of their exercise was vigorous and those who said more than 30 percent of their exercise was vigorous.

The death rate for those who said up to 30 percent of their physical activity was vigorous was 9 percent lower than those who reported no vigorous activity. The risk of death dropped 13 percent for those who said that more than 30 percent of their exercise was vigorous, the study authors reported.

“The benefits of vigorous activity applied to men and women of all ages, and were independent of the total amount of time spent being active,” study author Dr. Klaus Gebel, a senior research fellow at the Centre for Chronic Disease Prevention at James Cook University in Cairns, said in a university news release. “The results indicate that whether or not you are obese^[7], and whether or not you have heart disease^[8] or diabetes^[9], if you can manage some vigorous activity it could offer significant benefits for longevity.”

The findings were published online April 6 in JAMA Internal Medicine.

Most current guidelines for physical activity advise adults to get 150 minutes of moderate activity or 75 minutes of vigorous exercise on a weekly basis. The idea is that two minutes of moderate activity is the same as one minute of vigorous activity.

References

1. ^{^} exercise (www.webmd.com)
2. ^{^} physical activity (www.webmd.com)
3. ^{^} types of exercise (www.webmd.com)
4. ^{^} swimming (www.webmd.com)
5. ^{^} jogging (www.webmd.com)
6. ^{^} aerobics (www.webmd.com)
7. ^{^} obese (www.webmd.com)
8. ^{^} heart disease (www.webmd.com)
9. ^{^} diabetes (www.webmd.com)

Natural Ways to Clean Your Gums and Teeth

'Natural Ways to Clean Your Gums and Teeth'

If you’re looking for natural ingredients to keep your gums and teeth healthy, you’ve got more than one product to try. Whichever you choose, don’t forget that it’s not a replacement for brushing, flossing, or rinsing with a mouthwash. You’ve still got to stick with those good habits to protect your smile.

Safe and Effective?

Natural oral care products typically are safe to use, says Wenyuan Shi, PhD, chair of oral biology at the UCLA School of Dentistry.

Overall, we’re still learning which natural ingredients work best to help prevent cavities and gum disease. Fluoride definitely helps you avoid cavities, though. All toothpastes with the American Dental Association (ADA) Seal of Acceptance have it.

Peroxide, Tea, and Oils

Some natural or herbal substances, including common foods and drinks, can help clean teeth.

Look for these in your pharmacy or grocery store:

• Baking soda (sodium bicarbonate)
• Peroxide (must be carefully diluted, since it can cause burns to gums at full strength)
• Green tea
• Eucalyptol, menthol, and tea tree oil
• Xylitol gum or lozenges
• Vitamin D

Baking soda can help fight tooth decay and peroxide can help fight off certain bacteria, Shi says. On the downside, you need to mix peroxide with water to weaken it. If you use it at full strength, you might burn your gums.

One study suggests that rinsing with green tea extract may help keep your teeth from getting eroded. Another shows it might stop starchy foods, such as crackers or cake, from causing tooth decay. And a third shows that people who regularly drink green tea have healthier gums than those who don’t.

Oils such as eucalyptol, menthol, and tea tree, can help kill bacteria in your mouth. This keeps your gums from getting inflamed. You’ll find toothpaste and mouthwash with these ingredients.

Xylitol, an alcohol used in place of sugar, may help limit your tooth decay, Shi says. It’s sold as a gum or lozenge, but it’s not clear just how well it works. One study says it helped cut cavities in adults by only 10%. It can also help dry mouth by boosting saliva.

Vitamin D may be good for your mouth by helping your body kill bacteria.  Studies show you may be more likely to get gum disease if you don’t have enough of it.

Some foods and drinks that have vitamin D are eggs, tuna, salmon, and fortified orange juice.

Remember, your dentist can help point you to the natural ingredients that are best for you.

Fit at 50? Cardiac Arrest During Exercise Unlikely, Study Finds

'Fit at 50? Cardiac Arrest During Exercise Unlikely, Study Finds'

Fit at 50? Cardiac Arrest During Exercise Unlikely

Only 5 percent of attacks occurred during activities such as jogging or bicycling

WebMD News from HealthDay

By Steven Reinberg

HealthDay Reporter

MONDAY, April 6, 2015 (HealthDay News) — Physically active middle-aged men and women have little chance of suffering cardiac arrest while playing sports, a new study suggests.

Researchers reviewed more than 1,200 cases of sudden cardiac arrest^[1] — abrupt loss of heart function — among adults aged 35 to 65. They found only 5 percent of attacks occurred during sports activity such as jogging or bicycling.

And the outcome for those patients was positive, the researchers said.

“When you take a closer look at those who have a sports-related cardiac arrest, they were more likely to survive than those whose cardiac arrest was not sports-related,” said lead researcher Dr. Sumeet Chugh, associate director of genomic cardiology at Cedars-Sinai Heart Institute in Los Angeles.

“Overall, the news is good. The risk of dying suddenly if you participate in sports is quite low,” Chugh said.

However, if you have a known heart problem, any heart symptoms or are a “total couch potato,” you might want to see your doctor before starting any significant sports activity, he added.

Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, said the findings shore up recommendations that adults should get regular exercise.

For the report, published online April 6 in the journal Circulation, Chugh’s team reviewed almost 1,250 cases of sudden cardiac arrest among middle-aged adults from the Oregon Sudden Unexpected Death Study. Patients’ average age was 51.

They looked to see how many were stricken during physical activity (sexual activity was not included).

Of the 5 percent of cases suffered during exercise^[2], more than one-quarter took place while jogging. Basketball and cycling accounted for fewer than one in five sports-related cardiac arrests, the study found.

The attacks didn’t occur entirely out of the blue. More than one-third had symptoms of heart disease^[3], such as chest pain^[4] or breathlessness, in the week before their heart stopped, and more than half had risk factors for heart disease^[5], the study found.

Sports participation made it more likely the person would be seen and treated, the researchers found. Close to 90 percent of sports-associated cardiac arrests were witnessed — often because they occurred at a gym or other public place — versus roughly half of those that occurred at other times. Those people were also more likely to receive CPR — 44 percent versus 25 percent. (CPR increases the odds of survival.)

References

1. ^{^} sudden cardiac arrest (www.webmd.com)
2. ^{^} exercise (www.webmd.com)
3. ^{^} symptoms of heart disease (www.webmd.com)
4. ^{^} chest pain (www.webmd.com)
5. ^{^} heart disease (www.webmd.com)

Costlier Breast Cancer Treatments Linked to Better Survival

'Costlier Breast Cancer Treatments Linked to Better Survival'

Costlier Breast Cancer Treatments and Survival

Study shows recent advances help improve odds, but medical bills are rising

WebMD News from HealthDay

By Mary Elizabeth Dallas

HealthDay Reporter

MONDAY, April 6, 2015 (HealthDay News) — More expensive breast cancer treatments^[1] are linked to a greater chance of survival, new research suggests.

“Our findings indicate that in some instances, newer and costlier approaches may be leading to improved outcomes in breast cancer^[2] patients,” study senior author Dr. Cary Gross, director of Yale University’s Cancer Outcomes Public Policy and Effectiveness Research Center, said in a university news release.

“Now we need to tackle the harder questions about what we can afford to pay, and find out which treatments are effective for each patient,” Gross added.

The study, published in the April issue of Health Affairs, found an association between more expensive medical care and improved survival rates among breast cancer^[3] patients. It did not prove a cause-and-effect link between the two.

In conducting the study, the researchers looked at the Medicare billing records of almost 9,800 women across the United States. The women were between 67 and 94 years old. They all had stage 2 or 3 breast cancer^[4].

The researchers looked for trends in the women’s treatment costs and survival rates between 1994 and 1996, and compared them to trends from 2004 and 2006.

The study revealed that the costs for treating women with stage 3 breast cancer jumped from $18,100 to roughly $32,600. Meanwhile, the five-year survival rate for these women improved from 38.5 percent to 52 percent.

Treatment for women with stage 2 breast cancer increased by more than 40 percent. The average cost for treatment was $12,300 in 1996 and $17,400 in 2006, according to the researchers. Five-year survival rates for these women also improved, though more modestly, from 68 percent to 72.5 percent.

Gross said that the rising costs stemmed largely from big increases in the cost of chemotherapy^[5] and radiation therapy^[6].

“We view our findings as a glass half-full: survival is improving, although costs are rising substantially,” study first author Dr. Aaron Feinstein, currently a resident in head and neck surgery at UCLA in Los Angeles, said in the Yale news release.

“We need research that can help us not only to develop new treatments, but to learn how to contain costs while we are advancing patient care,” Feinstein added.

References

1. ^{^} breast cancer treatments (www.webmd.com)
2. ^{^} breast cancer (www.webmd.com)
3. ^{^} breast cancer (www.webmd.com)
4. ^{^} breast cancer (www.webmd.com)
5. ^{^} chemotherapy (www.webmd.com)
6. ^{^} radiation therapy (www.webmd.com)

Whiten Teeth at Home or in the Dentist's Office?

'Whiten Teeth at Home or in the Dentist's Office?'

You can get the shine back on your smile with a variety of teeth-whitening methods. There are pros and cons to brightening up at the dentist’s office or with an at-home kit.

At-Home Products

Whitening rinses. They’re easy to use. All you do is swirl it around in your mouth for a minute.

The whitening agent in the product is in contact with your teeth for just a short time, so your choppers get brighter gradually. Rinses can help prevent new stains after you whiten your teeth.

Whitening toothpaste. It has ingredients that remove surface stains with gentle brushing and may provide gradual brightening. But some people get sensitive teeth if they use these products.

Gel strips. You usually put them on your teeth once a day for up to 2 hours. Depending on how strong the product is, you may need to wear them for 10 to 20 days.

Whitening trays. These are filled with a gel that you fit over your teeth.

They can whiten your choppers fast. But the trays sold in at-home kits aren’t custom-made, so they’re more likely to rub and irritate your gums. Make sure you follow the directions on the package carefully.

In-Office Procedures

The most common one involves custom-made trays filled with bleaching solution that fit firmly over your teeth. Because your dentist supervises the procedure, a stronger bleaching solution can be used than what’s found in home kits.

He may recommend doing everything in his office. In that case, a light or heat source may be used to speed up the process. 

Another option is to get fitted for custom-made whitening trays that you can use at home.

Which Is Right for You?

“If your teeth and gums are in excellent condition, you may want to consider an [at-home] whitener,” says Kellee Kattleman Stanton, DDS, a spokeswoman for the American Academy of Cosmetic Dentistry.

At-home whiteners are easy to use and relatively cheap. But if your teeth or gums are sensitive, custom-made trays that you get at your dentist’s office may help you avoid irritation.

Professional solutions used by your dentist are typically stronger than those in over-the-counter kits, so your teeth may whiten more quickly. He can also make sure that sensitive gums don’t get more irritated.

Weight Watchers, Jenny Craig Beat Other Commercial Diet Plans, Study Finds

'Weight Watchers, Jenny Craig Beat Other Commercial Diet Plans, Study Finds'

MONDAY, April 6, 2015 (HealthDay News) — Many people turn to commercial weight-loss programs to help them shed excess pounds, but there’s surprisingly little scientific evidence to show whether or not these plans can help keep weight^[1] off for the long-term, a new report reveals.

Only two out of 32 major commercial weight-loss programs marketed nationwide — Weight Watchers^[2] and Jenny Craig^[3] — can boast scientific evidence showing their clients maintain weight loss^[4] for at least a year, the researchers found.

Most programs haven’t received any study at all regarding their effectiveness, or have only been reviewed for short-term success, said lead author Dr. Kimberly Gudzune. She is an assistant professor of medicine and a weight-loss specialist at the Johns Hopkins University School of Medicine in Baltimore.

“We still don’t know whether a lot of these programs work,” Gudzune said.

The study, which was not funded by any commercial weight-loss plan, is published in the April 7 issue of the Annals of Internal Medicine. Gudzune and several of her co-authors reported receiving support from the U.S. National Heart, Lung, and Blood Institute, and the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

The obesity^[5] crisis prompted the study, as doctors weigh the various options on hand to help their patients lose weight^[6], Gudzune said.

Two-thirds of adults in the United States are overweight^[7] or obese, increasing their risk for high blood pressure^[8], heart disease^[9] and type 2 diabetes^[10], the study authors pointed out.

In the United States, weight-loss programs were a $2.5 billion business in 2014, with Weight Watchers leading the pack with 45 percent of the market, according to background information in the study. Nutrisystem^[11] has about 14 percent of the market, while Jenny Craig has about 13 percent, the study said.

While these plans are popular, doctors don’t have a lot of information regarding which show real and sustained results, Gudzune said.

“Because I’m looking for the health benefits associated with sustained weight-loss, I feel more comfortable recommending a program to a patient that’s been scientifically proven to work,” she said.

References

1. ^{^} weight (www.webmd.com)
2. ^{^} Weight Watchers (www.webmd.com)
3. ^{^} Jenny Craig (www.webmd.com)
4. ^{^} maintain weight loss (www.webmd.com)
5. ^{^} obesity (www.webmd.com)
6. ^{^} lose weight (www.webmd.com)
7. ^{^} overweight (www.webmd.com)
8. ^{^} high blood pressure (www.webmd.com)
9. ^{^} heart disease (www.webmd.com)
10. ^{^} type 2 diabetes (diabetes.webmd.com)
11. ^{^} Nutrisystem (www.webmd.com)

In Rare Cases, Kids Can Get Food Allergies From Donated Blood

'In Rare Cases, Kids Can Get Food Allergies From Donated Blood'

Kids Can Get Food Allergies From Donated Blood

But these ‘transferred’ reactions clear up within a few months, experts say

WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

TUESDAY, April 7, 2015 (HealthDay News) — The case of an 8-year-old Canadian boy suggests that it’s possible, but still rare, for children to get food allergies^[1] from blood transfusions.

The boy developed an allergy^[2] to fish and peanuts after receiving a transfusion from a donor with severe allergies to these foods, reports a team led by Dr. Julia Upton, of The Hospital for Sick Children in Toronto.

He was treated promptly for the allergic reactions, and the allergies^[3] went away on their own within a few months, the researchers noted.

In the April 7 issue of the Canadian Medical Association Journal, Upton’s team explains that blood donors with food allergies^[4] can transfer an allergy-triggering antibody called immunoglobulin E (IgE) in blood products such as platelets.

While rare, parents and doctors need to be aware of the possibility in case children who have received blood products suddenly develop allergies^[5] to foods they could safely eat before.

However, “people shouldn’t be overly concerned about passive transfer of allergy from blood products,” Upton stressed in a journal news release. “This condition has an excellent prognosis and typically resolves within a few months.”

Two experts agreed.

“Passively transferred” antibodies like the one outlined in the study, are “unlike antibodies manufactured by a person’s own immune system [and] are present for only, at most, a few months before being destroyed by the body,” said Dr. Lennart Logdberg, medical director of the Blood Bank at North Shore University Hospital in Manhasset, N.Y.

“Passive transfer of allergy is a rare occurrence and has such an excellent prognosis that blood banks do not screen donors for allergies unless they display symptoms at the time of donation,” he added.

Dr. Sherry Fazan is an allergist and immunologist at North Shore-LIJ Health System in Great Neck, N.Y. She said that “over time, since [the boy’s] own immune system did not replenish the food-specific IgE, he ‘outgrew’ the allergy.”

According to Upton, when a child does develop food allergies^[6] after a transfusion, doctors should follow up within a few months to determine when to reintroduce the allergy-causing foods to the child, the researchers said.

It’s also important for doctors to report all cases of food allergies associated with transfusions so that health officials can investigate the cause and ensure the safety of the blood supply, she said.

References

1. ^{^} food allergies (www.webmd.com)
2. ^{^} allergy (www.webmd.com)
3. ^{^} allergies (www.webmd.com)
4. ^{^} food allergies (www.webmd.com)
5. ^{^} allergies (www.webmd.com)
6. ^{^} food allergies (www.webmd.com)

Physical Therapy Equals Surgery for Certain Lower Back Pain, Study Says

'Physical Therapy Equals Surgery for Certain Lower Back Pain, Study Says'

Physical Therapy Equals Surgery for Some Back Pain

Less risky treatment viable for older patients with lumbar spinal stenosis

WebMD News from HealthDay

By Alan Mozes

HealthDay Reporter

TUESDAY, April 7, 2015 (HealthDay News) — Physical therapy^[1] may be just as good as surgery for older adults with a type of chronic lower back pain^[2], new research suggests.

Standard treatments for lumbar spinal stenosis^[3] — a painful, often disabling narrowing of the spinal canal — are an operation known as surgical decompression or physical therapy.

But physical therapy is much less invasive and less risky than surgery.

“Adverse events from surgery range from 15 to 20 percent, with half of those being serious or life-threatening,” said study author Anthony Delitto.

“The risks of physical therapy are considerably less, and one would be hard-pressed to consider any of the risks serious,” said Delitto, a professor of physical therapy and associate dean of research with the school of health and rehabilitation sciences at the University of Pittsburgh.

Results of the study, funded by the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases, appear in the April 7 issue of the Annals of Internal Medicine.

According to the American Academy of Orthopaedic Surgeons, spinal degeneration and wear and tear (often due to chronic arthritis^[4]) can narrow the space surrounding the spinal cord, drying out spinal discs and compressing the cord and its nerve roots. This is called lumbar spinal stenosis.

The condition, which causes pain^[5], numbness and/or weakness across the lower back, rear and legs, mostly appears in patients aged 60 and older.

Non-surgical treatments, such as anti-inflammatory medicine and physical therapy, do not reverse spinal narrowing, but can provide a notable degree of pain relief and restored mobility, experts say.

Surgical options include spinal decompression^[6] (or laminectomy^[7]), which involves removal of the bones, bone spurs^[8] and ligaments that exert pressure on spinal nerves. Spinal fusion^[9], sometimes coupled with decompression, is another option. Delitto noted that both surgery and physical therapy are covered by Medicare, meaning that while surgery looks far more expensive on paper, physical therapy patients sometimes face slightly higher actual out-of-pocket costs.

To assess the comparative benefits of each treatment, investigators focused on nearly 170 patients with lumbar spinal stenosis who sought care in western Pennsylvania. On average, participants were in their late 60s, and none had undergone prior surgery for the condition. All demonstrated similar mobility impairment, and on a pain scale of 1 to 10 all were rated 7 prior to treatment.

References

1. ^{^} Physical therapy (www.webmd.com)
2. ^{^} lower back pain (www.webmd.com)
3. ^{^} lumbar spinal stenosis (www.webmd.com)
4. ^{^} arthritis (www.webmd.com)
5. ^{^} pain (www.webmd.com)
6. ^{^} spinal decompression (www.webmd.com)
7. ^{^} laminectomy (www.webmd.com)
8. ^{^} bone spurs (www.webmd.com)
9. ^{^} Spinal fusion (www.webmd.com)

Does This Common Pesticide Cause Cancer?

'Does This Common Pesticide Cause Cancer?'

By Bara Vaida
WebMD Health News

April 7, 2015 — An international group of health experts is questioning the safety of a widely used pesticide that had long been considered not harmful by U.S. regulators.

The International Agency for Research on Cancer (IARC), a research arm of the World Health Organization, in March said that glyphosate is a "probable" cancer^[1]-causing substance, or carcinogen. It's a key ingredient in hundreds of crop-control agents and weed killers, such as Bronco, Glifonox, KleenUp, Ranger Pro, Rodeo, Roundup, and Weedoff.

The finding — challenged by Roundup maker Monsanto — comes decades after the U.S. Environmental Protection Agency said glyphosate is safe for people. The agency reaffirmed that decision in 2012.

It is the most widely used pesticide worldwide, sprayed on everything from golf courses to home gardens. The chemical is mainly used in agriculture, and sprayed on genetically modified^[2] crops like soy, corn, and cotton. The plants are designed to resist the pesticide, which is used to kill weeds around them.

In a fact sheet, the EPA says workers or home gardeners might breathe it in or get it on their skin "during spraying, mixing, and cleanup."

Expert: ‘Be a Little Concerned’

Aaron Blair, PhD, of the National Cancer Institute, and a lead researcher on the IARC's study, says a panel of 17 scientists from around the world concluded that glyphosate might be dangerous. They looked at all publicly available and published studies on the chemical and its relationship to cancer^[3]. That included studies on people, animals, and laboratory cells. The panel didn't consider reviews done by regulatory agencies.

In 3 out of the 4 human studies of American, Canadian, and Swedish agricultural workers, the IARC panel found a link between glyphosate and non-Hodgkin lymphoma^[4], a cancer of the immune system. A fourth multi-year study of 80,000 American farmers showed no relationship, Blair says.

Evidence from animal studies also showed a link between glyphosate and rare kidney and pancreatic cancers. Cell studies showed abnormal changes to cell DNA when it was exposed to glyphosate. The combination of all the studies led the IARC to conclude that it is a "probable" carcinogen, Blair says.

"Probable means that there was enough evidence to say it is more than possible, but not enough evidence to say it is a carcinogen," Blair says.

"It means you ought to be a little concerned about" glyphosate, he says.

He could not say if glyphosate would "probably" cause cancer, because that question is connected to the level and type of exposure to the chemical. Blair's group doesn't consider factors like those.

References

1. ^{^} cancer (www.webmd.com)
2. ^{^} genetically modified (www.webmd.com)
3. ^{^} cancer (www.webmd.com)
4. ^{^} lymphoma (www.webmd.com)

Genes Linked to Breast, Ovarian Cancers Act Differently in Each Woman: Study

'Genes Linked to Breast, Ovarian Cancers Act Differently in Each Woman: Study'

BRCA Gene Mutations Act Differently in Each Woman

Angelina Jolie’s decision for surgery might not be right for everyone carrying BRCA mutations

WebMD News from HealthDay

By Amy Norton

HealthDay Reporter

TUESDAY, April 7, 2015 (HealthDay News) — Women who carry mutations in certain genes face a much higher risk of breast and ovarian cancers, but the impact varies depending on the type and location of the mutation, new research finds.

Film star Angelina Jolie, who carries a BRCA1 mutation, weighed that risk last month when she announced that she’d had her ovaries and fallopian tubes removed, almost two years after undergoing a double mastectomy^[1].

In a column published in The New York Times, Jolie stressed that her decision was personal, and that other women who carry BRCA mutations should choose what’s right for them.

This latest research aims to help women with these mutations arrive at a more concise sense of their individual risk.

“The goal of this study is to start to provide women with better risk estimates,” said lead researcher Timothy Rebbeck, a professor of epidemiology at the University of Pennsylvania Perelman School of Medicine, in Philadelphia.

“We want to give them figures based on their own mutations, and not just a general number,” Rebbeck explained.

Published in the April 7 issue of the Journal of the American Medical Association, the study focused on women who carried inherited mutations in the BRCA1 or BRCA2 genes.

It’s well known that mutations in those genes substantially raise a woman’s lifetime risk of breast and ovarian cancers. But the latest findings show that it’s more nuanced than that: The degree of the increase varies depending on the type of mutation and its location on the genes.

The findings are just a “first step,” Rebbeck and his colleagues said. And they do not provide any hard numbers that are immediately helpful to doctors and patients.

But that is coming, Rebbeck added.

Cassie Connerty is a physician’s assistant who counsels women at the High-Risk Breast Clinic at Scott & White Hospital in Round Rock, Texas. She said the findings are “very interesting,” and could eventually allow women to have a more personalized estimate of their cancer^[2] risks.

“Right now, we give women kind of a rough estimate,” said Connerty, who was not involved in the study.

References

1. ^{^} mastectomy (www.webmd.com)
2. ^{^} cancer (www.webmd.com)

Untested Stimulant Still in Dietary Supplements

'Untested Stimulant Still in Dietary Supplements'

April 7, 2015 — Researchers are warning consumers to avoid dietary supplements labeled as having the active ingredient Acacia rigidula.

The supplements claim to aid weight loss^[1], boost energy, and sharpen attention. But about half of the 21 "natural" acacia products tested by researchers contained a lab-made stimulant called BMPEA, which stands for beta-methylphenylethylamine.

"Whenever you buy a weight loss product, the best you can hope for is that it doesn't work. But why I would strongly caution against it is that the risk of getting a drug, and maybe even a drug that's never been tested in humans, is real," says Pieter Cohen, MD, an assistant professor of medicine at Harvard University. 

The test results are published in the journal Drug Testing and Analysis.

Acacia rigidula is a shrub that grows in parts of Texas and Mexico. And BMPEA, which is related to the stimulant drug ephedrine^[2], is the latest speed-like chemical to taint dietary supplements^[3], researchers say. 

In 2004, the FDA banned the stimulant Ephedra after it was linked to fatal strokes and heart attacks^[4], heart palpitations^[5], seizures^[6], and psychiatric problems.

In 2012, the agency warned 10 manufacturers to remove the stimulant DMAA from their products after supplements containing the ingredient led to cases of liver failure^[7] so severe, some people who took them needed transplants. DMAA has also been linked to at least one death.

But the agency has yet to warn consumers or recall products that have BMPEA in them.

In response to Cohen's findings, the FDA says its first priority when it comes to dietary supplements is ensuring safety.

"While our review of the available information on products containing BMPEA does not identify a specific safety concern at this time, the FDA will consider taking regulatory action, as appropriate, to protect consumers," says JuliAnn Putnam, an FDA spokesperson, in an emailed statement.

Researcher Criticizes the FDA

While researching the chemical, Cohen says he found something he calls disturbing: In 2012, the FDA's own scientists also tested acacia supplements and found BMPEA in about half the products they tested. And they determined — by testing Acacia rigidula leaves — that there was no such compound in the plant. Their study was published in 2013 in the Journal of Pharmaceutical and Biomedical Analysis.

References

1. ^{^} weight loss (www.webmd.com)
2. ^{^} ephedrine (www.webmd.com)
3. ^{^} dietary supplements (www.webmd.com)
4. ^{^} heart attacks (www.webmd.com)
5. ^{^} heart palpitations (www.webmd.com)
6. ^{^} seizures (www.webmd.com)
7. ^{^} liver failure (www.webmd.com)

Pouch in Heart May Trigger Unexplained Strokes: Study

'Pouch in Heart May Trigger Unexplained Strokes: Study'

Pouch in Heart May Trigger Unexplained Strokes

Researchers suspect it may allow clots to form, then travel to the brain

WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

TUESDAY, April 7, 2015 (HealthDay News) — A pouch-like structure in the heart may be the source of some strokes that have no other known cause, a new study suggests.

This pouch in the heart’s left atrial chamber — called a left atrial septal pouch — was first discovered in 2010 by cardiologists at the University of California, Irvine.

“The cul-de-sac nature of this heart pouch may promote stagnation of the blood, forming clots that can travel into the brain and cause a stroke^[1],” Dr. Mark Fisher, a professor of neurology and pathology and laboratory medicine, said in a UC Irvine news release.

The researchers looked at 75 stroke patients to find out if the pouch could be a source of stroke-causing blood clots^[2].

Of the 23 patients who had a stroke of undetermined origin, 30 percent had a left atrial septal pouch, compared with only 10 percent of the 52 patients whose cause of stroke^[3] could be pinpointed.

“This finding points to a potentially important cause of strokes. The presence of this pouch could change how neurologists treat these patients and lead to new therapeutic strategies for preventing strokes,” Fisher explained.

While the researchers found an association between the pouch and unexplained strokes, it did not prove a cause-and-effect link.

The study was published recently in the journal Frontiers in Neurology.

About 80 percent of the more than 700,000 strokes that occur in the United States each year are caused by blood clots blocking brain arteries. In up to one-third of these cases, the source of the clot can’t be pinpointed, the researchers said.

References

1. ^{^} stroke (www.webmd.com)
2. ^{^} blood clots (www.webmd.com)
3. ^{^} cause of stroke (www.webmd.com)

Teen Use of Long-Term Contraception Rising, But Remains Low

'Teen Use of Long-Term Contraception Rising, But Remains Low'

Teen Long-Term Contraception Use Up, Remains Low

U.S. government report says implants and IUDs are effective and safe options

WebMD News from HealthDay

By Steven Reinberg

HealthDay Reporter

TUESDAY, April 7, 2015 (HealthDay News) — The use of long-acting, reversible forms of contraception^[1] remains low among sexually active teen girls, though that trend seems to be changing, according to a U.S. government report released Tuesday.

Among teens aged 15 to 19, the use of long-acting reversible contraception^[2] rose from less than 1 percent in 2005 to about 7 percent in 2013, according to the federal Centers for Disease Control and Prevention.

“We encourage teens^[3] who aren’t sexually active to continue to wait, but for teens who are choosing to have sex, we want them to make an informed choice,” Ileana Arias, the CDC’s principal deputy director, said during a media briefing.

“We want them to think about the most effective types of birth control^[4], and ask their doctor or family planning counselor about long-acting reversible contraception as well as about other options,” she said.

Long-acting reversible forms of birth control^[5] include intrauterine devices (IUDs) and hormonal implants. These forms of birth control are extremely effective, with less than 1 percent of users getting pregnant during the first year of use, according to the CDC.

The report was published online April 7 in the CDC’s Morbidity and Mortality Weekly Report.

Teen births continue to decline in the United States, even reaching an all-time low in 2013, according to the CDC. Nearly 90 percent of teens said they used birth control^[6] the last time they had sex.

Still, more than 273,000 babies were born to U.S. teens in 2013. And, the teen birth rate in the United States is up to seven times higher than some other developed countries, the CDC said.

Most teens choose condoms^[7] or birth control pills^[8] as their preferred method of contraception, according to the CDC. But, if not used consistently and correctly, these methods are less effective for preventing pregnancy than implants and IUDs, the experts said.

Implants and IUDs are the most effective type of reversible birth control^[9] because they don’t require taking a pill every day or putting on a condom^[10] consistently before sex. Depending on the type of implant or IUD^[11], they can be used for three to 10 years and they’re safe, the CDC researchers added.

References

1. ^{^} contraception (www.webmd.com)
2. ^{^} contraception (www.webmd.com)
3. ^{^} teens (teens.webmd.com)
4. ^{^} types of birth control (www.webmd.com)
5. ^{^} birth control (www.webmd.com)
6. ^{^} birth control (www.webmd.com)
7. ^{^} condoms (www.webmd.com)
8. ^{^} birth control pills (www.webmd.com)
9. ^{^} birth control (www.webmd.com)
10. ^{^} condom (www.webmd.com)
11. ^{^} IUD (www.webmd.com)