Monday Is Deadline to Sign Up for Obamacare

By Karen Pallarito

HealthDay Reporter

MONDAY, March 31, 2014 (HealthDay News) -- Today is the deadline for most people to sign up for health insurance under the Affordable Care Act, the controversial healthcare-reform law.

More than 6 million Americans have already signed up for insurance coverage through online "marketplaces" created by the law, federal officials said on Thursday.

Earlier last week, the Obama administration said that Americans who've started applying for health insurance but can't complete the process by the March 31 deadline will be given an extension.

Administration officials said the extension was being offered partly out of concern that the federal online registration website, Healthcare.gov, could become overwhelmed as last-minute registrants scrambled to meet the original March 31 deadline or face a penalty in the form of a tax.

And that seemed to be the case Monday morning as the website struggled with high user traffic. Some visitors to HealthCare.gov were met with messages that the site was down for maintenance. At times, visitors were sent to a virtual waiting room -- a feature created to ease the strain on the site during periods of heavy demand, the Associated Press reported.

The troubled unveiling of HealthCare.gov last fall is still fresh in many people's memories, as computer glitches and software problems made the website almost unusable for long periods of time. Critics of the Affordable Care Act pounced on the troubled launch, which was deeply embarrassing to President Barack Obama. The health reform law, sometimes called Obamacare, is considered Obama's signature domestic achievement.

The federal website, which serves 36 states that do not operate their own registration websites, has been operating well for months, according to White House officials. But it had more than 1 million visitors each day several days last week. With the prospect of high visitor traffic leading up to March 31, the Obama administration said it wanted to avoid a repeat of last fall's problems with the website.

Administration officials did not specify how long the extended enrollment period would last.

With some exceptions, people who are uninsured for most of 2014 may have to pay a penalty during next year's tax season under provisions of the controversial law. The maximum penalty for 2014 is $95 per adult and half of that for children (up to $285 for a family of three or more) -- or up to 1 percent of household income, whichever is greater.

According to the White House, one of the main objectives of the Affordable Care Act is to expand access to affordable health care options. The law led to the creation of the online marketplaces, or exchanges, where people in each state and the District of Columbia may compare health plans and sign up for coverage.

The Congressional Budget Office initially projected that 7 million people would sign up for health coverage in 2014. It later lowered its estimate to 6 million.

Once the enrollment deadline passes, most Americans won't have another chance to sign up for coverage until the next open enrollment period, which begins Nov. 15. Coverage purchased during that time won't take effect until 2015.

source : Monday Is Deadline to Sign Up for Obamacare

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More Evidence Weight-Loss Surgery Helps People With Diabetes

One-third of gastric-bypass patients kept type 2 diabetes under control without meds during three-year study

HealthDay – Not on Site

By Serena Gordon

HealthDay Reporter

MONDAY, March 31, 2014 (HealthDay News) -- Weight-loss surgery might do more than help people shed pounds. For some who have the surgery, it may also put type 2 diabetes into remission for several years, a new study suggests.

The success rate in controlling diabetes depended on the type of weight-loss surgery, the researchers said.

Patients who had the more involved gastric-bypass surgery were more likely to achieve control of their type 2 diabetes without the use of medications, compared to those who had a procedure known as sleeve gastrectomy, according to the new research.

"This study is a three-year follow-up. Initially, we showed that people lost a lot of weight after surgery, and for some people, that caused their type 2 diabetes to come to an end," said study co-author Dr. Sangeeta Kashyap, an endocrinologist at the Cleveland Clinic's Endocrinology & Metabolism Institute. "But no one knew how lasting that would be."

"One-third [of patients] in the gastric bypass group had remission of diabetes -- meaning they had normal blood sugar control -- and a quarter of the people in the sleeve gastrectomy group had remission of type 2 diabetes," Kashyap said. "These effects are real, and they're persistent for at least three years. Essentially, these patients have had a vacation from diabetes for three years."

Even when people weren't able to achieve a full remission from type 2 diabetes, weight-loss surgeries still helped many participants take less medication to control their blood sugar, according to the study.

Kashyap also said quality of life was improved for people who had the weight-loss surgery compared to those who received standard type 2 diabetes management. Quality-of-life measures included bodily pain, physical functioning, energy levels and emotional well-being.

"People who have weight-loss surgery generally feel better, happier and healthier," Kashyap said.

The study was funded by Johnson & Johnson subsidiary Ethicon, which makes surgical devices.

Results of the study will be presented Monday at the American College of Cardiology annual meeting in Washington, D.C., and published in the March 31 issue of the New England Journal of Medicine.

Type 2 diabetes causes the body to use the hormone insulin inefficiently. Insulin helps get sugar from the blood into the body's cells to be used as fuel. When cells become insulin resistant, that fuel can't make it into the cells and instead builds up in the blood. High levels of sugar in the blood over long periods of time can cause serious complications, such as kidney and heart disease, according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Although the exact cause of type 2 diabetes remains unknown, one of the biggest risk factors for developing the disease is obesity.

source : More Evidence Weight-Loss Surgery Helps People With Diabetes

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Blood Test Shows Promise for Gauging Heart Attack Risk After Chest Pain

More study is needed, but the screening method measures levels of a chemical signal tied to heart damage

WebMD News from HealthDay

By Mary Elizabeth Dallas

HealthDay Reporter

SUNDAY, March 30, 2014 (HealthDay News) -- Though more study needs to be done, new research suggests that a simple blood test could help predict the heart attack risk of patients experiencing chest pain.

The Swedish study found that patients with chest pain who have undetectable levels of a certain chemical signal in their blood called "high-sensitivity cardiac troponin T," plus no sign of reduced blood flow, are at very low risk for heart attack over the next month.

The authors of the study, which is to be presented Sunday in Washington, D.C., at the annual meeting of the American College of Cardiology, believe the test could help prevent many unnecessary hospital admissions.

"Chest pain is a potentially life-threatening symptom, as well as being a very common one," study lead author Dr. Nadia Bandstein, from the Karolinska Institute in Solna, Sweden, said in a meeting news release. "In our hospital it's the second most common symptom reported in the emergency department. Since there are no established ways to quickly rule out heart attack, many patients are admitted to the hospital unnecessarily, at a large cost to the patient and to society."

According to Bandstein, "using this blood test along with an ECG [electrocardiogram], we will save about 500 to 1,000 admissions per year in our hospital alone, allowing us to use the beds for sicker patients."

Still, more research is required. And experts note that studies presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

As the researchers explained, high-sensitivity cardiac troponin T is a chemical signal in the blood that can help doctors detect heart damage. It is a relatively new factor used to diagnose heart attack and can be detected in the blood several hours before older methods of measuring troponins.

In conducting the study, Bandstein's team analyzed blood levels of this chemical signal in almost 15,000 patients who visited emergency rooms in Sweden from 2010 to 2012. They focused on more than 8,900 patients with undetectable levels of troponin who also had no signs of heart damage from reduced blood flow. These patients averaged 47 years of age.

The researchers then examined how many of these patients went on to suffer a heart attack within 30 days. During that time, only 39 of the patients included in the study had a heart attack, the researchers reported. Of these, 15 had no signs of damage due to reduced blood flow.

Overall, only one in every 594 patients who go to the emergency room for chest pain with no sign of heart damage and undetectable levels of troponin are at immediate risk for heart attack, the researchers calculated.

source : Blood Test Shows Promise for Gauging Heart Attack Risk After Chest Pain

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FDA Advisory Panel Recommends Approval of At-Home Colon Cancer Test

DNA analysis of stool boosts accuracy rate of Cologuard to more than 90 percent, researchers say

WebMD News from HealthDay

By Alan Mozes

HealthDay Reporter

FRIDAY, March 28, 2014 (HealthDay News) -- A panel of U.S. Food and Drug Administration experts on Thursday unanimously recommended approval of a new at-home stool test that screens for colorectal cancer with more than 90 percent accuracy.

The 10-member committee said the benefits of Exact Science Corp.'s Cologuard test outweigh its risks, the Associated Press reported. The FDA is not obligated to follow its panels' recommendations, but usually does.

The panel's blessing comes on the heels of a study published earlier this month that found Cologuard had a very high accuracy rate in spotting colon cancer.

Last year, nearly 143,000 new cases of colorectal cancer were diagnosed in the United States and almost 50,000 Americans died of the disease, according to the U.S. National Cancer Institute.

Yet, one-third of Americans fail to heed public health recommendations to undergo more invasive colonoscopy screenings every 10 years starting at age 50, said study co-author Dr. Steven Itzkowitz, director of the gastroenterology fellowship program at the Icahn School of Medicine at Mount Sinai in New York City

Commonly used stool tests such as FIT (fecal immunochemical testing) rely on detecting blood in the stool. The new Cologuard test checks for blood as well as abnormal DNA coming from the tumor, "with the advantage that some lesions, even cancers, don't bleed very much," Itzkowitz explained.

The Cologuard test also features a DNA analysis not included in other fecal exams.

"By increasing the pick-up rate in this way," said Itzkowitz, "we found that the new test had a 92 percent sensitivity for detection of colorectal cancer. That kind of result is really unprecedented for a noninvasive stool-based screening."

The research, published in the March 19 issue of the New England Journal of Medicine, was funded by Exact Sciences, which is based in Wisconsin.

To assess the potential of the DNA method, nearly 10,000 men and women aged 50 and older were screened for colon cancer and precancerous polyps at one of 90 sites across the United States and Canada. All were considered at average risk for colon cancer.

Each patient was screened three ways: by means of a standard colonoscopy; a commercially available fecal test (FIT); and the new DNA test, which requires patients to collect their own stool sample at home and mail it in for laboratory analysis.

In the end, colonoscopy screenings -- considered the gold standard of colon cancer screening -- unearthed colon cancer in 65 participants, while another 757 were found to have advanced precancerous lesions.

The new test accurately detected 60 of those 65 cancers. The FIT test spotted only 48 cancers, with an accuracy rate of 74 percent compared to 92 percent for the new test.

source : FDA Advisory Panel Recommends Approval of At-Home Colon Cancer Test

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Underweight Even Deadlier Than Overweight, Study Says

Death risk nearly doubled for excessively thin people

WebMD News from HealthDay

By Alan Mozes

HealthDay Reporter

FRIDAY, March 28, 2014 (HealthDay News) -- It's said you can never be too rich or too thin, but new research suggests otherwise. People who are clinically underweight face an even higher risk for dying than obese individuals, the study shows.

Compared to normal-weight folks, the excessively thin have nearly twice the risk of death, researchers concluded after reviewing more than 50 prior studies.

Obesity has occupied center stage under the public health spotlight, but "we have [an] obligation to ensure that we avoid creating an epidemic of underweight adults and fetuses who are otherwise at the correct weight," said study leader Dr. Joel Ray, a physician-researcher at St. Michael's Hospital in Toronto.

The findings appear in the March 28 issue of the Journal of Epidemiology and Public Health.

Studies included in the analysis followed people for five years or more and focused on associations between BMI (body-mass index, a key indicator of healthy weight) and fatalities related to any cause.

Ray's team also looked at how death rates related to weight patterns among newborns and stillborns.

Underweight patients of all ages (those with a BMI of 18.5 or under) were found to face a 1.8 times greater risk for dying than patients with a normal BMI (between 18.5 and 25.9), the study found.

By contrast, obese patients (those with a BMI between 30 and 34.9) face a 1.2 greater risk for dying than normal-size patients. Severely obese patients -- those with a BMI of 35 or more -- faced a 1.3 times greater risk.

Ray said it's important to keep a healthy body size in mind when attempting to tackle the obesity epidemic.

"BMI reflects not only body fat, but also muscle mass. If we want to continue to use BMI in health care and public health initiatives, we must realize that a robust and healthy individual is someone who has a reasonable amount of body fat and also sufficient bone and muscle," Ray said in a hospital news release. "If our focus is more on the ills of excess body fat, then we need to replace BMI with a proper measure, like waist circumference."

Typical factors linked to a higher risk for being underweight included malnourishment, drug or alcohol use, smoking, poverty and mental health issues.

source : Underweight Even Deadlier Than Overweight, Study Says

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Smoking Bans Linked to Drop in Premature Births, Kids' Asthma Attacks

Smoke-free policies offer health benefits for people of all ages, study authors say

WebMD News from HealthDay

By Mary Elizabeth Dallas

HealthDay Reporter

FRIDAY, March 28, 2014 (HealthDay News) -- Bans on smoking in public places and the workplace in North America and Europe are linked to a 10 percent drop in premature births and the number of children going to the hospital for an asthma flare-up, according to a new study.

The study authors said this positive trend occurred within one year of smoke-free policies being put into effect. They added that their findings show smoking bans have significant health benefits for both adults and children.

The study was published online March 28 in the journal The Lancet.

"Our research found significant reductions in preterm birth and severe asthma attacks in childhood, as well as a 5 percent decline in children being born very small for gestational age after the introduction of smoke-free laws," Dr. Jasper Been, of the Maastricht University Medical Centre, in the Netherlands, said in a journal news release.

"Together with the known health benefits in adults, our study provides clear evidence that smoking bans have considerable public-health benefits for perinatal and child health, and provides strong support for [World Health Organization] recommendations to create smoke-free public environments on a national level," Been said.

The researchers examined five North American studies on local smoking bans and six European studies focused on national smoke-free policies. The review involved a combined 2.5 million births and almost 250,000 asthma flare-ups among children.

Study co-author Professor Aziz Sheikh said the new study shows the potential that smoke-free laws have to decrease premature births and childhood asthma.

"The many countries that are yet to enforce smoke-free legislation should in the light of these findings reconsider their positions on this important health policy question," said Sheikh, of Brigham and Women's Hospital in Boston and the University of Edinburgh in Scotland.

The study authors said comprehensive smoking bans cover just 16 percent of the world's population, and 40 percent of children are regularly exposed to secondhand smoke. Young people account for more than 25 percent of all deaths and more than 50 percent of all healthy years of life lost to secondhand smoke exposure.

source : Smoking Bans Linked to Drop in Premature Births, Kids' Asthma Attacks

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Marriage Does Help the Heart, Study Finds

Researchers compared cardiovascular disease rates in more than 3 million Americans

WebMD News from HealthDay

By Kathleen Doheny

HealthDay Reporter

FRIDAY, March 28, 2014 (HealthDay News) -- Marriage is good for the heart, yet another study has found.

Married partners don't just have a lower risk of heart problems, the researchers said. They also have a lower risk of cardiovascular disease affecting the legs, neck or abdominal areas.

"We found that being married was associated with lower risks of cardiovascular disease in general," said study researcher Dr. Carlos Alviar, a cardiology fellow at NYU Langone Medical Center in New York City.

Alviar is scheduled to present the findings Saturday at the annual meeting of the American College of Cardiology, in Washington, D.C.

Although several other studies have found that marriage helps the heart and overall health, this newest one is believed to be the largest, Alviar said. And although some other studies have found the benefit greater for married men than for married women, this study did not find gender differences, he said.

For the new study, the researchers analyzed records from a database of more than 3.5 million people nationwide. All had been evaluated for cardiovascular disease, including heart disease and vascular problems in the limbs and other areas. The database included information on whether they had high blood pressure or diabetes, were smokers or were obese -- all risk factors for heart disease.

The participants' ages ranged from 21 to 102, and the average age was 64. Of all the people studied, 69 percent were married, 14 percent were widowed, 9 percent were divorced and 8 percent were single. The singles were considered the comparison group.

Even after taking into account risk factors such as age, gender and race, marriage was still protective, researchers found.

"Married men and women had 5 percent lower odds of any vascular disease," Alviar said, comparing them to singles. "Widowed men and women had 3 percent higher odds, and divorced men and women had 5 percent higher odds of any vascular disease."

Alviar called that degree of risk reduction good, but "not substantial." In younger people, however, the protection for the married men and women was even more pronounced, he said.

Although the researchers found a link between marriage and lower risk for heart disease, they didn't prove a cause-and-effect relationship.

"It's such a large population that you can't cast this study off," said Dr. J. Jeffrey Marshall, past president of the Society for Cardiovascular Angiography and Interventions. Marshall reviewed the findings but wasn't involved in the study.

Although other studies have looked at death rates from heart disease, this study is looking at the odds of getting cardiovascular disease, said Marshall, a cardiologist in Gainesville, Ga.

Neither Marshall nor Alviar could explain the apparent protective factor of marriage, but both have some thoughts about the reasoning behind it. "Maybe married people look out for each other," Marshall said. "They may exercise together. Your spouse may help you watch your diet."

source : Marriage Does Help the Heart, Study Finds

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Many Kids May Have High Cholesterol, Regardless of Weight

Abnormal levels seen in 1 of 3 children, possibly raising future heart disease risk, researcher says

WebMD News from HealthDay

By Dennis Thompson

HealthDay Reporter

FRIDAY, March 28, 2014 (HealthDay News) -- About one of three Texas kids screened for cholesterol between the ages of 9 and 11 had borderline or high cholesterol, potentially placing them at greater risk for future cardiovascular disease, a new study has found.

Obese kids were more likely to have abnormal cholesterol levels, but a large percentage of normal-weight children also had borderline or high cholesterol, said lead investigator Dr. Thomas Seery, a pediatric cardiologist at Texas Children's Hospital and an assistant professor of pediatrics at Baylor College of Medicine, in Houston.

"The reality is that 35 percent of kids who were not obese had abnormal cholesterol as well," Seery said.

Physicians and parents need to teach kids healthy habits, such as eating right and exercising regularly, or as adults they will be more likely to suffer heart disease and stroke, he said.

"Cardiovascular disease in children is rare, but we know that atherosclerosis has its beginnings in childhood," Seery said. "The better a job we do now, the better they will do later in life."

Previous studies have indicated that as many as 70 percent of children who have elevated cholesterol levels maintained those high levels as they entered young adulthood, said Dr. Patricia Vuguin, a pediatric endocrinologist at Cohen Children's Medical Center in New Hyde Park, N.Y.

"Your cholesterol at 9 is a reflection of where your cholesterol is going to be in your 40s and 50s," Vuguin said.

The new findings, scheduled to be presented Monday at the annual meeting of the American College of Cardiology, held in Washington, D.C., take an even darker tone when held next to another study also featured at the meeting.

That study found that middle-school kids who spend two hours or more at a television or computer screen each day are more likely to chow down junk food and have increased risk of cardiovascular disease, researchers said.

The study of about 1,000 sixth-graders in southeast Michigan found that avid TV viewers and computer/video game users both reported eating about 3.5 snacks a day -- one full snack more than children who had low exposure to these technologies.

"Parents need to monitor their kids' activities," said senior author Dr. Elizabeth Jackson, an associate professor in the division of cardiovascular medicine at the University of Michigan. "Our results offer even more reason to limit the amount of TV time kids have and are right in line with current recommendations," she said in a meeting news release.

Seery and his colleagues undertook their research after new guidelines for juvenile cholesterol screening were issued by the U.S. National Heart, Lung, and Blood Institute in 2011 and endorsed by the American Academy of Pediatrics.

source : Many Kids May Have High Cholesterol, Regardless of Weight

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Underweight Even Deadlier Than Overweight, Study Says

Death risk nearly doubled for excessively thin people

WebMD News from HealthDay

By Alan Mozes

HealthDay Reporter

FRIDAY, March 28, 2014 (HealthDay News) -- It's said you can never be too rich or too thin, but new research suggests otherwise. People who are clinically underweight face an even higher risk for dying than obese individuals, the study shows.

Compared to normal-weight folks, the excessively thin have nearly twice the risk of death, researchers concluded after reviewing more than 50 prior studies.

Obesity has occupied center stage under the public health spotlight, but "we have [an] obligation to ensure that we avoid creating an epidemic of underweight adults and fetuses who are otherwise at the correct weight," said study leader Dr. Joel Ray, a physician-researcher at St. Michael's Hospital in Toronto.

The findings appear in the March 28 issue of the Journal of Epidemiology and Public Health.

Studies included in the analysis followed people for five years or more and focused on associations between BMI (body-mass index, a key indicator of healthy weight) and fatalities related to any cause.

Ray's team also looked at how death rates related to weight patterns among newborns and stillborns.

Underweight patients of all ages (those with a BMI of 18.5 or under) were found to face a 1.8 times greater risk for dying than patients with a normal BMI (between 18.5 and 25.9), the study found.

By contrast, obese patients (those with a BMI between 30 and 34.9) face a 1.2 greater risk for dying than normal-size patients. Severely obese patients -- those with a BMI of 35 or more -- faced a 1.3 times greater risk.

Ray said it's important to keep a healthy body size in mind when attempting to tackle the obesity epidemic.

"BMI reflects not only body fat, but also muscle mass. If we want to continue to use BMI in health care and public health initiatives, we must realize that a robust and healthy individual is someone who has a reasonable amount of body fat and also sufficient bone and muscle," Ray said in a hospital news release. "If our focus is more on the ills of excess body fat, then we need to replace BMI with a proper measure, like waist circumference."

Typical factors linked to a higher risk for being underweight included malnourishment, drug or alcohol use, smoking, poverty and mental health issues.

source : Underweight Even Deadlier Than Overweight, Study Says

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Weight-Loss Surgery Cuts Risk for Heart Attack, Death: Study

People who are obese and at risk for heart disease should consider surgery, researchers say

WebMD News from HealthDay

By Mary Elizabeth Dallas

HealthDay Reporter

FRIDAY, March 28, 2014 (HealthDay News) -- Weight-loss surgery, such as gastric banding, can dramatically reduce the rate of heart attacks and deaths among people who are obese, a new study shows.

Researchers in the United Kingdom said their findings suggest that obese people at high risk for heart disease should seriously consider undergoing this type of procedure to lose weight.

The researchers also said their study is the first comprehensive review of weight-loss surgery -- known as bariatric surgery -- on heart disease, stroke and death.

"We looked at the outcomes for patients who undergo bariatric surgery, and compared them to figures for obese people who had not received surgery. We saw that surgery was potentially lifesaving and could lower the risk of having a heart attack and stroke by almost 50 percent," study senior author Dr. Yoon Loke, of the University of East Anglia's Norwich Medical School in England, said in a university news release.

The researchers examined 14 previous studies involving more than 29,000 patients who had weight-loss surgery. The mean age of the patients was 48, and 30 percent were men. The participants were followed for a period of two to 14 years.

The study also saw a 40 percent reduction in death rates among patients who had the surgery, compared to those who didn't have the procedure.

"Obesity is a worldwide problem with significant consequences on individuals and society. It is associated with heart disease, type 2 diabetes, many cancers and a shorter life expectancy," Loke said.

The study authors added that a large, high-quality study on the benefits of weight-loss surgery is needed.

The study was published March 28 in the International Journal of Cardiology.

source : Weight-Loss Surgery Cuts Risk for Heart Attack, Death: Study

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OK to kiss Fido? If you’re willing to take on a bit of bacteria, then yes.

By Suz Redfearn
WebMD Feature

Reviewed by Amy Flowers, DVM

Do you smooch your pooch?

Lots of dog moms and dads do. After all, his mouth is cleaner than yours, right?

Nope.

Think about it -- what he eats, what he licks. Common sense tells you it’s a germfest.

But the truth is, those bacteria aren’t big health risks for most people. So kissing your furry baby is OK, if it doesn’t gross you out. Just have a healthy awareness of what could be in your dog’s mouth, says Clark Fobian, DVM, president of the American Veterinary Medical Association.

What has your dog been doing?

Before you kiss a dog, or let a dog kiss your face, “you have to think of where their nose has been,” Fobian says. “Has it been inside a dead opossum on the side of the road, or the posterior of another dog, or in the litter box?”

Don’t think that kissing your dog on his snout or the top of his head is safer than on the mouth. When a dog has an infection -- say, in his ear -- germs can end up all over his body through scratching, Fobian says. And there’s a good chance whatever’s in his mouth will end up on his coat through slobber and licking.

Could you make each other sick?

Before you kiss a dog, or let a dog kiss your face, “you have to think of where their nose has been,” Fobian says. “Has it been inside a dead opossum on the side of the road, or the posterior of another dog, or in the litter box?”

Don’t think that kissing your dog on his snout or the top of his head is safer than on the mouth. When a dog has an infection -- say, in his ear -- germs can end up all over his body through scratching, Fobian says. And there’s a good chance whatever’s in his mouth will end up on his coat through slobber and licking.

If you’re sick, think twice

If you’re not healthy, skip it. People with weak immune systems should simply avoid kissing pets, Fobian says. That includes those with HIV/AIDS, those who have had an organ transplant, and those who are on medicines for cancer that limit the body’s ability to fight off infection.

Get the message from your dog

Some dogs may not like you to put your face close to theirs.

A dog who doesn’t want to be kissed will show his stress by leaning away, looking away, pursing and licking his lips.

“A lot of people miss those signs, and when they try to kiss the dog, the dog snaps at them,” says Melissa Bain, DVM, assistant professor at UC Davis School of Veterinary Medicine.

If your dog is giving you signs that this is not her thing, then don’t put her through it, Bain says.

It’s not much different from trying to kiss a human who doesn’t want to be kissed. “We respect people who are like that; we should also respect dogs who are like that,” Bain says.

source : OK to kiss Fido? If you’re willing to take on a bit of bacteria, then yes.

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Obama Announces 6 Million Have Signed Up For Insurance

By Mary Agnes Carey

Thu, Mar 27 2014

More than 6 million people have signed up for health insurance through the health law’s state and federal online marketplaces, or exchanges, since Oct. 1, the administration announced Thursday.

President Barack Obama, who is traveling in Europe, announced the number in a conference call with groups that are helping consumers sign up for coverage.

In a blog post, Centers for Medicare & Medicaid Administrator Marilyn Tavenner said  the health law’s web site, healthcare.gov, and 800 number, had near record traffic Wednesday, with 1.5 million visitors and more than 430,000 phone calls.

“With 4 days left for consumers to sign up for coverage, we are working hard to ensure that our systems can handle the unprecedented demand as people enroll before the March 31 deadline,” Tavenner wrote.

The Congressional Budget Office originally estimated that 7 million people would sign up for the exchanges by the end of the enrollment period. After computer problems botched the Oct. 1 rollout, the CBO revised that estimate down to 6 million. Federal officials have said they do not yet know how many people who have enrolled have paid their first month’s premium. Insurance industry officials have reported that about 70 to 80 percent of enrollees have paid.

Reaching 6 million has both practical and political significance. The more enrollees there are, the more likely the risk pool will be balanced between sick and healthy individuals. That calculus will be based on enrollments at the state and local levels where premiums are set, say experts. Republicans have expressed skepticism that the law would provide affordable coverage for millions of Americans and called for its repeal.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

source : Obama Announces 6 Million Have Signed Up For Insurance

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Spring Pollen Allergies

By Matt McMillen
WebMD Health News

Reviewed by Brunilda Nazario, MD

March 27, 2014 -- A bitterly cold winter followed by a sudden spring warm-up might spell massive misery if you have allergies.

“When pollen has been held up by cold weather, you can get a flood of pollen as the weather warms up,” says allergy researcher Kraig Jacobson, MD. “And that may indeed be happening now.”

Allergy season is already well underway in parts of the Midwest, where many states have experienced some of the most brutal winters in history. Reports of extremely high pollen counts are already coming in from Kansas and Oklahoma, where one expert predicts a “super bloom” of pollen as temperatures rise suddenly.

Forecasts, clearly, are not one-size-fits-all. How bad the allergy season will be depends on where you are.

“Things are very, very regional because of weather and what grows there,” says Jacobson, a pollen counter for the National Allergy Bureau.

Parts of Ohio and Missouri have moderate pollen counts so far, while Chicago and Minneapolis have yet to tally any pollen this year.

In the Northeast, a late storm brought more snow, not pollen. If temperatures rise quickly after the winter blast, that region could be in for a bad allergy season. In California and neighboring states, pollen counts are low because of drought. The rest of the country, on the other hand, has had plenty of moisture to produce high levels of pollen.

Jacobson predicts that New Orleans and coastal areas will be particularly hard hit because of their many live oaks, a common variety of oak tree.

In parts of Texas, cedars are expected to cause a lot of grief -- make that a lot more grief. Shortly after the mountain cedar pollen season began in late December, Austin and San Antonio measured pollen counts in the thousands, news reports said. Jacobson says there probably will be more of the same from other types of cedar trees now that it’s spring.

You can see what WebMD users are reporting in their states here.

What to Expect?

If things are bad in your part of the country in March, will they get worse? That’s hard to say.

“Predicting pollen is like predicting the weather,” Jacobson says. “There’s a lot of variability, and you can have sudden changes.”

There’s also a lot of variety when it comes to pollen providers. Some trees pollinate for a couple of weeks in early spring, while others pollinate a little later. Grass pollen follows tree pollen in April, May, and June. Ragweed and other weed pollens come next, to ruin late summer and early autumn.

source : Spring Pollen Allergies

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U.S. Autism Estimates Rise by 30 Percent for Kids

Researchers say increase could be due to better diagnosis of the developmental disorder

WebMD News from HealthDay

By Dennis Thompson

HealthDay Reporter

THURSDAY, March 27, 2014 (HealthDay News) -- One in 68 American children is now diagnosed with autism or a related disorder, federal health officials reported Thursday.

That's a 30 percent increase from just two years ago when the estimate was one in 88 children, according to a new report from the U.S. Centers for Disease Control and Prevention.

"The number of children identified with autism continues to rise," said Coleen Boyle, director of the CDC's National Center on Birth Defects and Developmental Disabilities.

The continuing increase in the percentage of kids diagnosed with autism could be due to better detection of the developmental disorder, Boyle said, but also might reflect an actual increase in autism.

"It could be a combination of better recognition and increased prevalence," she said. "Our system tells us what's going on. It only gives us clues about the why."

The new statistics also continue to show that autism spectrum disorder is five times more common among boys than girls. And they reflect an increase in the percentage of children being diagnosed with high-functioning autism, the CDC said.

People with an autism spectrum disorder display impaired social and communication skills. Symptoms, which can range from mild to severe, usually become apparent in the first three years of life. The developmental disorder is linked to abnormal biology and chemistry in the brain, according to the U.S. National Institutes of Health.

The CDC bases its estimates on reports from 11 communities that participate in its Autism and Developmental Disabilities Monitoring Network. The newest estimate is based on data from 2010.

Estimates of autism among 8-year-olds have more than doubled since the CDC network's first report in 2007, which calculated that about 1 in 150 children had the disorder based on 2002 data.

The continuing rise of autism highlights the need for more funding for research into the causes of autism and for support and treatment of kids diagnosed with the disorder, said Michael Rosanoff, associate director of research and scientific review at Autism Speaks.

"We really need to double down on our research into the environmental factors that work in some complex way with a child's genetics to increase the risk of autism," he said.

There also needs to be continued emphasis on earlier diagnosis of autism, added Dr. Melissa Nishawala, an assistant professor of child and adolescent psychiatry at the NYU School of Medicine and medical director of the Autism Spectrum Disorders Clinical and Research Program.

The new CDC study reports that most children are diagnosed with autism spectrum disorder after age 4, even though autism can be diagnosed as early as age 2.

"We need to push the frontier of diagnosis down to the earliest ages we can," Nishawala said. "The earlier we intervene, the more we can do to help nudge those brain pathways closer and closer to normal."

source : U.S. Autism Estimates Rise by 30 Percent for Kids

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'Grazing' Appears No Better for Weight Loss Than Standard Meals

Daily calories, not how often you eat, are what matter, study finds

WebMD News from HealthDay

By Kathleen Doheny

HealthDay Reporter

THURSDAY, March 27, 2014 (HealthDay News) -- For weight loss, some swear by "grazing" -- eating several small meals throughout the day -- instead of eating fewer meals at more traditional mealtimes.

Now, a small study comparing both approaches finds it doesn't matter which tactic you use, as long as you reduce total calories.

Women who ate five meals on one test day and two regular meals on another (consuming the same total calories each day) burned the same amount of calories both days, researchers found.

Despite folklore that grazing somehow revs up your metabolism, it doesn't appear to be the case, said study researcher Dr. Milan Kumar Piya.

"If you eat two meals or five, as long as it's the same number of calories; there is no difference in energy expenditures, so there is no effect on weight loss," said Piya, a clinical lecturer with the U.K. National Institute for Health Research, at University Hospital Coventry and University of Warwick.

He presented the findings Tuesday at a Society for Endocrinology meeting in Liverpool, England.

Those hoping to lose weight can choose the approach they prefer, Piya said. Based on the new findings, he said he would now tell patients trying to lose weight: "You have your own ways of eating and doing things. As long as you eat fewer calories [to lose weight], you will be fine."

He compared the approaches in 24 women, including some who were normal weight and some who were obese. The lean women, on average, were age 34, while the obese women, on average, were 42.

The women were given either two meals or five meals on two separate days, and the researchers measured calories burned, comparing each woman's own individual daily results. Both obese and lean women burned virtually the identical number of calories over a 24-hour period, regardless of which day was analyzed.

Piya also took blood samples twice during each 24-hour period to evaluate signs of inflammation, known as "endotoxins," among other measures. "Obese people have more inflammation to begin with," he noted.

Inflammation, in turn, has been linked in previous studies with a higher risk of developing type 2 diabetes and heart disease.

"At bedtime, when we compared the obese women with the lean women, the obese women had higher endotoxins after the five-meal day," Piya said. That would, he said, theoretically, boost their risk of diabetes and heart disease. "The lean women did not have higher endotoxins when they had five meals compared to two."

The new findings make sense to Michelle Kulovitz Alencar, an assistant professor of kinesiology at California State University, San Bernardino. "In my own research, I have found that it's all about calorie intake," she said, not how the calories are spread out during the day, for weight loss results.

source : 'Grazing' Appears No Better for Weight Loss Than Standard Meals

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Exercise Affects Men's, Women's Hearts Differently: Study

Finding might have implications for standard cardiac testing, experts say

WebMD News from HealthDay

By Steven Reinberg

HealthDay Reporter

THURSDAY, March 27, 2014 (HealthDay News) -- The formula doctors use to evaluate treadmill stress tests, and thereby assess heart health, doesn't account for important differences between men and women, a new study contends.

A revised formula would better determine peak exercise rate, or the maximum number of heart beats per minute, for each sex, the researchers said.

"Exercise physiology has been known to differ for men and women of different ages," said Dr. Gregg Fonarow, associate chief of cardiology at the University of California, Los Angeles, and spokesman for the American Heart Association.

The proposal for a sex-specific maximal heart rate warrants further research, he said. "This may represent a valuable improvement for guiding exercise stress testing," added Fonarow, who was not involved in the study.

Doctors now use the formula "220 minus age" to determine how hard patients should work out during exercise stress tests. Many people also use this formula to set their target heart rate during workouts.

For the new study, a team led by Dr. Thomas Allison, director of stress testing at the Mayo Clinic in Rochester, Minn., reviewed 25,000 stress-test results. They saw significant differences between men and women.

Allison's group found that although peak heart rate declines with age for both sexes, the rate declines more gradually in women. This difference results in an overestimated peak heart rate in younger women and underestimated peak heart rate in older women, the researchers said.

The findings are scheduled for presentation Saturday at the annual meeting of the American College of Cardiology, in Washington, D.C.

Based on their findings, the study authors developed a new formula.

According to the revised formula, the maximum heart rate for women aged 40 to 89 should be 200 minus 67 percent of their age. For men, the preferred formula is 216 minus 93 percent of their age, the study authors said.

"We want to make sure that when people do the stress test, they have an accurate expectation of what a normal peak heart rate is," Allison said in an American College of Cardiology news release.

Because of limited test results for women under 40, the researchers were unable to recommend a new formula for this group.

Allison's team also found that younger men have a lower resting heart rate and higher peak heart rate than women. In addition, men's heart rates rise more dramatically during exercise and return to normal more quickly after stopping, the researchers said.

Heart experts welcomed the preliminary results.

"This is timely and we've needed it for a while," said Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York City.

"All of these differences are very important, not only for diagnosis, but also for teaching people how best to exercise to get the most cardiovascular fitness," she said.

source : Exercise Affects Men's, Women's Hearts Differently: Study

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'Grazing' Appears No Better for Weight Loss Than Standard Meals

Daily calories, not how often you eat, are what matter, study finds

WebMD News from HealthDay

By Kathleen Doheny

HealthDay Reporter

THURSDAY, March 27, 2014 (HealthDay News) -- For weight loss, some swear by "grazing" -- eating several small meals throughout the day -- instead of eating fewer meals at more traditional mealtimes.

Now, a small study comparing both approaches finds it doesn't matter which tactic you use, as long as you reduce total calories.

Women who ate five meals on one test day and two regular meals on another (consuming the same total calories each day) burned the same amount of calories both days, researchers found.

Despite folklore that grazing somehow revs up your metabolism, it doesn't appear to be the case, said study researcher Dr. Milan Kumar Piya.

"If you eat two meals or five, as long as it's the same number of calories; there is no difference in energy expenditures, so there is no effect on weight loss," said Piya, a clinical lecturer with the U.K. National Institute for Health Research, at University Hospital Coventry and University of Warwick.

He presented the findings Tuesday at a Society for Endocrinology meeting in Liverpool, England.

Those hoping to lose weight can choose the approach they prefer, Piya said. Based on the new findings, he said he would now tell patients trying to lose weight: "You have your own ways of eating and doing things. As long as you eat fewer calories [to lose weight], you will be fine."

He compared the approaches in 24 women, including some who were normal weight and some who were obese. The lean women, on average, were age 34, while the obese women, on average, were 42.

The women were given either two meals or five meals on two separate days, and the researchers measured calories burned, comparing each woman's own individual daily results. Both obese and lean women burned virtually the identical number of calories over a 24-hour period, regardless of which day was analyzed.

Piya also took blood samples twice during each 24-hour period to evaluate signs of inflammation, known as "endotoxins," among other measures. "Obese people have more inflammation to begin with," he noted.

Inflammation, in turn, has been linked in previous studies with a higher risk of developing type 2 diabetes and heart disease.

"At bedtime, when we compared the obese women with the lean women, the obese women had higher endotoxins after the five-meal day," Piya said. That would, he said, theoretically, boost their risk of diabetes and heart disease. "The lean women did not have higher endotoxins when they had five meals compared to two."

The new findings make sense to Michelle Kulovitz Alencar, an assistant professor of kinesiology at California State University, San Bernardino. "In my own research, I have found that it's all about calorie intake," she said, not how the calories are spread out during the day, for weight loss results.

source : 'Grazing' Appears No Better for Weight Loss Than Standard Meals

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More Signs Autism May Originate During Pregnancy

Brain-tissue samples show differences linked to prenatal development

WebMD News from HealthDay

By Amy Norton

HealthDay Reporter

WEDNESDAY, March 26, 2014 (HealthDay News) -- Children with autism show key "patches of disorganization" in the outer layers of the brain, according to a new study said to offer more evidence that the developmental disorder begins in the womb.

Experts have long believed autism involves disruptions in typical brain development, going back to pregnancy. The new study, reported online March 27 in the New England Journal of Medicine, offers more direct evidence of such early origins.

For the study, researchers examined samples of brain tissue from 22 children after death -- 11 with autism and 11 without. They were able to spot tiny patches of disrupted development dotting the outer layers of the brain in the children with autism.

Differences like that would take shape during prenatal development, said Ed Lein, a researcher at Seattle's Allen Institute for Brain Science, who worked on the study.

"This is pretty direct evidence of a prenatal origin," Lein said.

An autism researcher who reviewed the study agreed. "The foundation for this would likely be prenatal," said Dr. Walter Kaufmann, a neurologist at Boston Children's Hospital. "How early in the prenatal period? That's hard to say."

An even bigger question is, What causes the early disruptions in brain development? Lein and Kaufmann said it's impossible to pin down.

"We still need to try to understand that," Lein said.

In general, however, experts believe autism arises from genetic susceptibility and yet unknown environmental factors. "Ultimately, it's an interplay between genes and environment," Kaufmann said.

In the United States, an estimated one in 88 children has an autism spectrum disorder, which affects the ability to communicate and interact with others. Some kids are profoundly affected, speaking very little or not at all and focusing obsessively on just a few interests. Others have milder problems communicating and reading social cues, such as other people's gestures and facial expressions.

Researchers have managed to find a few hundred genes that are linked to autism risk. And although there is no definite environmental culprit, studies have tied certain factors during pregnancy to an increased risk, including exposure to high levels of air pollution, low intake of the B vitamin folate and viral infections.

For the new study, Lein and his colleagues examined small samples of the neocortex -- the outer surface of the brain. During fetal development, the neocortex forms six layers, each with its own specialized brain cells. As those cells develop, they take on a "genetic signature" that can be visualized in tissue samples, using sophisticated techniques.

Overall, the study found, brain tissue from children with autism showed tiny patches where certain genetic signatures were absent from brain cells.

What's more, those patches were concentrated in areas associated with higher order brain functions, such as understanding language and social cues.

source : More Signs Autism May Originate During Pregnancy

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Top Last-Minute 'Obamacare' Questions

March 27, 2014 -- If you want health insurance coverage this year, the last chance for most people to sign up is March 31. Sign up through the federal Marketplace, and you'll be given extra time to enroll -- as long as you start the process on HealthCare.gov by March 31, the Obama administration announced Tuesday.

The only way you can enroll later in the year is if you have a “life event,” such as losing your job, moving, having a baby, or getting married. It may qualify you for a special enrollment period.

To help readers in the final days of 2014 open enrollment, WebMD hosted a live chat online to answer their questions about the Affordable Care Act.

While our experts answered questions on a range of subjects, the seven topics below came up most often.

Go to WebMD Answers to ask a question or search for more answers.

1. If I am on my spouse’s insurance through work, do I need to buy new insurance through "Obamacare"?

No. If you have insurance through an employer -- yours or your spouse’s -- you don't need to buy new insurance. You are covered. That’s also true if you have Medicare, Medicaid, or Tricare.

2. How can I get dental insurance?

Dental coverage for children, but not adults, is one of the law’s essential health benefits that insurers must provide. If you want a plan for yourself, you can shop on sites like Delta Dental or general health insurance sites such as GetInsured or eHealth.

3. How much will insurance cost vs. paying the penalty?

The penalty for not having health insurance will be $95 per adult or 1% of your annual taxable household income, whichever is larger. The penalty will be due at tax time in 2015. Depending on your income, it may be cheaper to pay the penalty. Keep in mind that without insurance, you will have to pay for all your medical expenses if you need health care.

You can look at HealthCare.gov to find out how much your premiums would be based on your income, age, and where you live. You can also find out whether or not you qualify for tax credits or Medicaid.

4. Does supplemental insurance count?

No. Supplemental insurance does not count as major medical insurance coverage under the Affordable Care Act. Its only purpose is to provide supplemental coverage to an existing insurance plan.

5. If I buy insurance outside the Marketplaces before March 31, will I avoid the penalty?

You can buy coverage either inside or outside the Marketplaces. As long as you don’t have more than 3 months in a row without coverage during the year, you won’t be charged a tax penalty.

6. If I have private insurance now, but it is very expensive, can I change it if I find a cheaper plan on a Marketplace?

Yes. You can switch plans through March 31. You can compare benefits and prices at HealthCare.gov.

7. If I’m unemployed and I get Marketplace health insurance, what happens if I start working later this year?

If you get a subsidy based on an estimate of your 2014 earnings, and your situation changes during the year, you can avoid a tax bill next year by reporting the change to your state’s Marketplace. They can adjust your federal premium subsidy based on your new earnings.

You also could keep paying the lower insurance premium you got through the subsidy and refund the government when you file your taxes next year.

source : Top Last-Minute 'Obamacare' Questions

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Tragedies Do Cause Broken Hearts, Study Suggests

Cases of Takotsubo cardiomyopathy -- or 'broken heart syndrome' -- jumped in Vermont, Missouri following natural disasters

WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

THURSDAY, March 27, 2014 (HealthDay News) -- The stress of natural disasters can break people's hearts, according to a new study.

Researchers found dramatic rises in "broken heart syndrome" in Vermont after a huge storm ravaged the state and in Missouri after a massive tornado.

People with broken heart syndrome -- formally called Takotsubo cardiomyopathy -- suffer a temporary enlargement and weakening of the heart. The condition is often triggered by extreme emotional or physical stress, such as losing a loved one or being in a traffic crash.

"Despite the seemingly increasing number of natural disasters we have, there is limited data about how it might affect the heart," said lead investigator Dr. Sadip Pant, an internist at the University of Arkansas for Medical Sciences.

"Our findings suggest two disasters -- one in Vermont and one in Missouri -- might have been possible triggers for the clustering of Takotsubo cardiomyopathy cases in these regions," Pant said.

For the study, a university team looked at data from nearly 22,000 people in the United States who were diagnosed with broken heart syndrome in 2011. They mapped the cases state by state and found that Missouri and Vermont had the highest rate of cases -- 169 and 380 per 1 million residents, respectively.

Most states had fewer than 150 cases per million people. In 2011, Vermont was devastated by Tropical Storm Irene, and an enormous tornado tore through Joplin, Mo., and killed at least 158 people.

The study is scheduled for presentation Saturday at the American College of Cardiology annual meeting, in Washington, D.C.

Symptoms of broken heart syndrome include chest pain and shortness of breath. The condition typically resolves within one or two months, but can lead to serious complications, such as heart failure, heart rhythm disorders and stroke in some cases.

"By and large, it is a very reversible form of cardiomyopathy, but in the acute phase these patients need to be monitored closely to be sure they are stable and to prevent and manage problems," Pant said in a college news release.

"It's also something that emergency doctors and medical personnel need to be aware of as they are often on the frontlines seeing patients after disaster strikes," he said.

Broken heart syndrome is "a perfect example of our brain-heart connection," Pant said. "The emotional stress we have in our brain can lead to responses in the heart, and not much is known about this condition."

Data and conclusions presented at meetings typically are considered preliminary until published in a peer-reviewed medical journal.

source : Tragedies Do Cause Broken Hearts, Study Suggests

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Take Heart: Mediterranean Diet Combats Diabetes, Study Says

It's especially beneficial to those at risk of heart disease, researcher contends

WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

THURSDAY, March 27, 2014 (HealthDay News) -- Adhering to a so-called Mediterranean diet may reduce your risk of diabetes, especially if you're at high risk for heart disease.

That's the finding of researchers who reviewed 19 studies that included more than 162,000 people in different countries for an average of 5.5 years.

The analysis revealed that a Mediterranean diet -- which is rich in fish, nuts, vegetables and fruits -- was associated with a 21 percent lower risk of diabetes compared with other eating patterns.

A Mediterranean diet reduced the risk of diabetes even more -- by 27 percent -- among people at high risk for heart disease. Diabetes prevention is especially important for people at risk of heart disease, according to the authors of the study, which is to be presented Saturday at the American College of Cardiology annual meeting, in Washington, D.C.

"Adherence to the Mediterranean diet may prevent the development of diabetes irrespective of age, sex, race or culture," lead investigator Demosthenes Panagiotakos, a professor at Harokopio University in Athens, Greece, said in a college news release. "This diet has a beneficial effect, even in high-risk groups, and speaks to the fact that it is never too late to start eating a healthy diet."

Panagiotakos noted that the studies included in the review included Europeans and non-Europeans. This is important because most studies that have examined the effects of a Mediterranean diet have been European-based and there have been concerns that region-specific factors such as genetics, environment, and lifestyle might affect the results.

This review showed that a Mediterranean diet reduces diabetes risk in both Europeans and non-Europeans. This type of large-scale analysis "is important to help inform guidelines and evidence-based care," Panagiotakos said in the news release.

The number of diabetes cases worldwide has doubled in the past 30 years and this spike has been linked to the growing obesity epidemic.

"Diabetes is an ongoing epidemic and its relation to obesity, especially in the Westernized populations, is well known. We have to do something to prevent diabetes and changing our diet may be an effective treatment," Panagiotakos said.

Studies presented at meetings are typically considered preliminary until published in a peer-reviewed medical journal.

source : Take Heart: Mediterranean Diet Combats Diabetes, Study Says

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