Eczema Tied to Bone Fracture Risk in Study

Risk was small; distractions caused by itch and sleep problems are possible factors, experts say

WebMD News from HealthDay

By Steven Reinberg

HealthDay Reporter

THURSDAY, Oct. 30, 2014 (HealthDay News) -- The skin condition eczema may increase slightly the risk of broken bones and injured joints, a new study reports.

In a study of 34,500 adults, researchers found that among 7 percent of people who had an eczema flare-up in the past year, 1.5 percent had a bone or joint injury and 0.6 percent had an injury that caused a limitation of function.

Compared to people without eczema, those with the skin condition had more than double the risk of having had a fracture or bone or joint injury, according to the study.

"Adults with eczema have higher rates of injuries, including fractures and bone and joint injuries," said lead researcher Dr. Jonathan Silverberg, an assistant professor of dermatology at Northwestern University in Chicago.

Although this study found an association between eczema and bone and joint injuries, it wasn't designed to prove whether eczema is somehow a direct cause of those injuries.

Another expert said follow-up research is necessary. "Further studies would be needed to show if there's a direct effect or association of eczema with bone condition and strength over time," said Dr. Doris Day, a dermatologist at Lenox Hill Hospital in New York City.

"The skin is often a reflection of the general health and well-being of our patients. Sometimes the connection is direct, but often it's more subtle," Day said.

The study was published online Oct. 29 in JAMA Dermatology.

Eczema is a chronic inflammatory condition of the skin that causes red, itchy, scaly patches. Eczema is not contagious, and is often triggered by allergies, according to the American Academy of Allergy, Asthma and Immunology (AAAAI).

The study included about 2,500 people with eczema and more than 32,000 without the skin condition.

The researchers found the risk of injuries increased with age and peaked at 50 to 69, he said.

"Eczema by itself was associated with higher rates of injuries. However, adults with eczema who also had sleep disturbance or psychiatric and behavioral disorders had even higher risk of injuries than those with eczema alone," Silverberg said.

Adults with eczema have a number of risk factors for injuries, including distraction caused by itch, sleep deprivation, psychological and behavioral disorders, and the use of sleep aids and steroids that may lower bone strength, he said.

Although there's no cure for eczema, treatments can help control it, which include moisturizers and topical steroids to control itching and reduce swelling, according to the AAAAI.

Oral steroids are usually reserved for more severe flare-ups, according to Day. However, over many years this can have an effect on bones and other organs, Day said.

"Adults with eczema would likely benefit from improved control of their skin disease and less use of medications that might increase the risk of injury," Silverberg said.

source : Eczema Tied to Bone Fracture Risk in Study

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Leprosy Still Occurs in U.S., CDC Reports

Experts estimate about 100 cases a year occur in America

WebMD News from HealthDay

By Steven Reinberg

HealthDay Reporter

THURSDAY, Oct. 30, 2014 (HealthDay News) -- Leprosy, although quite rare, continues to appear in the United States, a new U.S. government study reports.

Approximately 100 new cases are reported in the United States each year, researchers at the U.S. Centers for Disease Control and Prevention said. That compares to about 250,000 cases that occurred worldwide in 2008, according to the CDC.

Known since biblical times, leprosy is an infectious disease that causes skin sores, nerve damage, and muscle weakness that can worsen over time. Effective medications exist to treat the disease.

Most U.S. cases occur in people who traveled to the United States from areas of the world where the bacterial infection is endemic, the study authors said.

"It's a surprise to most people that leprosy is still in the United States," said lead researcher Dr. Leisha Nolen, an epidemic intelligence service officer with the CDC.

"Many people think leprosy is something limited to underdeveloped nations and has been eliminated from the United States," she said.

Leprosy does infect a few people born in the United States -- about 20 to 40 a year -- but is mostly a problem for people born outside the country who were infected before arriving here, Nolen said.

The rate of infection for those born in the United States hasn't changed in the past 15 years, Nolen said. Infections are mostly confined to areas where leprosy is still found, such as in Texas and Louisiana, according to past research.

In these states, the bacteria can be found on armadillos, and they can pass the infection to humans, Nolen explained.

According to the report, from 1994 to 2011, there were just over 2,300 new cases of leprosy -- also called Hansen's disease -- diagnosed in the United States.

The yearly incidence rate of leprosy from 1994 to 1996 was 0.52 cases per 1 million people in the United States. From 2009 to 2011, that rate dropped to 0.43 cases per 1 million people, the researchers found.

The rate for people born abroad is 14 times higher than that of those born in the United States, the findings showed. The study found that the highest rate is among those born in the South Pacific who traveled to Hawaii.

"The rates of leprosy in people born overseas is going down," Nolen said. "There's been a 17 percent decrease from 1994 to 2011."

"These data further emphasize the value of considering travel and residence history as part of the standard physical examination, as it may help clinicians detect otherwise potentially rare diseases in some individuals," said Richard Truman, chief of the Laboratory Research Branch of the National Hansen's Disease Program at the U.S. Department of Health and Human Services.

source : Leprosy Still Occurs in U.S., CDC Reports

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World Bank Pledges $100M More to Fight West Africa's Ebola Outbreak

It's hoped the added money will encourage additional foreign health care workers to get involved

WebMD News from HealthDay

By Dennis Thompson

HealthDay Reporter

THURSDAY, Oct. 30, 2014 (HealthDay News) -- The World Bank pledged Thursday an additional $100 million in the fight against the Ebola outbreak wreaking havoc in West Africa.

The money, which brings the World Bank's total pledge to more than $500 million, will be used to attract more foreign health care workers to the three hardest-hit countries -- Guinea, Liberia and Sierra Leone.

"The world's response to the Ebola crisis has increased significantly in recent weeks, but we still have a huge gap in getting enough trained health workers to the areas with the highest infection rates," World Bank Group President Jim Yong Kim said in a news release. "We must urgently find ways to break any barriers to the deployment of more health workers. It is our hope that this $100 million can help be a catalyst for a rapid surge of health workers to the communities in dire need."

The World Health Organization (WHO) says an estimated 5,000 international medical and support personnel are needed in the three countries in the coming months. In some cases, health care workers in the three countries are reluctant to treat Ebola patients because they lack adequate protection.

There have been an estimated 13,700 infections and about 5,000 deaths in West Africa.

The World Bank has warned that if the epidemic continues unchecked, the financial toll to the region could hit $32.6 billion by the end of 2015.

There has been a bit of encouraging news in recent days, however.

WHO officials said Wednesday that the outbreak in Liberia may be slowing.

Dr. Bruce Aylward, WHO's assistant director general, said there's been a decline in the number of burials in Liberia and no increase in laboratory-confirmed cases. He said he was cautiously optimistic that the global push to tame the epidemic may be making some progress, The New York Times reported.

"Do we feel confident that the response is now getting an upper hand on the virus?" he said in a telebriefing with reporters from the organization's Geneva, Switzerland, headquarters. "Yes, we are seeing slowing rate of new cases, very definitely" in Liberia.

Aylward cautioned against assuming that health care workers had turned the tide against Ebola in Liberia, where more than half of West Africa's infections have occurred. Ebola cases could surge again, as has happened since the epidemic began last spring.

Meanwhile, health officials in Sierra Leone said late Wednesday that the country remains "in a crisis situation which is going to get worse," the Associated Press reported.

source : World Bank Pledges $100M More to Fight West Africa's Ebola Outbreak

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Brain Scans Yield Clues to Chronic Fatigue Syndrome

Findings might help doctors diagnose the baffling condition

WebMD News from HealthDay

By Mary Elizabeth Dallas

HealthDay Reporter

THURSDAY, Oct. 30, 2014 (HealthDay News) -- There are clear differences in the brains of people with chronic fatigue syndrome and the brains of healthy people, new research indicates.

Scientists at Stanford University School of Medicine said their findings could help doctors diagnose this baffling condition and shed light on how it develops. People with chronic fatigue syndrome are often misdiagnosed or labeled as hypochondriacs.

Using three types of brain scanning technologies, "we found that [chronic fatigue syndrome] patients' brains diverge from those of healthy subjects in at least three distinct ways," said the study's lead author, Dr. Michael Zeineh, assistant professor of radiology, in a Stanford news release.

Chronic fatigue syndrome affects up to 4 million people in the United States alone, says the U.S. Centers for Disease Control and Prevention. The condition, which causes debilitating and constant fatigue that persists for six months or more, is difficult to diagnose. Other symptoms of chronic fatigue syndrome can vary from one patient to the next. They are also similar to symptoms often associated with other health issues.

"Chronic fatigue syndrome is one of the greatest scientific and medical challenges of our time," said the study's senior author, Dr. Jose Montoya, professor of infectious diseases and geographic medicine, in the Stanford release.

"Its symptoms often include not only overwhelming fatigue but also joint and muscle pain, incapacitating headaches, food intolerance, sore throat, enlargement of the lymph nodes, gastrointestinal problems, abnormal blood-pressure and heart-rate events, and hypersensitivity to light, noise or other sensations," he said.

Montoya and his team have been following 200 people with chronic fatigue syndrome for several years, hoping to improve diagnosis and treatment. In order to gain a better understanding of the condition, the researchers used MRI technology to compare the brains of 15 of these patients with 14 similar people without the condition or any related symptoms.

"If you don't understand the disease, you're throwing darts blindfolded," said Zeineh. "We asked ourselves whether brain imaging could turn up something concrete that differs between [chronic fatigue syndrome] patients' and healthy people's brains. And, interestingly, it did."

The study, published in the Oct. 28 issue of Radiology, found patients with chronic fatigue syndrome had less overall white matter (nerve tracts that carry information from one part of the brain to another) than the people who didn't have the condition.

Chronic fatigue syndrome is thought to involve chronic inflammation, which may be due to an unidentified viral infection. Since such an infection can take a toll on white matter, this finding was not surprising, the researchers said.

Using advanced imaging techniques, however, the study's authors also identified a specific brain abnormality among the patients with chronic fatigue syndrome. This abnormality was found in an area of the brain that connects the frontal lobe and temporal lobes, called the right arcuate fasciculus.

There was a strong link between the severity of this abnormality and the severity of chronic fatigue syndrome, the researchers said.

The study also found that patients with chronic fatigue syndrome had a thickening of the gray matter in two areas of their brain connected by the right arcuate fasciculus.

The researchers said that despite the strength of their findings, the results should be confirmed with more research. "This study was a start," Zeineh said. "It shows us where to look."

source : Brain Scans Yield Clues to Chronic Fatigue Syndrome

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Scientists Set Their Sights on First Whole-Eye Transplant

Nerve regeneration is challenge, but real headway is being made in the field, researchers say

WebMD News from HealthDay

By Alan Mozes

HealthDay Reporter

THURSDAY, Oct. 30, 2014 (HealthDay News) -- In the world of 21st-century medicine, organ transplantation is nothing new.

The first kidney transplant took place in 1950, followed by the first liver transplant in 1963 and the first human heart transplant in 1967. By 2010, doctors had even managed the transplantation of a patient's entire face.

One major organ still eludes the transplant surgeon, however: the entire human eye. But if one team of U.S. scientists has its way, that dream may become reality, too.

"Until recently, eye transplants have been considered science fiction," said Dr. Vijay Gorantla, an associate professor of surgery in the department of plastic surgery at the University of Pittsburgh. "People said it was crazy, bonkers."

However, "with what we now know about transplantation and, more importantly, nerve regeneration, we are finally at the point where we can have real confidence that this is something that actually can be pursued and eventually achieved," he said.

Whole-eye transplants would be of enormous benefit for many of the 180 million blind or severely visually disabled people around the world, including nearly 3.5 million Americans, experts say.

"Macular degeneration and glaucoma are the root cause of much the world's visual impairment," explained Dr. Jeffrey Goldberg, director of research at the Shiley Eye Center at University of California, San Diego.

Certainly, there are therapies that often help restore sight in these cases, or in people who've lost sight through injury. "But for some people the eye is too damaged or too far gone," Goldberg said. "For patients with a devastating eye injury where there's no remaining connective optic nerve -- or perhaps not even an eyeball in their eye socket -- restorative approaches are simply not enough."

In these cases, transplantation of a healthy donor eye would be a solution. "It's a scientific long shot," Goldberg said. "But it's a very attractive long shot."

So, Gorantla and Goldberg -- and their two universities -- have teamed up to push whole-eye transplantation from theory into practice. The effort is funded by the U.S. Department of Defense.

One of the biggest challenges is how to regenerate and regrow delicate optical nerves.

"The chief problem," Goldberg explained, "is that when you switch out an eyeball you have to completely cut all connections between the optic nerve and the eye. So then you need to reconnect the donor eye's nerve fibers back to the recipient's brain in order to achieve vision restoration. But we know that once you make that cut, the nerve fibers just do not regrow on their own. That doesn't happen automatically."

"That's what distinguishes an eye transplant from most other types of transplants," Gorantla added. In other organ transplants, the chief hurdle is simply reconnecting a proper blood supply. "For example, if you get the plumbing connected and the blood going, then a transplanted heart will beat in the recipient patient immediately," Gorantla said.

source : Scientists Set Their Sights on First Whole-Eye Transplant

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FDA Approves New Vaccine to Protect Against Meningitis

Trumenba guards against type of bacteria that is one of leading causes of life-threatening disease

WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

WEDNESDAY, Oct. 29, 2014 (HealthDay News) -- A new vaccine that could help prevent some cases of life-threatening meningococcal disease was approved by the U.S. Food and Drug Administration on Wednesday.

Trumenba is approved to protect people between the ages of 10 and 25 from invasive meningococcal disease caused by Neisseria meningitidis serogroup B bacteria.

The bacteria can infect the bloodstream (sepsis) and the lining that surrounds the spinal cord and brain. It is a leading cause of bacterial meningitis, and infection can occur through coughing, kissing or sharing eating utensils.

Of the 500 cases of meningococcal disease reported in the United States in 2012, 160 were caused by serogroup B, according to the U.S. Centers for Disease Control and Prevention.

Antibiotics can reduce the risk of death or serious long-term problems in patients with meningococcal disease, but immediate medical treatment is crucial. Until now, vaccines in the United States covered four -- A, C, Y and W -- of the five main N. meningitidis serogroups that cause meningococcal disease.

"Recent outbreaks of serogroup B meningococcal disease on a few college campuses have heightened concerns for this potentially deadly disease," Dr. Karen Midthun, director of the FDA's Center for Biologics Evaluation and Research, said in an agency news release.

In 2013, outbreaks of meningitis at the University of California-Santa Barbara (UCSB) and Princeton University prompted those institutions to get special permission from the FDA to use a vaccine that had been sanctioned in Europe but not in the United States.

According to USA Today, a total of 12 cases occurred in those two outbreaks. A UCSB lacrosse player had to have his feet amputated due to the meningitis infection, the paper reported. Amputations occur because the bacteria can trigger blood clots that reduce blood flow and can cause gangrene.

However, Midthun said that "the FDA's approval of Trumenba provides a safe and effective way to help prevent this disease in the United States."

The FDA's accelerated approval of the new vaccine from Wyeth Pharmaceuticals Inc. was based on three studies in the United States and Europe that included about 2,800 teens. After vaccination with Trumenba, 82 percent of the teens had antibodies in their blood that killed four different N. meningitidis serogroup B strains, compared with less than 1 percent of teens before vaccination.

The four strains targeted by the vaccine are the same ones that cause serogroup B meningococcal disease in the United States, according to the FDA.

The safety of Trumenba was assessed in 4,500 participants in studies in the United States, Europe and Australia. The most common side effects were pain and swelling at the injection site, headache, diarrhea, muscle and joint pain, fatigue and chills.

source : FDA Approves New Vaccine to Protect Against Meningitis

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Scientists Create Tiny Stomachs From Stem Cells

Feat may help researchers learn more about causes of stomach diseases

WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

WEDNESDAY, Oct. 29, 2014 (HealthDay News) -- Scientists who used stem cells to create miniature human stomachs in the laboratory say their breakthrough could provide a new way to learn more about the development and treatment of stomach diseases.

The team used human pluripotent stem cells -- which can become any type of cell in the body -- to grow the functional miniature stomachs, to study infection by H. pylori bacteria, a major cause of ulcers and stomach cancer.

The miniature stomachs offer many research opportunities, including modeling early stages of stomach cancer, developing new drugs and learning more about obesity-related diabetes, according to principal investigator Jim Wells. He's a scientist in the developmental biology and endocrinology divisions at Cincinnati Children's Hospital Medical Center.

"Until this study, no one had generated gastric [stomach] cells from human pluripotent stem cells. In addition, we discovered how to promote formation of three-dimensional gastric tissue with complex architecture and cellular composition," he said in a medical center news release.

The ability to create human stomachs in the lab is important because significant structural differences in mouse stomachs make them less than ideal for studying human stomach development and disease, Wells explained.

The study was published Oct. 29 in the journal Nature.

source : Scientists Create Tiny Stomachs From Stem Cells

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High-Fat, Low-Carb Diet May Help With Tough-to-Treat Epilepsy

Regimens seem to cut down on seizures but are hard to stick to long-term, study shows

WebMD News from HealthDay

By Mary Elizabeth Dallas

HealthDay Reporter

WEDNESDAY, Oct. 29, 2014 (HealthDay News) -- Eating a low-carb, high-fat diet could help control epilepsy that is difficult to treat, according to new research.

A review of five studies found that a ketogenic, or modified Atkins diet, that focuses on foods like bacon, eggs, heavy cream, butter, fish and green vegetables, could help reduce seizures in adults whose condition doesn't improve with medication.

"We need new treatments for the 35 percent of people with epilepsy whose seizures are not stopped by medications," study co-author Dr. Pavel Klein explained in an American Academy of Neurology news release. "The ketogenic diet is often used in children, but little research has been done on how effective it is in adults."

In conducting the review, the researchers analyzed five studies on the ketogenic diet involving 47 people. The ketogenic diet consists of a ratio of fat to protein/carbohydrate of three or four to one.

The researchers also reviewed five more studies on the modified Atkins diet, which included 85 people. The modified Atkins diet has a one-to-one fat to protein/carbohydrate ratio by weight.

The researchers found that 32 percent of the patients on the ketogenic diet and 29 percent of those following the modified Atkins diet had reduction in their seizures by 50 percent or more. Meanwhile, 9 percent of those in the ketogenic diet group and 5 percent in the modified Atkins group had drops in their seizures by 90 percent or more, according to the study published online Oct. 29 in Neurology.

The benefits of these high-fat diets happened quickly -- just days or weeks after the patients began following them. The results persisted, but only if the adults continued to follow the diets. Once the patients stopped following the diets, the benefits also stopped, the researchers noted. None of the side effects of the diets were serious, and most often the patients experienced weight loss, not weight gain, the researchers said.

However, of those on the ketogenic diet, 51 percent stopped before the study ended and 42 percent on the modified Atkins diet also stopped early.

"Unfortunately, long-term use of these diets is low because they are so limited and complicated," said Klein, from the Mid-Atlantic Epilepsy and Sleep Center in Bethesda, Md. "Most people eventually stop the diet because of the culinary and social restrictions. However, these studies show the diets are moderately to very effective as another option for people with epilepsy."

Two experts said the ketogenic diet approach may have pluses and minuses for patients.

"For persons with epilepsy who have difficult-to-control seizures, a dietary treatment rather than trying another antiseizure medication has a lot of appeal," said Dr. Cynthia Harden, director of North Shore-LIJ's Comprehensive Epilepsy Care Center in Great Neck, N.Y. "It allows patients and their families to have full participation in this treatment approach and empowers them to self-manage their illness to some degree."

source : High-Fat, Low-Carb Diet May Help With Tough-to-Treat Epilepsy

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Hormone Therapy May Up Heart-Related Deaths in Some Prostate Cancer Patients

But the overall risk is small, researchers say

WebMD News from HealthDay

By Steven Reinberg

HealthDay Reporter

WEDNESDAY, Oct. 29, 2014 (HealthDay News) -- Giving hormone therapy to men with prostate cancer who also have certain heart problems may increase their odds of dying from a heart-related cause, a new study suggests.

The therapy in question is called androgen deprivation therapy (ADT). It's used in prostate cancer to reduce levels of male hormones to prevent the growth of cancer cells, according to the study. And, in the current research, this hormone therapy was linked to triple the risk of heart-related death in men with heart failure or in those who had a previous heart attack, researchers found.

"ADT is a mainstay of prostate cancer therapy, but may not be the best option for all men," said lead researcher, David Ziehr, a medical student at Harvard Medical School in Boston.

Among men with heart failure or a past heart attack, ADT was associated with a 5 percent absolute increased risk of death from heart disease in five years, Ziehr said.

"The greatest cause of death among men with prostate cancer is heart disease, and patients and doctors must ensure that treatments and lifestyle choices harmonize to improve men's overall health," he said.

However, there is evidence that many men with prostate cancer are helped by hormone therapy. "When prescribing ADT for prostate cancer, physicians should take their patients' heart health into consideration," Ziehr said.

It's also important to note that while the study found a link between ADT and heart-related deaths in certain patients, the current study wasn't designed to prove that hormone therapy was the direct cause of the increased deaths.

For the study, Ziehr and colleagues collected data on more than 5,000 men treated for prostate cancer between 1997 and 2006. Among these men, 30 percent were treated with hormone therapy, according to the study.

Over an average follow-up of nearly five years, Ziehr's team found that men treated with hormone therapy who had heart failure or who had a previous heart attack were more likely to die from a heart-related cause than similar men not given ADT (7 percent versus 2 percent).

Ziehr said that based on these findings, giving hormone therapy to 20 men with heart failure or a history of heart attack could result in one heart-related death.

The researchers, however, did not find any significant link between ADT and heart-related deaths among men who didn't have heart disease or in men with diabetes, high blood pressure or high cholesterol.

The report was published online Oct. 29 in the journal BJU International.

Dr. Gregg Fonarow, a professor of cardiology at the David Geffen School of Medicine at the University of California, Los Angeles, said that overall, the benefits of hormone therapy appear to outweigh its risks.

"While some studies have suggested that ADT may be associated with an increase in risk for heart-related problems, an analysis of randomized clinical trials found no evidence of excess cardiac deaths," he said.

This new study also found no excess risk associated with ADT in the majority of patients studied, with the exception of a small subgroup with pre-existing heart failure or prior heart attack, Fonarow said. "However, these findings were of borderline statistical significance," he said.

"While the balance of data are reassuring with benefits outweighing potential risks, further studies are needed to determine if any specific group of patients are at increased risk with the use of ADT," Fonarow said.

source : Hormone Therapy May Up Heart-Related Deaths in Some Prostate Cancer Patients

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Ebola Outbreak in Liberia May Be Slowing: WHO

But health agency says epidemic in West Africa is far from under control

WebMD News from HealthDay

By Dennis Thompson

HealthDay Reporter

WEDNESDAY, Oct. 29, 2014 (HealthDay News) -- The Ebola outbreak in Liberia -- one of three West African nations ravaged by the disease -- may be slowing, World Health Organization officials said Wednesday.

Dr. Bruce Aylward, WHO's assistant director general, said there's been a decline in the number of burials in Liberia and no increase in laboratory-confirmed cases. He said he was cautiously optimistic that the global push to tame the epidemic may be making some progress, The New York Times reported.

"Do we feel confident that the response is now getting an upper hand on the virus?" he said in a telebriefing with reporters from the organization's Geneva, Switzerland, headquarters. "Yes, we are seeing slowing rate of new cases, very definitely" in Liberia.

However, Aylward cautioned against assuming that health care workers had turned the tide against Ebola in Liberia, where more than half of West Africa's infections have occurred. Ebola cases could surge again, as has happened since the epidemic began last spring.

Benoit Carpentier, a spokesman for the International Federation of the Red Cross, also urged restraint, noting that Ebola outbreaks tend to come in waves. And Red Cross figures show deaths are still increasing outside Monrovia, the capital of Liberia, the Associated Press reported.

Aylward said WHO's latest statistics show slightly more than 13,700 infections and at least 5,000 deaths in West Africa. Besides Liberia, the other hard-hit countries are Guinea and Sierra Leone.

Also Wednesday, U.S. Defense Secretary Chuck Hagel approved a recommendation by military leaders that all American troops sent to West Africa to help in the fight against Ebola be kept in supervised isolation for 21 days upon their return, the AP reported.

The decision exceeds Obama administration precautions for civilians, although President Barack Obama has noted that the situation of troops is different from that of civilians because troops aren't in West Africa by choice, the news service said.

Hagel called the 21-day isolation policy a "safety valve." Top military leaders cited several factors that argue in favor of the extended confinement, including the concerns of military families and the communities where the troops are based, according to the AP.

On Monday, U.S. health officials issued new guidelines for monitoring people at risk for Ebola exposure -- a move designed, in part, to combat some of the fear surrounding Ebola infection.

The new guidelines apply to health care workers, whether they're returning home from the West African outbreak zone or caring for patients in the United States.

The guidelines establish four levels of risk -- "high" risk, "some" risk, "low" risk and "no" risk -- and recommend the sorts of restrictions and health monitoring that should accompany each category, Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, said at an afternoon news briefing.

source : Ebola Outbreak in Liberia May Be Slowing: WHO

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Egg Freezing for a Future Pregnancy: What to Know

By Kathleen Doheny
WebMD Health News

Reviewed by Arefa Cassoobhoy, MD, MPH

Oct. 29, 2014 -- Soon after Apple and Facebook announced plans to offer workers egg freezing as a health plan benefit, debates began about whether this newest corporate-America perk is good or bad for women, the workplace, and motherhood.

No matter what side you take in that debate, you may have questions about the technique itself.

WebMD asked three experts to address the questions they most often get about egg freezing.

What is egg freezing, and how long has it been available?

Women can have their own eggs frozen and stored, or can have donor eggs frozen and stored if there's a medical issue that prevents them from using their own.

The focus is often on using the technique for working women who aren't ready for motherhood. But the organization for fertility doctors, the American Society for Reproductive Medicine, hasn't yet endorsed the procedure solely for this purpose. The group says there isn’t enough data on the “safety, efficacy, cost-effectiveness, and emotional risks” of elective egg freezing for it to be recommended.

Also, some women may choose to have their eggs frozen because of medical issues, such as cancer treatment, that may affect their fertility.

About 5 million babies have been born worldwide after regular in vitro fertilization, or IVF, Richard J. Paulson, MD, estimates. He's chief of reproductive endocrinology and infertility at the Keck School of Medicine, University of Southern California. IVF combines eggs and sperm outside the body in a lab, allowing the sperm to fertilize the eggs. Once an embryo or embryos form, they're then placed in the woman's uterus.

Exact statistics on the number of babies born from frozen eggs are hard to get, says Zsolt Peter Nagy, PhD, an Atlanta embryologist and laboratory director. But he thinks it's about 5,000 births worldwide.

The process of freezing eggs was first described in people in 1986, Nagy says. The first reported birth from a frozen egg was that year.

A newer technique known as vitrification uses ultra-rapid cooling that is not true freezing, but causes less damage to the egg than actual freezing, Nagy says.

What else does egg freezing involve?

First you receive fertility drugs to spur your ovaries to help more than one egg mature at a time, says Daniel Shapiro, MD, an Atlanta reproductive endocrinologist. This is called ovarian stimulation. It can help your body make 20 or 25 mature eggs (which are ready to be to be fertilized) per month, Shapiro says. That's instead of the usual one mature egg women release, or ovulate, into the uterus each month. 

The procedure involves a variety of medications, including shots. Your doctor may give you other medicines  to help your eggs mature and to prevent them from being released too early.

source : Egg Freezing for a Future Pregnancy: What to Know

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Stroke Prevention Guidelines Emphasize Healthy Lifestyle

Eat lots of fruits and veggies, get exercise, limit salt and don't smoke, experts say

WebMD News from HealthDay

By Randy Dotinga

HealthDay Reporter

WEDNESDAY, Oct. 29, 2014 (HealthDay News) -- Want to lower your risk of a first-time stroke? New guidelines from the American Heart Association and American Stroke Association reinforce the idea that a healthy lifestyle is crucial.

The new guidelines advise people to exercise, control blood pressure and eat what's known as Mediterranean or DASH-style (Dietary Approach to Stop Hypertension) diets that emphasize fruits, vegetables, whole grains and seeds, plus poultry and fish.

"We have a huge opportunity to improve how we prevent new strokes, because risk factors that can be changed or controlled, especially high blood pressure, account for 90 percent of strokes," said Dr. James Meschia, lead author of the guidelines and professor and chairman of neurology at the Mayo Clinic in Jacksonville, Fla., in an American Heart Association news release.

The guidelines recommend that people:

• Eat a Mediterranean or DASH-style diet with nuts added. These diets emphasize eating plenty of fruits and vegetables, and limiting saturated fats, such as red meat, cheese and butter.
• Monitor blood pressure at home with a portable cuff device and avoid developing high blood pressure by exercising, eating properly and avoiding excess weight. Get your blood pressure checked by your health care provider every year. If you take blood pressure medications and they aren't working, ask your provider to adjust them.
• Limit the levels of sodium in the diet.
• Don't smoke. Smoking and taking oral birth control pills raises stroke risk, as does smoking if you get migraines with aura. Avoid secondhand smoke.

"Talking about stroke prevention is worthwhile," Meschia said. "In many instances, stroke isn't fatal, but it leads to years of physical, emotional and mental impairment that could be avoided."

The guidelines appear online Oct. 29 in the journal Stroke.

source : Stroke Prevention Guidelines Emphasize Healthy Lifestyle

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Women Often Ignore Signs of Heart Trouble

Study finds they're more likely than men to delay seeking medical help

WebMD News from HealthDay

By Randy Dotinga

HealthDay Reporter

WEDNESDAY, Oct. 29, 2014 (HealthDay News) -- When it comes to heart disease, a new study finds women are more likely than men to delay care when they have symptoms that spell trouble.

"The main danger is that when someone comes to the hospital with a more severe or advanced stage of heart disease, there are simply fewer treatment options available," study author Catherine Kreatsoulas, a Fulbright Scholar and research fellow at the Harvard School of Public Health, said in a news release from the Heart and Stroke Foundation of Canada.

In the study, researchers talked to patients who sought medical care for angina and were waiting to undergo angiogram tests to look for signs of coronary artery disease. Angina, or chest pain, occurs when the heart doesn't get as much blood and oxygen as it needs because of a blockage in the heart's arteries.

The researchers found that men acted more quickly when they developed symptoms and spent less time denying the symptoms existed or dismissing them as not important enough to require immediate care.

"Women displayed more of an optimistic bias, feeling that the symptoms would pass and get better on their own," Kreatsoulas said. "When women feel even a small improvement in symptoms, they seem to dismiss them for a longer period of time."

Previous research suggests that women are more likely to worry about being out of commission due to medical care, "and not necessarily as concerned about the best treatment options," Kreatsoulas added.

The research was to be presented Tuesday at the Canadian Cardiovascular Congress in Vancouver. Research released at conferences should be considered preliminary until it goes through the peer review process required to be published in major medical journals.

source : Women Often Ignore Signs of Heart Trouble

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Home Blood Pressure Monitors May Occasionally Miss the Mark

Study finds inaccurate readings in small percentage of patients

WebMD News from HealthDay

By Randy Dotinga

HealthDay Reporter

TUESDAY, Oct. 28, 2014 (HealthDay News) -- A small new study raises more questions about the accuracy of home blood-pressure monitoring devices.

On average, researchers found, the readings were slightly inaccurate in up to 15 percent of patients. The readings were off by more than 10 mm Hg -- a potentially significant difference in a blood pressure reading -- in about 8 percent of cases.

There's no way to know whether the inaccuracies are likely to mislead patients into seeking care when they don't need it or not getting care when it's required. It's also not known if physicians would be able to detect that something is wrong with the readings because they're different from those derived from more accurate machines at the doctor's office.

Still, the findings add to previous research suggesting that the in-home devices aren't perfect.

"Home blood pressure machines should be tested against a reliable device," like one in a doctor's office, said study co-author Dr. Swapnil Hiremath, a kidney specialist at The Ottawa Hospital and University of Ottawa in Canada. "I recommend my patients get one whenever possible, but now I get them checked out."

Home blood-pressure monitors are widely available at drug stores and online. They're often sold for as little as $25 or $30, said Dr. Willie Lawrence, chief of cardiology at Research Medical Center in Kansas City, Mo., and patients use them to track their blood pressure over time at home. This helps doctors monitor whether patients are suffering from high blood pressure or properly controlling it.

The monitors are common and "very valuable," said Lawrence, who pointed to research that's shown home monitoring is beneficial and lowers rates of high blood pressure.

In the new study, Hiremath and colleagues looked at data from 210 patients -- 60 percent men, with an average age of 67 -- who brought their blood-pressure monitors to the doctor's office.

"Our nurse, an RN, would measure blood pressure in both arms using the office blood pressure machine," he said. "Once it was confirmed that there was no difference between arms, measurements were taken in both arms simultaneously -- one with the home machine, one with the office machine. Since the data we report is from measurements taken by the RN, this is not a case of patient error."

The office machine was considered to be accurate.

On average, the systolic and diastolic blood pressure readings -- the upper and lower numbers, respectively -- were only a few points off in the home devices. Between 30 percent and 32 percent of the time, the blood pressure readings were off by 5mm Hg with the home devices. But the readings were off by more than 10mm Hg -- a difference that could be significant --- between 8 percent and 9 percent of the time.

source : Home Blood Pressure Monitors May Occasionally Miss the Mark

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Second Dallas Nurse Ebola-Free, Leaving Hospital

Head of World Bank urges thousands of medical professionals to travel to West Africa to fight outbreak

WebMD News from HealthDay

By Dennis Thompson

HealthDay Reporter

TUESDAY, Oct. 28, 2014 (HealthDay News) -- The second Dallas nurse who became infected with Ebola while caring for a Liberian man -- the first diagnosed case of the disease in the United States -- has recovered and will be released Tuesday from the hospital.

Amber Vinson, 29, has been undergoing treatment at Emory University Hospital in Atlanta, which has successfully treated several Ebola patients already, the Associated Press reported.

Vinson and fellow nurse Nina Pham became infected with the Ebola virus at Texas Health Presbyterian Hospital Dallas while caring for Thomas Eric Duncan, who died on Oct. 8.

Pham was released Oct. 24 from a National Institutes of Health hospital in Bethesda, Md. The Atlanta and Bethesda hospitals are among four U.S. hospitals with advanced biocontainment facilities designed to treat highly infectious diseases like Ebola.

It's not clear how either nurse became infected with the virus that has been wreaking havoc in the West African nations of Guinea, Liberia and Sierra Leone since the spring.

Vinson's case made headlines after it was revealed she flew from Texas to Ohio and back in mid-October to prepare for her wedding before she was diagnosed with Ebola. Officials have been monitoring 164 people in Ohio who were thought to have had some level of contact with her, the AP reported.

Also Tuesday, the president of the World Bank appealed for thousands of doctors, nurses and other health care professionals to volunteer and travel to West Africa and help contain the growing Ebola outbreak.

Jim Yong Kim said at least 5,000 health professionals and support staffers are needed to contain the epidemic, which has already infected more than 10,000 people and claimed nearly 5,000 lives.

Many potential volunteers are too scared to travel to West Africa, Kim said, according to BBC News.

On Monday, U.S. health officials issued new guidelines for monitoring people at risk for Ebola exposure -- a move designed, in part, to combat some of the fear surrounding Ebola infection.

The new guidelines apply to health care workers, whether they're returning home from the West African outbreak zone or caring for patients in the United States.

The guidelines establish four levels of risk -- "high" risk, "some" risk, "low" risk and "no" risk -- and recommend the sorts of restrictions and health monitoring that should accompany each category, Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, said at an afternoon news briefing.

Under the guidelines, people at high risk of Ebola exposure would be confined to their homes in voluntary isolation, while people carrying some risk would have their health and movements monitored by local officials.

Those at high risk or with some risk would have daily in-person check-ups from state and local health departments for 21 days -- the outside limit for infection from Ebola. This active monitoring began Monday in the six states where approximately 70 percent of incoming travelers from West Africa are headed -- Georgia, Maryland, New Jersey, New York, Pennsylvania and Virginia.

source : Second Dallas Nurse Ebola-Free, Leaving Hospital

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Baby Wipes Recalled Due to Possible Bacteria

WebMD News from HealthDay

Ten brands of baby wipes sold at Walgreens, Sam's Club and other stores nationwide are being voluntarily recalled due to possible bacteria contamination, the company announced Monday.

According to Nutek Disposables, Inc., included in the recall are baby wipes sold under the brand names Cuties, Diapers.com, Femtex, Fred's, Kidgets, Member's Mark, Simply Right, Sunny Smiles, Tender Touch, and Well Beginnings. The products were sold prior to Oct. 21, 2014 at Walgreens, Sam's Club, Family Dollar, Fred's stores, and at Diapers.com.

"After receiving a small number of complaints of odor and discoloration, Nutek conducted microbial testing that showed the presence of the bacteria Burkholderia cepacia (B. cepacia), in some of these products," the company said in a news release.

"B. cepacia poses little medical risk to healthy people," Nutek added. "However, people who have certain health problems like weakened immune systems or chronic lung diseases, particularly cystic fibrosis, may be more susceptible to infections with B. cepacia." People with any of those conditions who think they have used the wipes should contact their doctor, the company said.

Nutek says it has received "numerous" complaints of rash, irritation, infections, gastrointestinal troubles, and respiratory issues from consumers, although it's not clear if these complaints are tied to the baby wipes.

Consumers who have purchased the products can return them to point of purchase for a full refund, Nutek said. If consumers have questions they should call Nutek at 1-855-646-4351 Monday through Friday between 10 a.m. and 4 p.m. ET.

source : Baby Wipes Recalled Due to Possible Bacteria

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