Coffee May Lower Risk of Dying From Oral Cancers

Dec. 12, 2012 -- Heavy coffee drinkers -- those who drink more than four cups a day -- may cut their risk of dying from cancers of the mouth and throat by nearly half, according to new research.

"We examined coffee drinking habits in nearly 1 million men and women," says Janet Hildebrand, MPH, an epidemiologist with the American Cancer Society.

"Those who reported drinking at least four cups per day of caffeinated coffee incurred about half the risk of dying from mouth and throat cancers compared to people who did not drink caffeinated coffee daily or only drank it occasionally."

That link held even when the researchers took into account smoking habits and alcohol use. 

Smoking and alcohol use are among the strongest risk factors for oral cancers.

About 35,000 new cases of oral cancers are expected in the U.S. this year, with 6,800 deaths, according to the American Cancer Society. The new study is published online in the American Journal of Epidemiology.

Previous research by others has linked drinking more than four cups of coffee a day to about the same risk reduction in getting a diagnosis of oral cancer.

Hildebrand's team evaluated more than 968,000 men and women enrolled in the Cancer Prevention Study II. It began in 1982 and is overseen by the American Cancer Society.

At the start of the study, all men and women were free of cancer. During the 26-year follow up, 868 deaths from oral or throat cancers occurred.

The researchers evaluated the coffee- and tea-drinking habits of the men and women. They found the link between coffee and a reduced risk of dying from oral cancers.

More than 97% of the men and women drank either coffee or tea. More than 60% said they drank at least a cup a day of caffeinated coffee.

Among those who drank regularly, most had three cups a day.

The risk reduction of nearly half was similar for those who drank four, five, or six cups daily. Beyond seven cups, Hildebrand says, there weren't enough people to gauge the effect on risk accurately.

Hildebrand found only a suggestion of a link between those who drank more than two cups of decaf daily.

No benefit was found for tea drinkers.

"We really don't clearly know the mechanism," Hildebrand says. "But we do know that coffee contains hundreds of biologically active compounds."

Many of them, she says, are now known to have anti-cancer properties.

The researchers can't be sure in this study whether the coffee lowered the risk of getting the cancers or improved the odds of survival once cancer occurred. The study only looked at deaths, not the diagnosis.

"We're not recommending people start to drink coffee or that people increase their coffee [intake] for cancer prevention," Hildebrand says. "Much more epidemiological and scientific and clinical evidence would be needed to support such a recommendation."

The new findings are ''fascinating and remarkable," says Joel Epstein, DMD. He is director of oral medicine at the City of Hope Comprehensive Cancer Center, located outside Los Angeles. He reviewed the study findings.

"It seems like there is a significant theme,'' he says, citing several other studies finding a lower risk of various cancers in coffee drinkers. "They are large studies," he says, usually funded by reputable organizations such as the American Cancer Society.

By and large, the studies are coming up with the same findings, he says, even though the researchers study different populations and different cancers. That's a good sign, he says.

View the original article here

Smoking Doubles Women’s Sudden Death Risk

Dec. 11, 2012 -- Smoking cigarettes may more than double a woman’s risk of sudden cardiac death. But quitting can reduce that risk significantly over time, according to a new study.

Sudden cardiac death is a sudden, unexpected death caused by loss of heart function. It is the leading cause of heart-related deaths in the U.S. and is responsible for up to 400,000 deaths per year.

Researchers found that women who were current smokers were two-and-a-half times more likely to suffer sudden cardiac death than nonsmokers. The risk of sudden cardiac death was even higher among heavy and lifetime smokers.

“We found the more that you smoke, the higher the risk of sudden cardiac death,” says researcher Roopinder Sandhu, MD, MPH, assistant professor of medicine at the University of Alberta in Alberta, Canada. “But the important thing is that this risk can be eliminated after smoking cessation.”

The study showed that quitting smoking had an almost immediate effect in reducing the risk of sudden cardiac death within five years among women without any symptoms of heart disease.

For women already diagnosed with heart disease, the benefits of quitting smoking took much longer to take effect.

Researchers say for many women, sudden cardiac death is the first sign of heart disease.

Although smoking is a known risk factor for sudden cardiac death, researchers say few studies have looked at the nature of this relationship in a large number of women both with and without heart disease.

This study looked at the impact of smoking and smoking cessation on the risk of sudden cardiac death among 101,018 women who took part in the Nurses’ Health Study. The results appear in Circulation: Arrhythmia & Electrophysiology.

During 30 years of follow-up, 351 cases of sudden cardiac death were reported.

Researchers found the amount and duration of cigarette smoking was strongly associated with the women’s risk of sudden cardiac death.

“Even with a very small amount, one to 14 cigarettes per day, women’s risk of sudden cardiac death was almost two-fold higher compared to women who did not smoke,” says Sandhu, who conducted the study as a visiting scientist at Brigham and Women’s Hospital in Boston.

Overall, the study showed:

The risk of sudden cardiac death increased by 8% for every five years a woman smoked.Heavy smokers who smoked 25 cigarettes a day or more had more than three times the risk of sudden cardiac death than women who didn’t smoke.Women who smoked for more than 35 years had a 2.5 times higher risk of sudden cardiac death than never smokers.

“This is an important study because it links smoking to sudden cardiac death in those unfortunate women who don’t make it to the hospital,” says Nieca Goldberg, MD, medical director of the women's heart program at New York University’s Langone Medical Center.

“The study shows that even modest levels of smoking can increase the risk of sudden cardiac death,” says Goldberg, a spokesperson for the American Heart Association. “People should know that just one cigarette is too much.”

View the original article here

7 Pregnancy Complications: Bleeding, Preeclampsia, and More

Some symptoms during pregnancy are par for the course, but others are cause for alarm. How do you know the difference?Reviewed by Nivin Todd, MD, FACOG

You may wonder what symptoms during pregnancy warrant immediate medical attention and what symptoms can wait until your next prenatal visit.

Always ask your health care provider at your visits about your concerns. But keep in mind some symptoms do need swift attention.

If you are newly pregnant, or trying to conceive, you have many questions about what to expect. How will your body change? What's happening inside you? Here's what to expect week by week.

© 2008 WebMD, LLC. All rights reserved.

Bleeding means different things throughout your pregnancy. “If you are bleeding heavily and have severe abdominal painand menstrual-like cramps or feel like you are going to faint during first trimester, it could be a sign of an ectopic pregnancy,” Peter Bernstein, MD, ob-gyn professor at New York's Albert Einstein College of Medicine and Montefiore Medical Center, says. Ectopic pregnancy, which occurs when the fertilized egg implants somewhere other than the uterus, can be life-threatening.

Heavy bleeding with cramping could also be a sign of miscarriagein first or early second trimester. By contrast, bleeding with abdominal pain in the third trimester may indicate placental abruption, which occurs when the placenta separates from the uterine lining.

“Bleeding is always serious,” women’s health expert Donnica Moore, MD, says. Any bleeding during pregnancy needs immediate attention. Call your doctor or go to the emergency room.

It's very common to have some nausea when you're pregnant. If it gets to be severe, that may be more serious.

“If you can’t eat or drink anything, you run the risk of becoming dehydrated,” Bernstein says. Being malnourished and dehydrated can harm your baby.  

If you experience severe nausea, tell your health care provider. Your doctor may prescribe medication or advise changing your diet.

What does it mean if your previously active baby seems to have less energy? It may be normal. But how can you tell?

Some troubleshooting can help determine if there is a problem. Bernstein suggests that you first drink something cold or eat something. Then lie on your side to see if this gets the baby moving.

Counting kicks can also help, Nicole Ruddock, MD, assistant professor of maternal and fetal medicine at University of Texas Medical School at Houston, says. “There is no optimal or critical number of movements,” she says, “but generally you should establish a baseline and have a subjective perception of whether your baby is moving more or less. As a general rule, you should have 10 or more kicks in two hours. Anything less should prompt a phone call to your doctor.”

Bernstein says to call your doctor as soon as possible. Your doctor has monitoring equipment that can be used to determine if the baby is moving and growing appropriately.

Contractions could be a sign of preterm labor. “But a lot of first-time moms may confuse true labor and false labor,” Ruddock says. False labor contractions are called Braxton-Hicks contractions. They’re unpredictable, non-rhythmic, and do not increase in intensity. “They will subside in an hour or with hydration,” Ruddock says. “But regular contractions are about 10 minutes apart or less and increase in intensity.”

If you're in your third trimester and think you're having contractions, call your doctor right away. If it is too early for the baby to be born, your doctor may be able to stop labor.

View the original article here

Vision Problems Rising Rapidly in the U.S.

Dec. 11, 2012 -- The diabetes and obesity epidemics may be fueling a dramatic rise in the number of people with vision problems, a new study suggests.

Rates of vision problems that can’t be treated with glasses or contact lenses, known as nonrefractive vision problems, increased by 21% between two survey periods: 1999 to 2002 and 2005 to 2008. The findings suggest that as many as 700,000 more people developed these types of vision problems in a short amount of time.

Nonrefractive vision problems include glaucoma, macular degeneration, cataracts, and diabetes-related eye disease. They are caused by underlying diseases. Many of these diseases are age-related and would not be expected to increase among young people. Diabetes, however, is occurring in younger and younger people.

“The increasing diabetes prevalence in the U.S. is leading to more vision loss,” says researcher David S. Friedman, MD, PhD, MPH. He is the director of the Dana Center for Preventive Ophthalmology at the Johns Hopkins Wilmer Eye Institute and Bloomberg School of Public Health in Baltimore. “We have to recognize that this is a large public health problem so we can start developing methods to deal with it.”

The findings appear in the Dec. 12 issue of the Journal of American Medical Association.

Friedman and colleagues analyzed data from a large national database in 1999-2002 and 2005-2008. Participants aged 20 or older answered questions and underwent lab tests and physical exams.  

Those most at risk were older, poorer, had less education, and had diabetes for 10 or more years. The only one of these risks that increased between the two surveys was a history of diabetes.

“The number of people who have had diabetes for more than 10 years has more than doubled in the last six or seven years,” Friedman says. The new findings are likely just the tip of the iceberg. If current diabetes rates continue, “we will see more and more people with diabetes and vision impairment.”

Preventing diabetes in the first place is key to preserving vision, he says. This includes losing weight (if necessary), eating a healthier diet, and getting regular exercise. But, he says, “if you have diabetes, make sure get your eyes checked, as this type of vision loss is preventable.”

Alan N. Carlson, MD, says that it is too early to say that the increase in vision problems is driven by diabetes. “Diabetes is on the rise and vision problems are on the rise, and patients with diabetes are more likely to have eye problems, but that is all we can say right now.” He is the chief of the corneal and refractive surgery services at the Duke Eye Center in Durham, N.C.

“Certainly people need to be aware of the risks of getting nonrefractive vision impairment down the road,” he says. “If there is a family history of certain diseases like macular degeneration, glaucoma, or diabetes, you should be seen more regularly by an eye doctor to make sure these diseases are caught earlier when they are much more treatable.”

View the original article here

Generic Drug May Ease Autism in Children

Dec. 11, 2012 -- An inexpensive generic drug may ease autism in children, a small new study shows.

The drug, bumetanide, is a diuretic, or a drug that rids the body of extra water through urine. It’s been FDA-approved since 1983 to reduce fluid buildup in patients with heart failure, kidney disease, or liver disease.

In autism, bumetanide may help to correct a chemical imbalance in the brain, says Jing-Qiong Kang, MD, PhD, an assistant professor of neurology at Vanderbilt University in Nashville, Tenn. Kang studies the biology of autism, but she was not involved in the current research.

Unlike other medications, which are used to quell behavioral problems that are sometimes associated with autism, like hyperactivity, insomnia, and aggression, bumetanide seems to ease some of the core features of the condition, including problems connecting and interacting with other people.

“They were making more eye contact, more spontaneous speech, and more two-way conversation,” says Daniel Coury, MD, a pediatric psychiatrist in Columbus, Ohio, who is medical director for the Autism Speaks Autism Treatment Network.

 “At the end of the day parents said, ‘I like this. My child is doing better,’” says Coury, who was not involved in the research.

For the study, French researchers had 60 children with autism take either bumetanide or a look-alike placebo pill for 90 days. 

Children in the study ranged from 3 to 11 years old. Their symptoms were scored by clinicians who did not know whether they were taking the drug or the placebo. Parents and teachers were also asked about changes in the children’s behavior over time.

By the end of the study, children in the treatment group shifted from average autism scores in the severe range to the mild or moderate range.

“A third of the placebo group improved, but three-fourths of the treatment group improved. So that suggests that it seems to be a real finding there,” Coury says.

The study is published in the journal Translational Psychiatry.

Despite the hopeful news, Coury and other experts urged caution.

“Is it going to have a sustained improvement, a continued improvement? There’s a lot that we don’t know,” he says.

About 30% of the children in the study developed low potassium levels, which were reversed with supplements. Two children stopped the study because of bedwetting. One of them was taking the placebo.

At the end of the study, researchers say most parents asked to continue on the bumetanide treatment. Researchers report that 87 children are now taking the medication. Some have now been on it for as long as two years.

Researcher Yehezkel Ben-Ari, PhD, director of research at the National Institute of Health and Medical Research in Marseille, France, says the medication seems to help children with milder forms of autism spectrum disorders, like Asperger’s syndrome, the most.

View the original article here

Asperger's and Violence: Experts Weigh In

Dec. 19, 2012 -- Reports that Newtown shooter Adam Lanza had Asperger’s syndrome, a highly functioning form of autism, have led some to wonder whether that diagnosis could have played a role in the mass shooting, which killed 20 children and six adults at a Connecticut elementary school last week.

As with many cases such as this, the answer is complex. While experts are clear that Asperger's doesn’t make a person more likely to commit a violent crime, some say it may affect the way a crime is carried out.

Advocates for people with autism are more direct.

“Autism did not cause this crime,” says Peter Bell, MBA, executive vice president for programs and services at the nonprofit group Autism Speaks.

Bell, who also has a son with autism, says it’s important to understand that the condition is a developmental disorder that arises early in life. Children and adults with autism spectrum disorders struggle to communicate with others. They may feel socially isolated and have trouble feeling like part of a group. They may also have repetitive or restrictive behaviors, like rocking or shaking their hands.

“There’s absolutely nothing in that definition that talks about violence or committing aggressive acts,” Bell says.

Indeed, psychologists and psychiatrists agree that people with autism or Asperger’s are not more likely to commit violent crimes than members of the general population, but they say in very rare cases, it can happen.

In those isolated instances, forensic psychiatrists tell WebMD, a diagnosis of Asperger’s or autism may help explain some aspects of seemingly unfathomable acts.

“I think it does matter. I think that’s probably part of making sense of this horrible thing that happened. I think that’s part of the equation,” says Marc Hillbrand, PhD, a clinical psychologist at Yale University in New Haven, Conn.

Hillbrand has studied the psychology of mass shootings, but he had no direct knowledge of Adam Lanza’s medical history.

“What’s so unusual about this individual, if indeed he has Asperger’s, is the use of weapons. There are a few cases of people with high-functioning autism who have committed violent crimes using weapons, but it’s a very small number of people,” he says.

Marianne Kristiansson, PhD, professor of forensic psychiatry at Karolinska Institute in Stockholm, Sweden, has published one of the few studies looking at the characteristics of a small number of violent offenders who also had autism.

She said when she heard about the Connecticut shooting, her first thought was that the shooter might have had Asperger’s.

“That was just my diagnosis,” Kristiansson says. “This offender behavior that he has presented is quite typical of a subject with ... autistic traits.”

View the original article here

A guide to beating nasal allergies, from medication to self-care.

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Track your way to weight loss success Manage your family's vaccinations Join the conversation See more benefits Sign Up Why WebMD? My WebMD Show Menu My Tools My WebMD Pages My Account Sign Out FacebookTwitterPinterest WebMD Home Allergies Health Center Help for Sinus Pain Email a FriendPrint Article Help for Sinus Pain and Pressure Next Article: Skip to Article Content Help for Sinus Pain and Pressure Is Your Cold Causing Sinus Problems? What happens to your sinuses when you have a cold, and what to do about it. Sinus Problems From Allergies What's the best way to treat a stuffy nose caused by allergies? Dealing With Sinus Pressure Don't let sinus congestion and pressure get you down. Here's how to cope. Sinus Headache Relief How do you know if it's really a sinus headache? What's Causing Your Sinus Problems? What to do when your sinuses misbehave. Home Remedies for Sinus Problems Creating a sinus-friendly environment at home. Your Sinus Action Plan 6 tips for relieving sinus pain and pressure. Sinus Terms to Know Check out this glossary of sinus terms. Using a Neti Pot for Congestion Can flushing out your nasal passages help? Natural Sinus Relief See 6 things you can do at home in this slideshow. False Allergies and Your Sinuses: Fighting Allergic Rhinitis A guide to the best stuff for stuffy noses, from prescription treatments to self-care. WebMD Feature

By R. Morgan Griffin

Reviewed By Laura J. Martin, MD

One in five adults in the U.S. has nasal allergies, or allergic rhinitis. Yet as common as it is, experts say that allergic rhinitis is terribly underdiagnosed, undertreated, and underestimated.

“Allergic rhinitis is a trivialized disease,” says Jonathan A. Bernstein, MD, an allergist at the University of Cincinnati College of Medicine. “Obviously, nobody dies from it. But it does cause a tremendous amount of sickness and suffering.”

All that sneezing, congestion, and teary-eyed misery takes a toll. Allergic rhinitis can cause missed workdays, and it can detract from your performance at school or on the job. Because of this, allergic rhinitis costs the country billions of dollars every year.

Nasal allergies can also lead to other conditions such as sinus problems. But they don’t have to.

“Allergic rhinitis is a treatable problem,” Bernstein says, “and when people get diagnosed and treated properly, they do very well.” If you’ve been limping through life with nasal allergies, it’s time to get the best of them.

Nasal Allergies and Sinus Problems

Allergy symptoms are miserable enough on their own. But in many people, allergic rhinitis can cause -- or aggravate -- other complications or conditions.

What’s the connection between allergies and sinus problems?

Sinuses are hollow pockets in the skull that are connected to the nasal passages. When allergies trigger swelling in the mucous membranes, the inflamed tissue can block off the sinuses. The sinuses can’t drain, trapping mucus and air inside. That leads to pain and pressure.

Take Allergy Symptoms Seriously

Despite the misery of allergies and their complications, many people don’t take the symptoms very seriously.

They don’t realize the impact that their allergies are having on their lives, especially when added up over years and decades, says Leonard Bielory, MD, director of the division of Allergy, Immunology and Rheumatology at New Jersey Medical School in Newark.

They get used to the congestion, chronic sinus problems, and mouth breathing. They get used to disturbed sleep and fatigue. After a while, they just don’t remember what life was like before allergies.

When symptoms get bad, they make do. They grab over-the-counter medicines at random at the drugstore. They make guesses at the cause of their allergies and half-hearted attempts to control their exposure, but never get a diagnosis.

That’s not the way to go about it, experts say. Given the impact that nasal allergies can have on your life, you really need to get proper medical evaluation and treatment.

Allergic Rhinitis Treatments: Over-the-Counter Medicine

For mild allergic rhinitis -- or symptoms that only strike for a few weeks a year -- over-the-counter medicines may be enough. OTC treatments for allergic rhinitis include:

Antihistamines. These drugs work by blocking histamine, a chemical that causes many allergy symptoms. They help relieve itching and sneezing. Examples include certirizine (Zyrtec), chlorpheniramine (Ahist, Chlor-Trimeton), diphenhydramine (Benadryl, Genahist), fexofenadine (Allegra), and loratadine (Agistam, Alavert, Claritin).

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Chronic Illness and Relationships: Communicating and Managing Stress

Don't let chronic illness weaken the bond between you and your partner.Reviewed by Kimball Johnson, MD

Having a chronic illness such as diabetes, arthritis, or multiple sclerosis can take a toll on even the best relationship. The partner who's sick may not feel the way he or she did before the illness. And the person who's not sick may not know how to handle the changes. The strain may push both people's understanding of "in sickness and in health" to its breaking point.

Studies show that marriages in which one spouse has a chronic illness are more likely to fail if the spouses are young. And spouses who are caregivers are six times more likely to be depressed than spouses who do not need to be caregivers.

Making Lust Last

By Keith Ablow, M.D. Rekindling Passion For The Husband You Still Love   People sometimes tell me they know a couple married 20 years whose sex life is still as good as it ever was. Here's what I tell them in return: "There are only three possibilities. One: This couple is lying. Two: They are telling the truth, because they didn't have good sex to begin with. Or three: Sex is all they really have together. They never connected emotionally." I've drawn that conclusion by listening...

Read the Making Lust Last article > >

Clinical psychologist Rosalind Kalb, vice president of the professional resource center at the National Multiple Sclerosis Society, says, "Even in the best marriages, it's hard.  You feel trapped, out of control, and helpless."

But with patience and commitment, there are ways you and your partner can deal with the strain a chronic illness can place on your relationship.

Relationships can suffer when people don't discuss problems that have no easy or obvious solution, Kalb says. And that lack of discussion can lead to feelings of distance and a lack of intimacy.

"Finding ways to talk openly about challenges," she says, "is the first step toward effective problem-solving and the feelings of closeness that come from good teamwork."

Marybeth Calderone has limited use of her legs and hands because of a neurological disorder called Charcot-Marie-Tooth. Her husband Chris says that figuring out when to communicate is his biggest challenge.

"My wife gets frustrated with herself when she can't do things, like organize our 8-year-old daughter's desk," he says. "A lot of times, I'm not sure if Marybeth is angry at me or with her condition. Often, I try to figure it out on my own and don't say anything.”

The right level of communication is key. Boston College social work professor Karen Kayser says, "If the couple is consumed with talking about the illness, that's a problem. If they never talk about it, it's also a problem. You have to find a middle ground."

View the original article here

What Causes Sinus Problems?

If you are plagued by sinus problems, take a moment to consider these valuable parts of your head. What can turn good sinuses into problem sinuses?

Your sinuses are hollow air spaces within the bones between your eyes, behind your cheekbone, and in the forehead. They produce mucus, which helps keep the inside of your nose moist. That, in turn, helps protect against dust, allergens, and pollutants.

No one is completely sure why we have sinuses, but some researchers think they keep the head from being too heavy.

Sinuses are also are responsible for the depth and tone of your voice. This explains why you sound like Clint Eastwood when your sinuses are all stuffed up.

If the tissue in your nose is swollen from allergies, a cold, or environmental triggers, it can block the sinus passages. Your sinuses can’t drain, and you may feel pain.

There are eight sinus cavities in total. They are paired, with one of each in the left and right side of the face.

Two sinus cavities are located in the forehead.Two are behind each cheekbone.Two sinus cavities are within the bones between your eyes.Two are behind each eye.

Sinus Blockages

Each sinus has a narrow spot, called the transition space (ostium), which is an opening that’s responsible for drainage. If a bottleneck or blockage occurs in the transition of any of the sinuses, mucus backs up.

An Extra Sinus

About 10% of people have an extra sinus. The extra sinus “effectively narrows that transition space,” says Ford Albritton, MD, chairman of otolaryngology at Presbyterian Hospital of Dallas.

Deviated Nasal Septum

Another common issue is a deviated nasal septum, the thin wall of bone and cartilage inside your nasal cavity that separates your two nasal passages. Ideally, your septum is situated in the center of your nose, equally separating the two sides. But whether from genetics or injury, in about 80% of people, the nasal septum is displaced to one side, making one nasal passage smaller than the other. A deviated septum is one reason some people have sinus issues. A deviated septum can also lead to obstructed breathing and snoring.

Narrow Sinuses

More often, certain people just have variations in their anatomy that creates a longer, narrower path for the transition spaces to drain. “It’s pure genetics, since it’s the way we’ve inherited how our sinuses are put together and how easy or difficult it is for them to stay open or become blocked,” Albritton says.

Sinus Sensitivity and Allergies

Finally, there are certain people who have sensitivity to things in the environment and to the foods they eat. This sensitivity triggers a dilation of blood vessels in the nose, and sometimes releases chemicals from cells in the nose that cause swelling.

Your doctor can prescribe medications to control your symptoms. People with sinus problems and allergies should avoid environmental irritants such as tobacco smoke and strong chemical odors, which may increase sinus problems.

View the original article here

Fungal Meningitis Patients: A Long Road to Recovery

Dec. 26, 2012 -- Johnnie McKee thought she was out of the woods.

McKee, a 72-year-old grandmother of four from Bethpage, Tenn., was one of nearly 14,000 people who found out this fall that they'd been exposed to tainted medications made by the now shuttered New England Compounding Center.

In her case, the threat came from a steroid shot that she'd had on Sept. 7 to relieve some nagging back pain.

"We got a letter. We were told that if we could make it 28 days, that we'd be clear," says Fred McKee, her husband of 51 years. "We watched it and worried about it," says Fred, his voice filling with emotion.

But Johnnie felt fine. She didn't have any of the symptoms they were told to look for -- headaches, nausea, fever.

The waiting period passed, and she felt good enough to get back to her yard, which she had always tended with great care. "She mowed the lawn," says Fred.

Then, on Oct. 8, the pain hit like a bolt of lightning at the base of her spine. "It was just excruciating pain," says Fred. Their surgeon told them to drive to the emergency room at St. Thomas Hospital in Nashville, where doctors had started to treat a wave of patients who were battling a rare type of fungal meningitis, an infection of the brain and spinal cord.

"There were three criteria they looked for to determine if you have fungal meningitis, and she met all three," Fred says.

Still, he says, they didn't worry. But that may have been because they didn't understand what was coming.

"I don't think we really realized that we were really getting into a two- to three-month hospitalization period and a six-month-to-a-year complete recovery," he says.

Since the outbreak began, 620 people have been infected and 39 have died in 19 states. No one has been cured.

"As far as we know, no one has been taken off medicines, and we wouldn't recommend that now; it's still too early," says Tom M. Chiller, MD, MPH, deputy chief of the Mycotic Diseases Branch at the CDC in Atlanta.

Many hope they are on the road to recovery, but no one can tell them when it will end.

Experts say they've never seen these kind of fungal infections, much less this many cases.

"It's very difficult for the doctors and the patients because we can't say, 'Well, just two more weeks of this and it will be over.' What we're saying is that we're going to keep treating you. We're going to keep caring for you, and when the experts tell us we can stop, we're going to do that," says William Schaffner, MD, an infectious disease specialist at Vanderbilt University in Nashville.

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How a Child's ADHD Affects Their Siblings

Having a child with ADHD means dedicating time to meeting their special needs, and to making sure that doesn't come at the expense of your other children.

"Being a parent of a child with ADHD can be hard," says Terry Dickson, MD, director of the Behavioral Medicine Clinic of NW Michigan, and an ADHD coach.

ADHD Multimodal Treatment

ADHD (attention deficit hyperactivity disorder) is characterized by inattention, hyperactivity, and the inability to control impulses. It affects an estimated 1.5 to 3.5 million school-age children in the U.S. Everyone, especially younger children, may have symptoms of ADHD from time to time. But with ADHD, the ability to function with daily activities is affected. A diagnosis of ADHD can be hard to make, and evaluation must be made by a specialist. There are several different approaches to...

Read the ADHD Multimodal Treatment article > >

"It's so important for parents to show all of their children -- both the child with ADHD and the kids without -- that they are equally loved. But given the needs of a child with ADHD, it takes work to keep it balanced."

When there's a child with ADHD in the family, it's common for their siblings to feel jealous and to act out if they sense their parents' attention shifting away from them.

"It works like a squeaky wheel," says Los Angeles psychotherapist Jenn Berman, PhD. "The child who is being the loudest gets the most attention from the parents."

Usually, that's the child with ADHD, so it's normal for parents to spend most of their energy focusing on meeting that child's special needs, whether it's in therapy, extra time at home doing homework, or a special effort on managing disobedience or impulsivity.

The behavior of children with ADHD can also make them hard to get along with as a peer, which means their brothers or sisters simply might not like being around them.

"The child who doesn't have ADHD might prefer to be at a friend's house than at home, might not invite other kids over to hang out, or might be embarrassed socially," says Dickson, who has a child with ADHD.

School is another outlet for kids who have a brother or sister with ADHD.

"It can be a reprieve where kids can get away from the stress they might be experiencing at home, or kids can use it as an opportunity to act out for attention," says Mark Wolraich, MD, a pediatrics professor at the University of Oklahoma Health Sciences Center.

The bottom line is that parents need to share the love and the attention with all their children,whether or not they have ADHD.

Balance is the key. Here are tips from the experts on how to help your kids with an ADHD sibling learn, adjust, and grow:

1. Manage expectations. Parents expect immediate obedience from their kids who don't have ADHD, Dickson says. It's common for them to think that their child should know better because they don't have the condition. But remember, they're still kids, and helping them understand boundaries and rules is just as important for them as it is for the child with ADHD.

2. Be fair. Just like you shouldn't be extra hard on your kids who don't have ADHD, you shouldn't be too lenient with the one that does, Dickson says. Be clear about the house rules and enforce them equally with all the kids.

View the original article here

Teen Marijuana Use Remains at All-Time High

By Rita Rubin
WebMD Health News

Dec. 19, 2012 -- A new survey shows marijuana use by teens remains high, and officials say it will probably increase as a result of Washington and Colorado decriminalizing the drug last month.

“Based on what we know ... we are predicting that it’s going to go up,” says Nora Volkow, MD, director of the National Institute on Drug Abuse. “Just the fact that there are some states that have made it legal ... will send a message” to teens throughout the country.

Already, the proportion of teens who consider marijuana to be harmful is the lowest it’s been in decades, according to the 2012 “Monitoring the Future” survey of eighth, 10th, and 12th graders. The annual survey of teen drug use is conducted by researchers at the University of Michigan.

The survey's silver lining is that it shows the use of illicit drugs, alcohol, and cigarettes is declining.

Still, about 70% of eighth graders said they thought regular use of marijuana was harmful, while about 42% said they considered occasional use harmful. Those rates are the lowest since the survey began asking eighth graders that question in 1991.

Among 12th graders, the proportion who said regular use was harmful was about 44%, occasional use, about 21%. Those are the lowest rates since 1979 and 1983, respectively.

The survey shows that 6.5% of high school seniors said they smoke marijuana daily, which is about the same as last year but up from 5.1% five years ago.

Use of synthetic marijuana, known as K-2 or Spice, was stable in 2012, with slightly more than 11% of high school seniors reporting they had used it in the past year, the survey shows.

Teens who think marijuana is safe to use are mistaken, Volkow says. “I think that the data are quite clear that smoking marijuana during adolescence is harmful to your brain.”

A National Institutes of Health-funded study, published in August in the Proceedings of the National Academy of Sciences, found a significant drop in IQ -- an average of eight points -- between the ages of 13 and 38 in people who had been heavy marijuana users since their teens. Even those who quit using the drug showed impaired mental abilities if they had started smoking marijuana in their teens.

“Findings are suggestive of a neurotoxic effect of cannabis on the adolescent brain and highlight the importance of prevention and policy efforts targeting adolescents,” the researchers concluded.

Washington and Colorado voters approved measures legalizing possession of up to an ounce of marijuana by people 21 and older. Washington’s law went into effect Dec. 6, while Colorado’s is set to become effective Jan. 5. Medical use of marijuana is legal in 18 states and the District of Columbia.

Although marijuana is illegal under federal law, President Obama told ABC’s Barbara Walters in a Dec. 11 interview that going after recreational users in states where marijuana is legal should not be a “top priority” of federal law enforcement officials.

View the original article here

What Cancer Patients Need to Know About the Flu

By Rita Rubin
WebMD Health News

What do cancer patients and survivors need to know about the flu? WebMD asked Lisa Richardson, MD, associate director for science in the CDC’s Division of Cancer Prevention and Control.

Should cancer patients get immunized against the flu?

Absolutely. The CDC recommends that everyone 6 months of age and older get a flu vaccine. That message is especially important for cancer patients, because if they get the flu, their risk of getting severe complications is higher, due to their weakened immune system.

What type of flu vaccine is best for cancer patients?

Flu shots are safer than FluMist, the nasal vaccine approved for healthy people ages 2 to 49. FluMist contains live, albeit weakened, flu virus, while flu shots contain killed virus, which can’t make you sick. (Some people run a low-grade fever after getting a flu shot, but that’s a sign your body is making antibodies against the disease, not a symptom of the flu itself.) If you’re over 65, the CDC recommends that you get the Fluzone High-Dose shot, which spurs the aging immune system to produce more antibodies against the flu. The CDC has not yet recommended that younger people with weakened immune systems, such as cancer patients, also get the high-dose vaccine.

What about survivors who have been cancer-free for a long time?

People who’ve had leukemia or lymphoma, which are cancers of the immune system, are most at risk for complications from the flu. Another group of survivors who have an elevated risk of complications from the flu are those who were treated with certain chemotherapy drugs that could alter their immune system long-term.

But if your immune system is compromised, does the flu vaccine work as well?

Getting a flu shot is better than not getting a flu shot, although it might not work as well as in a healthy person. If you do contract the flu after getting immunized, chances are you won’t get as sick as someone who hadn’t received a flu shot.

Does having cancer increase your risk of contracting the flu?

Some scientists believe cancer patients are more susceptible to coming down with the flu, but that hasn’t been confirmed. However, it is clear that once they become sick, they have a higher risk of complications.

Will a flu shot interfere with any cancer treatments?

Flu shots haven’t been shown to reduce the effectiveness of cancer therapy, but that misconception probably helps explain why many patients mistakenly refuse to get immunized.

What should cancer patients or survivors do if they think they might have come in contact with someone who has the flu?

Call your doctor. If you’ve had chemotherapy or radiation therapy within the past month, or if you have leukemia or lymphoma, your doctor might prescribe an antiviral medication to prevent you from getting sick.

View the original article here

How to Talk to Children About School Shooting

Dec. 14, 2012 -- As the nation grieves over the horror of the school shooting in Connecticut, parents across the U.S. -- both in Newtown, Conn., and elsewhere -- are struggling with how to help their children through this tragedy.

WebMD talked to Leslie Garrard, PsyD, a child psychologist at Miami Children's Hospital, and Melissa Brymer, PhD, director of terrorism and disaster programs at the UCLA-Duke National Center for Child Traumatic Stress. We asked for their best suggestions on what parents and others can do now to help children cope.

Q: What reactions should parents and other caregivers in Newtown expect from the children who have gone through this tragedy?

A: Kids can have a wide range of reactions, Garrard says. "Any exposure to trauma can have immediate reactions and lasting effects. Parents need to be very [mindful] and watch their children."

"Some kids withdraw, some are dismissive, although internally they are scared. Some cry and some are outwardly terrified. Some become depressed. Some just kind of shut down. Some might have nightmares and re-experience the traumatic events. ... They may be fearful of leaving their parents."

Q: What reactions are typical from children who didn't go through it, but watched news coverage or heard details about the tragedy?

They can also have [the same range of] reactions -- maybe not as strong, but they can also be impacted, Garrard says. "When watching it and seeing it on TV, it's very scary."

The American Academy of Pediatrics President Thomas McInerny, MD, says in a statement that if possible, "young children should not be exposed to the extensive media coverage of the event -- in other words, turn off the TV, computer, and other media devices."

Q: Is this age -- elementary school -- a particularly difficult one to experience trauma?

A: Yes, according to Garrard, because it affects emotional development and the way we view the world -- whether it's safe or not.  But "I think kids are very resilient. They can learn to maneuver the world and get through and past things. However, they do need a lot of care to get through things.''

Q: What is the best thing parents can do now?

A:  The most important thing parents can do is talk to their children, Garrard says. "Sit down with your child. Tell them a really bad thing has happened. Maybe they have already heard it on the news. Tell them, 'We need to talk about this.'"

See how they feel about it, Garrard says. You want them to share their feelings.

"Technology makes things a lot more complex," Brymer says. "They are getting information through Twitter feeds and Facebook. It's harder to keep up with what your kids are hearing. When we tweet, we hear something from someone and then you re-tweet. You can't fact-check when you tweet or post something on Facebook."

View the original article here

When Are Children Ready to Date?

By Virginia Sole-Smith
WebMD Feature

Dating. Parents may joke that it’s an experience they want their child to have -- just not until somewhere around the age of 30.

Seriously, though, when is your child ready to date? Consider this: It's not just about their age.

You and your child may see that very differently.

A 6th grade girl may say, "Jacob is my boyfriend," but what does that mean?

"At this age, kids use dating labels but aren’t ready to have much direct one-on-one interaction beyond maybe sitting together at lunch or recess," says Dale Atkins, PhD, a family therapist in New York. "Most of the activity happens in a pack, and communication takes place between friend groups."

By 8th grade, dating probably means talking on the phone and hanging out, usually in groups. By high school, kids are more likely to develop serious romantic attachments.

Notice what "dating" seems to mean to your child and then talk about it. Michelle Anthony, PhD, a developmental psychologist and learning therapist in Denver, suggests an opening line like: “It sounds like a lot of kids are talking about dating now. Is that something you’re interested in?”

If you can't tell what dating means to your kid, try discussing dating as shown on TV shows or in movies that are age-appropriate. For instance, Atkins suggests asking your child why they think someone acted the way they did, and whether they made a good or healthy choice.

It's not just about your child's age. It's your job, as their parent, to figure out if your child is ready to handle the level of dating they have in mind.

Pay attention to how they respond when you start a conversation about dating. “Of course it will probably be uncomfortable for both of you,” Anthony says. “But if he’s so uncomfortable that he gets angry or shuts down or otherwise just can’t continue the conversation, that’s a big sign that he’s not ready for this.” If so, assure your child that there’s no hurry to start dating.

Instead, if they answer your questions or seem eager to date, you can steer the conversation toward reassuring them that these feelings are normal. 

Is your child ready to connect with someone? Are they just trying to keep up with their friends? Are they confident and able to take care of themselves? Would they tell you if something went wrong? Do they look physically more mature than they are, emotionally? "A 12-year-old who looks 16 isn’t ready to date someone who is 16," Anthony says.

You may not love the idea of your child beginning to date, but don't try to pretend it’s not happening.

"Parents can be so uncomfortable with the idea of their kid becoming more grown up -- we wish our kids could stay kids," Atkins says. "The problem with that attitude is that your kid still is a kid. And he or she needs your guidance and support right now."

You don’t want them learning the rules of dating from peers or the media, without your input. The more you talk to your kids about what it means to be in a healthy relationship, the more likely they are to experience that, whenever they start dating.

View the original article here

Recall of More Hydrocodone-Acetaminophen Tablets

Dec. 26, 2012 -- More lots of the combination painkiller hydrocodone-acetaminophen are being recalled by Mylan Institutional. The new alert follows a nationwide recall of 101 lots of the drugs issued by Qualitest Pharmaceuticals that occurred earlier this month.

The FDA says the newly recalled lots were manufactured by Qualitest Pharmaceuticals and were repackaged and distributed by Mylan Institutional. The three lots include:  

The recalled bottles are supposed to contain tablets made up of 10 milligrams of hydrocodone and 500 milligrams of acetaminophen. But they are being recalled because the tablets may contain higher amounts of acetaminophen or hydrocodone than indicated on the label.

High doses of acetaminophen may put you at increased risk for liver damage.

Especially at risk are people who:

Take other medications containing acetaminophenHave liver diseaseDrink more than three alcoholic beverages a day

Additionally, too-high doses of hydrocodone can cause increased sedation and/or breathing problems, particularly among the elderly, people with severe kidney or liver impairment, and those who are taking other sedating medications or certain antidepressants.

If you have the affected lots you can contact Mylan Customer Service at 800-848-0462. People who are unsure should call their pharmacist or doctor.

View the original article here

Sinus Problems: Home Remedies and Tips

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Track your way to weight loss success Manage your family's vaccinations Join the conversation See more benefits Sign Up Why WebMD? My WebMD Show Menu My Tools My WebMD Pages My Account Sign Out FacebookTwitterPinterest WebMD Home Allergies Health Center Help for Sinus Pain Email a FriendPrint Article Help for Sinus Pain and Pressure Next Article: Skip to Article Content Help for Sinus Pain and Pressure Is Your Cold Causing Sinus Problems? What happens to your sinuses when you have a cold, and what to do about it. Sinus Problems From Allergies What's the best way to treat a stuffy nose caused by allergies? Dealing With Sinus Pressure Don't let sinus congestion and pressure get you down. Here's how to cope. Sinus Headache Relief How do you know if it's really a sinus headache? What's Causing Your Sinus Problems? What to do when your sinuses misbehave. Home Remedies for Sinus Problems Creating a sinus-friendly environment at home. Your Sinus Action Plan 6 tips for relieving sinus pain and pressure. Sinus Terms to Know Check out this glossary of sinus terms. Using a Neti Pot for Congestion Can flushing out your nasal passages help? Natural Sinus Relief See 6 things you can do at home in this slideshow. False Sinus Problems: Home Remedies and Tips Do you have sinus problems? Here's how to make your home kinder to your sinuses. WebMD Feature

By Kathleen Doheny

Reviewed By Michael W. Smith, MD

Are you among the 37 million Americans who have sinus problems each year? If so, there's a lot you can do around the house to create a "sinus-friendly" environment -- reducing your risk for sinus pressure.

Even better, many of the measures are simple and inexpensive.

Sinus Problems: Getting to the Triggers

First, it's crucial to figure out why you have sinus problems, says Jordan Josephson, MD, a Manhattan ear-nose-throat specialist and author of Sinus Relief Now.  "Allergies are a fairly common reason for sinus problems," he says.

Allergies that affect the nose, such as hay fever and indoor allergies, can cause the nasal membranes to swell, and the passages to the sinuses -- hollow spaces within the bones around the nose -- to become blocked. Mucus, which typically drains from the sinuses to the nose, can't drain.  

Other reasons? "A dry nose leads to more sinus problems," says Richard F. Lavi, MD, an allergist in Beachwood, Ohio.

Whatever the trigger, you can pick and choose from these five tips, or adopt all of them.

Sinus Tip 1: Keep Your Cool

"When the heat is on, the membranes get dry," says Russell B. Leftwich, MD, an allergist in Nashville, Tenn. Mucus isn't cleared as effectively, boosting the risk of sinus problems.

He can't recommend a specific indoor temperature range as ideal, but offers this guide: "You are better off wearing a sweater and keeping it cooler than cranking it up so you are comfortable wearing only a T-shirt."

Let your nose guide your indoor temperature range, suggests Lavi. "If you are not waking up with nosebleeds or congestion, that is probably a good temperature range."

Sinus Tip 2: Humidify Your Air

Strive for an indoor environment that's not too dry and not too humid.  "Dust mites love greater than 50% humidity," Lavi warns. And if you're allergic to dust mites, that's bad news for your sinuses.

A too-humid indoor environment can also encourage the growth of mold, which can also set off sinus problems, says Todd Kingdom, MD, director of rhinology and sinus surgery at National Jewish Health in Denver.

Experts are divided on the value of room humidifiers for creating a sinus-friendly home.

Forget them, Leftwich says. "A room humidifier never makes a difference. There is too much air to humidify."

But Josephson says using humidifiers in the bedroom beginning in October through March or April can make a difference in keeping sinus problems at bay.

Vaporizers can keep you more comfortable if you are in the midst of a sinus problem, Leftwich says. But you need to have it close by. "It doesn't do any good to have a vaporizer on the other side of the room." And, he warns, the devices must be cleaned daily to keep bacteria from growing in them.

Breathe the mist coming from vaporizers, but not the steam, he warns. Steam can easily burn you. Ten minutes at a time is often recommended.

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