Obesity Linked to Prostate Cancer, Study Finds

TUESDAY, April 23 (HealthDay News) -- Obese men are more likely to have precancerous changes detected in benign prostate biopsies and are at increased risk for eventually developing prostate cancer, new research suggests.

For the study, researchers examined data from nearly 500 men who were followed for 14 years after undergoing an initial prostate biopsy that was found to be noncancerous, or benign.

Prostate abnormalities were detected in 11 percent of the patients, and these abnormalities were strongly associated with obesity, said study author Andrew Rundle, an associate professor of epidemiology at Columbia University Mailman School of Public Health in New York City.

After taking into account factors including family history of prostate cancer, the researchers concluded that obesity at the time of the initial biopsy was associated with a 57 percent increased risk of developing prostate cancer during the 14 years of follow-up.

This association, however, was seen only for prostate cancer that occurred earlier in the follow-up period, according to the study, which was published in the April 23 issue of the journal Cancer Epidemiology, Biomarkers & Prevention.

"We don't absolutely know what the true biology is," Rundle said in a news release from the American Association for Cancer Research. "In some ways, this reflects the association between the body size and larger prostate size, which is thought to reduce the sensitivity of the needle biopsy. It is possible that the tumors missed by initial biopsy grew and were detected in a follow-up biopsy."

The association found in this study does not prove cause and effect.

Rundle noted that previous studies "have attempted to determine if there are subpopulations of men diagnosed with benign conditions that may be at a greater risk for developing prostate cancer. This is one of the first studies to assess the association between obesity and precancerous abnormalities."

These findings indicate that obesity "should be considered a factor for more intensive follow-up after a benign prostate biopsy," Rundle said.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: American Association for Cancer Research, news release, April 23, 2013

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Hospitalization OK for Psych Patients Can Take Hours

WEDNESDAY, April 24 (HealthDay News) -- U.S. psychiatrists spend a total of 1 million hours on the phone each year getting insurance companies to approve hospitalization for patients with severe mental illnesses, a new study reports.

For the study, which was published April 23 in the journal Annals of Emergency Medicine, researchers looked at psychiatrists in the Boston area and found that they spent an average of 38 minutes per patient on the phone getting insurance authorization.

About one in 10 cases took more than an hour to get approval, and one case took up five hours of the psychiatrist's time, the investigators found.

Each year in the United States, there are about 1.6 million psychiatric admissions for patients with private insurance. An average of 38 minutes of phone time per patient to get insurance authorization works out to about 1 million hours of "wasted" time for psychiatrists nationwide, according to the news release from the Physicians for a National Health Program.

The three-month study did not include uninsured patients or those covered by Medicare, which does not require prior authorization.

Most of the patients that required hospitalization had been deemed suicidal or, in some cases, posed a danger to others. The time spent obtaining insurance authorization delayed care for the patient in need and prevented psychiatrists from seeing other patients, the study authors noted. Only one of the 53 requests for authorization was denied, they pointed out.

The average time that patients spent in an emergency department (ED) awaiting hospital admission was 8.5 hours. The shortest wait was three hours and the longest was 20 hours, according to the study findings.

Mental health disorders affect nearly one-quarter of American adults a year, but less than one-third of them receive psychiatric care, according to background information in the news release.

"Society pays for inadequate psychiatric care; more than half of all prison inmates and a third of all homeless people are mentally ill. Massachusetts is considered a model for health reform, yet we found that seriously ill patients routinely spent hours stranded in the ED due to insurance bureaucracy. The hours psychiatrists spend obtaining those authorizations could be far better spent treating our patients," study lead author Dr. Amy Funkenstein, a child psychiatry fellow at Brown University, said in the news release.

She led the study while she was a psychiatric resident at Cambridge Health Alliance (CHA) and Harvard Medical School.

Study senior author Dr. J. Wesley Boyd, attending psychiatrist at CHA, said that "private insurers are obstructing care by requiring authorizations before a qualified psychiatrist can hospitalize a dangerously ill patient. With doctors, nurses and emergency departments already overburdened, adding a time-consuming bureaucratic task that doesn't help patients is unconscionable," he said in the news release.

"Insurers hope that clinicians will be so hassled by authorization procedures that they won't seek admission for their patients, saving insurance companies money," Boyd, who is also an assistant clinical professor of psychiatry at Harvard Medical School, suggested in the news release. "Placing profits ahead of the health of patients when mental illness makes them vulnerable is immoral. A single-payer Medicare-for-all health care system would represent a great leap forward for patients and providers alike."

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: Physicians for a National Health Program, news release, April 23, 2013

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Skipping Breakfast May Raise Diabetes Risk

Overweight women who ate morning meal had lower blood sugar, better insulin response in small study

By Kathleen Doheny

HealthDay Reporter

SUNDAY, June 16 (HealthDay News) -- Eating breakfast every day may help overweight women reduce their risk of diabetes, a small new study suggests.

When women skipped the morning meal, they experienced insulin resistance, a condition in which a person requires more insulin to bring their blood sugar into a normal range, explained lead researcher Dr. Elizabeth Thomas, an instructor of medicine at the University of Colorado.

This insulin resistance was short-term in the study, but when the condition is chronic, it is a risk factor for diabetes, Thomas said. She is due to present her findings this weekend at the Endocrine Society's annual meeting in San Francisco.

"Eating a healthy breakfast is probably beneficial," Thomas said. "It may not only help you control your weight but avoid diabetes."

Diabetes has been diagnosed in more than 18 million Americans, according to the American Diabetes Association. Most have type 2 diabetes, in which the body does not make enough insulin or does not use it effectively.

Excess weight is a risk factor for diabetes.

The new study included only nine women. Their average age was 29, and all were overweight or obese.

Thomas measured their levels of insulin and blood sugar on two different days after the women ate lunch. On one day, they had eaten breakfast; on the other day, they had skipped it.

Glucose levels normally rise after eating a meal, and that in turn triggers insulin production, which helps the cells take in the glucose and convert it to energy.

However, the women's insulin and glucose levels after lunch were much higher on the day they skipped breakfast than on the day they ate it.

On the day they did not eat breakfast, Thomas explained, "they required a higher level of insulin to handle the same meal."

"There was a 28 percent increase in the insulin response and a 12 percent increase in the glucose response after skipping breakfast," she said. That's a mild rise in glucose and a moderate rise in insulin, she noted.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

"Their study doesn't prove causation," said Dr. Joel Zonszein, a professor of clinical medicine at the Albert Einstein College of Medicine and director of the Clinical Diabetes Center at Montefiore Medical Center, in New York City.

The study found only a link or association between breakfast skipping and higher insulin levels. More research is needed for confirmation, another expert said.

"This is a small, but very interesting, study," said Dr. Ping Wang, director of the University of California, Irvine, Health Diabetes Center. "The findings will have to be verified with larger studies."

Whether the effect is short-term or long-term is not known, Wang said.

Zonszein recommends against either skipping meals or eating very frequent meals, the so-called nibbling diet. "Studies done in Europe have shown that a large meal in the middle of the day is better than a large meal at dinner," he said.

However, he acknowledged that pattern is more of a habit in Europe than in the United States. Even so, he advises his patients to eat a good breakfast, a good lunch and a lighter dinner.

Other ways to reduce diabetes risk, according to the American Diabetes Association, are to control weight, blood pressure and cholesterol and to be physically active.

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Jessica Pare at a Mad Men reception in NY

Aqua green is a definite DO this season, and Mad Men's Jessica Pare is hitting all the right notes in this embellished-hem number. We only wish she chose a more colourful shoe, don't you?

Top Shoes & Bags For Spring

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Fewer Young Americans Lack Health Care Coverage

But 45 million Americans overall still don't have health insurance

By Dennis Thompson

HealthDay Reporter

TUESDAY, June 18 (HealthDay News) -- The number of young adults without health care coverage in the United States has declined significantly over the past few years, according to a new government report released Tuesday.

That's the good news.

Not-so-good are the findings that: 45.5 million people, 14.7 percent of the American population, still don't have health care coverage, and 4.9 million kids under the age of 18 also lack health insurance.

The U.S. Centers for Disease Control and Prevention's National Center for Health Statistics used data on 108,131 people contacted for the 2012 National Health Interview Survey to compile the latest profile on health insurance coverage.

Of immediate interest was the apparent impact of the Affordable Care Act, President Obama's landmark health reform law passed in 2010.

The new report found that 27 percent of young adults between the ages of 19 and 25 had no health care coverage in 2012, down from more than 35 percent in 2010, according to report co-author Robin Cohen, a CDC health statistician.

At the same time, the number of young adults covered by a private health plan increased, from 49 percent in 2010 to 58 percent in 2012.

Health policy experts said the increase is most likely due to a provision in the Affordable Care Act (ACA) that allows young adults to remain on their parents' health insurance plan up to age 26.

"You see a significant decline in uninsurance among young adults and a corresponding uptick in private health insurance coverage," said Kathleen Stoll, director of health policy at Families USA, a national nonprofit health reform organization. "That is clearly due to the provisions in the ACA that allowed young adults to stay on their parents' health coverage. That's a positive change you can directly tie to the ACA."

By comparison, the number of uninsured adults aged 26 to 35 remained the same at 27 percent between 2010 and 2012. There also was no big difference in private coverage for this age group, which was about 59 percent in both 2010 and 2012.

The effectiveness of this single provision of the Affordable Care Act should give hope to the 45.5 million Americans still without health insurance in 2012, said Sara Collins, vice president for affordable health insurance at the Commonwealth Fund, a health policy think tank.

That's because most of the major provisions of the ACA take effect in 2014, including the opening of the health insurance exchanges and a major expansion of Medicaid, she noted.

"Going forward, starting next year, we're probably going to start seeing the same thing across the age spectrum," Collins said. "Next year we're likely to see a new trajectory of uninsured rates across the whole population."

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Older Adults' Posture May Predict Future Disability

FRIDAY, April 19 (HealthDay News) -- The shape of an older person's spine may predict their future need for home assistance or admission to a nursing home, according to a new Japanese study.

The findings appeared online recently in the Journals of Gerontology Series A: Biological Sciences and Medical Sciences.

The study included more than 800 people aged 65 and older in Japan, who underwent four types of spinal measurement. The researchers found that only one of the measurements was associated with becoming dependent on help for activities of daily living.

These activities include basic self-care tasks such as bathing, feeding, using the toilet, dressing and getting in or out of a bed or chair.

The measurement that predicted the need of assistance is called the "trunk angle of inclination." This is the angle between the true vertical and straight line from the first thoracic vertebra (near the head) to the first sacral vertebra (in the lower spine), the researchers said in a journal news release.

Over four and a half years of follow-up, about 16 percent of the participants became dependent on help for basic daily activities. Those with the greatest angle of spinal inclination were about three and a half times more likely to become dependent on help for basic daily activities than those with the least spinal inclination, the researchers found.

Although the study found an association between spinal angle and future disability in older adults, it did not establish a cause-and-effect relationship.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: Journals of Gerontology Series A: Biological Sciences and Medical Sciences, news release, April 2013

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Choosing food at a restaurant

I'm off out for dinner tonight, and want to pick something that's not totally calorie loaded!

My options:

-Tortilla wrap with either chargrilled veg & mozzarella, or tuna & red onion mayo, and salad and coleslaw

-Baked potato with either baked beans & cheddar cheese, cheddar cheese & coleslaw, or tuna mayo, with salad and coleslaw

-Chickpea and spinach burger with chips/fries, salad and coleslaw.

-Mac & cheese with garlic bread

Unfortunately there's no nutritional info about. I think the mac & cheese would probably be the most fat loaded and calorie heavy. What would you pick?

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Katy Perry at The Smurfs 2 party in Mexico

Sorry, I could not read the content fromt this page.

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January Jones at a Mad Men reception in NY

While there's nothing wrong with January Jones' casual spring outfit, we DO think a pencil skirt, which was a catwalk favourite for spring, would have turned this look from sweet to chic.

January Jones' Style Evolution

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Gene Variants May Play Role in Obesity

But findings don't explain exactly how they are connected

By Randy Dotinga

HealthDay Reporter

MONDAY, June 17 (HealthDay News) -- Two new studies offer some solace to those who can't control their weight despite diet and exercise by providing more evidence that genetics may play a role in obesity.

One study offers unique insight because it finds genetic mutations in severely obese children that suggest their excess weight may be more connected to their DNA because they put on pounds at such a young age. The other study found that certain genetic traits boost the risk of obesity in families.

The exact connection between genes and weight remains elusive. Still, "it's very likely that many of the genetic variants that contribute to weight interact with our environment -- the food that we eat and the amount of exercise that we get," said Sadaf Farooqi, professor of metabolism and medicine at the University of Cambridge in the U.K. and co-author of the study on children. "In fact, some of these genes act by influencing our appetite and how much we like food."

Previous research has shown that certain genetic variations boost the risk of obesity, but not in everyone, said Daniel Belsky, a postdoctoral fellow at Duke University's Center for the Study of Aging and Human Development. "Many people who carry a high load of common genetic risks remain lean while others who carry a light load of common genetic risks develop obesity," he said.

The two new studies, both published in the June 17 issue of the Journal of Clinical Investigation, examine variations in the SIM1 gene that are very rare but may have a big effect on the people who have them, Belsky said. "The purpose of studying these variants is to learn something about obesity -- what systems are disrupted and how -- with the aim of guiding the development of new treatment and prevention strategies," he said.

In one study, researchers found several genetic mutations in 2 percent of 2,100 severely obese kids with an average age of 10, but in fewer than 0.1 percent of the others.

"When the genetic variations do occur, they play a major role in a person's weight," study co-author Farooqi said.

In the other study, researchers studied the DNA of hundreds of children and adults (many of them severely obese), as well as the DNA of children who seem to have a condition called Prader-Willi syndrome, which can lead to overeating and out-of-control obesity. Led by a researcher from the Lille Pasteur Institute in France, the study authors linked three genetic mutations -- related to those in the other study -- to a high risk of obesity in families.

Scientists suspect that the genetic variations in the studies affect hunger and the way the body handles energy.

What can people do if their genes put them at higher risk of obesity? For now, nothing beyond trying the usual weight-loss strategies, such as diet, exercise and surgery.

"Despite this new discovery, there are still many genes to be found and we still don't understand how some of these genes actually work to affect our weight over long periods of time," Farooqi said. "If we can find new genes and understand how they work, we may be able to find more appropriate treatments for people who struggle with their weight."

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Health Tip: Understanding Heel Pain

(HealthDay News) -- When your heel starts to hurt, even walking can be difficult and incredibly painful.

The American Podiatric Medical Association says possible causes of heel pain include:

Heel spurs, which are bony growths that develop on the heel.Inflammation of the fascia, known as plantar fasciitis.Excessive pronation, or inward tilt of the foot as you walk.Achilles tendinitis, in which the tendon at the back of the foot becomes inflamed.A deformity, injury or chronic disease, such as rheumatoid arthritis.

-- Diana Kohnle
Copyright © 2013 HealthDay. All rights reserved.

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Rheumatoid Arthritis, Smoking, and Drinking Alcohol

The potential risks smoking and drinking pose to people with rheumatoid arthritis.By Stephanie Schupska
WebMD Feature

You already know that smoking is bad for you and that it's unhealthy to drink too much alcohol.

But do you know how tobacco and alcohol relate to rheumatoid arthritis -- your odds of developing RA, or, if you already have RA, your odds of making it worse?

Joint Stiffness and Rheumatoid Arthritis

Joint stiffness is a hallmark of rheumatoid arthritis (RA), a chronic disease that affects 1.3 million adult Americans. Resulting from an abnormal response of the immune system, rheumatoid arthritis inflames the soft tissue that lines the surface of joints (called the synovium). It is a systemic disease that not only makes joints stiff and painful, but can also affect other parts of your body, such as internal organs. By noting symptoms such as joint stiffness and seeking early treatment, you can...

Read the Joint Stiffness and Rheumatoid Arthritis article > >

Here's what the research shows.

Smoking may make people more likely to get RA. And, depending on their genes, it may make their RA worse. On top of that, smoking mixed with RA can lead to even greater problems, like heart disease.

“Very clear studies indicate that tobacco is highly associated [with] and probably causal in rheumatoid arthritis and is causal in the worst form of the disease,” says Susan Goodman, MD, an assistant attending rheumatologist and internist at the Hospital for Special Surgery and assistant professor of medicine at Weill Cornell Medical College.

Your genes may also matter. A Swedish study, published in December 2010, shows that the odds of developing RA was related not just to how much a person smokes, but also to their genetic makeup. People with a certain gene variation, called HLA-DRB1, who smoke are much more likely to get rheumatoid arthritis than someone who doesn’t smoke -- and to have severe RA.

“It turns out that people who smoke who bear this genetic factor are much more likely to develop rheumatoid arthritis and do develop more severe disease," Goodman says.

Smoking can also make dealing with the disease more difficult.

“In a lot of the studies on the course of rheumatoid arthritis, patients who smoke do less well, and they’re less likely to achieve remission,” Goodman says. “They’re more likely to have a worse outcome. Smoking gives them a worse prognosis.”

Smoking can increase painful rheumatoid nodules, which form in the joints, she says. It can also lead to heart disease, which -- even on its own -- is a big problem in people with RA. And smoking makes it worse.

“In the last 10 years, there have been studies that show the leading cause of death in patients with RA is cardiovascular disease,” says Walter Moore, MD, senior associate dean for graduate medical education and veteran affairs at Georgia Health Sciences University and chief of rheumatology at Charlie Norwood Department of Veterans Affairs Medical Center. “And smoking itself is clearly associated as a risk factor for cardiovascular disease.”

Stroke is another concern for RA patients.

“RA is an illness like diabetes. In and of itself, it’s a risk factor for heart attack and stroke,” says Andrew Ruthberg, MD, an assistant professor of medicine and an attending physician at Rush University Medical Center and director of Rush Rheumatoid Arthritis Clinic. “And those two things conspire to raise your risk for those other problems to a higher level.”

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Tune Into Brain Games Tonight, Chemical-Free Spring Cleaning and More!

National Geographic Channel's new show Brain Games shows you how to "hack your brain" so you can figure out how your mind works. Way more fun than a biology lesson, right? Check it out tonight at 9 p.m. ET. [CNN]

We're always looking for non-toxic ways to get our place sparkling for spring. Here, 27 chemical-free, DIY cleaning products. [Greatist]

The top 40 Vine Film Festival finalists pack a lot of talent into six seconds. Which one's your favorite? [All Twitter]

Our May cover girl Kelly Osbourne doesn't only look good, she does good too. Kelly and her mom, Sharon, have signed on to be the faces of Fashion Targets Breast Cancer 2013, which raises money for the disease via fashion sales. [The Drum]

Next week, your Twitter feed will be bringing the laughs. Starting April 29th, Comedy Central is hosting #Comedyfest, a five-day Twitter festival with jokes, routines, and even a panel discussion with Judd Apatow. [Rolling Stone]

Image Credit: Getty Images

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I have an open sore on the bottom of my foot — do I need to see a doctor?

Posted June 19, 2013, 2:00 am

I have an open sore on the bottom of my foot. Can I just cover it with a Band-Aid until it heals, or do I need to see a doctor?

I am glad you asked this question, because in most circumstances, just covering it with a Band-Aid is a really bad idea.

I’m guessing that this “sore” is more than some redness of the skin. I assume it is a little hole or crater, and that the top skin of the sole of your foot is gone. If that’s the case, what you’ve got is called a foot ulcer. A foot ulcer crater is often surrounded by a border of thickened, callused skin. (I’ve put an illustration below.) Some craters are shallow. In severe ulcers, the red crater may be deep enough to expose tendons or bones. If you have a foot ulcer, you should see your doctor.

People with diabetes are more likely to get severe foot ulcers. That’s because diabetes can cause nerve damage in the feet, which makes them less sensitive to pain or discomfort. People with diabetes can injure their foot significantly and not know it because they experience no pain. As a result, the ulcer can slowly get worse.

People with diabetes are at special risk from having a foot ulcer. Because diabetics often have poor blood supply in their feet, their foot ulcers have more trouble healing. Healing requires a good blood supply to provide energy and a steady flow of immune system cells to do its work.

Foot ulcers are vulnerable to infection. An untreated infection can develop into:

An abscess, or pus-filled pocket;A spreading infection of the skin and underlying fat;A bone infection;Gangrene, an area of dead, darkened body tissue.

If you have good circulation, your doctor can treat your foot ulcer by trimming away diseased tissue and removing any nearby callused skin. The doctor will apply a dressing and may prescribe specialized footwear to relieve pressure on the affected area. If there is a possibility of infection, you may need to take antibiotics.

Foot ulcers that do not respond to more conservative therapy may require surgery. If you have poor circulation, you may need surgery to correct blood-flow problems in your leg arteries. And if the circulation is poor enough, there may be no way to cure a foot ulcer, and the recurrent infections that develop in that ulcer, except by amputating the foot.

So if you’ve had one foot ulcer, you should see your doctor about it. After the ulcer is cured, you should take steps to help prevent future ulcers:

Examine your feet every day to check for rubbed areas, cracks or calluses.Wash your feet every day using mild soap and warm water. Dry thoroughly. Apply moisturizing lotion to dry areas.Wear roomy, well-cushioned shoes and soft, absorbent socks. window.fbAsyncInit = function() { FB.init({appId: "199616670120169", status: true, cookie: true, xfbml: true});}; (function() { var e = document.createElement("script"); e.async = true; e.src = document.location.protocol + "//connect.facebook.net/en_US/all.js"; document.getElementById("fb-root").appendChild(e);}());

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