Rates of Mental Health Tx, Diagnosis Up for College Students

FRIDAY, Nov. 16, 2018 — From 2007 to 2017, there was an increase in the rates of mental health treatment and diagnosis among college students and a decrease in stigma, according to a study published online Nov. 5 in Psychiatric Services.

Sarah Ketchen Lipson, Ph.D., Ed.M., from the Boston University School of Public Health, and colleagues used 10 years of data from the Healthy Minds Study, which included 155,026 students from 196 campuses, to examine mental health service utilization by college students.

The researchers observed significant increases in the rates of mental health treatment and diagnosis. From 2007 to 2017, the rate of treatment increased from 19 to 34 percent, and an increase from 22 to 36 percent was seen in the percentage of students with lifetime diagnoses. Increases were also seen in depression and suicidality, while there was a decrease in stigma.

“We found that utilization increased substantially over the past decade, with much of this burden falling to campus counseling centers,” the authors write. “To better meet the mental health care demand from students and reduce strain on existing services, campuses may wish not only to expand capacity but also to increase the use of preventive and digital mental health services, such as those delivered via mobile apps.”

One author disclosed receiving consulting fees from Actualize Therapy.

Abstract/Full Text (subscription or payment may be required)

Posted: November 2018

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Why early diagnosis of autism should lead to early intervention

Research suggests children can be reliably diagnosed with autism before the age of two. It also shows that many of the behavioural symptoms of autism are present before the age of one.

These behaviours include decreased interest in social interaction, delayed development of speech and intentional communication, a lack of age-appropriate sound development, and unusual visual fixations.

Preliminary results of a study in the Wellington region indicate most children are diagnosed when they are around three years old. However, there is arguably little point of providing early diagnosis if it does not lead to evidence-based early intervention.

Early start

The Early Start Denver Model (ESDM) is a promising therapy for very young children (between one and five years) with, or at risk for, autism. ESDM uses play and games to build positive relationships in which the children are encouraged to boost language, social and cognitive skills.

Where ESDM differs most from traditional intervention is that behavioural teaching techniques are embedded within this play. This includes providing clear cues for a behaviour, and rewarding that behaviour. Parents, therapists and teachers can use ESDM techniques within the children’s play and daily routines to help them reach developmentally appropriate milestones.

For example, a child who does not yet talk, may be learning to reach for preferred items. A child who has a lot of language may be learning to answer questions like “what is your name?”.

Initial research conducted in the United States, where the model was developed, suggests that ESDM is particularly effective when implemented for more than 15 hours a week by trained therapists in the home environment.

Improved cognition in early childhood

The model was adopted in Australia where the government funds autism specific early childhood centres. Research conducted in these centres indicates that children receiving ESDM intervention from trained therapists show greater improvements in understanding and cognitive skills than children who were not receiving treatment.

In New Zealand there is no government funding for such therapy. As a result, the cost of providing this intensive level of early intervention is beyond the budget of most families. There is also a lack of trained professionals with the technical expertise to implement such therapies.

For these reasons, we are working with the Autism Intervention Trust and Autism New Zealand to develop a New Zealand-specific low-intensity approach to delivering ESDM. The team is using the research of what is effective overseas and is applying it within a New Zealand context.

Mainstream schooling

New Zealand takes an inclusive approach to education. The main goal of the research programme therefore is for children with autism and their families to receive support earlier so that they can get a better start in their development and go on to mainstream schools.

One project involves training kindergarten teachers in ESDM. Inclusion of ESDM strategies in kindergartens is the biggest unknown because there is little teacher training in New Zealand around how to best support children with autism in mainstream settings.

A second project involves providing parent coaching and then adding on a small amount of one-on-one therapy. This will provide some preliminary evidence as to whether adding a minimal amount of one-on-one therapy is any more beneficial that just coaching parents.

Each project involves examining specific measures of communication, imitation (a key early learning skill children with autism typically struggle with) and social engagement with others.

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Adenomyosis causes pain, heavy periods and infertility but you’ve probably never heard of it

Adenomyosis is a condition of the uterus (womb), where the tissue that grows on the lining of the uterus (also known as the endometrium) is also present on the inside muscular wall of the uterus. Adenomyosis can cause symptoms such as heavy bleeding during your period, bleeding when you are not due for your period, period pain (dysmenorrhea), pain during or after sex (dyspareunia) and infertility.

Although women with adenomyosis often also have endometriosis, they are different conditions. With endometriosis, cells similar to those that line the uterus are found in other parts of the body such as the fallopian tubes, the ovaries or the tissue lining the pelvis (the peritoneum).

The area of the uterus affected by adenomyosis is known as the endometrial-myometrial junction, which is where the endometrium and the myometrium (the muscular part of the uterus) meet.

Disruption in the endometrial-myometrial junction is now considered an important contributor to reproductive problems such as recurrent implantation failure, a condition that can prevent women falling pregnant. Adenomyosis can either be quite spread out, known as generalised adenomyosis or localised in one place, also known as an adenomyoma.

Adenomyosis can have a number of causes though none have been definitively identified. There is an association between the presence of adenomyosis and the number of times a women has given birth: the more pregnancies, the more likely you are to have adenomyosis. Women with adenomyosis have also often had a trauma to the uterus such as surgery in the uterus, like during a caesarean section.

How common is adenomyosis?

Like endometriosis, we don’t know exactly how many women may be affected by the condition. What makes the impact of adenomyosis so tricky to determine is that it is quite commonly found during regular screening tests, even when women are not complaining of any symptoms, which means many women may have it and not know about it.

Because it’s often found in women with other conditions like endometriosis, it’s difficult to determine which condition caused the symptoms. We don’t currently know why some women with adenomyosis have symptoms and others don’t.

There are also a number of different criteria for diagnosing adenomyosis, which can differ in important factors. For instance, the number of sections of adenomyosis that need to be affected for a diagosis when looking at tissue samples under a microscope. This makes it a problem when we try to work out how common adenomyosis is.

There can also be differences of opinion among the experts who look at these tissue samples. Experts can look at the same slides and come to very different conclusions.

How is it diagnosed?

Unlike endometriosis, which can only be definitively diagnosed through a key-hole surgery, a diagnosis of adenomyosis can be done through both invasive and non-invasive methods. The most common invasive method is a uterine biopsy (tissue sampling). A biopsy of the uterus can also be performed to make the diagnosis by an abdominal key-hole surgical procedure (laparoscopy) but this remains limited to clinical trials.

Biopsies going through the vagina up to the uterus may have a role in the diagnosis of adenomyosis, but can potentially damage the uterus and therefore are avoided in women wishing to fall pregnant. The ultimate biopsy is a hysterectomy (the removal of the uterus). This is the most accurate method but is obviously a significant surgical procedure and will prevent women having children. A diagnosis of adenomyosis has been made in between 10-88% of hysterectomy specimens showing how common this condition is.

Non-invasive diagnosis can be made by different types of imaging. Ultrasound is commonly available and can be done either using the probe on the abdomen or, preferably, placing the probe in the vagina.

However, ultrasound isn’t always the best choice as it only detects adenomyosis about 50-87% of the time. Magnetic resonance imaging (MRI) is a better choice as there are a number of typical features seen during MRI. These vary throughout the cycle and in response to hormonal therapy but can reliably predict adenomyosis.

What are the treatments?

Management options for adenomyosis include hormonal therapy and surgery. These are mainly targeted at reducing symptoms such as pain. There isn’t much research into whether these increase the chance of getting pregnant.

Hormonal treatments focus on suppressing menstruation. This can be achieved by combined oestrogen and progesterone therapy (such as the combined oral contraceptive pill), progestogen-only treatment (such as a Mirena) or placing women into an “induced” menopause (through GnRH analogs).

Surgical treatment is most effective when the adenomyosis is localised to a smaller area and can be removed, and this type of surgery doesn’t prevent women falling pregnant in the future. If the adenomyosis is spread throughout a larger area then treatments include destroying the lining of the uterus (endometrial ablation) provided adenomyosis is not too deep, and hysterectomy, both of which will prevent further pregnancy.

Other treatment options are interventional radiology such as uterine artery embolisation, where the blood supply to the uterus is cut off and magnetic resonance-guided focused ultrasound where the adenomyosis is destroyed with ultrasound energy.

Does it affect fertility?

There is some evidence adenomyosis can reduce fertility, but this is still controversial. Clinical studies are limited by difficulties and differences in diagnosis and their study designs have problems.

Some MRI studies show changes consistent with infertility, but because patients presenting with infertility in their 30s and 40s are more likely to be diagnosed with adenomyosis, it’s difficult to say if adenomyosis is the cause of their fertility issues.

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Cancer May Soon Replace Heart Disease as Leading Killer of Affluent Americans

MONDAY, Nov. 12, 2018 — Cancer is expected to overtake heart disease as the leading cause of death for well-off Americans by 2020.

The expected shift owes to advances in technology and drugs that are making big headway against heart disease, according to a new report.

But lack of access to quality care is likely to keep heart disease the leading killer of poorer folks in the United States, the researchers said. The change may also happen more slowly in poorer counties where risks for heart disease and death rates are higher.

“Recent data over the last two decades suggests that the U.S is in the midst of a new epidemiological transition within chronic disease, as the leading cause of death moves from heart disease to cancer,” said lead researcher Dr. Latha Palaniappan. She is a professor of medicine at Stanford University School of Medicine in Stanford, Calif.

Better prevention and treatment throughout the 20th century caused deaths from chronic disease to overtake those from infections, the study authors noted.

“Significant advances in cardiovascular disease prevention and treatment have enabled heart disease mortality rates to decrease for all populations in recent decades, but those in poorer areas may not transition as quickly,” Palaniappan said.

For the study, the researchers looked at U.S. death records from 2003 to 2015.

Overall, death rates dropped about 1 percent per year. Deaths from heart disease fell nearly 3 percent per year, while cancer deaths decreased by about 1.5 percent per year, the findings showed.

Although deaths from heart disease during the study period fell 28 percent, the drop was more significant in high-income counties than in poorer ones — 30 percent versus 22 percent, the investigators found.

This difference suggests the change from heart disease to cancer as a leading cause of death will take longer in poorer areas.

The transition is complex, and large overlaps exist in risk factors for these chronic diseases, the study authors said. In addition, socioeconomic, geographic, demographic and political factors could influence the speed of the transition, they added.

The report was published Nov. 12 in the Annals of Internal Medicine.

In 2016, in the United States, heart disease claimed more than 635,000 lives and cancer took nearly 600,000, according to the U.S. Centers for Disease Control and Prevention.

Accidents, the third-leading cause of death, claimed a little more than 160,000 lives.

A researcher in Switzerland who co-authored an editorial that accompanied the study attributes the change to people living longer.

“The shift … is mainly due to population aging and larger declines in age-specific mortality from cardiovascular and respiratory diseases among the elderly, especially among those socioeconomically better off,” said Silvia Stringhini. She’s a research associate at the Institute of Social and Preventive Medicine at Lausanne University Hospital.

Stringhini added that the cost of new cancer treatments and genetic testing may contribute to “inequalities” in cancer deaths, as rich patients are more likely to get advanced care than poor patients.

More information

For more about causes of deaths in the United States, visit the U.S. Centers for Disease Control and Prevention.

Posted: November 2018

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Bad molars? The origins of wisdom teeth

Our grandparents and parents tell stories about the time when kids routinely had their tonsils removed. But for people born in the 1960s and later, their routine surgery stories are about having third molars, a.k.a. wisdom teeth, taken out.

As a scientist who studies the evolution and development of faces and teeth in humans and other animals, whenever I ask a room of people if they’ve had any wisdom teeth removed, the hands of at least half the audience shoot up.

People want to share their wisdom tooth stories as well as to ask: Why do we have wisdom teeth? Why do they get impacted? Why don’t we just evolve them away?

Humans are primates. Our species’ closest living cousins are African apes, specifically chimpanzees. Apes have wisdom teeth, so do monkeys. Having wisdom teeth is just part of our evolutionary legacy.

Evolved wisdom?

Just like the rest of your teeth, wisdom teeth form inside your jawbone. But they form very late compared to our other teeth.

Second molars start developing around age three. Wisdom teeth often don’t start growing until age nine, but they’re highly variable, starting as young as five and as old as 15. They erupt from the gum between ages 17 and 24, if not older.

A tooth that doesn’t properly emerge through your gums and into your mouth is “impacted.” Impacted teeth can be linked to problems including gum disease, cysts or damage to the second molar.

Even when wisdom teeth start out badly angled, they can rotate and shift position in your 20s or 30s.

Wisdom teeth are not only the teeth most often impacted, but also the teeth that often fail to form at all.

Because wisdom teeth aren’t essential to modern human survival, people often ask whether evolution is weeding out this bothersome trait. But I don’t think so.

First, impacted wisdom teeth may cause us problems, but they rarely kill us. Even if they did, for evolution to select against wisdom teeth, impacted molars would have to cull us from the gene pool before we had kids. This would stop us from passing on any genes that might lead to impaction.

But it’s unlikely that specific “impaction genes” exist in the first place. There are, however, several risk factors for impaction, including what we eat.

Cramped quarters

The main reason we get impacted wisdom teeth is lack of space at the back of the jawbone. Our team found that when wisdom teeth develop and emerge very late, most of this space is already claimed by the first and second molars, so the wisdom tooth can’t move upwards and through the gums.

A related problem is jaw growth and overall length. If the jaw doesn’t grow long enough, fast enough, later-forming wisdom teeth also run out of space and can’t erupt properly, if at all.

But space isn’t the whole story. Scientists still can’t explain why some wisdom teeth become impacted. We need new ways to help dentists reliably predict which wisdom teeth are at risk.

Something to chew on

Based on what we do know, can we prevent impaction? Maybe.

Apes rarely have impacted wisdom teeth. The same holds true for humans who eat non-industrialized diets.

Our jaws evolved to expect biomechanical stimulation from a diet of, say, nuts, uncooked veggies and raw meats. These days, we tend to feed our jaws soft, processed foods, like smooth peanut butter on squishy bread. As a result, for the past few decades, we’ve probably not been maxing out the growth potential of our jawbones.

If you’re still growing, you can act now. Start eating crunchier, chewier foods, such as nuts and raw vegetables. And if you have kids, encourage them to eat jaw-moving foods as early as it’s healthy to do so. While science can’t yet say for sure that it will work, it probably can’t hurt.

A public health problem?

Millions of wisdom tooth extraction surgeries are performed worldwide each year. The treatment rate for wisdom tooth problems is higher than the rate of impaction itself. Up to one-third of these surgeries are needless.

Extraction surgery carries its own risks, too, including injury to nearby teeth, nerves, jawbone or sinuses. That’s a big waste of time, energy, money, avoidable pain and risk. Shunning non-essential surgery is why we no longer routinely send kids for tonsillectomies.

Healthy, erupted wisdom teeth aren’t usually a big problem for most people. They may have to brush these hard-to-reach teeth extra carefully to avoid decay.

Some impacted wisdom teeth don’t pose risk. But others can damage the second molar and surrounding jawbone, or cause infection and pain. These molars probably will need to come out.

When should you get them taken out? Some surgeons prefer to remove wisdom teeth early, at age 16 or 17, even though these molars may still rotate and emerge properly. On the other hand, removing molars late in life can be harsh on elderly, fragile or ill patients.

Watchful waiting may be a reasonable approach, and one advocated by several federal and public health agencies, as well as dentists.

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The most original baby names of 2018

When it comes to baby names, some parents go the traditional route and give their precious bundles of joy tried and true names that have been beloved for generations. Other parents, however, take a more creative route and give their babies names that are a bit further off the beaten path. In some cases, the names are even made up altogether! Parents in 2018 have given their babies some pretty unique names, to say the least. 

Parenting website BabyCenter keeps an up-to-date list of popular baby names of the year based on user data collected from parents who report what they named their babies. While these rankings are subject to change, and we can’t know for sure how popular a name is until the Social Security Administration releases the official rankings of 2018 U.S. baby names in 2019, the list does give us some insight into some of the uncommon names that parents are choosing for their little ones. Here are some of the most original names of 2018.

Niamey

Geography whizzes and globetrotters might recognize Niamey as the capital of the African country of Niger, but they have probably never thought of it as a potential baby name. In addition to being the capital, Niamey is also Niger’s largest city and sits along the Niger River. This unique name follows in the footsteps of other beloved baby names inspired by international locations such as Paris, London, and Cairo.

Niamey’s history as a baby name is fairly recent, but the name is proving to be quite the contender. In 2017, users ranked the name at an abysmally low 19,630 on the BabyCenter charts, but by 2018 it had catapulted into the top 50 names for girls — talk about a big leap! Perfect for world travelers, or for people who want to pay homage to the city, Niamey is a unique baby name that we will be seeing more of in the future. 

Reign

It was just a few years ago that Lorde was telling us that we’ll never be royals, but parents of 2018 are ignoring her lyrics. They’re determined to raise their kids as princes and princesses and are picking regal names to prove it. Reign has been seeing an upward trend for girls over the last few years and hit an all-time high in 2018. In fact, it has been on the rise since Lorde debuted “Royals” in 2013, so maybe we have her to thank for the growing popularity of the name. 

It’s only in the top 500 BabyCenter names so far, but at this rate the original name will likely catch on with more parents in the near future. This isn’t the only royal baby name on the rise, either. Parents of little girls are going with Reign, but parents of boys are loving the royal moniker King, which made BabyCenter’s top 100 list in 2018.

Kayson

Kayson is a modern-sounding name that is anchored in a traditional one. A more up-to-date take on the popular name Jason, a classic name that can trace its roots back to Greek mythology, Kayson has been sneakily on the rise with parents over the last few years. The spelling of this name is pretty flexible. If you aren’t a fan of the “y” in the middle of Kayson, don’t worry because you still have options if you like the sound of the name. Spelling variations of Kayson include Kason and Kasen. 

While Kayson has a distinctive ring to it, the moniker is part of an ongoing name trend of popular baby names (especially for boys) ending in the letter “n.” Other increasingly popular names that are also part of this trend include Grayson, Mason, Carson, Hudson, and Kayden, all of which consistently rank in the top 100 baby names for boys.  

Brinley

This English name has been in the top 500 names for a few years now, and is slowly but steadily making its way to the top of the charts. BabyCenter users put Brinley in the top 350 names for girls in 2018. The name means “tawny,” and can be spelled in a variety of ways including Brynlee and Brynleigh. It lends itself easily to nicknames and can be broken down to Brin and Lee, giving parents two built-in options for shortening the name for their baby girls.

Brinley’s “ley” ending will appeal to the wave of parents who are choosing names ending in the syllable for their little ones. Other unique “ley” names that are catching on with parents include Kinley, Kinsley, Paisley, Finley, and Hadley. Brinley manages to sound fresh while also incorporating the trendy “ley” ending, making this name both an original and stylish pick for fashion forward parents. 

Everleigh

Names ending in “ley” and “ly” are quite popular right now, which has some parents turning to different spellings in order to put a new spin on beloved names. One such name is Everleigh, a spelling variation of the far more popular Everly. This new version preserves the sound of the more traditional spelling, while making it different enough to not be too common. Everly is an upwardly mobile name that hit the top hundred in the U.S. in 2017, while Everleigh lagged far behind, only coming in at 387.

This distinctive spelling of the name is climbing up the ranks too, though, and made it into the top 200 on BabyCenter’s list in 2018. It might take a couple of years for this take on the name to close the gap, so for now, Everleigh remains one of the most original names of 2018.

Avianna

Avianna is a name that is both striking and elegant, so it’s pretty clear why parents are loving it for their baby girls. It broke into the top 400 on BabyCenter’s baby name charts for girls in 2018. Similar in sound to the more popular Arianna, the one letter between the two names makes a world of difference — Avianna is a great alternative if you’re looking for something a bit more original.

If you’re worried that the name is a bit too long-winded for a baby girl, you can easily shorten Avianna to Avi, Ava, Anna, or even Vianna. If you prefer a sleeker look, you could also opt to spell the name as Aviana, a variation which is catching up in popularity to Avianna. This name has a lot of potential, and it’s easy to envision the unique moniker overtaking the more traditional Arianna within the next few years.  

Little

In a field of unique names, Little still stands out since it’s not something that most people would typically think of as name. While it’s recognizable as a last name, such as with the Little family of the book and film Stuart Little, seeing it used as a first name is quite uncommon. Little made BabyCenter’s top 200 names for boys in 2018, and is also on the rise for girls where it is in the top 300 names.

This name might be a bit too unique for some parents, though, and it’s hard to say whether a baby will appreciate being named Little once they are all grown up. The name’s ascent up the charts, however, means that a few years from now the name might not be considered that unusual, so parents who like the sound of Little could be getting in early on a trendy name by giving it to their babies in 2018

Alivia

One time-tested way of creating a new and original baby name is to take an existing name and put a bit of a spin on it. That’s what’s happening with the name Alivia, a name that is in BabyCenter’s top 250 names for baby girls. Say it out loud, and it sounds nearly identical to the name Olivia, which is just one letter different. Olivia is one of the most popular names in the United States. It has been ranked in the top 10 baby names for girls since 2001, making it well overdue for an update.

Olivia itself was made up by William Shakespeare for his play Twelfth Night. Considering the fact that the playwright is famously remembered for making up many words that are still used in the English language today, we think that he would appreciate the twist parents are putting on the name he coined.

Atlas

While this name isn’t exactly a new one and can trace its roots back to Greek mythology, its use as a baby name in America is far from common. Atlas was on the Social Security Administration’s baby name charts in 1883 and 1890, but then disappeared from the ranks for more than a century. It popped back up in 2013, and has seen a slow and steady rise since then. BabyCenter users ranked it in the top 300 names for boys in 2018.

The story of Atlas in Greek mythology varies depending on the source, but a couple of the more well-known legends portray him as being responsible for holding up the heavens. This version of Atlas is the one we commonly remember today, and inspired the title of author and philosopher Ayn Rand’s magnum opus, Atlas Shrugged. If you want a unique name with a long legacy for your baby, Atlas is a solid choice.

Jhazelle

Jhazelle is a name that you’ve likely never heard of, but you will in the near future. This original name calls to mind a couple of other more widely used names. It is quite similar in sound to the German name Giselle, which means “a pledge.” It is also close to the names Janelle and Jasmine. In Jhazelle, these beloved names have been rolled together in a new and unique package. Its popularity has been rather sudden, seemingly springing up overnight. In 2017, Jhazelle was barely noticeable with a ranking in the 12,000s on the charts, but by 2018 had jumped into the top 150 names for girls. 

The name’s newness on the charts makes it a prime pick for trendsetting parents. Its distinctive spelling, combined with its commonalities with classic names, make Jhazelle unique without being too unusual. This makes it ideal for parents who are looking for a name that makes a statement, but who still appreciate the sound of more traditional monikers. 

Wynter

When it comes to the four seasons, Summer and Autumn are the only ones that really get much love as baby names, with Spring and Winter traditionally being rarely used. Winter has begun to break that trend, however, and has started to see use as a given name in the last few years. Winter would be distinctive enough, but some parents are taking things one step further and changing up the season’s spelling by naming their babies Wynter.

Wynter entered the top 600 BabyCenter names in 2018. Winter might be the chilliest of seasons, but it still has a lot to offer. While it doesn’t have the warmth of Summer or the rich colors of Autumn, the name Wynter calls to mind the holiday season, snowflakes, cozy nights by the fire, and cups of hot cocoa. What’s not to love, especially when the name comes with such a striking spelling?

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Promising new targeted therapy for acceleration of bone fracture repair

There are over six million fractures per year in the U.S. with direct costs in the billions, not to mention lost productivity. The only drug currently available to accelerate the healing process must be applied directly onto the fracture surface during surgery, but not all breaks require such intervention. New research, Bone Fracture-Targeted Dasatinib Conjugate Potently Enhances Fracture Repair In Vivo, presented today at the 2018 American Association of Pharmaceutical Scientists (AAPS) PharmSci 360 Meeting highlights a novel bone anabolic agent that, when injected, intravenously reduces femur fracture healing time by 60 percent without impacting the surrounding healthy tissue.

Researchers from Purdue University designed a new chemical entity (a dasatinib-aspartate10 conjugate, DAC) that employs a targeted peptide attached to dasatinib, an anti-cancer drug that has been shown to promote the growth of new bones. Following systemic injection, DAC is observed to concentrate on the fracture surface, resulting in accelerated repair and increased bone density. The data shows that the healing process that typically takes eight weeks for full recovery of mechanical strength is reduced to three to four weeks when treated with the targeted drug.

“We foresee a significant need for this type of therapy,” said presenting author, Mingding Wang, Purdue University. “Even though many broken bones don’t need surgery, most require a prolonged healing process that can lead to morbidity, loss of work productivity, and in some cases even death. By developing a therapy that can accelerate bone fracture repair without damaging healthy bones or tissues, we can hopefully address these critical issues.”

The study results indicate that treatment with DAC every other day for three weeks was equally effective as daily injections of DAC, yielding a 114 percent increase in bone density, and was found to be the best treatment interval. Reducing this dosing interval to every four days, however, resulted in a measurable decline in potency. Since the blood supply to the fracture area is often disrupted immediately after a fracture, waiting a week or two for blood vessels to stabilize prior to administering DAC did not negatively impact its effectiveness or the healing speed.

While administration of nontargeted dasatinib provided some improvement in healing rate, DAC was dramatically better, doubling the bone density. In addition, since the nontargeted form of dasatinib is administered chronically to cancer patients without significant toxicity, the fracture-targeted form is expected to be even safer. That is, when dasatinib is selectivity targeted to the bone fracture surface, its presence in all other tissues should be greatly reduced.

Philip Low, principal investigator and Presidential Scholar for Drug Discovery, Purdue Institute for Drug Discovery noted, “While the use of casts, rods, or pins may still be required in some cases, the ability of this therapy to accelerate the return of a fracture patient to normal function and lifestyle could have widespread benefits to the entire orthopedic community.”

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Societies publish new guidance for the treatment of slow, irregular heartbeats

The American College of Cardiology, the American Heart Association and the Heart Rhythm Society today released a guideline for the evaluation and treatment of patients with bradycardia, or a slow heartbeat, and cardiac conduction disorders.

In the guideline, bradycardia is defined as a heart rate of less than 50 beats per minute, compared to a normal heart rate of 50-100 beats per minute. A slow heartbeat can limit the amount of blood and oxygen that is pumped to all the organs of the body. Bradycardia is generally classified into three categories—sinus node dysfunction, atrioventricular (AV) block, and conduction disorders. In sinus node dysfunction, the sinoatrial node, the main pacemaker of the heart, cannot maintain an adequate heart rate. In AV block, there is partial or complete interruption of electrical impulse transmission from the atria to the ventricles. Cardiac conduction disorders occur when electrical impulses in the heart that cause it to beat are delayed. Common conduction disorders include right and left bundle branch block. Bradycardia and conduction abnormalities are more often seen in elderly patients.

The writing committee members outline the clinical presentation and approach to clinical evaluation of patients who may have bradycardia or conduction diseases. They reviewed study data and developed recommendations from the evidence. These recommendations include the selection and timing of diagnostic testing tools—including monitoring devices and electrophysiological testing—as well as available treatment options such as lifestyle interventions, pharmacotherapy and external and implanted devices, particularly pacing devices. The authors also address special considerations for different populations based on age, comorbidities or other relevant factors.

Conduction abnormalities are common after transcatheter aortic valve replacement (TAVR). The guideline includes recommendations on post-procedure surveillance and pacemaker implantation. The guideline also addresses ways to approach the discontinuation of pacemaker therapy and end of life considerations.

The writing committee members stress the importance of shared decision-making between the patient and clinicians, as well as patient-centered care.

“Treatment decisions are based not only on the best available evidence but also on the patient’s goals of care and preferences,” said Fred M. Kusumoto, MD, cardiologist at Mayo Clinic Florida in Jacksonville and chair of the writing committee. “Patients should be referred to trusted material to aid in their understanding and awareness of the consequences and risks of any proposed action.”

Yet, according to the authors, there are still knowledge gaps in understanding how to manage bradycardia, especially the evolving role of and developing technology for pacing.

“Identifying patient populations who will benefit the most from emerging pacing technologies, such as His bundle pacing and transcatheter leadless pacing systems, will require further investigation as these modalities are incorporated into clinical practice,” Kusumoto said. “Regardless of technology, for the foreseeable future, pacing therapy requires implantation of a medical device, and future studies are warranted to focus on the long-term implications associated with lifelong therapy.”

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Should we be afraid of cancer from the mobile phone, if you are a male rat?

In connection with the completion of a major study on mobile phone cancer risk news headlines exploded with reports on the subject. Given that the study provoked a barrage of information, was not conducted on humans and used the specific type of radiation, the proposed deal that really shows this scientific work and what we can expect from their phones.

The national toxicology program (National Toxicology Program NTP) presented the final reports on the studies of the effect of radio frequency (RFID) used in mobile phones 2G and 3G, in rats and mice.

Scientists have subjected their experimental radiation exposure within two years, nine hours a day. The results of more than a decade of research has shown that strong RF exposure associated with the development of tumors. Have been provided:

  • Compelling evidence linking RFID and tumors (malignant sannam) in hearts of male rats;
  • Some evidence of connection with tumors (malignant gliomas) in the brain of male rats;
  • Some evidence of benign and malignant tumors in the adrenal glands of male rats;
  • Ambiguous (unclear) evidence linking observed in the study of tumors in female rats and mice of both sexes.

The exposure used in the studies cannot be directly compared with the impact that people experience when using a mobile phone. In our studies, rats and mice received radio-frequency radiation throughout the body. On the contrary, people are mostly exposed to certain tissues near the place where they hold the phone. In addition, exposure levels and duration in our study was higher than people, explained John Bucher (John Bucher), doctor of philosophy, senior researcher of the NTP.

Health magazine columnist , Forbes argues that it makes no sense to panic if you are not male rats. In addition to the above reservations, it should be noted that the study used the radiation, which was used only for early models of mobile phones which now practically are not applied. Also noteworthy is the fact that strong evidence that RFID causes cancer in female rats and mice that were not received.

However, to reduce exposure to RF radiation, people should take precautions:

  • Keep the cell phone away from the head and body;
  • Do not place the phone near me while sleeping;
  • Use, whenever possible, speakerphone or headset;
  • Avoid using mobile phone when the signal is weak. In this case, because of the constant attempts to connect, RFID enhanced;
  • Do not use your mobile phone to download large files or streaming video. This also leads to increased RFID;
  • Before buying, carefully study the label and information about models by phones. Different devices may have different levels of RFID;
  • Do not wear the headset when not in call;
  • Put the phone in airplane mode or even turn off, if possible;
  • Skeptical about protective screens and other devices that are positioned as reducing RFID;
  • Try as little as possible to use the phone. Shorten the length of your calls, communicate face to face.

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The Pros & Cons of Co-sleeping With Older Kids

It makes sense to sleep with your child within their first few years of life. Your kids might be scared of the dark — which is a pretty common fear — and they could also be looking for attachment and safety. Yet at a certain point, your kids need to grow up and learn to sleep on their own.

“Children typically are taught to sleep in their own beds between ages 5 and 8 years old. Some parents need education on how to successfully do that, which is why they never teach their children or teach them too late,” licensed marriage and family therapist Katie Ziskind tells SheKnows. “I recommend parents start their child around age 5 in the child’s bed to teach their child that their bed is safe,” she says.

Not only will this improve your own quality of sleep (and probably your sex life!), but also, it’ll create a sense of independence for your child and help them learn to feel comfortable on their own.

If you’re struggling to say no — which can be hard when your kids are so darn cute — consider these pros and cons of letting older kids share your bed.

Pro: It fosters closeness

Co-sleeping does provide that bonding experience between parent and child — on both ends. Kids feel safe throughout the night. If a kid starts in the parents’ bed, the child will consider that bed to be theirs all the time. So, if a nightmare happens, the child can spend the whole night in the parent’s bed and feel protected, Ziskind explains.

If the kids start in their own beds but have a nightmare in the middle of the night, letting them join you could be the only way to mitigate their anxiety. “Kids need comfort. If your child wakes up crying, absolutely offer comfort, soothing and support by bringing them from their own room into your bedroom and into your bed for some cuddles,” she says.

Likewise, sometimes parents need some extra comfort. “For instance, if a parent has recently lost their spouse, they may want their child or teen to sleep with them for their own comfort, but this may not be in the best interest of the child,” says Ziskind.

Con: It also fosters dependence

It’s OK for your kids to feel dependent on you when they’re young; however, once they reach a certain age, it’s time to learn to take care of themselves. This isn’t to say they should be thrown on a subway or start walking home alone — they’re still young! — but learning how to clean up after themselves and withstand a night of darkness and potential terrors would be beneficial for both parents and child.

“Children need to learn independence and that they can be OK on their own and in the dark,” Ziskind says.

Con: It wreaks havoc on your sex life

Womp-womp. If you’re wondering why sexy-time has diminished, you can look to your co-sleeping habits with your children. “When kids sleep with parents, the parents lose out on intimate time. Children can weave their way into a marriage and cause parents to miss out on important alone time as adults,” she says.

Parents need to have firm boundaries about their bed being theirs and theirs alone. “If parents are struggling and are in conflict in their marriage, I often see one parent be passive-aggressive by bringing a child into the parent’s bed to block intimacy,” Ziskind adds. This will only exacerbate the sexual drought and cause tension in the relationship.

Con: It causes you to skimp on sleep

Co-sleeping can also mess with your shut-eye and prevent you from getting those 7 to 8 hours of sleep you need each night to wake up feeling restored. (And as busy parents, you really need those!)

Kids can be noisy, take up room on the bed to limit space for parents and be needy when scared. These distractions can make bedtime hard for parents, explains Ziskind. What’s more, since you’re missing out on regular sex, you’re not able to active feel-good hormones, such as oxytocin, the love hormone, to help you snooze faster and soundly throughout the night.

The takeaway? If your kid is really struggling at a young age, it’s OK to bend the rules. However, once kids turn 5, it’s smart to create some rules, educating kids on sleeping alone and prioritizing alone time for your and your S.O.

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