FDA OKs Device With No Finger-Prick For Diabetes
http://ift.tt/2fvbytr By Robert Preidt HealthDay Reporter THURSDAY, Sept. 28, 2017 (HealthDay News) -- The first fingerstick-free blood sugar monitoring system for adults with diabetes has been approved by the U.S. Food and Drug Administration. The FreeStyle Libre Flash Glucose Monitoring System features a small sensor wire that's placed below the skin's surface and continuously monitors blood sugar (glucose) levels. People with diabetes can wave a mobile reader above the sensor wire to check their glucose levels. The system is approved for use in people with diabetes aged 18 and older. After a 12-hour start-up period, it can be worn for up to 10 days, the FDA said. "This system allows people with diabetes to avoid the additional step of fingerstick calibration, which can sometimes be painful, but still provides necessary information for treating their diabetes -- with a wave of the mobile reader," Donald St. Pierre said in an FDA news release. He is deputy director of new product evaluation in the FDA's Center for Devices and Radiological Health. Approval of the system, made by Abbott Diabetes Care, was based on a clinical trial of diabetes patients aged 18 and older. The system does not provide real-time alerts on its own, the FDA noted. For example, it cannot warn patients about low blood glucose levels while they're sleeping. Potential risks associated with the system include low or high blood sugar if data it provides is inaccurate and used to make treatment decisions, the FDA said. Some patients may also have mild skin irritation around the area where the sensor wire is inserted. More than 29 million people in the United States have diabetes, according to the U.S. Centers for Disease Control and Prevention. People with diabetes either don't make enough insulin (type 1 diabetes) or cannot use insulin properly (type 2 diabetes). When the body doesn't have enough insulin or can't use it effectively, sugar builds up in the blood. High blood sugar levels can lead to heart disease; stroke; blindness; kidney failure; and amputation of toes, feet or leg, according to background information in the FDA news release. WebMD News from HealthDay SourcesSOURCE: U.S. Food and Drug Administration, news release, Sept. 27, 2017 Copyright © 2013-2017 HealthDay. All rights reserved.Health via WebMD Health http://www.webmd.com/ September 28, 2017 at 03:36PM
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Nearly Half of the World's Abortions Are Unsafe
http://ift.tt/2wlW9Cj By Robert Preidt HealthDay Reporter THURSDAY, Sept. 28, 2017 (HealthDay News) -- More than 25 million unsafe abortions are performed worldwide each year, a new study says. That means nearly half of the 55.7 million abortions that take place annually aren't safe, said researchers led by the World Health Organization (WHO) and the Guttmacher Institute in New York City. The vast majority of these dangerous pregnancy terminations occur in Africa, Asia and Latin America, they found. Analyzing records for abortion globally, the research team deemed 55 percent of all terminations between 2010 and 2014 "safe." That meant they were performed using a WHO-recommended method (medical abortion, vacuum aspiration, or dilatation and evacuation) and involved at least one trained person. "The highest proportions of safe abortions were seen in countries with less restrictive laws, high economic development and well-developed health infrastructures, suggesting that both the legal framework and overall development of a country plays a role in abortion safety," said lead author Dr. Bela Ganatra, a scientist at the WHO. Nearly 31 percent of all abortions (about 17 million) were classified as "less safe." These included abortions done by a trained provider but with an outdated method, such as sharp curettage, or an abortion done with a safe method like the drug misoprostol but without the support of a trained person. About 8 million abortions, or 14 percent, were classified as "least safe." These were performed by an untrained person using dangerous or invasive methods, such as ingestion of caustic substances, insertion of foreign bodies or use of "traditional concoctions." In Africa, the least safe abortions were associated with higher rates of death, likely due to serious complications and poor health systems, the researchers said. The study was published Sept. 27 in The Lancet journal. "Our findings call for the need to ensure access to safe abortions to the full extent of the law, particularly in low income regions of the world, and efforts are needed to replace the use of unsafe methods with safe methods," Ganatra said in a journal news release. "Increasing the availability, accessibility and affordability of contraception can reduce the incidence of unintended pregnancies, and therefore abortions, but it is essential to combine this strategy with interventions to ensure access to safe abortions," she concluded. WebMD News from HealthDay SourcesSOURCE:The Lancet, news release, Sept. 27, 2017 Copyright © 2013-2017 HealthDay. All rights reserved.Health via WebMD Health http://www.webmd.com/ September 28, 2017 at 03:36PM
How Zika Virus Went From Mild to Devastating
http://ift.tt/2x0eqd2 By Dennis Thompson HealthDay Reporter THURSDAY, Sept. 28, 2017 (HealthDay News) -- A single genetic mutation just a few years back gave the Zika virus the ability to cause severe neurological birth defects like microcephaly, a new study in mice suggests. Scientists have known about the Zika virus since 1947, when it was discovered in a monkey from the Zika Forest in Uganda. At that point, it was only linked to mild symptoms. It wasn't until the Zika epidemic of 2015 in Central and South America that Zika became known as a cause of microcephaly, a devastating condition in which a newborn's brain and skull are severely underdeveloped. How did that happen? One particular genetic change, which likely occurred in 2013, boosted Zika's ability to damage the neural stem cells that serve as building blocks for a fetus' developing brain, Chinese researchers report. "The evidence suggests this particular mutation somehow increased the ability of the virus to get into these neural progenitor cells," said Dr. Joseph McCormick, regional dean at the University of Texas School of Public Health in Brownsville. McCormick wasn't involved in the new study. This discovery is disturbing because it suggests that the virus could have more unwelcome surprises in store for humanity, said Michael Osterholm, director of the University of Minnesota's Center for Infectious Disease Research and Policy. "The mutation that potentially caused this health outcome in humans is occurring in a virus where additional mutations could still occur, which could bring us other new health challenges," said Osterholm, who had no role in the research. Zika is transmitted primarily by infected mosquitoes. It can also be spread by having sex with an infected person. The Chinese team, whose first author is Ling Yuan of the Chinese Academy of Sciences in Beijing, compared three current Zika strains against an older strain isolated in Cambodia in 2010. The three current strains killed all lab mice exposed to it, producing a series of neurological symptoms. On the other hand, the 2010 strain only killed about 17 percent of mice. Comparing the strains, researchers found a critical mutation that altered a key protein in the protective coating of newer Zika viruses. This single change greatly enhanced Zika's ability to infect, damage and destroy human precursor brain cells, they said. ContinuedAn evolutionary analysis revealed that this change likely arose sometime in 2013, just a few months before an explosive outbreak of Zika in French Polynesia. That timing coincides with the first reports linking Zika to microcephaly and Guillain-Barre syndrome, a neural disorder that causes muscle weakness and paralysis in adults. "They've concluded it looks like the contemporary virus is more virulent than its ancestors," said Dr. Richard Temes, director of the Center for Neurocritical Care at North Shore University Hospital in Manhasset, N.Y. "When patients are infected, it's more likely to lead to neurological disease than the former strains." Although the analysis "is in many ways a very good explanation of what happened," it needs to be both confirmed and expanded upon, Osterholm said. Research on animals does not always produce the same results in humans. McCormick agreed. For example, he said, the conclusions leave open the possibility that a genetic trait in some humans might leave them more vulnerable to the threat posed by this Zika mutation. "Clearly a lot of people got infected with this, and a lot more pregnant women got infected than had microcephalic children," McCormick said. "Is there a human side of this that may make some people with the right genetic background more susceptible to this particular mutation?" The findings were published Sept. 28 in the journal Science. WebMD News from HealthDay SourcesSOURCES: Joseph McCormick, M.D., regional dean, University of Texas School of Public Health, Brownsville; Michael Osterholm, Ph.D, MPH, director, Center for Infectious Disease Research and Policy, University of Minnesota; Richard Temes, M.D., director, Center for Neurocritical Care, North Shore University Hospital, Manhasset, N.Y.; Sept. 28, 2017,Science Copyright © 2013-2017 HealthDay. All rights reserved.Health via WebMD Health http://www.webmd.com/ September 28, 2017 at 03:22PM
Woman dies from flesh-eating bacteria from Harvey-flooded home
http://ift.tt/2k57NQm Nancy Reed -- Harris County's 36th fatality related to the storm -- died on September 15. Necrotizing fasciitis is the cause of Reed's death recorded by the medical examiner. Complications in the form of an infected wound followed an accidental fall that resulted in "blunt trauma of an upper extremity," the report indicates. "She was in good health. She was very active," said Mark Renn, associate pastor for missions and evangelism at First Presbyterian Church of Kingwood, where her memorial service was held. When Reed contracted the bacterial disease from the contaminated waters, Renn explained, she was helping her son clear out his house and accidentally injured herself. "She was in the ICU for two weeks," said Renn. "She went into the hospital, she was making good progress, they thought they had treated the bacterial infection, and then just to find out one morning that she was gone." A widow, Reed worked as a community volunteer in Kingwood, a suburb of Houston, and president of the Reed Foundation, a philanthropic organization, according to her Rosewood Funeral Home obituary. She is survived by her son, John F. Reed, as well as her sister, niece, nephew, and numerous cousins. 'Not strange or unique'A serious skin infection, necrotizing fasciitisspreads quickly, destroying the body's soft tissue, and can become lethal within a very short time, according to the Centers for Disease Control and Prevention. However, treatment with antibiotics can prevent death if diagnosed quickly. In some cases, surgery is needed to prevent the spread of this infection, which can be caused by more than one type of bacteria. "The bacteria that caused necrotizing fasciitis are not strange or unique bacteria," said Dr. David Persse, public health authority for the city of Houston. He explained these bacteria can live in swimming pools or natural bodies of water, and the flood waters, contaminated by sewage and fecal matter, just "happened to have more" bacteria than other bodies of water. "Necrotizing fasciitis, the thing that is different about that is just how rapidly it spreads," said Persse. Most people have had an infected wound at some point in their lives and seen the slight redness, indicating an infection, that surrounds it. "But necrotizing fasciitis, the way you know it is because that redness starts to spread -- you will notice the change in just a couple of hours." While anyone could develop an infection from flesh-eating bacteria, the people at the highest risk are those with compromised immune systems, said Persse. This would include "people with diabetes, cancer patients, folks who have poorly controlled HIV disease, and the elderly because as we get old are immune systems are not as robust." Children, simply because they are more likely to be climbing around and get nicks and cuts, may also be in danger of developing an infection. Preventing infectionGood wound care is the best way to prevent any bacterial skin infection, according to Persse and the CDC. Keep open wounds covered with clean, dry bandages until healed and don't delay first aid for even minor wounds, including blisters or any break in the skin. If you have an open wound, avoid spending time in water that is not related to bathing. Wash your hands often with soap and water, as well. "If you're worried or just want to be super attentive, take a ballpoint pen and draw a line between where the skin is red and the normal skin and mark down the time. Two hours later, mark it again. If it's moved a half an inch or more, you need to go" to the hospital, he said. "Most of our contaminated waters are gone, they receded and we had some rain to flush out the bayous and stuff," said Persse. "But it's the trash at the end of the driveway along the curb that is still soaked with that same contaminated water." Houston todayRenn said, "it's been a long four weeks." At first the folks in Kingwood, a neighborhood less hard hit than some others, gave thanks "that nobody directly died in the flood. Meaning no one drowned, no one was abandoned in their house," said Renn. "But in the two weeks following the flood, we lost three older members of our church," said Renn. He believes they were already in poor health and then succumbed to heart attacks brought on by the stress. "We can look back and say the flood probably caused their deaths even though they were not immediate drownings or injuries." Today, most homes have been cleared out. "We literally demolished the bottom 4 feet of entire houses," said Renn. "If it was in the water -- and most of these houses had 3 to 4 feet of water in them -- it had to go because of all the contaminants in the water." "There was all that talk about the 'danger of the water' and 'don't be in this water' as we mucked out houses for the better part of three weeks and we were ripping out carpet and flopping around wet insulation and stuff," said Renn. He added that a lot of people get cuts and injuries doing this type of labor. Reed's death was "really, really hard," said Renn. "It really opened a lot of people eyes to [the fact that] this is serious stuff we are dealing with and the water does not just smell, it's full of sewage and deadly bacteria and all this kind of stuff." "Nancy was a very special lady," said Renn. "She was one of those women that I never heard her complain about anything. She saw the bright side of most things, she was encouraging." Hers was a life well-lived, he said. Health via CNN.com - RSS Channel - Health http://ift.tt/1rsiniF September 28, 2017 at 03:21PM
Julia Louis-Dreyfus Reveals Breast Cancer
http://ift.tt/2wn8dU8 Sept. 28, 2017 -- Julia Louis-Dreyfus has breast cancer. Louis-Dreyfus, who stars in the HBO comedy “Veep,” announced the news in a brief Instagram post, captioned “Just when you thought…” “1 in 8 women get breast cancer. Today, I’m the one,” reads the note, which was printed on personal stationery. Few other details about her diagnosis or prognosis were given. Instead, she turned her sad news into a call to action: “Let’s fight all cancers and make universal health care a reality.” In a statement given to The Hollywood Reporter, HBO said the actress was diagnosed the day after her record-breaking Emmy win this month. She made history by winning her sixth Emmy in a row for her work on the show. She is 56. HBO said her illness had no bearing on its decision to renew “Veep” for a final season. The network said it would change the production schedule as needed. © 2017 WebMD, LLC. All rights reserved.Health via WebMD Health http://www.webmd.com/ September 28, 2017 at 02:39PM
How the economy is making men less appealing partners
http://ift.tt/2wlW41K Somewhere between 1979 and 2008, Americans decided it was much less worth it to get hitched: the share of 25 to 39-year-old women who were currently married fell 10 percent among those with college degrees, 15 percent for those with some college, and a full 20 percent for women with a high school education or less. This great American marriage decline -- a dropfrom 72 percent of U.S. adults being wed in 1960 to half in 2014 -- is usually chalked up to gains in women's rights, the normalization of divorce, and the like. But it also has a lot to do with men. Namely, economic forces are making them less appealing partners, and it ties into everything from China to opioids. The most revealing data comes from University of Zurich economist David Dorn. In a 2017 paperwith an ominous title ("When Work Disappears: Manufacturing Decline and the Falling Marriage-Market Value of Men"), Dorn and his colleagues crunched the numbers from 1990 to 2014. They found that employability and marriageability are deeply intertwined. The flashpoint is a sector of the economy that politicians love to talk about: manufacturing. It used to be a huge slice of the employment pie: In 1990, 21.8 percent of employed men and 12.9 percent of employed women worked in manufacturing. By 2007, it had shrunk to 14.1 and 6.8 percent. These blue collar gigs were and are special: they pay more than comparable jobs at that education level in the service sector, and they deliver way more than just a paycheck. The jobs are often dangerous and physically demanding, giving a sense of solidarity with co-workers. Not coincidentally, these jobs are also incredibly male-dominated -- becoming even more so between 1990 and 2010. But since 1980, a full thirdof all manufacturing jobs -- five million since 2000 -- have evaporated, making guys less appealing as potential husbands in the process. Dorn and his colleagues find that when towns and counties lose manufacturing jobs, fertility and marriage rates among young adults go down, too. Unmarried births and the share of children living in single-parent homes go up. Meanwhile, places with higher manufacturing employment have a bigger wage gap between men and women, and a higher marriage rate. "On simple financial grounds, the males are more attractive partners in those locations because they benefit disproportionately from having those manufacturing jobs around," he tells Thrive Global. It underscores how in the U.S., the norms around money, marriage, and gender remain -- perhaps surprisingly -- traditional. Marianne Bertrand, an economist at the University of Chicago's Booth School of Business, has found a "cliff"in relative income in American marriages at the 50-50 split mark. While there are lots of couples where he earns 55 percent of their combined income, there are relatively few where she makes more than he does. While the pay gapis certainly a factor here, Bertrand and her colleagues arguethat the asymmetry owes more to traditionalist gender roles and remains a class issue. They referencerecent results from the World Values Survey, where respondents were asked how much they agreed with the claim that, ''If a woman earns more money than her husband, it's almost certain to cause problems.'' The results broke along socioeconomic lines: 28 percent of couples where both parties went to at least some college agreed, while 45 percent of couples where neither partner went beyond high school agreed. Spouses tend to be less happy, more likely to think the marriage is in trouble, and more likely to discuss separation if the wife outearns her husband, as well. "Either men don't like their female partners earning more than they do," Dorn says, or women feel like "if the man doesn't bring in more money, then he's an underachiever." As manufacturing jobs are lost, there are also increases to mortality in men aged 18 to 39, Dorn says, with more deaths from liver disease, indicative of alcohol abuse; more deaths from diabetes, related to obesity; and lung cancer, related to smoking -- not to mention drug overdoses. (These " deaths of despair" have taken over a million American lives in the past decade.) Ofer Sharone, a sociologist at the University of Massachusetts, has foundthat while Israelis blame the system when they can't find a job, Americans see themselves as flawed when they can't find work, which sounds a lot like perfectionism. And remarkably, halfof unemployed men in the U.S. are on some sort of painkiller. Unremarkably, all that makes long-term monogamy less appealing. "This is consistent with the notion that males become less attractive partners because they have less money and start doing drugs," Dorn says. The precarious situation that American men face has a lot to do with the nature of the jobs they're doing. Germany and Switzerland, which are bleeding manufacturing at a much slower rate, do more precision work (read: watches and cars), which is harder to ship overseas to hand over to robots and algorithms. Traditionally masculine, American blue collar jobs tend toward repetitive tasks, making them easier to replace. (One British estimatepredicted that 35 percent of traditionally male jobs in the UK are at high risk of being automated, compared with 26 percent of traditionally female jobs.) And the working-class jobs that are being added tend toward what's traditionally taken to be "women's work." Care-oriented jobs like home-care aides continue to go up -- a trend that's only going to continue as America gets olderand boomers move into retirement. These are not trends that add to the marketability of guys. "The lack of good jobs for these men is making them less and less attractive to women in the marriage market, and women, with their greater earnings, can do fine remaining single," says Bertrand, the Chicago economist. "For gender identity reasons, these men may not want to enter into marriages with women who are dominating them economically, even if this would make economic sense to them." So what's a man to do within change like this? Dorn recommends, if one is able, to specialize in areas that are harder to automate -- jobs that require problem-solving and creativity. But those jobs also often require more education. Then comes the much woolier, complex issue of gender norms. There are individual choices to be made at a personal level for men to take on traditionally feminine work, or for heterosexual couples to settle on a situation where the wife brings home the bacon. But these individual choices don't happen in a vacuum -- they're necessarily informed by the broader culture. "Traditional masculinity is standing in the way of working-class men's employment," Johns Hopkins sociologist Andrew Cherlin saidin an interview. "We have a cultural lag where our views of masculinity have not caught up to the change in the job market." (This was captured in a recent New York Times headline: "Men Don't Want to Be Nurses. Their Wives Agree.") Parents and educators will play the biggest role in teaching more gender neutral attitudes regarding who belongs in the home and who belongs in the marketplace, Bertrand says. And eventually, she adds, gender norms "will adjust to the new realities" that are already present in the economy: women are getting better educations and are more employable, and the work opportunities that are growing are -- for now -- thought to be feminine. Health via CNN.com - RSS Channel - Health http://ift.tt/1rsiniF September 28, 2017 at 05:56AM
Puerto Rico's looming medical crisis is 'about to explode'
http://ift.tt/2wY8M6b She's the medical director of Concilio de Salud Integral de Loíza, a community health center in a small town in the northeastern portion of Puerto Rico. Inside the clinic, with her hair pulled back and large glasses framing her eyes, she appears every inch a practical and compassionate health care provider. Yet today, she is struggling. She's been told the center has just six hours worth of diesel. It's been a week since Hurricane Maria besieged the island, yet fuel distribution has been inconsistent throughout the island. When those hours are up, Rodríguez will likely have to shut the doors. "What else we can do?" she asks. "I haven't seen anything like this." For 24 years, she's worked at the center, which serves about 15,000 underprivileged patients each year. Despite the possibility of a power outage, she and her co-workers are still trying to provide services. In normal conditions, the center provides everything from primary care and pharmacy services to X-rays. "We can do some things. I have a stethoscope and the antiseptics and I can prescribe. But the pharmacy can't work with that, they need the system -- they need labs to provide medications to these patients," Rodríguez says. "The desperation that all these people have, they've lost everything -- on the whole island," she says. With the fuel and power shortages, she expects the No. 1 health concern in the days ahead will be infectious diseases. As people who need medications do not get them, she predicts mental health issues will become a problem as well. "It will get worse before it gets better," she says. Her feelings are shared by other health care providers on the island, who believe a medical crisis is about to unfold. But it isn't inevitable, since preventive steps can be taken now. That's the opinion of Dr. Robert Fuller, an emergency medicine physician at University of Connecticut and International Medical Corp. A 'complicated mess'Fuller's been in medicine for 27 years, and though he has arrived at the scene of disasters for a dozen years, the conditions in Puerto Rico were a surprise, he says. "I didn't realize it was gonna be corner-to-corner everybody affected by the storm," says Fuller, squinting into the sunlight. "Every family's been touched and disturbed in some way or another. And the degree of destruction -- the power the storm had -- took me by surprise." Communities are disabled by the storm, he says, yet it's fuel and electricity that are driving this disruption. "If we had good logistics and good communications, things could probably settle out a little faster," Fuller says. However, the lack of those things could lead to a medical problem, since medications might not be delivered where needed. Puerto Rico is a "complicated mess" right now, he says. He has driven around the island, and there are wires down, which will make it hard to light up the houses. He agrees, fuel distribution is still a problem. He sees plenty of good doctors and nurses on the island, so it's not a matter of human resources. "It's a matter of getting the medications and treatments to the people," Fuller says. It's also a matter of being able to move around and get services to people, which cannot happen without fuel. In the shortest term, people with diabetes who don't have access to the right food and medication will be most vulnerable, Fuller says. A week without insulin, which requires refrigeration and a needle, can lead to a coma, which in turn can lead to death, he says. People relying on dialysis may also be in trouble. Naturally, if the lack of fuel and power continues, others will begin feeling the pain as well. "People are haggard and tired and maybe become impatient," Fuller says. "I worry that it's quite possible it will get rough before it gets better." Then Fuller rushes off and climbs into a car, his destination a clinic where he might do some good. 'It is about to explode'At San Jorge Children's Hospital in San Juan, the waiting room is unexpectedly bright, though very few patients occupy the chairs. In a room, a baby wails. For 27 years, Domingo Cruz Vivaldi, executive director, has made this hospital his life's work. "The structure itself did not suffer very bad," says Cruz Vivaldi. "But the main problem with the hospital is the electrical power." He explains that in the wake of the hurricane, the hospital is relying "100%" on diesel to feed its emergency power generator. Just two days ago, the hospital's diesel ran out and for about four hours in the early morning the hospital was dark -- no power, no electricity. Everybody, both staff and patients, were very nervous. Cruz Vivaldi worked hard with the hospital nurses to evaluate patients. Together they discharged or transferred 45 sick children. Other hospitals took in patients in unstable condition, while those not needing emergency treatment went home. "We were lucky that a hospital nearby brought to us 1,200 gallons of diesel," says Cruz Vivaldi. "That saved us." Once again, the hospital is close to 80 patients, he says, the sick children coming in from all over the island. His demeanor is calm throughout this difficult work of finding places to send patients. And, he's doing in the wake of personal tragedy. Cruz Vivaldi's 86-year-old mother died just before the hurricane arrived. "I buried her the day of the storm," he says, unable to hide his tears. "The day after the storm, I came here. We needed to be open. We had people looking for us." Considering the needs of the entire island, Cruz Vivaldi says immediate help with diesel and power is what needs to happen first. "We're getting help, we need more help," he says. "As we get power back, we will be able to recover faster." Puerto Rico does not yet have a medical problem, Cruz Vivaldi believes. But as everybody repairs houses and stands in line for food, it's only a matter of time. "It is about to explode," he says. The patients at home who are not receiving proper care will become sicker. He predicts an influx of patients will occur beginning in October. "We need to plan that the number of visits will triple or increase by four times in October, November and December," says Cruz Vivaldi. The health care system in Puerto Rico was already weak before the hurricane, he says. Now the problems will be magnified. "We need more federal and armed forces here on the island," Cruz Vivaldi says. Still, he remains hopeful. Cruz Vivaldi believes Congress and President Trump will provide funds and help rescue his home island. "Puerto Rico is going to get better," he says, as if talking about a patient. Fuller, the emergency doctor, is pragmatic. For those mainland Americans who want to help their fellow US citizens in Puerto Rico, he requests they do so in practical ways. "Don't send stuff, send money. Money arrives cheap and money can turn into whatever we need it to be instantly. It doesn't sit in a hangar unused," Fuller says. "You get much more value for the money ... even if it's not as emotionally satisfying." Health via CNN.com - RSS Channel - Health http://ift.tt/1rsiniF September 28, 2017 at 05:56AM
Nearly half of all abortions each year worldwide are unsafe, study says
http://ift.tt/2hyNRVa Since 2008, the obstetrician-gynecologist has been traveling to sub-Saharan Africa. While working in Zambia, she saw gynecologic units in the hospital filled with women admitted with heavy bleeding or life-threatening infections, she said. The women often would remain tight-lipped about why they were hemorrhaging, but Haddad said that it was clear to her and the Zambian clinicians what was happening. Some of the women had unsafe abortions and were facing serious complications, she said. "This is a public health priority and I don't think it's been placed on that level and given the attention that it needs," said Haddad, associate professor in the department of gynecology and obstetrics at Emory University School of Medicine. A new study finds nearly half of all 55.7 million estimated abortions around the world each year between 2010 and 2014 were performed in an unsafe manner, putting women at risk for serious complications. The study , published Wednesday in the journal The Lancet, suggests that unsafe abortions are still a major health problem globally, especially in developing countries. "These are the first global estimates to show the distribution of the abortions across three safety categories," said Dr. Bela Ganatra, a scientist at the department of reproductive health and research at the World Health Organization and lead author of the study. "For the first time, we actually tried to determine the conditions under which abortions take place, how, who, where. This allows us to develop a better understanding of actions needed," she said. Based on the WHO definition, an unsafe abortionresults from a pregnancy that is terminated either by someone who lacks the necessary medical skills or in an environment that does not conform to minimal medical standards, or both. Unsafe abortions can lead to complications, such as heavy bleeding, infection, damage to genitals or internal organs, or an incomplete abortion, such as when all of the pregnancy tissue is not removed from the uterus, according to WHO. "I think that there's no question that unsafe abortion continues to be one of the leading causes of maternal mortality and morbidity, and importantly this is preventable," said Haddad, who was not involved in the new study. Abortions performed by trained providers through evidence-based approaches are safe, she said. Counting unsafe abortionsThe study, conducted by an international team of researchers at WHO and Guttmacher Institute, involved 150 pieces of data from 61 countries on both safe and unsafe abortions performed around the world between 2010 and 2014. The information was collected from previous surveys and studies, bibliographic databases, and ministries of health or national statistical organizations. The researchers analyzed the data to determine how many abortions fit within the WHO's definition of "unsafe." They found that, in total, about 55.7 million abortions occurred annually worldwide between 2010 and 2014. Among those abortions, about 25.1 million were performed in unsafe circumstances each year -- with about 17.1 million being "less safe" and 8 million being "least safe," the researchers found. Overall, almost all abortions in developed countries were deemed safe, whereas roughly half of those in developing countries were safe, according to the findings. "Among the developed regions, the distributions of abortions across the safety categories were similar with the majority of abortions being performed under safe conditions, except for Eastern Europe, where 14% were less safe," Ganatra said. "While both Africa and Latin America had low proportions of abortions that were carried out in safe conditions, it was striking to note that among the unsafe abortions, the vast majority in the Latin America region were performed under less safe conditions (59.7%) while in Africa the majority of unsafe abortions were performed under the least safe conditions (48%)," she said. "It is also important to note that women undergoing abortions in Africa had the highest risk of dying from a least safe abortion." Eastern Asia, including China, had a distribution similar to developed regions, Ganatra said. Yet in South-Central Asia, less than one in two abortions were safe. "The paper did not examine country specific data, but other evidence shows that the same disparities exist within countries as well -- between rural and urban, rich and poor," Ganatra said. Such a disparity often emerges when any health outcome is measured in developed versus developing regions, but safe abortion care is possible in developing countries, Ganatra said. She pointed to Nepal, Ethiopia, and Uruguayas examples of countries that have made progress in expanding access to safe abortion procedures, she said. A separate study found that in 2012 almost 7 million women were treated for complications of unsafe abortions in the developing world. The study published in BJOG: An International Journal of Obstetrics and Gynaecologyin 2015. 'She really saw no other option for herself'The researchers wrote in the new study, "this analysis suggested that unsafe abortion is still a major problem in developing countries and that progress towards safer abortion is needed, even in some developed countries." Yet the study came with several limitations due to the dearth of data. "They're basing their data on other studies and numbers that are available and those numbers that are out there are limited based on their ability to estimate the true incidence," Haddad said. "So, they're likely underestimates." The researchers themselves noted in the study that, in general, empirical data on abortions were scarce, especially in countries where abortions were legally restricted, stigmatized or less likely to be reported. "This study gives us the first global estimates of how often women are able to find safe abortions, even if they are not getting legal abortions. It is very difficult to accurately measure abortion and abortion-related mortality, especially in countries where it is illegal. These may be the best estimates possible and yet still be an undercount," said Diana Greene Foster, professor of obstetrics, gynecology, and reproductive sciences at the University of California, San Francisco, who was not involved in the new study. "I have studied women who are unable to get a legal abortion in six countries: the United States, Colombia, Tunisia, South Africa, Bangladesh and Nepal. Even where abortion is supposed to be legal and available, many women are unable to access services within the medical system," she said. "Some women facing an unwanted pregnancy go on to get illegal, but safe, abortions, some get illegal unsafe abortions and some carry the unwanted pregnancy to term." Emory University's Haddad said that she remembers traveling to Nepal as a medical student around 2005, after the South Asian country liberalized some of its abortion restrictions. Knowledge of those reduced restrictions was not widespread, she said. "We had a woman who came in the clinic who was right above the gestational age limit to which abortion was legal. ... It was very clear that she was seeking any way to end the pregnancy," Haddad said. "She spoke openly about suicide as an option rather than continuing with the pregnancy." The woman was desperate because she was raped while her husband was away and she feared what would happen when her husband would return to find her pregnant, Haddad said. "She really saw no other option for herself. ... I don't know whatever happened with her, but I can't imagine that it was good," Haddad said. "It spoke to me because she did nothing on her own to get herself in that situation and saw no way out of it, and there was nothing I could do," she said. "And unfortunately, irrelevant of what people think of abortion, you can't ignore the fact that this is a crisis that is avoidable." Health via CNN.com - RSS Channel - Health http://ift.tt/1rsiniF September 28, 2017 at 05:56AM
Rapid, Easy Zika Test Developed
http://ift.tt/2xLRAov By Dennis Thompson HealthDay Reporter WEDNESDAY, Sept. 27, 2017 (HealthDay News) -- A new fast, easy and cheap "dipstick" test for the Zika and dengue viruses could revolutionize public health response to dangerous tropical germs, a new study reports. The test accurately diagnoses Zika and dengue and can tell the two mosquito-borne viruses apart, an area in which commercially available tests now stumble, said senior researcher Lee Gehrke, a professor with the MIT Institute for Medical Engineering and Science. "In light of the problems with Zika virus causing microcephaly [a genetic abnormality resulting in a smaller-than-normal head] and other defects in babies born to infected mothers, it's very important a pregnant woman would know if her fever is caused by Zika virus or dengue virus," said Gehrke, who's also a professor at Harvard Medical School. The new test resembles a pregnancy test strip, Gehrke noted. The strip contains antibodies that react to the presence of Zika or dengue virus, and gold nanoparticles that respond to the antibody reaction. To use the test, a medical professional would dip the strip into a tube of either blood serum or whole blood. "If it is a positive test, then we see a dot or a line on the test that results from seeing the gold nanoparticles that signal the antibodies recognizing the viral protein," Gehrke said. The test can tell Zika from dengue, and also can distinguish among four different strains of dengue, Gehrke added. Zika and dengue both belong to the same viral family, which are called flaviviruses. "They are two closely related viruses spread by the same mosquito," said co-researcher Kimberly Hamad-Schifferli, an associate professor of engineering with the University of Massachusetts in Boston. The research team, which also included members from Mount Sinai School of Medicine in New York City, developed the new test because current testing products sometimes cross-react between Zika and dengue, providing a false positive for Zika when the patient actually has the other virus, Gehrke said. Researchers checked the accuracy of the test by testing blood serum samples taken from people in regions where Zika has hit hardest, including Brazil, Colombia, Guatemala, India, Mexico and Panama. Serious birth defects caused by Zika appeared for the first time in the western hemisphere in 2015 in northern Brazil; then the epidemic swept outward. Continued"We validated the test in the areas where the virus is found, using human serum from infected patients," Gehrke said. "This is not just a test we performed using materials in a laboratory. We actually traveled to the endemic areas." The test proved 80 percent to 90 percent accurate in detecting Zika and avoiding false positives, Hamad-Schifferli said. It will take about a year to get the test out on the market in Zika-impacted areas, since the technology is based on existing products like pregnancy tests, Hamad-Schifferli said. The test also is expected to be very affordable. Currently, material costs are about $5 per strip, but Gehrke said costs should decline as production gets rolling. "Our target is under $1 per strip, which we think is reasonable once the antibody production is scaled up," Gehrke said. "The gold nanoparticles are already quite inexpensive." Infectious disease expert Dr. Amesh Adalja said the new test "will fulfill a great need and be of high value. "The availability of rapid, sensitive and specific diagnostic tests is crucial for the identification, treatment, and control of infectious disease," said Adalja, a senior associate with the Johns Hopkins Center for Health Security in Baltimore. He added, "That a rapid antigen test that meets this criteria is feasible for dengue and Zika -- two clinically indistinguishable diseases with different prognoses -- is a major step forward." The new report appears Sept. 27 in the journal Science Translational Medicine. WebMD News from HealthDay SourcesSOURCES: Lee Gehrke, Ph.D., professor, Massachusetts Institute of Technology, Institute for Medical Engineering and Science, and professor, Harvard Medical School, Cambridge, Mass.; Kimberly Hamad-Schifferli, Ph.D., associate professor, engineering, University of Massachusetts, Boston; Amesh Adalja, M.D., senior associate, Johns Hopkins Center for Health Security, Baltimore; Sept. 27, 2017,Science Translational Medicine Copyright © 2013-2017 HealthDay. All rights reserved.Health via WebMD Health http://www.webmd.com/ September 27, 2017 at 03:11PM
High Blood Pressure During Pregnancy Tied to Obesity in Children
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High blood pressure during pregnancy poses serious risks to mothers and babies. It may also increase the risk for childhood obesity, a new study reports. Chinese researchers studied 88,406 mother-child pairs, with complete data on maternal blood pressure during pregnancy and multiple follow-ups between ages 4 and 7 for the children. About 10 percent of the children were overweight or obese. In the second and third trimesters of pregnancy, each 10-unit increase in systolic (the top number) or diastolic (the bottom number) blood pressure was associated with a 5 to 8 percent increase in the risk for childhood obesity, even among women who were not hypertensive. Among all women, whatever their blood pressure before pregnancy, a reading higher than 140/90 in the second trimester was associated with a 49 percent increase in the risk for childhood obesity, and in the third trimester a 14 percent increase. The study, in The Journal of Clinical Endocrinology & Metabolism, controlled for maternal age, body mass index, education, number of previous pregnancies and other factors. Fewer than 4 percent of American women have dangerously high blood pressure during pregnancy, according to the National Institutes of Health. But the lead author, Ju-Sheng Zheng, a postdoctoral researcher at the University of Cambridge, said that “the majority of women who are not hypertensive are still at risk when their blood pressure increases, even to levels not generally considered dangerous. There is still that obesity risk to offspring.” Continue reading the main storyHealth via NYT > Health http://ift.tt/2koaaw3 September 27, 2017 at 02:39PM |
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