Posted by on July 11, 2016 - 8:35am

A recent study published in the American Journal of Emergency Medicine found that sex-differences exist in emergency room evaluation and treatment times for patients presenting with a heart attack [1]. The retrospective study conducted at the University of Pennsylvania analyzed treatment times for over 250 patients with confirmed heart attacks. The study authors found that women, on average, wait 3 minutes longer to receive an initial EKG than men. Additionally, women wait 7 minutes longer than men for a heart attack treatment protocol to be activated, with the total average time being 25.5 minutes for women and 18.5 minutes for men. Current recommendations suggest that anyone presenting with a suspected heart attack should be evaluated and a treatment protocol initiated in less than 20 minutes [2]. Thus, women may be subject to additional heart damage as time passes without intervention.

According to the American Heart Association, women may experience a wide variety of symptoms during a heart attack which can include:

  • Chest pain
  • Shortness of breath
  • Sweating
  • Pain in the arms, jaw, back or stomach
  • Nausea or vomiting

 However, the most common symptom is chest pain or discomfort which is experienced by both men and women. It may be possible that sex-based bias exists in the initial diagnosis of heart attacks as evidence by this research. Additional studies which explore sex-differences within evaluation, diagnosis, and treatment of heart attacks and other cardiovascular disease may promote enhanced survival for both men and women.

 To learn more about the signs and symptoms of heart attacks in women check out the following video by the American Heart Association which was directed by, and stars Elizabeth Banks: It’s Just a Little Heart Attack.  

 Sources:

  1. Choi et al., Am J Emerg Med. 2016; EPub ahead of print.
  2. McCabe et al., Circ Cardiovasc Qual Outcomes. 2012; 5(5):672-9.
  3. American Heart Association
Posted by on June 29, 2016 - 7:53am

This year, the Summer Olympics are scheduled to be held in Rio De Janeiro, Brazil, throughout the month of August. However, several athletes, coaches, staff, and journalists have decided to stay home this year, citing concerns for Zika virus infection. Brazil is currently experiencing a Zika virus outbreak with over 148,00 suspected cases of Zika virus disease as of May 2016 [1]. According to the Centers for Disease Control (CDC), the Zika virus disease is spread through the bite of an infected mosquito and can cause symptoms such as fever, rash, and joint pain. While in a healthy individual, Zika virus disease may only cause a mild illness, less is known about its effects in the elderly, immunocompromised, and those with underlying health problems. Perhaps most concerning is the risk of associated birth defects, such as microcephaly, which can occur if a pregnant woman is infected with Zika virus. Furthermore, it has recently been shown that Zika virus can be transmitted through sexual contact. This has left many individuals scheduled to travel to Brazil concerned for the health of themselves and their families.

Savannah Guthrie, a TV journalist who is currently pregnant, has reported that she will not be attending the Olympics due to concerns for the Zika virus [3]. Additionally, professional golfer Rory McIlroy has stated the same [4]. Those who do plan on traveling to the Olympic games, such as U.S. men’s volleyball coach John Speraw, are taking numerous precautions to avoid Zika virus. Speraw plans wearing long sleeves, staying indoors, and as an extra measure of precaution, he will freeze his sperm prior to the Olympics in the event that he contracts the virus while in Brazil [5].

The CDC recommends that all individuals traveling to Brazil practice enhanced precautions which include:

  • Covering all exposed skin with long sleeved shirts and pants
  • Applying insect repellent containing DEET
  • Pre-treating clothes with the repellant permethrin
  • Staying indoors in air-conditioning

To date, no mosquito-borne transmission of Zika virus has been reported in the United States. However, as of June 22nd, there are 820 confirmed cases of individuals living in the U.S. who have contracted the virus while travelling abroad. If you plan on travelling abroad or to other U.S. territories this summer, check with the CDC for travel health notices and updates for local precautions.

 Sources:

  1. Pan American Health Organization Epidemiological Update
  2. Centers for Disease Control and Prevention
  3. New York Times
  4. ESPN
  5. New York Times
Posted by on June 27, 2016 - 8:33am

For some women, the onset of menopause can be fraught with unpleasant symptoms such as hot flashes, night sweats and vaginal dryness. If a woman wishes to avoid or is not a candidate for hormone replacement therapy, lifestyle and dietary modifications may provide some relief. Last week, an article published in the Journal of the American Medical Association analyzed the results of over 62 studies which examined the use and effectiveness of plant-based therapies on menopausal symptom relief [1]. The authors found that use of phytoestrogen-containing foods and dietary supplements may reduce hot flashes and vaginal dryness but not night sweats.

Phytoestrogens are naturally-occurring compounds found in plants which have a similar chemical structure to the hormone estrogen. When ingested, phytoestrogens can mimic, albeit to a lesser extent, the actions of estrogen since they “look alike” to our bodies. Phytoestrogens can be found in various fruits, vegetables, and even wine. Soybeans, in particular, have a high phytoestrogen content. For some individuals, there is increasing evidence that consuming soy-based products may provide relief from menopausal symptoms [1,2].

 Because phytoestrogens have estrogen-like properties, it was thought that consuming food which contained high amounts of phytoestrogens, such as soy, could increase your risk for breast cancer. However, there is no concrete evidence which suggests that this is true. So if you are looking for a natural approach to curb your menopause symptoms, increasing phytoestrogen-rich foods in your diet may be a safe and healthy alternative.

 

Sources:

  1. Franco et al., JAMA. 2016; 315(23):2554-2563.
  2. Patisaul and Jefferson, Front Neruoendcrinol. 2010; 31(4):400-419. 
Posted by on June 17, 2016 - 9:14am

Recently, the use of talcum powder has become a controversial issue as growing evidence suggests that its use may be related to an increased risk of ovarian cancer. Talcum powder, also known as talc, is a mineral composed of the elements magnesium, silicon, and oxygen. As a common household product, talcum powder can be used as an antiperspirant or in the application of cosmetics. Because of its ability to absorb moisture it may be applied to sensitive areas of the body, such as the genitals, to prevent chaffing.

A new study published in the journal Epidemiology, analyzed the use of talcum powder in over 4,000 women with and without ovarian cancer. The authors found that use of talcum powder in the genital region may increase a woman’s risk for ovarian cancer by 33%, especially in instances where the powder was used daily.

More research is necessary to determine how talcum powder causes cancer. In the meantime, the American Cancer Society suggests that it may be prudent to avoid or limit use of products containing talc, if you are concerned about developing ovarian cancer.  

Although the overall lifetime risk of developing ovarian cancer is low, it is one of the most deadly gynecological cancers. Therefore it is important to recognize some of the major signs and symptoms of ovarian cancer for early detection and diagnosis.

Signs and Symptoms

  • Lower abdominal pain or pressure
  • Weight gain or weight loss
  • Abnormal periods
  • Gas, nausea, or vomiting
  • Trouble eating or feeling “full” after eating

While these symptoms may be associated with other benign conditions, it is always important to discuss any questions or concerns you may have with your doctor.

 

Sources:
Cramer et al., Epidemiology. 2016;27: 334–346.1
American Cancer Society
National Library of Medicine

 1Two authors of the study have received compensation related to ongoing litigation regarding ovarian cancer. 

Posted by on March 29, 2016 - 2:28pm

We are well aware that cigarette smoking has a direct link to lung cancer.  Did you know that the latest Surgeon General's report identified 21 other diseases that have a causal relationship to cigarettes?

The list included 12 types of cancer, 6 categories of cardiovascular disease, diabetes, chronic obstructive pulmonary disease, and some pneumonias.  But a new report put  out by the American Heart Association, the National Cancer Institute and several major medical centers that pooled data on millions of subjects of both sexes and age 55 years and older found other concerns for smokers. In this study,  mortality was followed from 2000 to 2011.

There were 181,377 deaths overall---19% in smokers and 14% in non smokers. The study reconfirmed the increase morality due to smoking in the conditions listed above. However, 17% of the smokers with increased mortality helped identify new conditions impacted by smoking:   renal failure, intestinal ischemia, hypertensive heart disease, infections, various respiratory conditions, breast cancer and prostate cancer---conditions not part of the earlier "21".

While the study provides a more complete lists of conditions increased due to smoking, it also reinforces the fact that the rate of death from almost any cause was two to three time higher in current smokers when compared to non smokers.  While more study is needed to rule our other behaviours and determine how smoking effects treatment, the study demonstrates how important it is to reduce smoking espeically in young people.   Smoking also impacts one's  quality of life and will often cause mortality due to chronic conditions a decade earlier in smokers.  It sure makes sense to put those cigarettes away.

 

Posted by on March 3, 2016 - 2:33pm

We need a certain amount of fat in our diets to stay healthy. Fats provide needed energy in the form of calories. Fats help our bodies absorb important vitamins—called fat-soluble vitamins—including vitamins A, D and E. Fats also make foods more flavorful and help us feel full. Fats are especially important for infants and toddlers, because dietary fat contributes to proper growth and development.

“Fats are really the most concentrated source of energy in the foods we eat, and our bodies need that energy,” says NIH nutritionist Dr. Margaret McDowell. “Fats are truly an essential nutrient.” Problems arise, though, if we eat too much fat. Dietary fats have more than twice as many calories per gram as either proteins or carbohydrates like sugar and starch. Excess calories, of course, can pack on the pounds and raise your risk for diabetes, cancer and other conditions. “Some fats are better for our bodies than others,” McDowell says. “We should really aim to eat the right types of fats.”

Unsaturated fats are considered “good” fats. They’re sometimes listed as “monounsaturated” and “polyunsaturated” fat on Nutrition Facts labels. These can promote health if eaten in the right amounts. They are generally liquid at room temperature, and are known as oils. You’ll find healthful unsaturated fats in fish, nuts and most vegetable oils, including canola, corn, olive and safflower oils.

The so-called “bad” fats are saturated fats and trans fats. They tend to be solid at room temperature. Solid fats include butter, meat fats, stick margarine, shortening, and coconut and palm oils. They’re often found in chocolates, baked goods, and deep-fried and processed foods.

“When we eat too many solid fats, we put our bodies at risk. These fats tend to raise total blood cholesterol, as well as the part of cholesterol known as low-density lipoprotein (LDL) cholesterol (bad cholesterol),” says McDowell.  LDL can lead to the buildup of plaque in the arteries and cardiovascular problems.

Experts say that the total fat intake for adults ages 19 and older should be 20% to 35% of the calories eaten each day. For children ages 4 to 18, it should be 25% to 35%.  Less that 10% of our fat calories should come from saturated fatty acids.

Other NIH-funded research found that, when it comes to weight loss, the source of calories—whether from fat, protein or carbohydrate—isn’t as important as the number of calories you consume. But when it comes to risk factors for heart disease, replacing some carbohydrates with protein or unsaturated fats can greatly improve blood cholesterol. In a specialized diet designed to lower blood pressure, using unsaturated fats in place of some carbohydrates boosted blood levels of “good” cholesterol (HDL cholesterol) and caused a more healthful drop in blood pressure.

 

Source:  National Institutes of Health

 

Posted by on February 19, 2016 - 3:48pm

This past Tuesday, the Women's Health Research Institute welcomed U.S. Rep. Jan Schakowsky in the celebration of the recently announced National Institutes of Health (NIH) and Food and Drug Administration policies to include women in basic science and clinical studies. The event attracted over 200 guests and WHRI Director Teresa Woodruff, PhD shared the floor with Congresswoman Schakowsky and Jay Walsh, PhD, Vice President for Research at Northwestern University. 

Since the launch of the Women's Health Research Institute in 2007, its members have advocated for policy that addresses the need to examine sex as a research variable from bench to clinical science. Walsh stated, "I look forward to watching, over the rest of my career, the results that will come out because of this new notice from the NIH, that would not have come out if there hadn't been such leadership that exists in women's health." Woodruff and her team of Leadership Council members (comprised of researchers and clinicians across the Feinberg School of Medicine) celebrated these new policy rollouts as a major victory for women's health--health that extends beyond pregnancy, breast cancer, and menopause.

Read more about the event on Northwestern University's Feinberg School of Medicine news page.

Watch event video here!

Posted by on February 16, 2016 - 3:08pm

Protect your daughter from cervical cancer by getting her the HPV vaccine. It takes 3 shots to complete the series, so make sure she gets them all to be protected. It's easy to get very busy with school, activities, work, and all of the juggling that parents of preteens and teens do every day. However, for the sake of your daughter's health, it's important to take the time to get her the life-saving HPV vaccine to protect against cervical cancer. Every year in the United States about 12,000 women are diagnosed with cervical cancer, and 4,000 die. If we protect girls now, we could reduce disease and cancer due to HPV.

About 20 million people, most in their late teens and early 20s, are infected with HPV, the type of virus that causes cervical cancer. That's why it's important to protect preteen and teen girls early through vaccination. The HPV vaccine is safe and effective and is given in a series of 3 shots over about a six-month period. The second shot is given 1 or 2 months after the first, and the third shot is given 6 months after the first shot. It is very important to complete all of the shots to be fully protected. 35 million doses of HPV vaccine have been safely given to girls across the country. If your daughter is age 11 years or older, the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), and the Society for Adolescent Health and Medicine (SAHM) recommend you vaccinate now to protect her against cervical cancer. If your daughter is older than 11 or 12 and has not started these shots, it's not too late.

The HPV vaccine is not just for young girls! Young men are encouraged to get vaccinated as well, so see your doctor today!

Posted by on February 11, 2016 - 2:27pm

Over the past several years, gluten free diets have been all the rage. Is it true that gluten free diets can help you lose weight or is this just a fad? Gluten is a protein present in foods including wheat, rye, oats, and barley, but may also be found in everyday products such as medicines, vitamins, and even lip balms. There's absolutely nothing wrong with eating gluten unless you have celiac disease, or gluten sensitive enteropathy (GSE), an autoimmune disease that damages the small intestine and interferes with absorption of nutrients from food. If you are sensitive to gluten, the body produces an abnormal immune response to it, attacking the lining of small intestine where digestion takes place. This leads to the symptoms of celiac disease:

• abdominal bloating and pain
• chronic diarrhea
• vomiting
• constipation
• pale, foul-smelling, or fatty stool
• weight loss

About 1% of the population has GSE. But there may be another 9% or so who have what is called gluten sensitivity or gluten intolerance. These people may have similar symptoms to those with GSE but do not show the same damage to the bowel as those with GSE. The only treatment for celiac disease is a lifelong, gluten-free diet. But can it cause you to lose weight? The answer is complicated. Studies have shown that patients with GSE who were underweight gained  weight on a gluten-free diet. Those with GSE and obesity tended to lose weight after starting a gluten-free diet. What about people who don't have GSE? Celebrities have touted a gluten-free diet as a way to lose weight, and proponents hype it as a healthier way to eat. They claim it improves sleep, increases energy, and clears skin. But Dee Sandquist, MS, RD, a spokeswoman for the Academy of Nutrition and Dietetics, who also happens to have celiac disease, says, "There is nothing magical about eliminating gluten that will improve your health or enhance weight loss unless you are intolerant to gluten."

The academy points out that "Research on individuals with celiac disease reports that long-term compliance with a gluten-free dietary pattern improves outcomes related to bone density, iron deficiency anemia, villous atrophy, gastrointestinal and neurological symptoms, pregnancy outcomes and quality of life." One problem is the fact that many people with GSE don't even know that they have the disease, and those with gluten intolerance are less likely to be diagnosed.  Researchers conclude that there is no scientific evidence supporting the alleged benefit that a gluten-free diet will promote weight loss and  that adherence to the gluten-free dietary pattern may actually result in a diet that is low in carbohydrates, fiber, and important vitamins.

Many confuse a gluten-free diet with a low-carb diet (which can promote weight loss). A gluten-free diet eliminates foods such as bread and pasta, it doesn't eliminate other high-carb foods such as rice, beans and corn. The popularity of gluten-free diets has lead to an explosion of gluten-free food availability and a financially growing industry. This is great if you need to be on the diet. However, people need to be aware that these are not low-calorie foods! Some prepared foods have additional fat and sugar added and mixed into substitute flours such as white rice flour or potato starch to make them more palatable. A gluten-free diet is not a panacea for weight loss. It is, however, an important diet for those who suffer from GSE or intolerance.

Posted by on February 8, 2016 - 2:57pm


Although mental health counseling centers and awareness services exist on many campuses, if students and staff do not know about these services, do not have the tools to help themselves, and do not have the tools to help someone else in distress, these resources go unused. Hunt and Eisenberg (2010) indicate that while many college students are seen as being more privileged than their non-student peers, there is very little difference in the occurrence of mental health problems between the two groups. According to the authors, college attendance in high school graduates is at 65%. Among people age 18-24, half of all health concerns are related to mental illness. Also, onset generally occurs by the age of 24. This is a prime time for college administrators to recognize and intervene with mental health issues. Untreated mental health affects academic success, productivity, substance abuse, and relationships. Because students are often immersed in campus life including their involvement in academics, recreational activities, social interactions, and work, they are well known by their peers and by staff, who can serve as allies when needed (Wagner and Rhee, 2013).

Hunt and Eisenberg (2010) report that one in three college students have reported that they have experienced depression symptoms that have resulted in a significant life impact. Of those students, 4% admitted to having seriously considered suicide. Anxiety is another common challenge on college campuses. Academics are becoming more competitive as the prospects for employment following college are decreasing. Stress is increasing as a result. While the effects of stress are often minor and  common among college students (go here for further reading),  there is nevertheless a lurking danger, and in severe cases,  treatment is necessary.  Many students are dealing with critical levels of stress on college campuses, and this is a concerning reality.

Many campus administrators and counselors are of the opinion that they are providing appropriate information on mental health to promote awareness and prevention. However, the study by Wagner and Rhee (2013) does not bear this out. Students are likely to report that they do not find the information helpful in self-identification or in recognizing problems in others. This is a mistake given the close relationships that tend to occur on campuses. Students are interested in information on depression and anxiety, grief, stress, sleep, and relationship difficulties in addition to information on how to help others. This is a fertile population to educate as they spend considerable education and social time together.

In a study on school based mental health which is more focused on primary education, there are trends that translate to similar issues at the college level (Weist, 2005). The findings of this study indicate that mental health services were not a focus and were not well funded.  Assessment of needs and linking to services are not done effectively. Educators can certainly be promoters of mental health awareness but time and resources are limited. At the college level, these effects may be amplified. However there is great opportunity to catch mental health concerns early and before they become more severe.

Dogan (2012) points out that many mental health problems emerge in the first year of college because it is a difficult time of transition in the lifespan. There is more freedom, different types of support systems, and increased stress. College students are often struggling to find a good balance between education and social interactions. The authors also found that students are increasingly presenting with more intense problems, and that as time goes on toward graduation, stress levels and mental health issues increase dramatically. Self-referral continues to be the main avenue to first contact, but that parents, staff, and friends are also making referrals.

Given all of the above, there has been a focus on campaigns to increase awareness and to decrease the stigma of diagnosis and treatment (Livingston, et al., 2012). This was shown to make individuals more aware of problems, but did not necessarily decrease stigma which can lower the likelihood that an individual will seek treatment. Perhaps it is important for universities to change the way that they approach promotion of mental health awareness. Asking students and staff what they need for themselves and in order to help others seems to be a significant step. While this may work now, it may need to be fluid and change over the years. It also makes sense for information to be disseminated in such a way that all staff and students know where to turn if experiencing a mental health problem, or when they recognize a problem in another individual. Finally, universities can hope to succeed in the promotion of mental health if they provide the staff the necessary training and resources for that success.

By Christie Hunter

 

Souces:

Dogan, T. (2012). A long-term study of the counseling needs of Turkish university students. Journal of Counseling and Development : JCD, 90(1), 91-96.

Hunt, J., Eisenburg, D. (2010). Mental health problems and help-seeking behavior among college students. Journal of Adolescent Health, 46(1), 3-10.

Livingston, J. D., Tugwell, A., Korf-uzan, K., Cianfrone, M., & Coniglio, C. (2013). Evaluation of a campaign to improve awareness and attitudes of young people towards mental health issues. Social Psychiatry and Psychiatric Epidemiology,48(6), 965-73.

Wagner, M., & Rhee (2013). Stress, sleep, grief: Are college students receiving information that interests them? College Student Journal, 47(1), 24-33.

Weist, M. D. (2005). Fulfilling the promise of school-based mental health: Moving toward a public mental health promotion approach. Journal of Abnormal Child Psychology, 33(6), 735-41.

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