Month: November 2013

How one woman recovered from a 20 year struggle with Munchausen syndrome

When Lindsay* was 11 years old, she started having the same dream every night.  After she fell asleep, she would envision herself suffering from fainting spells, as various people stood around her and worried about her health.

Then, when she woke up, she would be embarrassed about how good the fantasies made her feel.

“I just thought over it a lot,” Lindsay told FoxNews.com.  “…I’d get these dreams so often, and they were very pleasant.”

Her recurring dream eventually manifested into reality when Lindsay was 13 years old, after a strong allergic reaction caused her to repeatedly pass out.  In order to determine the source of her fainting spells, Lindsay was admitted to the hospital, where she stayed for two weeks.

And the longer she stayed in the hospital, the more she didn’t want to leave.

“I loved it in the hospital,” she said. “I just loved it.”

Once she was released, Lindsay wanted so badly to find her way back to this new place she had enjoyed so much.  So in spite of her good health, she started pretending to be sick with stomach pains, hoping this would allow her to return to that pleasant hospital setting.

Lindsay credits this experience with sparking the beginning of her long struggle with factitious disorder – more commonly referred to as Munchausen syndrome.   Craving that good feeling she had experienced while staying in the hospital, Lindsay eventually began researching and faking illnesses that she knew would keep her hospitalized for as long as possible.

Over the course of her lifetime, Lindsay would go on to feign more than 12 physical and mental illnesses – including extreme disorders like schizophrenia, multiple sclerosis and even epilepsy.

A student of illness

Although Lindsay’s first bout with Munchausen began when she was 13, she didn’t start faking full-blown illnesses until she was a young adult.

Then, at 24 years old, Lindsay gave birth to her first child and was admitted to a psychiatric ward after doctors suspected she was developing severe postpartum depression.

While in the hospital, those good feelings from her childhood returned.  The admission to the hospital gave her relief from the obligations of being a new parent – and she didn’t want that relief to end.

“I wanted to stay; I enjoyed it,” Lindsay said. “So I started faking the symptoms of other peoples’ illnesses… I didn’t really know what I was faking.  I was just mimicking other patients, like their illusions and hallucinations.”

Lindsay became a student of all the patients around her, closely studying their movements and their behaviors.  She would often spend one-on-one time with individuals in order to gain an accurate understanding of how their psychiatric illnesses manifested.  Once, she spent an entire afternoon with a highly disturbed person with schizophrenia who talked using a word salad – a confusing mixture of random words and phrases. Lindsay would eventually mimic the behavior she learned from him to get diagnosed with schizophrenia herself.

Over the next three years, Lindsay was in and out of the psychiatric hospital nine different times, mostly for depression but also for the other mental illnesses she had adopted.  Having had a taste of what it felt like to feign psychiatric disorders, she decided it was time to ramp up her performances – and start faking physical symptoms.

At first, Lindsay presented to different hospital emergency rooms with abdominal pains. However, she would become too scared to follow through with her charade and leave before she was admitted.

Then over time, she did more research on the disorders she wanted to mimic and became much more sophisticated at faking the different signs and symptoms.  She eventually became so adept at acting out these diseases, she would go on to be diagnosed with epilepsy, multiple sclerosis, Guillain-Barre syndrome, stroke, insulinoma, appendicitis and status epilepticus.

Throughout this time, Lindsay knew what she was doing was wrong – but she felt like she couldn’t stop.

“A million different things were going through my head,” Lindsay said.  “I felt terribly, terribly guilty, yet I would get the relief that I wanted – the attention, the feeling of control over my life that I didn’t have that I wanted.”

Over the next seven years, Lindsay would be admitted to 100 different hospitals.

Getting help

Though Lindsay found comfort in her Munchausen syndrome, the disorder wreaked havoc on both the personal and professional spheres of her life.  She was never able to hold down a steady job, as she would miss too many days of work while staying in the hospital.  And her repeated absences from her family inevitably took their toll: After eight years of marriage, her husband filed for divorce and gained full custody of their three children.

Additionally, Lindsay’s body was starting to wear out.  Her veins had become grievously scarred due to numerous IV injections, and she developed radiation sickness from all of the X-rays she had undergone.  Faking her various physical illnesses was becoming an extremely painful process.

Feeling utterly exhausted and alone, Lindsay decided it was time to get help for her problem.  Eventually, she read a book by Dr. Marc Feldman – one of the nation’s leading experts in Munchausen syndrome. In his book Patient or Pretender, Feldman claimed that “curing” a patient with factitious disorder was incredibly difficult – and nearly impossible.

“The classic thinking about patients with Munchausen is they have always been described as hopeless cases, and the best thing the doctor can do is run in the other direction,” Feldman, who is based in Birmingham, Ala., told FoxNews.com.  “Most don’t really entertain the idea of providing treatment.  Recovery is considered so rare, it’s publishable in the medical literature and considered a medical anomaly worthy of attention.”

However, this way of thinking frustrated Lindsay, who was determined to get her life back on track.  So she reached out to Feldman, and he invited her to come visit him in Alabama.

“She came to Birmingham and stayed for two and a half weeks, and we met every day,” Feldman said.  “It was kind of a crash course; we’d meet over coffee or lunch and talk for an hour and a half each day, and I learned a lot from her – and we’ve remained friends ever since.”

After hearing more about Lindsay and her story, Feldman asked her if she felt comfortable speaking about her illness to other medical professionals.  So the two met in Washington D.C., where Lindsay presented her tale to members of the American Psychiatric Association during their annual conference.

It marked one of the first times a Munchausen patient had spoken out about his or her disorder.

“I wanted to stand up there and say, ‘I do want help, and I have the capability to understand, so work with me,’” Lindsay said of her motivations.  “’Don’t be afraid and don’t run away.’”

The road to recovery

Though Lindsay was never Feldman’s patient, he helped put her in touch with a number of psychiatrists and other individuals who could potentially help her.  According to Feldman, Munchausen patients often have additional psychiatric disorders, such as depression or bipolar disorder, which go unnoticed – and by treating these underlying illnesses, individuals can then start to recover.

“Sometimes they get better with treatment,” Feldman said. “The fuel for the Munchausen tends to dissipate, and they find healthier ways to move on. Life changes occur, either through a spiritual element or social element, and they start to find that feigning illness gets in the way of the things the like to do.”

Eventually, Lindsay learned that she had an undiagnosed form of bipolar disorder, and she underwent three years of intensive psychotherapy to help alleviate her manic-depressive symptoms. And in turn, the treatment helped erase her Munchausen urges.

To help with her healing, Feldman also put Lindsay in touch with other Munchausen patients who were working towards recovery as well.  Lindsay noted that this was extremely beneficial to her own recovery process, just as Alcoholics Anonymous can be very helpful for those suffering from alcoholism.

“It’s a daily struggle,” Lindsay said. “…I look at it in terms of how a drug addict would talk about their cure.  It’s always there, and you have to work at it all the time.  It’s more like addiction.”

After a more than 20 year battle with Munchausen syndrome, Lindsay says she is now in recovery, having not feigned any illnesses for the past two years.  Thanks to her therapy, she was able to go back to school, procure a steady job, and reconnect with her children during their teenage years.  More than anything, she hopes that her story will serve as an example to patients and therapist alike that Munchausen syndrome can be cured – and that there is hope for those who feel alienated.

“Don’t let shame get in the way of talking it out with somebody,” Lindsay said.  “I was so ashamed of how ugly the thoughts were in the first place that I wouldn’t bring it up with anyone for years and years…I would tell people, not to feel ashamed of their own thoughts. Just talk about it with somebody.

Source: USA News

New treatment discovered for deadly flesh-eating disease

In January 2012, Lori Madsen, then 51, was walking through a parking lot, when she fell and skinned her arm. Initially, she didn’t think much about the rugburn-like abrasion on her arm – but later that night, Madsen’s arm began to swell.

Two days later, the pain was so bad she couldn’t get out of bed.

“My husband had to take me to the ER and my blood pressure wasn’t reading and everything was shutting down,” Madsen told FoxNews.com. “I was in septic shock.”

Madsen was admitted to the intensive-care unit, where the infection in her arm raged on – causing fevers, blistering and swelling. A week later, Madsen was taken into surgery for the first time.

“They opened my arm up for the first time and excised some of the dead tissue in there,” Madsen said. “I got better for a couple days. My fever went down, but then I took another turn for the worse.”

At this point, Madsen feared she would lose her arm – or even worse – her life. Finally, she was introduced to Dr. John Crew, a vascular surgeon and wound specialist at Seton Medical Center in Daily City, Calif., where she was receiving treatment. Crew told Madsen he might know what was causing her health problems: A deadly disease known as necrotizing fasciitis.

The flesh-eating disease

Necrotizing fasciitis, commonly known as the flesh-eating disease, results from a bacterial infection and rapidly destroys the body’s soft tissue. The condition garnered national attention in 2012, when 24-year-old Aimee Copeland underwent a quadruple amputation after contracting necrotizing fasciitis in the aftermath of a zip lining accident.

Typically, necrotizing fasciitis is treated with antibiotics and surgical excision of the infected areas of the body. Though rare, the disease can carry a fatality rate of up to 70 percent – and those that survive are often left with devastating handicaps due to loss of limbs.

“They excise (the dead tissue), and (sometimes) you excise the hands and the legs and that’s a lousy way to end up,” Crew said.

Desperate to save Madsen’s limbs and life, Crew, director of the hospital’s Advanced Wound Care Center, devised a plan in which he would excise the dead tissue from Madsen’s arm and then regularly irrigate the area with an FDA-approved wound cleanser called NeutroPhase. Crew is a paid consultant for NovaBay Pharmaceuticals, the company that manufactures NeutroPhase, and he had been using the product to sterilize wounds for many years. NeutroPhase contains hypochlorous acid, a common chemical disinfectant.

“Hypochlorous acid is produced by the body’s white blood cells when it fights infection,” Dr. Harvey Himel, medical director of the wound program at Icahn School of Medicine at Mount Sinai in New York City, told FoxNews.com. “(It) is one of the common chemicals found to purify water in swimming pools and is used as a disinfectant in food preparation.”  Himel was familiar with the study, but not involved in Madsen’s treatment.

Luckily, Madsen’s initial surgical treatment –coupled with the NeutroPhase irrigation – appeared successful.

However, six days later, Crew noticed another infected spot in a different area on Madsen’s arm. This time, Crew decided to simply insert a catheter and irrigate the area with NeutroPhase – without performing surgery to excise any more of the tissue in her arm.

Remarkably, this area of Madsen’s arm healed just as quickly as the area that underwent the standard surgical excision. Additionally, using NeutroPhase bypassed the severe scarring that now covered much of the rest of her limb.

Madsen noticed a difference in her condition almost immediately after being treated by Crew.

“Before they started NeutroPhase, the pain was unbearable. You can’t describe the way the pain is, and the fever I had was just unbelievable,” Madsen said. “But then, after they started the NeutroPhase and started killing all of the toxins in my arm, the fever subsided and went away. The pain wasn’t as bad…It wasn’t the kind of pain that you feel when it’s infected, and your arm is dying.”

‘People don’t have to lose their limbs or their lives’

Madsen eventually made a full recovery, and while she sustained some nerve damage in her arm, she has regained full function in the limb and now lives a normal life.

After Madsen’s recovery, Crew set out to discover what it was about NeutroPhase that had halted the infection.

“We had to go back to the lab after Lori was healed,” Crew said. “They isolated five or six of the toxins involved in this kind of necrotizing fasciitis, and individually, they treated cells in the lab… and it killed them.”

Crew and his fellow researchers discovered that NeutroPhase seemed to effectively neutralize the toxins produced by the infection, halting the body’s inflammatory-reaction and allowing the patient to begin to heal normally.

Crew recently published his findings in the peer-reviewed journal,Wounds, and he hopes to convince other doctors to begin using NeutroPhase to treat necrotizing fasciitis. Since Madsen’s case, Crew said he has successfully treated several other patients with necrotizing fasciitis using NeutroPhase – even avoiding surgery, in some cases.

“I had one 95-year-old, (and) when I just put in a catheter and irrigated it with NeutroPhase, she healed from that standpoint,” Crew said. “We didn’t need a big massive operation to drain or excise necrotic tissue. We’re looking to tell people this is the way to treat this problem. We won’t make big massive incisions, but small incisions to get the irrigation going as quick as we can.”

Himel warned that while this case appeared to be successful, more research is still needed.

“Since this is a single case report, it is hard to say if this treatment was instrumental in the patient’s recovery,” Himel said. “In order to scientifically prove the value of this additional treatment, they would need to conduct more extensive research.”

For Madsen, her hope is that this treatment will eventually help prevent others in her situation from going through the same agony she did.

“I don’t want to see anyone go through what I went through. I want the word out there that this stuff works on this necrotizing fasciitis,” Madsen said. “People don’t have to lose their limbs or their lives.”

Source: inagist

Why Bacteria Keeps You Healthy

We have more bacteria in our gut than cells in our body. Here’s why minding these microbes can help you get healthy from the inside out.

As foreign as it sounds, the word micro biome may soon be part of the mainstream lexicon. The term refers to the microbes or bacteria that naturally inhabit the body from the surface of your skin to your gut. We tend to think of microbes as bad-pathogens that need to be killed-but new research suggests that storing scores of them is paramount to our health and metabolism.

“We have 100 trillion microbes in our gut-more bacteria than cells in the body. They aid in digestion and detoxification, help support our immune system, and manufacture key vitamins, among other functions. Western medicine is catching on to the importance of all the bacteria in our bodies-especially in our gut. In Functional Medicine we’ve been manipulating this microbiome for some time, but it’s primarily been guesswork.” says Frank Lipman, MD, the founder of Eleven Eleven Wellnessin Manhattan. “Understanding these microbes is the future of medicine.”

The Human Microbiome Project, a National Institute of Health initiative, is working to shed light on the topic. “It’s such a new field and there are so many studies underway. But we do know that it’s important to keep your flora in a balanced state,” says Lipman. “A disturbed microbiome, where bad bacteria and yeast overtake the good ones can cause all sorts of health problems from autoimmune diseases to weight gain.”

Thus far, gut microbes have been shown to influence metabolism, and certain types may play a role in obesity. In fact, one family of bacteria called Firmicutes can even cause you to absorb more calories from your food. Another, called Bacteroidetes, is associated with leanness.

Wondering how to keep your belly balanced-and flat? Your trump card may be a healthy diet, which can prevent microbes associated with obesity from flourishing. No real surprises there, and until more is known Lipman suggests keeping your microbiome in mind when you eat. Here are his five tips:

1. Eat pre-biotic foods.

Healthy gut bacteria thrive on pre-biotics, which are non-digestible fibers found in foods like root vegetables, onions, leeks, garlic, artichokes, beans, asparagus, oats, nuts, and bananas. Think of it as giving the good microbes something to chew on.

2. Drink your green juice.

There are thousands of bacterial strains, and while we don’t know enough about all these organisms yet, greens appear to help improve the diversity of healthy organisms in the gut. Plus, research shows that the greater the diversity, the greater the health benefits.

3. No more processed foods.

The additives in processed foods can kill off good bacteria. Refined carbs are also problematic because sugar feeds bad bacteria, allowing it to proliferate and leading to physical cravings for more sugar. Stay away from wheat and soy, too. Most are genetically modified and GMOs disrupt gut flora.

4. Limit antibiotics-the over-the-counter meds and the ones in your meat.

There’s a place for antibiotics, but don’t take them every time you have a runny nose. They’re overused and even though they target bad bacteria, they also kill off the good guys. Another surprising problem is factory-farmed meats. Seventy percent of antibiotics in the U.S. are used in livestock, leading to chronic exposure; when you consume the meat, you’re absorbing those antibiotics, too.

5. Get your probiotics.

Fermented foods like kimchi, kombucha, and sauerkraut are making appearances on more menus as people learn more about body ecology. They’re important because they naturally contain probiotics, which encourage the growth of good bacteria. Some people also respond well to a supplement. Choose one containing some of the most studied probiotic strains: Lactobacillus acidophilus, Lactobacillus paracasei, Lactobacillus plantarum, Bifidobacterium longum, Bifidobacterium lactis.

Source: Yahoo shine

 

 

Going vegan? Here are 5 foods to help you get your protein

Many people turn to a vegan diet in search of better health and love it so much they can’t imagine ever going back. No matter what the reason, a common challenge for non-meat eaters is keeping their carbohydrate levels within a moderate range and making sure to get enough protein, every day.

The Mayo Clinic recommends getting 10 to 35 percent of total daily calories from protein, which amounts to between 50 and 175 grams of protein per day, based on a 2,000-calorie diet.

Proteins are the building blocks for life; they break down into amino acids that promote both cell growth and repair. Protein is important to a variety of physiological functions, from building and maintaining muscle and bone, to keeping cells functioning properly.

Studies have shown that protein is also important for maintaining a healthy body weight. A study published in the American Journal of Clinical Nutrition found that an increase in protein from 15 percent to 30 percent of total calories resulted in sustained weight loss. This could be because protein takes longer to digest than carbohydrates, helping you feel fuller longer.

Here are some foods that will help you get a healthy amount of protein while eating vegan.

Legumes
Whichever you prefer, from kidney beans to chickpeas and green peas, they are all a great choice. Full of fiber, protein and magnesium they are versatile enough to eat in salads, soups, veggie burgers, dips or all by themselves. When cooking beans, try adding a piece of seaweed kombu which can help soften them and make them more digestible, thanks to its amino acid profile. Simply add a four to six inch strip of kombu to the pot of cooking beans, it will disintegrate after an hour or two of cooking and any remaining pieces can be eaten.

Hemp and Chia Seeds
These tiny little seeds are protein powerhouses. Hemp seeds contain about 10 grams of protein in 3 tablespoons, and chia seeds are just short of 5 grams of protein in only 2 tablespoons. Both can be sprinkled over salads, blended into smoothies, and made into delicious sauces.

Quinoa
Many think it’s a grain, but it’s actually a seed that packs a giant punch. It provides nine essential amino acids that our bodies cannot produce on their own and is known as a complete protein while containing more than 8 grams of protein per cup. This versatile little seed is most well known in its beige variety, but is also available in red and black varieties, which offer a slightly different taste profile. Quinoa can be eaten alone, added to soups, tossed with vegetables to make a salad, cooked with vegetable juices instead of water to change the flavor, or even served warm with a touch of cinnamon and coconut oil for a great breakfast.

Leafy Green Vegetables
Even though they don’t have as much protein as legumes, seeds or nuts, they still contain significant amounts while also being low in carbohydrates, rich in fiber and antioxidants and alkalinizing to the body. Spinach, kale and broccoli are some of the most protein-rich vegetable choices.

Avocados
While not the highest in terms of protein count, avocados should be a staple of any vegan diet. They provide all 18 essential amino acids necessary for the body to form a complete protein. They also boast an excellent combination of vitamins C and E, selenium, zinc, carotenoids and omega-3 fatty acids that protect against inflammation. Don’t shy away from this fruit because of its fat content; its healthy fats can actually boost your “healthy” cholesterol levels, and help protect against damage caused by free radicals.

Any healthy diet centers around fresh vegetables, and quality protein. Avoid empty calories from processed foods whenever possible, and strive to stay on the higher side of the recommended amount of protein – that will ensure you always get an adequate amount. And always remember to consult with your doctor before making diet and lifestyle changes.

Source: News.nom

Norway’s Army Goes Vegetarian to Combat Climate Change

The Norwegian military announced on Tuesday that it’s putting its soldiers on a new diet. In an effort aimed not at cutting waistlines, but combating climate change, the army is imposing a vegetarian diet once a week for its troops.

The goal is to cut its consumption of environmentally unfriendly foods, like meat, as the UN Food and Agriculture Organization attributes 18 percent of global greenhouse gas emissions to livestock farming. “It’s a step to protect our climate. The idea is to serve food that’s respectful of the environment,” a military spokesman told Agence France-Presse.

The “meatless Monday” vegetarian diet has already been tried at one army base in the country and the military will soon extend it to all of its troops, including those deployed overseas, according to AFP. The army estimates the new diet will cut the force’s meat consumption by 150 tons a year.

Source: slate

Vancouver bans doorknobs for future construction projects

Hold on to your knobs while you still can. Humanity is about to embark on an era of doorknob prohibition, and it’s all starting with our friendly neighbor to the north, right in Vancouver, Canada.

Look at any door in your immediate vicinity; there’s a good chance it’s bearing a classic doorknob beloved by utilitarian’s and highly specific enthusiasts alike. In Vancouver, they’re about to become a dying breed. This past September, the city’s council amended its building code—the only city-specific building code in all of Canada—to mandate lever handles and lever faucets only.

Don’t kiss your knobs goodbye just yet, though. While all new construction projects will be required to follow the no-knob mandate, all buildings currently standing will be have their knobs grandfathered in. But this pro-lever movement isn’t about mere aesthetics; there’s something more important at play—a developing concept known as universal design.

As Tim Stainton, a professor and director of the School of Social Work at the University of B.C., told the Vancouver Sun, the movement focuses on the idea of a society that’s as physically accessible as possible:

Basically, the idea is that you try to make environments that are as universally usable by any part of the population. The old model was adaptation, or adapted design. You took a space and you adapted for use of the person with a disability. What universal design says is let’s turn it around and let’s just build everything so it is as usable by the largest segments of the population as possible.

A really simple version is the cut curbs on every corner. That helps elderly people, people with visual impairments, and moms with strollers. It makes a sidewalk that could otherwise be difficult for parts of the population universally accessible.

In fact, the Americans with Disabilities Act’s (ADA) guidelines for small businesses explicitly emphasize the problems with inaccessible door hardware and goes on to recommend the most universally accessible option: the lever.

Because Vancouver is the smallest sector of Canada that has its own building code, ideas that come to fruition there are often pushed out into the B.C. Building Code and, eventually, Canada’s National Building Code. And at that point, it’s not at all unlikely to expect the lever law to start making its way down towards the US.

As the ADA’s guidelines prove, universality of design is hugely important in creating a world of equal opportunity. So though we’ll still be able to keep our precious knobs for the time being, let’s hope for everyone’s sake that, one day, we’ll all be telling our grandchildren tale of the great doorknobs of yesteryear

Source: Gizmodo

Exercise may help pregnant women quit smoking

For pregnant women who want to quit smoking, a brisk walk can temporarily stave off tobacco cravings, says a Canadian study.

Previous research has shown that exercise can interrupt nicotine cravings for both men and women. Whether the same was true for expecting mothers was unclear because pregnant women have increased metabolism, which can intensify longings for a cigarette, the researchers write in the journal Addictive Behaviors.

“This was the first time we have been able to replicate the findings with pregnant smokers,” Harry Prapavessis said.

Prapavessis, director of the Exercise and Health Psychology Laboratory at Western University in Ontario, Canada, led the research.

According to his team’s results, 15 to 20 minutes of walking at a mild to moderate pace is sufficient to ward off cravings.

For the study, researchers recruited 30 pregnant women in their second trimester in Canada and England. All of the women smoked more than five cigarettes a day and were not regular exercisers.

Half of the women were assigned to walk on a treadmill and the rest to watch a home gardening video for 20 minutes. Both groups did not smoke for between 15 and 19 hours before entering the lab.

The walkers reported an average 30 percent reduction in the desire to smoke based on a seven-point scale. But the cravings returned. Thirty minutes after exercising, the same group of women reported only a 17 percent craving reduction.

The exercising women also reported less irritability, restlessness, tension and other withdrawal symptoms. But because of the study’s small size, those results could have happened by chance.

“This translates not as a cure for quitting, but it can be part of a strategy,” said Dr. Sharon Phelan, who was not involved in the study.

Phelan is a fellow with the American Congress of Obstetricians and Gynecologists (ACOG) and professor at the University of New Mexico School of Medicine in Albuquerque.

“The challenge is that there isn’t one reason why pregnant women have an addiction,” Phelan said.

“I think it’s a very positive study,” said Dr. Raul Artal of Saint Louis University School of Medicine in Missouri. Artal helped write exercise and pregnancy guidelines for ACOG.

He said the new study will need to be repeated according to medicine’s gold standard of testing – a randomized, controlled trial. “But, based on common sense, the message is good,” he said.

Prapavessis said his team’s results can only be applied to women about 25 years old, the average age in the study. But, “I would like to think that we can repeat the findings with older or younger pregnant smokers.”

Prapavessis pointed out that because of the social stigma associated with smoking while pregnant, recruiting pregnant women for such studies can be extremely difficult.

The next step, he said, would be to repeat the results with women walking in natural environments outside of their homes. “We want to see if this craving effect can be reproduced when women go for a brisk walk for about 15 minutes in their natural setting,” he said.

Pregnant women also have the option to try nicotine replacement therapy drugs, like skin patches or lozenges, but more evidence is needed to know if these are completely safe during pregnancy, Phelan said.

To help pregnant smokers quit, Phelan stressed the importance of understanding the underlying reasons why a pregnant woman smokes. “It’s like when someone has a fever. You can treat it with an aspirin, but you haven’t gotten to the underlying cause.”

“One therapy for everyone isn’t going to fit all,” Phelan noted. Still, regardless of whether a woman has stopped smoking, exercise offers positive benefits, like improved circulation and muscle tone she said.

ACOG supports 30 minutes of light exercise like walking three or four times a week during pregnancy, Phelan said, but pregnant women should always talk with their healthcare provider before beginning exercise.

To beat cigarette cravings, she said, “This is a valid option to suggest to women and it may be helpful for some, but not to others.”

Source: Zee news

Mid life economic recessions linked to later cognitive decline

The greatest economic downturn since the Great Depression may wreak lasting neurological damage on a generation of Americans who lost jobs, homes, and even marriages — with steeper levels of cognitive decline as they age.

Older, wizened Americans recognized trouble on Sept. 28, 2008, as Congressmen rejected a massive Wall Street bailout, voting one by one as the Dow Jones Industrial Average continued to slide, thus beginning the Great Recession. Although Washington later approved controversial bailouts and fiscal stimuli, macroeconomic malaise blossomed millions of times over as personal recessions deeply ingrained in the mind.

Now, economic recovery continues in the United States with record corporate profits and broad public support for raising the federal minimum wage to more than $10 per hour, restoring the wage floor to pre-inflation 1968 levels. However, painful repercussions from the past half-dozen years of recession and recovery continue with downward career mobility and lowered expectations for millions of Americans, with many European populations faring worse throughout the 28-country economic block.

Those personal recessions may later hit middle-aged people the hardest, investigators from the University of Luxembourg find. In analyzing data from more than 12,000 Europeans throughout 11 countries in the European Union, investigator Anja Leist finds recessionary troubles most damaging to middle-aged men in their mid- to late-forties and women ages 25-44.

“Our study was motivated by previous evidence that working conditions are associated with later-life cognitive function and decline,” Leist and her colleagues wrote in a study published Wednesday. “Our findings provide evidence that economic recessions experienced at vulnerable periods in midlife are associated with decreased later-life cognitive function and that part of this association may operate through the link of recessions with working conditions and career trajectory.”

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When hit by economic setbacks at this most vulnerable point in career trajectory, people in early middle-age suffer a hampered ability to build “cognitive reserve” — the neurological equivalent to a retirement savings account.

Despite some beliefs held by conservatives and libertarians, the investigators assumed for the purpose of study that individuals wage little control over large macroeconomic forces, meaning that people across a broad spectrum of intellectual functioning would be harmed by massive shocks to the economy, such as the recent global recession. Leist and her colleagues analyzed data from study subjects assessed for cognitive ability in 2004 through 2005, and then again in 2006 through 2007, to determine whether past recessions had affected them as they aged into retirement.

Those results they linked to detailed work histories collected retrospectively between 2008 and 2009, and analyzed along with factors, such as self-rated health, material deprivation, occupational status, self-reported language and math skills, educational attainment, and even the number of books in the home. Among men, those in their mid- to late-forties had lived through an average of 0.73 recessions, whereas women, between the ages of 35 and 44, had lived through 1.33.

In the analysis, men and women who’d endured economic recession scored lower on cognitive tests than others, suggesting effects lasting a lifetime.

Source: Medical daily

Too Much Sport for Teenagers May Be bad for health

Peak scores of well-being for teenagers occurred with about 14 hours a week of sport practice, or twice the recommended 7 hours, but higher sport durations independently predicted poor well-being, according to a Swiss survey study published online November 21 in the Archives of Disease in Childhood.

“Sport practice is widely encouraged, both in guidelines and in clinical practice, because of its broad range of positive effects on health,” write Arnaud Merglen, MD from the Institute of Social and Preventive Medicine at the University of Lausanne in Switzerland, and colleagues. “However, very limited evidence directly supports this statement among adolescents and the sport duration that we should recommend remains unknown. We aimed to determine sport durations that were associated with poor well-being.”

Between February 2009 and January 2010, the investigators recruited 1245 adolescents, aged 16 to 20 years, from various settings in the French-speaking part of Switzerland, including sport centers, peers of sport-practicing adolescents, and Web sites.

Using answers to a Web-based questionnaire, the investigators categorized weekly sport practice of the participants into 4 groups, from low (0 – 3.5 hours) to average (approximately equal to the recommended 7 hours; 3.6 – 10.5 hours), high (≈14 hours; 10.6 – 17.5 hours), and very high (>17.5 hours). The 5-item World Health Organization well-being index, scored from 0 to 25, with scores below 13 indicating poor well-being, allowed evaluation of well-being.

Participants had an average age just younger than 18 years, half were male, and 8.9% were overweight or obese. Sports participation was low in 35.2%, average in 41.5%, high in 18.5%, and very high in 4.8% of participants.

Very High Sports Practice Predicts Low Well-Being

The average well-being score for the entire sample was 17. Those in the very high sports practice group had more than twice the risk for poor well-being than those in the average group (odds ratio [OR], 2.29; 95% confidence interval [CI], 1.11 – 4.72), as did those in the low-activity group (OR, 2.33; 95% CI, 1.58 – 3.44). In contrast, those in the high-activity group had about half the risk for poor well-being as those in the average group (OR, 0.46; 95% CI, 0.23 – 0.93).

“We found an inverted, U-shaped relationship between weekly sport practice duration and well-being among adolescents,” the study authors write. “The peak scores of well-being were around 14 h per week of sport practice, corresponding to twice the recommended 7 h. Practicing higher sport durations was an independent risk factor of poor well-being.”

Limitations of this study include possible selection bias, observational design, reliance on self-report, and unknown direction of causality.

“[H]igher levels of pro-inflammatory cytokines have been reported in very high and chronic sport practice, with a negative impact on physical and mental health,” the authors conclude.

“These results highlight the importance for physicians, caring for adolescents, to follow-up their level of sport practice and concurrently inquire about their well-being.”

Source: Med scape

PTSD Linked to Obesity in Women

Women with symptoms of posttraumatic stress disorder (PTSD) are more likely to become overweight or obese, according to a study published online Nov. 20 in JAMA Psychiatry.

Laura D. Kubzansky, PhD, from the Harvard School of Public Health in Boston, and colleagues used data from the subsample of the Nurses’ Health Study II (54,224 participants aged 24–44 years in 1989) to examine whether women with PTSD symptoms were more likely to gain weight and become obese compared to trauma-exposed women without PTSD symptoms or women without trauma exposure or PTSD symptoms.

The researchers found that body mass index (BMI) increased more steeply during follow-up for women with ≥4 PTSD symptoms before cohort initiation (1989). BMI trajectory did not differ by PTSD status before onset of PTSD among women who developed PTSD symptoms in 1989 or later. Women with ≥4 PTSD symptoms had a faster rise in BMI after PTSD symptom onset. For women with a normal BMI in 1989, onset of ≥4 PTSD symptoms in 1989 or later correlated with a significantly increased risk of becoming overweight or obese (odds ratio, 1.36). After adjustment for depression, these effects were maintained.

“The presence of PTSD symptoms should raise clinician concerns about physical health problems that may develop and prompt closer attention to weight status,” the authors write.

Source: MPR