Health News

Camp Lejeune water contamination linked to birth defects

Water pollution at the Camp Lejeune military base in North Carolina has been linked to increased risk of birth defects and childhood cancers, according to the U.S. Centers for Disease Control and Prevention.

A study released by the CDC’s Agency for Toxic Substance & Disease Registry on Thursday confirmed a long-suspected link between chemical contaminants in tap water at the Marine Corps base and serious birth defects such as spina bifida

It also showed a slightly elevated risk of childhood cancers including leukemia.

Dr. Vikas Kapil, a medical officer and acting deputy director of the CDC agency that produced the study, said it surveyed the parents of 12,598 children born at Lejeune between 1968 and 1985, the year most contaminated drinking water wells at Camp Lejeune were closed.

From that same group of participants, 106 cases of birth defects and childhood cancers were reported. But Kapil said researchers could only confirm the diagnoses in 52 cases.

Computerized birth certificates first became available in 1968. The study’s authors said they could not prove exposure to the chemicals caused specific individuals to become ill.

The CDC has linked the contamination to a number of sources including leaking underground storage tanks, industrial spills, and an off-base dry cleaning firm.

Lejeune spokeswoman Captain Maureen Krebs said the Marine Corps has supported scientific and public health organizations studying the health impacts of the contamination.

“These results provide additional information in support of ongoing efforts to provide comprehensive science-based answers to the health questions that have been raised,” Krebs said in a statement.

“The Marine Corps continues to support these initiatives and we are working diligently to identify and notify individuals who, in the past, may have been exposed to the chemicals in drinking water.”

The Veterans Administration has already been providing disability compensation claims to the affected families and personnel exposed to the contaminated water.

Source: Reuters

J&J, Pharmacyclics leukemia drug effective long term: study

The oral drug, ibrutinib, last month won U.S. approval to treat a rare and aggressive form of non-Hodgkin lymphoma known as mantle cell lymphoma. It is awaiting a Food and Drug Administration decision on treating chronic lymphocytic leukemia (CLL), a slowly progressing form of blood cancer that primarily affects people aged 65 and older.

Some industry analysts had expected the CLL approval to come at the same time as the lymphoma decision. Data from this and other studies being presented at the American Society of Hematology (ASH) meeting in New Orleans could give regulators additional comfort about the medicine’s safety and effectiveness in treating CLL.

“Patients receiving ibrutinib are doing much better than historically what we’re used to seeing with CLL,” Dr John Byrd, a co-leader of the study, said in a telephone interview.

The 148-patient ibrutinib extension study looked at both previously untreated CLL patients and those who had relapsed or stopped responding following prior therapies.

With a median follow-up of more than 27 months of treatment, nearly all of the previously untreated, or treatment-naive, patients and almost three quarters of the relapsed and refractory patients had no evidence of the disease progressing.

REMISSIONS CONTINUE

“With extended follow-up the remissions with ibrutinib appear to be continuing and the safety of this long-term is being maintained,” said Byrd, professor of internal medicine and director of hematology at the Ohio State University Comprehensive Cancer Center in Columbus.

“There has not been an increase of infections or other late-term complications, suggesting that it’s going to be a drug that patients can take for a continued, extended period of time without it being a detriment,” he added.

Researchers had not yet been able to determine median progression-free survival – the point at which the disease begins to worsen for half the patients in a study.

Among previously untreated patients, about 96 percent had not yet experienced disease progression, with just one of 31 patients in that group relapsing so far, researchers said.

Typically you would expect about 50 percent to see disease progression at two years, Byrd explained.

“You don’t even need a statistician to see the difference. The data are better,” he said.

Of the 117 previously treated patients in the extension study, 21 had experienced disease progression and 11 had died within 30 days of receiving their last dose of the drug. That left more than 70 percent whose disease remained in check.

“Ibrutinib is the single most active drug that’s come into the clinic for CLL in terms of the durability of remission induced with it, so it’s going to be a game-changer in CLL,” Byrd predicted.

“A lot of the patients from the initial phase II study have been on drug for two to three years,” he added.

Serious adverse side effects, such as pneumonia, declined after the first year of treatment, researchers said. The incidence of serious side effects was twice as high in patients who had received prior therapies, which may have had more to do with the state of their disease than a reaction to ibrutinib, they said.

“Long term follow-up has only shown a low risk of infection that you would expect to see in this patient population,” said Byrd. “Otherwise the safety has been very favorable relative to other things that have been used in this patient population.”

RBC Capital Markets analyst Michael Yee is forecasting eventual annual worldwide sales of $5 billion for the medicine, now being sold for lymphoma under the brand name Imbruvica.

About 15,000 Americans are diagnosed with CLL each year, according to ASH. While there are effective treatments for the disease, such as chemotherapy combined with Roche’s Rituxan, current therapies can be highly toxic.

Ibrutinib is one of several new medicines for CLL – including one in late stage development from Gilead Sciences Inc – that have fewer toxicities and safety issues and may lead to better quality of life for patients being treated.

“The future will hold combining this with some of the other new targeted therapies that we have coming forward to get complete remissions and hopefully get us onto the path of cure,” Byrd said.

Source: health render

Georgetown hospital receives US$10,000 donation of urology equipment

Members of the visiting Caribbean Medical Mission on Tuesday presented medical equipment to the Urology Clinic of the Georgetown Public Hospital valued around US$10,000 to 15,000.

The team is a part of the Organisation for Health Advancement for Guyana/ Caribbean. Dr Winston Mc Grill, a member of the team (residing in New Jersey) told Guyana Times that the gesture was initiated through good relationships he shared with friends in Guyana.
Georgetown Public Hospital Corporation (GPHC) Chief Executive Officer Michael Khan said the donation was timely, and noted that Dr Mc Grill will be conducting surgery with the Guyana team today.

Dr Chris Prashad of the Urology Clinic said the hospital needed new equipment since the old ones have deteriorated, pointing out that the fight is on to battle cervical and prostate disease.

Dr Mc Grill said this is his first visit to Guyana but will not be his last as the tour was worthwhile and visibly appreciated by those seen and treated. He further noted that there is much more to be done and his mission will continue.

During the simple presentation ceremony, questions were raised about prostate cancer, more specifically if it is true that men are reluctant to do checkups because they are ridiculed by their womenfolk.

Dr Prashad, who responded, said this is not so since women often urge their husbands, fathers or other male relative to take necessary actions as the need arises.

Though there is no data on men suffering from prostate cancer, Dr Mc Grill said the number of African men affected has been on the increase.

Source: Guyana Times

Artist carves stunning portraits in Oreo frosting

We’ve all been taught not to play with our food, but for Massachusetts artist Judith Klausner playing with food is a craft.

Since 2010, Klausner has been creating works of art from items like Oreo cookies and Chex cereal for her “From Scratch” series on expertly altered food stuffs.

The series includes embroideries made on toast, portraits carved in Oreo frosting, wallpaper painted with condiments, cross-stitching in Chex cereal and stained glass made from gummies.

“This nostalgia for the culinary past—before packaged foods and high-fructose corn syrup—fails to take into consideration just how much time it takes to make three full meals a day from scratch,” Klausner writes on her blog. “Today, as we come to realize that something has been lost in the mechanization of everything around us, there is a return to the idea that making something from its most basic parts has great value.”

Source: Fox news

9 Evidence-Based Medicinal Properties of Oranges

Orange is one such food-medicine marvel, containing a broad range of compounds increasingly being recognized to be essential for human health. We consider it a sweet treat, its juice a refreshing beverage, but do we ever really reflect on its medicinal properties? GreenMedInfo.com has indexed no less than 37 distinct health benefits its use may confer, all of which can be explored on our Orange Medicinal Properties research page. What follows are some of its most well-established therapeutic applications, divided into three parts: the juice, the peel and the aroma:

The Juice of the Orange
Many of us mistakenly look to orange juice today as a dangerous source of highly concentrated fructose – simple “carbs” – without recognizing its profound medicinal properties. We sometimes think we can get the vitamin C activity oranges contain through the semi-synthetic ‘nutrient’ ascorbic acid, without realizing that an orange embodies (as do all whole foods) a complex orchestra of chemistries, the handiwork of millions of years of evolution, which is to say a process of intelligent biological design. The ‘monochemical nutrient’ – ascorbic acid – is merely a shadow of the vitamin C activity that is carried and expressed through only living foods. The orange, after all, looks like a miniature sun, is formed as a condensation of energy and information from sunlight, and therefore is capable of storing and after being eaten irradiating us with life-giving packets of information-dense gene-regulating nutrition, by a mechanism that will never be fully reducible to or intelligible by the chemical skeleton we know of as ascorbic acid.

Orange Juice Improves “Good” Cholesterol: While it is debatable that lowering so-called “LDL” cholesterol is nearly as good for heart health as statin drug manufacturers would like for us to believe, raising “HDL” cholesterol does seem to have real health benefits. This is, however, quite hard to do with diet and nutrition, and impossible through medication. Other than taking high-dose fish oil, few things have been studied to be effective. Except, that is, orange juice. A 2000 study found that the consumption of 750 mL of orange juice a day, over a 4 weeks, improved blood lipid profiles by decreasing the LDL-HDL cholesterol ratio by 16% in patients with elevated cholesterol.

Orange Juice Boosts Bone Health: A 2006 animal study in male rats found that orange juice positively influenced antioxidant status and bone strength.

Orange Juice (mixed with Blackcurrant Juice) Reduces Inflammation: A 2009 study in patients with peripheral artery disease found that orange and blackcurrant juice reduced C-reactive protein (11%) and fibrinogen levels (3%), two concrete measures of systemic inflammation.[3] A 2010 study found that Orange juice neutralizes the proinflammatory effect of a high-fat, high-carbohydrate meal and prevents endotoxin induced toxicity.

Orange Juice Boosts Weight Loss: A 2011 study found that children who regularly drank orange juice consumed an average of 523 calories a day more than children who did not drink orange juice regularly. Yet surprisingly, there was no difference in the weight levels between the orange juice consumers and the non-orange juice consumers.

Orange Juice May Dissolve Kidney Stones: A 2006 study found that orange juice consumption was associated with lower calculated calcium oxalate supersaturation and lower calculated undissociated uric acid, two indices of lowered urinary calcium stone formation.

Orange Juice Extract Suppresses Prostate Proliferation: Despite the fructose content, a 2006 study found a standardized extract of red orange juice inhibited the proliferation of human prostate cells in vitro.

The Peel of the Orange

The peel of the orange contains a broad range of potent, potentially therapeutic compounds. These include pectin and flavonoid

constituents, such as hersperiden, naringin, polymethoxyflavones, quercetin and rutin, various carotenoids, and a major odor constituent known as d-limonene, which makes up 90% of the citrus peel oil content, and is a compound that gets its name from the rind of the lemon, which contains a significant quantity of it. It is listed in the US Code of Federal Regulations as generally recognized as safe (GRAS), and is commonly used as a flavoring agent. D-limonene has been studied to have potent anti-cancer properties, including against metastatic melanoma.

Source; Green med info

Online medical education tool aspires to improve patient interactions in challenging situations

Drexel University College of Medicine has developed an online medical education program to help healthcare professionals hone those skills in simulated interactions with patients and their families.

Although the goal is to improve performance by physicians and other healthcare professionals, it is also designed to help hospitals boost patient satisfaction scores, which impact Medicare reimbursement. This is one trend in healthcare that startups are increasingly addressing.

Dr. Christof Daetwyler of Drexel University College of Medicine will use the $100,000 he received from the University City Science Center QED Proof of Concept award to fund a pilot program with a well-known hospital next year and build a company around the technology.

In an interview with MedCity News, Daetwyler said one of Drexel’s collaboration partners is the Gift of Life donor program in Philadelphia, which licensed the technology.

A prototype of the technology was developed in 2002 at the Technology in Medical Education group at Drexel. It was used as a video conferencing tool to help medical students prep for the Objective Structured Clinical Examinations through simulated patient interactions.

Since then, technology advancements have made it easier to bring the platform online. User interactions with simulated patients are recorded online. Users get structured feedback on performance. They can also access videos that offer examples of best practice. In addition to organ donation and breaking bad news, it also includes modules on how to broach other difficult situations such as smoking cessation.

A separate joint venture between the College of Medicine and the American Academy on Communication in Healthcare, Doc.Com, produced 41 modules to improve communication skills.

The company’s approach also helps address the physician shortage, which is projected to worsen as Obamacare extends healthcare access to millions of people.

Several other health IT companies are taking different approaches to medical training using simulators. Shadow Health and Kognito Interactive have focused on developing patient simulator tools to improve patient and physician communication. SimplySim developed a way to train physicians to properly use a stethoscope and CaseNetwork developed a training tool to reduce readmissions. The idea is to provide more meaningful interactions to improve adherence and so that healthcare professionals better understand their patients’ needs.
Source : Med City News

First full face transplant recipient in U.S.

A December 2010 photo shows Dallas Wiens prior to receiving a full face transplant. Wiens was injured in an electrical accident in Texas in 2008. Before his face transplant, he had surgeries to graft smooth skin over much of his face.

Dallas Wiens, first full face transplant recipient in U.S., grows comfortable in his new skin

‘My entire life is a miracle,’ said Wiens, 28, speaking at a conference of the Radiological Society of North America. Doctors are learning more from Wiens and other facial transplant patients about how the body evolves and adapts following the experimental surgeries.

The nation’s first full face transplant patient Dallas Wiens looks on during a news conference about new research into full facial transplants. Wiens was the first person in the U.S. to receive the surgery, in 2011.
The nation’s first full face transplant patients are growing into their new appearances—literally.

The nation's first full face transplant patient Dallas Wiens looks on during a news conference at McCormick Place in Chicago, Wednesday, Dec. 4, 2013. Despite still visible facial scars from the March 2011 surgery, Wiens looks and sounds like a recovered man. Medical imaging shows new blood vessel networks have formed, connecting transplanted skin with the patients' facial tissue, a finding that may help improve future face transplant surgeries, doctors announced Wednesday. (AP Photo/Paul Beaty)

Medical imaging shows new blood vessel networks have formed, connecting transplanted skin with the patients’ facial tissue, a finding that may help improve future face transplant surgeries, doctors announced Wednesday.

Dallas Wiens, the first U.S. man to get a full face transplant, is a remarkable example of that success. The 28-year-old Fort Worth man attended Wednesday’s annual meeting of the Radiological Society of North America with his new wife and golden retriever guide dog. Despite still visible facial scars from the March 2011 surgery, he looks and sounds like a recovered man.
A 2008 family photo shows Dallas Wiens with his daughter Scarlette prior to an electrical accident that disfigured his face.

“My entire life is a miracle,” Wiens said at a news conference.
His face was burned off in a 2008 painting accident at his church. He was on a cherry-picker lift when his head hit a high voltage wire.
After surgery, Wiens lived for two years with no facial features and just a two-inch slit for a mouth, until his transplant at Boston’s Brigham and Women’s Hospital.

A December 2010 photo shows Dallas Wiens prior to receiving a full face transplant. Wiens was injured in an electrical accident in Texas in 2008. Before his face transplant, he had surgeries to graft smooth skin over much of his face.

Dallas Wiens (r.) poses for a photo with his wife Jamie Nash and his guide dog Charlie. Despite still-visible facial scars from the March 2011 surgery, Wiens looks and sounds like a recovered man.Imaging studies on Wiens and two other full face transplants done at Brigham in 2011 show that a network of new blood vessels had formed just a year after the operations. A fourth full face transplant was performed at Brigham earlier this year.
The same thing typically happens with other transplants and it helps ensure their success by boosting blood flow to the donor tissue. But Brigham doctors say this is the first time it has happened with full face transplants.
The finding could eventually shorten the operating time for future face transplants, Brigham radiologist Dr. Frank Rybicki said. The operations can take up to 30 hours and include attaching spaghetti-thin arteries in the patients’ existing tissue to the donor face, but the findings suggest attaching only two facial or neck arteries instead of several is sufficient, he said.

Dr. Samir Mardini, a Mayo Clinic expert in reconstructive transplant surgery, said blood vessel reorganization occurs with other types of tissue transplants — doctors call it “neovascularization” and it helps ensure the tissue’s survival by improving blood flow.

“It’s interesting that they’ve shown it” with face transplants, but it’s not a surprise, Mardini said.
Face transplants, using cadaver donors, are still experimental. Fewer than 30 have been done since the first in 2005, said Dr. Branko Bojovich, a surgeon involved in a 2012 face transplant at the University of Maryland Medical Center.

He called the Boston team’s findings “very reassuring” for surgeons and for future patients.
“We’re assuming that these patients will hopefully go on to live productive and long lives,” Bojovich said.
Wiens’ life before the accident was troubled, and he says he misses nothing about it except possibly his eyesight.

Source: Daily news

It is possible to think yourself well

What if you had the ability to heal your body just by changing how you think and feel? I know it sounds radical, coming from a doctor. When people are doing everything “right”—eating veggies, avoiding red meat and processed foods, exercising, sleeping well and so forth—we should expect them to live long, prosperous lives and die of old age while peacefully slumbering, right? So why is it that so many health nuts are sicker than other people who pig out, guzzle beer and park in front of the TV?

I consider myself one of those health nuts. I drink my green juice, take my vitamins, hike and practice yoga daily, get quality sleep, see a doctor and avoid harmful toxins. And yet I have come to believe that the purely physical realm of illness—the part you can diagnose with laboratory tests—is only part of the equation. It’s a big part, mind you, but not the whole shebang. My experience with patients (as well as my personal background) has led me to the conclusion that whether they become sick or stay healthy, as well as whether they remain ill or manage to heal themselves, might have more to do with everything else that’s going on in their lives than with any specific health standard they abide by.

When healthy habits aren’t enough
Five years ago, I started working in an integrative medicine practice. My new patients were some of the most health-conscious people I’ve ever had the privilege to serve. Many of them ate a vegan diet, worked out, slept soundly each night and took vitamins every morning. But some of them were also mysteriously sick, complaining of fatigue, aches, gastrointestinal disturbances and other symptoms. I was baffled! I ran batteries of tests, and occasionally I would pick up something that eventually resulted in the complete resolution of a patient’s symptoms. But more often than not, I would find nothing.

I was really motivated to solve the puzzle of why these “healthy” patients were so sick. Instead of focusing exclusively on physician-recommended behaviors, medical history and other traditional factors, I dug deep into their personal lives. I asked them questions: “What do you love about yourself? What’s missing from your life? What do you appreciate about your life? Are you in a romantic relationship? If so, are you happy? If not, do you wish you were? Are you fulfilled at work? Do you feel like you’re in touch with your life’s purpose? Do you feel sexually satisfied? Do you express yourself creatively? Do you feel financially stable, or are you stressed about money? If your fairy godmother could change one thing about your life, what would you wish for?”

My patients’ answers often gave me more insight into why they might be sick than any lab test or exam could. They were unhealthy not because of bad genes or poor habits or rotten luck, but because they were lonely or miserable in their relationships, stressed about work, freaked out about their finances or profoundly depressed.

On the flip side, I had other patients who ate junk, forgot to take their supplements, rarely exercised and enjoyed seemingly perfect health. Their responses revealed that their lives were filled with love, fun, meaningful work, creative expression, spiritual connection and other traits that differentiated them from the sick health enthusiasts.

Source: health

New Artificial hearts won’t beat

The human heart beats 60 to 100 times a minute, more than 86,000 times a day, 35 million times a year. A single beat pushes about 6 tablespoons of blood through the body.

An organ that works that hard is bound to fail, says Dr. Billy Cohn, a heart surgeon at the Texas Heart Institute. And he’s right. Heart failure is the leading cause of death in men and women, killing more than 600,000 Americans every year.

For a lucky few, a heart transplant will add an average of 10 years to their lives. For others, technology that assists a failing heart — called “bridge-to-transplant” devices — will keep them alive as they wait for a donor heart.

Unfortunately, more often than not, the new heart doesn’t arrive in time.

That’s why Cohn and his mentor — veteran heart surgeon Dr. O.H “Bud” Frazier — are working to develop a long-term, artificial replacement for the failing human heart. Unlike existing short-term devices that emulate the beating organ, the new machine would propel blood through the body at a steady pace so that its recipients will have no heartbeat at all.

The concept of a pulseless heart is difficult to fathom. Cohn often compares it to the development of the airplane propeller. When people started to develop flying machines, he says, they first tried to emulate the way birds fly — by flapping the wings aggressively.

“It wasn’t until they decided, ‘We can’t do this the way Mother Nature did,’ and came up with the rapidly spinning propeller that the Wright Brothers were able to fly,” Cohn says.
The idea of an artificial heart goes back decades.

Frazier began medical school in what he describes as “the Kennedy Era.”

“We were going to the moon; we were going to achieve world peace,” and Frazier wanted to develop the first artificial heart. In 1968, he left for Vietnam as a flight surgeon. Thirteen months later, his helicopter was shot down, and he nearly died.

“That experience convinced me I should stick to something more meaningful for the rest of my life.”
That he did. The veteran surgeon, inventor and researcher has devoted the last half century to developing technologies to fix or replace the human heart, the most notable of which is the newest generation of continuous flow Left Ventricular Assist Devices, known as LVADs.

Modeled after an Archimedes Screw, a machine that raises water to fill irrigation ditches, the continuous flow LVAD is a pump that helps failing hearts push additional blood through the body with a rapidly spinning impeller.

Today, the continuous flow LVAD has been implanted in 20,000 people worldwide, including former Vice President Dick Cheney before he received a heart transplant nearly two years later.

In some cases, the LVAD’s turbine has essentially taken over the pumping process entirely from the biological heart. In these instances, the implant recipient barely has any pulse at all.

Observing what happened in these patients led Frazier to one compelling question: If the LVAD can take
over for a weakened heart, could it replace the organ entirely?

In 2004, Frazier asked Cohn to collaborate on a new research project. Cohn’s interest in heart surgery dates back to when he was a young boy reading articles about world-renowned heart surgeons Dr. Michael E. Debakey and Dr. Denton Cooley, who developed and played a role in the transplant of the first artificial heart in a human in 1969.

Now the holder of some 70-odd U.S. patents, Cohn says his work with Frazier to build an artificial heart is the most ambitious project of his career.

The surgeons set out to combine two LVADs to replicate the functions of the heart’s right and left ventricles. Using two commercially available LVAD turbines, Frazier and Cohn combined the devices with plastics and other material used for implants: hernia mesh, Dacron cardiovascular patches and medical silicone. Everything met FDA standards, but Cohn describes the final product as “rather kludged together.”

The surgeons tested their invention by installing it in around 70 calves. All of the cows produced a flat line on an EKG, which measures heart electrical activity, yet they stood, ate and walked around, paying seemingly no notice to a small technicality: They had no heartbeat.

In order for the FDA to approve the device for clinical trials, the calves needed to live for at least one month. Cohn and Frazier’s device trumped these standards, with many calves living healthily for full 90-day studies.

Cohn and Frazier were encouraged, and in March 2011, put their artificial heart into a human patient.
Craig Lewis, 55, was admitted to the Texas Heart Institute with amyloidosis, a rare autoimmune disease that fills internal organs with a viscous protein that causes rapid heart, kidney and liver failure. Without some intervention, Lewis would have been dead in days. Frazier and Cohn decided it was the right moment to test their device and the surgeons undertook the lengthy procedure.

Less than 48 hours later, Lewis was sitting up, talking and using his laptop. When doctors put the stethoscope to Lewis’s heart, all they heard was a steady whir of what sounded like a boat propeller. Lewis survived for six weeks until his failing kidneys and liver got the best of him and his family asked doctors to unplug the device.

Source: CNN

Triplet Births Due to Fertility Treatments Are Declining

More than one-third of U.S. twins, and more than three-quarters of triplets and other multiple births, are now born as a result of fertility treatments, according to estimates from a new study.

In 2011, 36 percent of twin births and 77 percent of triplet and higher-order births (quadruplets, etc.) were aided by fertility treatments, which include both in vitro fertilization (IVF) and other treatments, such as the use of drugs to stimulate the ovaries and induce ovulation, the study found.

Between 1998 and 2011, the national rate of triplet and higher-order births decreased by nearly 30 percent — a trend that researchers called good news.

Part of that decline may be related to a 1998 change in guidelines that discouraged doctors from implanting three or more embryos during a single IVF cycle. After that, the proportion of triplet and higher-order births attributable to IVF declined by 33 percent (from 48 percent in 1998 to 32 percent in 2011).

However, there’s still a lot of work to be done to reduce the U.S. rate of multiple births, said study researcher Dr. Eli Y. Adashi, a professor of obstetrics and gynecology at Brown University. The percentage of twin births resulting from IVF and non-IVF fertility treatments is still on the rise.

Why a decline in multiple births is good

Twin and other multiple births increase the risk of complications for the mother and infant, including the risk of premature delivery. An unintended consequence of fertility treatment technology was an increase in the nation’s multiple-birth rate, Adashi said.

The new study also suggests that non-IVF fertility treatments deserve greater attention, as they now contribute to a greater proportion of multiple births than IVF does. The percentage of triplet and higher-order births resulting from non-IVF treatments increased from 36 percent in 1998 to 45 percent in 2011, the study found.

“When people hear ‘multiple,’ they intuitively point at IVF,” Adashi said. The study found “IVF is an actor,” he said, but “not the leading culprit when it comes to the genesis of multiples.”

But unlike multiple births from IVF, which result from the number of embryos that are intentionally implanted, multiple births from non-IVF fertility treatments are difficult to prevent, Adashi said. That’s because non-IVF treatments, including oral and injectable drugs, stimulate ovulation in ways that cannot be precisely controlled, Adashi said.

How to reduce multiple births

But there are a few steps doctors can take that may reduce the rate of multiple births from non-IVF fertility treatments, such as lowering the doses of the ovulation-stimulating drugs, Adashi said.

“Increased awareness of multiple births resulting from non-IVF fertility treatments may lead to improved medical practice patterns and a decrease in the rate of multiple births,” the researchers wrote in the Dec. 5 issue of The New England Journal of Medicine.

To come up with their estimates, the researchers analyzed information on birth rates between 1962 and 1966 — before the advent of fertility treatments — to get a measure of the natural rate of multiple births. They also used publicly available data on IVF births between 1997 and 2011.

Because no database tracks multiple births due to non-IVF treatment, the researchers estimated this number by factoring in the natural rate of multiple births and IVF births. The researchers also took into account maternal age, which increases the chance of giving birth to multiples, but were not able to account for other factors, like obesity, which some studies suggest increases the chances of giving birth to twins.

source: live science