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Health24.com | Obesity surgery may lower heart attack danger in diabetics

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Obesity surgery may dramatically lower the danger of heart attacks and strokes in patients with diabetes, new research suggests, reinforcing evidence that benefits extend beyond weight loss.

The study tracked about 20,000 severely obese patients with Type 2 diabetes. Those who had weight loss surgery had a 40 percent lower chance of developing a heart attack or stroke in the five years following surgery compared to those who got usual care with diabetes medicines or insulin.

For every 1,000 patients in the study who had surgery there were roughly 20 heart attacks or strokes compared to 40 such events per 1,000 who got regular care.

More than 30 million Americans have diabetes, mostly Type 2 where the body loses the ability to produce or use insulin to turn food into energy.

Other research has shown obesity surgery can reverse and even prevent diabetes. Taken together, it means doctors should discuss weight loss surgery more often, said study co-author Dr. David Arterburn of Kaiser Permanente Washington Health Research Institute in Seattle.

Doctors usually mention insulin and pills, “but it’s not always brought up that weight loss surgery is another available treatment option,” Arterburn said.

Researchers analyzed records from four U.S. health care systems: HealthPartners in Minnesota and Kaiser Permanente in Washington state, Northern California and Southern California. Results were published Tuesday in the Journal of the American Medical Association.

The study can’t prove cause and effect because patients weren’t randomly assigned to get surgery. The researchers tried to match patients for gender, age, blood sugar levels and other factors. But other things they didn’t account for could have contributed to the surgery patients’ better results.

Everyone in the study had a BMI, or body mass index, of at least 35. For instance, someone who is 5-foot-8-inches and weighs 230 pounds has a BMI of 35.

Of the more than 5,300 who had surgery, most had gastric bypass, the most common type of stomach-shrinking operation. Some had gastric sleeve or gastric band procedures. The rest, nearly 15,000 people, had usual care.

Obesity surgery can cost $20,000 to $25,000. Insurers are increasingly covering it, but some impose strict limits.

The new findings suggest insurance coverage should be expanded for the right patients, Dr. Sayeed Ikramuddin of the University of Minnesota wrote in an accompanying editorial.

Surgery is thought to help by affecting hormones, gut bacteria and other substances that affect how the body handles insulin and blood sugar. Weight loss without surgery also helps, but is difficult for many people to achieve.

Most weight loss surgery today is done through small incisions. The dangers are similar to other surgeries, including a small chance of life-threatening complications, and some people need to have their surgeries repeated.

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Health24.com | Postpartum depression may raise heart risks

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Otherwise healthy women diagnosed with postpartum depression may be at higher risk of a heart attack, stroke or heart failure, a new study suggests.

Acting on mounting evidence linking clinical depression to cardiovascular disease, researchers sought to explore whether other forms of depression might also increase the risk for conditions affecting the heart or brain.

They examined a registry of 1.8 million California women who did not have a history of cardiovascular disease or chronic depression. Of those women, 40 276 were diagnosed with postpartum depression.

Within roughly five years of giving birth, the women who had postpartum depression had a nearly 70% higher risk of developing cardiovascular disease, including heart attack, stroke and heart failure. And that was even after adjusting for traditional cardiovascular risk factors such as diabetes and high blood pressure, pregnancy-related conditions such as preeclampsia, and social and behavioural factors such as smoking, alcohol use and insurance access.

The findings will be presented on 11 November 2018 at the American Heart Association’s Scientific Sessions meeting in Chicago.

Cause is still uncertain

What’s causing these women to be more at risk is uncertain, said Dr Punag Divanji, the study’s lead researcher and a cardiologist at the University of California, San Francisco.

Among the possibilities is a link to the drop in oestrogen and progesterone after childbirth. These two hormones increase exponentially during pregnancy, and women with postpartum depression may have a greater decline in levels after childbirth than other new mothers.

But more research needs to be conducted before actual causal reasons can be pinned down, Dr Divanji said.

“There’s still a lot of work to be done in terms of better understanding cardiovascular risk in women,” he said, particularly risk factors other than high blood pressure, high cholesterol and diabetes.

Dr Leslie Cho, director of the Women’s Cardiology Center at The Cleveland Clinic, agreed that more research would help validate the findings, as well as shed light on the mechanics behind them.

Depression can lead to unhealthy lifestyle choices

“What we do know is that if you’re depressed, straight-up depressed, you tend to eat badly. You tend to drink. If you’re depressed, you don’t tend to exercise,” said Dr Cho, who was not connected with the new study. “It goes with so many other unhealthy lifestyle choices.”

Past studies have shown a link between clinical depression and its impact on cardiovascular disease, including high blood pressure, Dr Cho said.

“It’s been linked with platelet reactivity – your platelets are more sticky when you’re depressed,” meaning there’s a greater chance they could clump and form a blot clot, she said. “So, there are all sorts of interesting heart-brain connections there.”

She noted that women of all ages should consider having their cardiovascular risk assessed anyway because heart disease is the leading cause of death for women.

Dr Divanji said he hopes the study will help raise awareness about the potential link between all types of depression and cardiovascular disease.

“This level of evidence isn’t sufficient enough to say we need to sound the alarm but rather, this is something to be aware of and think more about,” he said. “When we see patients, we should be cognisant that depression plays a role in future cardiovascular disease risk.”

If you need help, contact SADAG. You can speak to a counsellor between 08:00 and 20:00 Monday to Sunday by calling 011 234 4837. For a suicidal emergency call 0800 567 567. The 24-hour contact is 0800 12 13 14. Alternatively, you can SMS 31393 and SADAG will call you back.

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Health24.com | 50% of older women suffer incontinence in silence – US study

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Nearly half of older American women have urinary incontinence, but many have not talked to a doctor about it, a new national poll shows.

More than 1 000 women, aged 50 to 80, were asked questions about their bladder control. The poll found that 43% of those in their 50s and 60s had urinary incontinence. That percentage jumped to 51% among those over 65.

But two-thirds of those women had not discussed the problem with a doctor, and only 38% said they do exercises to strengthen muscles that can help keep urine from leaking.

Common condition

“Urinary incontinence is a common condition that may not be routinely screened for in primary care, yet it can impact a woman’s quality of life and health, and is usually treatable,” said Dr Carolyn Swenson, a urogynaecologist with the University of Michigan. She helped develop the poll questions and analyse the findings.

Of the women who said they’d experienced urine leakage, 415 said it was a major problem or somewhat of a problem. One-third of those with leakage said it occurred almost every day.

Most found ways of coping on their own, according to the poll – from using pads or special underwear to wearing dark clothing and limiting fluid intake.

But nearly half worried it would get worse as they got older.

Don’t ignore the symptoms

“It’s not an inevitable part of ageing and shouldn’t be overlooked,” Dr Swenson noted in a university news release.

The most common triggers of urine leakage were coughing or sneezing (79%), trying to get to a bathroom in time (64%), laughing (49%) and exercise (37%).

The poll, published on 1 November 2018, was conducted by the University of Michigan Institute for Healthcare Policy and Innovation, and sponsored by AARP and Michigan Medicine, the university’s medical centre.

“The last thing that older women should be doing is avoiding exercise or not being able to enjoy other activities that make life worthwhile,” said poll director Dr Preeti Malani, a professor of internal medicine at Michigan with special training in geriatric medicine.

“We hope these findings will help spur conversations between women and their healthcare providers, so that activities aren’t limited,” Dr Malani added.

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Health24.com | How to get the most from your cardio workouts

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You’ve made the decision to meet the 150-minutes-per-week goal of cardio workouts for better health.

Now use the following tips to make the most of these workouts:

Shot of a group of seniors having a spinning class

If you’re using a machine, like a treadmill or stationary bike, check that you’re maintaining proper form. Just as coasting when riding a bike outdoors doesn’t provide a workout, resting your upper body on the handles of a machine or slumping on its console means you aren’t working as well as you could be. If you’re having a hard time staying upright, you may have set the machine a too fast or challenging setting.

Fit young female doing stretching exercises on the

Speaking of machines, resist making one machine in particular your only type of cardio workout. You’ll expand your horizons and get some fresh air by running or walking outdoors or taking a swim when weather permits. You might find that being outside makes the workout more interesting and invigorating.

Young people exercising in a gym on treadmill. Foc

When working out at a gym, add a fun element by creating a cardio fitness circuit, especially if you find yourself getting bored after the first 10 minutes on a machine. Break up your workout into a mini triathlon: 10 minutes on the treadmill, 10 on the bike and 10 in the pool doing laps or water exercises.

Shot of a young woman dancing in the nightclub

Remember that cardio doesn’t always have to feel like hard work. Spend a fun evening going dancing with friends or your significant other. It may not seem like it, but if you break into a sweat, you’re getting your heart rate up.

Finally, make a plan to regularly try a new form of cardio, not just to stave off boredom, but also to challenge different muscles and add to your overall fitness level.

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Health24.com | Could you handle multiple orgasms every day?

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What would you do if doing simple tasks, like brushing your teeth, driving or yawning triggered an orgasm? While it might seem unusual, it does happen to certain people.

In one case, women taking a certain antidepressant experience much more than an improvement in their mood… when yawning, many of them have a spontaneous orgasm. Despite this unusual side effect, it appears that doctors are still prescribing the medication.  

Some fitness fanatics experience the same effect, apparently brought on by increased blood flow to the genitalia when doing exercises like crunches or sit-ups. 

Medical professionals are familiar with a condition called Persistent Genital Arousal Disorder (PGAD), formerly known as Persistent Sexual Arousal Syndrome (PSAS).

While PGAD may not be the correct diagnosis for those people who experience random orgasms throughout the day, these unwanted occurrences can have a negative effect on their lives. 

Women suffering from this condition have been given all sorts of labels — from “nymphomaniac” to “whore” – but it is not something they can control, and doctors are trying their best to find the cause and a possible cure for this reaction.

Even though many people might see it in a positive light, those who suffer from the condition tend to regard it as more of a burden.

Do you, or someone you know, suffer from a condition of this nature? Share your story by emailing healthnews@health24.com and we may publish your story. Should you wish to remain anonymous, please us know.

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Health24.com | One man’s journey back from stroke at 52

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Price Woodward was the picture of health at age 52. He lived an active lifestyle and ran marathons. He was definitely not the type of person you’d expect to have a stroke.

But one night, his wife, Tammy, heard a strange noise coming from the other side of the bed. She turned on the light and Price started talking to her, but she couldn’t understand what he was saying.

Tammy could tell something wasn’t right, so she called 911. But because Price had the stroke in his sleep and his wife had no way of knowing exactly when the stroke began, he wasn’t eligible for clot-busting medication that can sometimes stop a stroke before much damage is done.

“His stroke was really bad. It affected the left side of his body, and he couldn’t even sit up. If I hadn’t been home, I think he would’ve died. It’s been a long road to recovery,” Tammy said.

Specific, tailored rehab

But Price, who lives in Greensboro, Georgia, had a lot of motivation to go through stroke rehabilitation to get better. His middle daughter got engaged after he’d had the stroke, and he was determined to be there for her wedding day.

“I told my therapist I was going to walk her down the aisle,” he said.

Stroke therapy is very specific, tailored rehab. Tammy explained that even though Price started rehabilitation in a wheelchair, his therapist helped him achieve the goal of walking. She calculated how many steps it would be, how his gait might affect his balance, and even considered how the train of the dress would play into his walking down the aisle.

Lots of hard work paid off. Not only did Price escort his middle daughter down the aisle, he was also able to attend his youngest daughter’s graduation and welcome his oldest daughter’s first child.

But as far as he’s come in recovery, Price knows that if he could have gotten help faster, things might have been very different.

A friend of his also had a stroke, but it happened in front of the friend’s family. His friend was able to get to the hospital right away and received the clot-buster drug called TPA. His friend was essentially back to normal in four months, Price said.

In comparison, Price is still recovering from his stroke four years later.

“If you see someone having a stroke, make a note of what time it is,” he advised, because doctors will want to know what time the symptoms began.

Acting quickly can save lives

Dr Olajide Williams, director of acute stroke services at New York-Presbyterian Hospital, agreed that acting quickly can save lives. An easy way to remember what to look out for is the acronym FAST:

  • F is for face. If one half of the face droops when you ask someone to smile or show their teeth, that person may be having a stroke.
  • A is for arm. Ask the person to raise both arms. If someone is having a stroke, one arm won’t go up at all or may not go up as much and then goes down quickly.
  • S is for speech. Talking gibberish or slurring words might be a sign of a stroke.
  • T is for time to call 911. “Time is brain. Every minute that a stroke is allowed to continue, you lose two million brain cells. The more brain cells that die, the less the chance is for reversing the stroke with treatment,” Williams said.

There’s usually a three-hour window from the time stroke symptoms begin until you can receive treatment with TPA, or in certain cases, 4.5 hours. With endovascular (blood vessel) treatments, you have six hours from the first symptoms, Williams said.

Don’t try to drive yourself to the hospital, he said. “The call to 911 is critical. It bypasses any waiting. The ambulance notifies the hospital and that activates the hospital system and stroke team,” he added.

Williams also cautioned not to think you’re immune from stroke if you’re younger. He said strokes are occurring in younger people, especially in communities with more obesity and diabetes.

Like Price, Williams wants people to know there is life after stroke. “Even if an individual doesn’t receive acute treatment, rehabilitation can improve function and accelerate recovery,” Williams said.

More than seven million Americans aged 20 and older have had a stroke, according to the American Stroke Association.

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Health24.com | Maker of ‘potential HIV cure’ moves to calm frenzy over new drug

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Israeli-based pharmaceutical company, Zion Medical, which recently broke the news of a successful first clinical trial for what they called a potential HIV cure, has issued a further statement on Twitter making it clear that more trials will be needed, and their official results will need to be published and peer-reviewed.

Since the company made the announcement on 31 October, there has been a wave of excitement on social media in particular, with people clamouring for more information on the “potential cure”.

According to the World Health Organisation, at the end of 2017 approximately 36.9 million people worldwide were living with HIV.

In a statement at the time, Zion Medical announced the results of the first clinical trial of its HIV-drug Gammora, which, the company said, eliminated up to 99% of the HI virus within four weeks of treatment.

Nine HIV-infected patients took part in “Part I and II” of the trial, at Dr. Ronald Bata Memorial Hospital in Entebbe, over 10 weeks.

But the company has moved to temper expectations, saying on Twitter: “We want to thank everyone for their interest in the promising results of our first clinical trial. Like you, we are hopeful that #Gammora may one day offer those affected by #HIV a viable path to ridding themselves of infection. Much work remains in this mission including additional trials, publication of results and the steps required to make #Gammora commercially available.

“We are not there yet, but we are a step closer, hopeful – and committed to keeping you informed of our progress.”

The company also acknowledged that the official results should be peer-reviewed in a scientific journal, which it hopes to have done in early 2019.

Lengthy process

Professor Adrian Puren, Head of the HIV Surveillance and Sero-Molecular Diagnostic Section at the National Institute for Communicable Diseases (NICD), told Health24 that there is a lengthy process that needs to be followed, before being bold enough to call the drug a potential cure.

“You would need to go through several stages to prove something like this. Doing the research, gathering the evidence and building up all that’s required to find some potential is important.

“There are different phases that you would need to go through as well. You may need to do an animal trial, then a small human trial – the process is complex and you may need to start out really small and run several tests in order to determine that the drugs aren’t toxic and that there aren’t any harmful side effects.

“You would also need to test the efficacy of the medication at various stages, going through the different phases of trials. At some stage you would also need to run randomised tests so that you eliminate biases from the research and really make sure people aren’t being harmed.

“Going through something like this is not easy. It is highly complex, needs to be detailed and it’s quite expensive. If I were going to look into this drug, I would want to see the published literature and be able to trace everything back to the authors, knowing that everything has been reviewed.

“Once all of the research has been done, it’s been reviewed and it is run through all the regulatory authorities, various ethics boards, and sufficiently scrutinised, then a company will be able to make a statement like that. And when they do make announcements like this, they usually do it at big conferences,” said Puren.

The Health Department’s Deputy Director General for HIV/AIDS, TB and Maternal, Child and Women’s Health, Dr Yogan Pillay, added, “As far as we are aware, there is no published clinical trials on this.

“Unless this is published in peer reviewed journals and the World Health Organisation approved this drug, we cannot take this claim seriously.”

Quackery

On Tuesday, a prominent SA HIV scientist slammed the “cure”, which was widely being punted on social media, as smacking of “quackery”.

“The HIV world has seen quackery in different forms for decades – sadly this smacks of more of it,” Professor Francois Venter from the University of Witwatersrand’s Reproductive Health and HIV Institute, told Health-e News.

He said that saying the drug is a potential cure with no side-effects are “over-the-top biological claims that appear in public before the formal literature [is published] and should be viewed with deep scepticism”.

“I looked at the press report and the unsophisticated company website, and even if you believe their claims, they are many years away from testing them,” said Venter.

Zion Medical is a relatively new company, established in 2014. According to the company website, it develops AIDS and Cancer curing products based on peptides derived from HIV and targeted lentivirus particles.

It lists its partners as The Hebrew University of Jerusalem, Mount Sinai Hospital in New York (USA), and the Tel-Aviv Sourasky Medical Center, among others.

All of Health24’s attempts to contact Zion Medical directly for further comment have so far been unsuccessful – all forms of electronic mails have been undeliverable due to an invalid email address and all telephone calls go unanswered.

Health24.com | How to tell which of the 4 weight-loss stages you’re in

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Trying to lose weight but struggling? We hear you. But don’t lose heart – you’re likely in one of the four stages of weight loss.

A small study from the University of Copenhagen showed that if you can maintain your weight loss for one year, your body may stop ramping up the hunger hormones that typically make the kilograms return. Past research indicates that those ravenous chemicals persist after you drop fat, though, so more investigating needs to be done. But this got us thinking: What are the other crucial stages in your weight-loss journey?

Day 1 – set a goal

To lean out for life, set a realistic goal. “You can see great improvements in health by losing between five and 15% of your body weight, and you’re more likely to keep those kilos off,” says Donna Ryan, an obesity researcher at Pennington Biomedical Research Center.

Read more: Here’s what you need to know about counting net carbs to lose weight

5 Weeks – you’re in the zone

Ghrelin, a hormone that revs appetite, begins to spike after you start cutting kilojoules, making it hard to stick to your plan. Stay satiated by “keeping low-kilojoule foods around, like vegetables and fruits, to snack on when your stomach growls,” says Dr Robert Kushner, an obesity specialist at Northwestern University.

Read more: Here’s how to use ginger to cut your body fat

6 months – you’re bored

Bored with eating the same foods over and over again? Yeah, it’s bound to happen now. Mix up your meals (by, say, adding back brown rice to lunch if you’ve been low-carbing) – the wiggle room will make you less likely to bail, says Dr Kushner.

Read more: Okay, what is your metabolism – and can you actually make it faster?

9 months – success!

By this point, you’re probably settling at a manageable weight. Shift your focus from cutting food kilojoules (tough to do forever) to burning the kilojoules you consume by upping exercise. “Aim for an hour a day of moderate activity, six days a week, to keep weight off long-term,” says Ryan.

This article was originally published on www.womenshealthsa.co.za

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Michelle October

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Health24.com | Here’s why you aren’t always ready to go for round 2

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Is there anything more frustrating than having great sex and wanting to go for another round, but not being physically able to? There’s actually a scientific term for this: The refractory period.

“A refractory period is the time after a man ejaculates when he is no longer able to have an erection,” Emily Morse, sexologist and host of the Sex With Emily podcast, tells MensHealth.com.

While there’s not much you can do to eliminate your refractory period altogether (hey, you can’t fight science), there are things you can do to make your recovery time shorter. Here’s everything you need to know about refractory periods, from why they occur in the first place, to how you can try to shorten yours.

Read more: Take these 4 sex positions from average to amazing with these workouts

Why do guys have refractory periods?

It all has to do with the changes in your body that occur after you have an orgasm. Post-ejaculation, “your penis becomes flaccid from neural signals telling your body to relax,” explains Dr Jamin Brahmbhatt, urologist at Orlando Health and Assistant Professor at UCF College of Medicine. “Dopamine and testosterone levels drop, and prolactin [a hormone produced by your pituitary gland] rises.”

Elevated prolactin levels post-ejaculation could play a role in your inability to get it up again. “Increased prolactin and subsequent lower testosterone is like a double whammy affecting your sex,” says Dr Brahmbhatt.

By contrast, women generally have a much shorter refractory period – or even none at all. “Women are designed to be multi-orgasmic, which means they can have one after another after another,” Morse says.

But just because they can doesn’t necessarily mean they want to: Your partner may be ultra-sensitive post-orgasm, which might make her wary of further stimulation. You should always check in and make sure your partner is up for round two before trying anything further.

How long does a refractory period generally last?

Refractory periods are different for every guy. “Some men can be ready in a half hour or less, and others may take hours or even a full day,” says Morse.

Read more: Spice up your sex life with these flavoured condoms and lube

You may have noticed that the length of your refractory period changes at different points in your life. “Recovery depends on age, how much arousal you get in between sessions, hormones, and your overall health,” Dr Brahmbhatt says. “Studies have found teenagers can take minutes to recover, while men in their 30 and 40s can take 30 to 60 minutes or longer. There is no hard and fast rule on how quickly you will recover.”

Can you do anything to shorten your refractory period?

While it’s often a good idea to let your body rest, if you really want to be able to go again ASAP, there are a few things you can do to try and shorten your refractory period.

“Increasing arousal is the fastest way for guys to get back into the game,” Morse says. “This could be doing something different, like trying out a toy or talking dirty (or dirtier than usual). Even small changes can be just the novelty and excitement needed to rev up the engines for round two.”

Getting into shape can also help to reduce your refractory period. “The fitter you are, the better your hormones will be able to regulate themselves,” says Dr Brahmbhatt.

Read more: 8 ways to be a gentleman after sex

If you’re looking for external help, there are supplements that claim to be able to get you harder, faster – but you should be extremely wary of them, says Dr Brahmbhatt. “There is no hard science backing up the proposed claims. Plus, supplements are not FDA-regulated so what you think you are taking, may not be what you are taking.” Instead, you can try manual penile pumps or cock rings to help speed up the process.

And remember that if your partner wants to go again ASAP, you can always pass the time by getting her off again, which should help to get you in the mood for round two.

“Remember that guys don’t need an erection to give pleasure to their partners,” Morse says. “Just because he’s not ready to go again, doesn’t mean a female partner isn’t ready for more. As long as he has his hands and fingers, he’s more than equipped to keep the party going.”

Read more: Game night with a twist: 6 adult games to spice up your sex life

This article was originally published onwww.menshealth.com

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Sarah Fielding

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