Health Updates, Medical Videos, and More…
With over half of the American population either overweight or obese, we are constantly bombarded in the media with new diets promising to help us lose weight. This makes it very difficult for anyone to decide which diet will actually work for them. But a recent study shows that more than the specific diet, it is calories taken in that may be the most important factor for weight loss. (more…)
Medical risks of multiple gestation (multiple pregnancies)
The initial reaction to the recent birth of octuplets to a California woman was very positive, praising the skills of the expert medical team that delivered the premature infants without complications. However, the early praise quickly turned to criticism from fertility and ethics experts over the details of her initial fertility care. The case is highly unusual, because all of the babies survived, but an octuplet pregnancy should never be considered a positive fertility outcome. In fact, it is a negative outcome with potential serious medical and psychological outcomes. In this section, we will answer some medical questions about the risks of multiple births.
• How many babies can a woman carry safely during a pregnancy?
It is safest to have one baby at a time. Even a twin pregnancy increases the risk of complications for both the mother and the babies. However, with good medical care, the majority of twins do reasonably well. Triplet pregnancies are considered to be very high risk, and some doctors consider pregnancy reduction procedures in this situation (see below). “Higher-order” multiple gestations (triplets or more) are extremely high risk, and doctors always discuss multifetal pregnancy reduction with women to lower the risk of pregnancy complications (for both the mother and the babies).
• If a woman does have triplets or more, what are the risks to the babies?
With multiple gestations, the babies grow more slowly than they should and they are born prematurely (too early). Therefore, when they are born, they are at very low birth weights, and have to spend time in the neonatal intensive care unit. Sadly, babies from a multiple birth have a higher risk of dying because of complications, such as bleeding in the brain, or heart and lung problems. They are also at higher risk for developing cerebral palsy.
• What are the risks to the mother?
With higher-order multiple pregnancies, 20-60% of women develop preeclampsia, a potentially serious complication with high blood pressure and protein in the urine. Women are also at high risk for developing diabetes, blood clots, and premature rupture of membranes. They are very likely to have to undergo cesarean deliveries.
• Could the doctors have prevented the woman with octuplets from having so many babies? If so, how?
Yes. This woman got pregnant through in vitro fertilization, a procedure where embryos are implanted into the uterus. There are clear guidelines on how many embryos should be implanted based upon the woman’s age and fertility history. The guidelines were written by The American Society for Reproductive Medicine and the Society for Assisted Reproductive Technology. These are voluntary guidelines, but the majority of practitioners follow them, and as a result, the rate of multiple births has steadily decreased over the past decade.
For the mother of octuplets, the guidelines would have suggested that only one embryo (or at most two) be transferred, because she is under age 35, and she had had previous success with IVF. For reasons that are unclear, her practitioner chose not to follow these guidelines.
• What are your options if you find out that you are have a higher-order multiple gestation and you are worried about the potential medical risks for you and the babies?
There is a procedure called multifetal pregnancy reduction (MPR) that doctors offer to couples with higher-order multiples. The procedure is performed between the 10th and 13th week of pregnancy; it reduces the number of fetuses and makes it more likely that the remaining babies will survive. Although doctors offer the procedure to women when a higher-order multiple pregnancy occurs, not all women or couples choose to go through the procedure.
A study in the February issue of the Journal of Nutrition at Tufts University showed that green tea may help people lose weight. The study looked at 123 obese adults who all ate about the same amount of daily calories. They also participated in 180 minutes of moderate intensity exercise. They drank a daily beverage containing 39 mg of caffeine, with one group consuming green tea with 625 mg of catechins, an antioxidant that is found in green tea. After 12 weeks, the group who drank the green tea had greater weight loss, 4.4 lbs. compared with 2 lbs in the control group. The green-tea group also had larger declines in total abdominal fat, subcutaneous abdominal fat and triglycerides.
The mechanism of action for green tea is not completely understood, but some scientists believe that it speed the rate at which fat is broken down in the body. It may also help the body’s sensitivity to insulin, lowering the risk of diabetes.
Another study examined 7000 women in China. The women were evaluated for breast cancer incidence and consumption of green tea. Compared with nondrinkers, women who drank green tea had a slightly decrease risk of breast cancer. The benefit was strongest for women who drank the most green tea over the longest periods of time.
Inthe January Archives of Otolaryngology, there is a study of 21,009 pediatric head and neck infections caused by staph germs from 2001 through 2006. These include certain ear and sinus infections and abscesses that can form in the tonsils and throat. They found that the percentage caused by MRSA bacteria more than doubled during that time from 12% to 28%. MRSA infections, which were once mostly found in hospitals and nursing homes, are becoming more common in the community, and do not respond to penicillin-based antibiotics.
How to help maintain our memory
The Autumn 2008 Harvard Medical Alumni Bulletin is called “The Memory Issue”, with most of the articles discussing different aspects of aging and memory loss. An article by Aaron Nelson, PhD, gives 12 tips to help keep our memory intact.
In today’s (Jan. 8, 2009) Wall Street Journal, Betsy McCaughey has an article entitled: “Hospital Scrubs Are a Germy, Deadly Mess.” In the article she states that many hospital personnel, including nurses and physicians, wear the same scrubs and lab coats for several days without laundering. This enables bacteria, such as Clostridium difficile, enterococcus, and staphylococcus to be spread easily among patients. Some hospitals have adopted new policies regarding scrubs which have helped to significantly reduce therate of hospital acquired infections: the hospital provides and launders the uniforms daily, and prohibits them being worn outside the building. Ms. McCaughey recommends that all hospitals do the same!
Hearing loss with MP-3 Players
Millions of children and tends are at risk of noise-induced hearing loss due to the increasing popularity of MP3 players, and the loud listening habits of today’s youth. The hearing damage is directly related to the duration of exposure – not just the volume- so steady long-term exposure to even moderately loud music could result in premature hearing loss.
According to the American Speech-Language-Hearing Association, more than half of American high school students have at least one symptom of hearing loss. The European Union’s Scientific Committee on Emerging and Newly Identified Health Risks reported that 5-10% of personal music listeners risk permanent hearing loss if they listen for more than one hour per day each week at high volume settings for at least five years.
To prevent damage, keep the volume down, and limit the listening time. Also, when wearing the MP3 player, you should be able to hear conversations around you. If not, it’s too loud. It is also helpful to replace earbuds with the more expensive noise-canceling headphones.
A recent isuue of Men’s Health had an article about David Sinclair. He is a scientist at Harvard University studying mitochondria, which are responsible for the energy of all the cells in our bodies. Mitochondria work by transforming nutrients that enter cells into supplies of the energy molecule ATP. ATP provides the energy the cell needs to function. Mitochondria sometimes do not work correctly – either due to genetic mutations or due to aging.
When our mitochondria are functioning correctly, this helps with our muscle growth, energy levels, endurance, and hair growth. When they don’t, people may suffer from diabetes, heart disease, obesity, and neuromuscular problems. Dr. Sinclair is researching the enzymes called sirtuins, which have been shown to invigorate mitochondria. In 2003, Dr. Sinclair found that the sirtuin known as SIR2 could be activated with resveratrol, a substance found in red wine. When he gave mice large amounts of resveratrol it made them healthier, more energetic, and in some cases extended their lives by up to 30%. His company developed a compound that is a thousand times more potent than resveratrol prompting GlaxoSmithKline to purchase the company for millions of dollars.
It has been known since the 1930’s that caloric restriction lengthens life. Dr. Lenny Guarente has also been studying sirtuins and found that there is a link between SIR2 and caloric restriction. It seems that decreasing calories activates SIR2, which helps to rev up the mitochondria, keeping them young and vital.
So the search now goes on for sirtuin-activating, mitochondrial boosting drugs. Because it is difficult to demonstrate anit-aging effects of these drugs in humans ( it would take many years to see any effects) they are looking instead at how they will affect diabetes, which can be tested quickly. It will probably not be marketed specifically for anti-aging, but the researchers hope that these drugs will help decrease the levels of age-related diseases.
HGH
More bad news on the HGH front:
In the Jan/Feb 2009 edition of the magazine SOBeFIT, they discuss the pros and cons of HGH for anti-aging. They question the safety of using the injections, especially the possibility of an increased risk of cancer with long term use. They also look at a study done at the Garvan Institute for Medical Research in Sydney, Australia. The researchers enlisted 100 young recreational athletes to whom they administered a high (but safe) dose of HGH. They then looked at changes in strength, power and endurance. They found NO sports performance benefit. They did see an increase in body mass, but felt that the effect was due largely to fluid retention, not to increased muscle mass.
HGH: Human Growth Hormone
In the most recent edition of Cosmetic Surgery Times, there is an article discussing the use of Human Growth Hormone for anti-aging. Dr. Hau Liu, M.D., M.B.A., M.P.H., a researcher from Stanford University was the lead author of a study that reviewed 31 articles of patients who had received HGH. He said that based on the data, they would not recommend HGH for anti-aging purposes. He also states that the data suggests that there is minimal benefit, with only slight increases in lean body mass. The side effects included soft tissue edema, arthralgias, carpal tunnel syndrome, gynecomastia, and a possibility of developing diabetes. In addition, he states that the use of growth hormone for anti-aging purposes is illegal in the United States. The cost of HGH supplementation is quite high, and Dr. Liu states that it would be more efficacious to spend that money at the gym with a trainer.