Monthly Archives: May 2016

Do All guys need a PSA test

Actor Ben Stiller is crediting a prostate cancer screening test for saving his life, revealing today that he was diagnosed and treated for prostate cancer two years ago. But should all men get this screening test?

In an interview today (Oct. 4) on The Howard Stern Show, Stiller revealed for the first time that he was diagnosed with prostate cancer at age 48. The actor, who is now 50, said doctors detected the cancer because Stiller had undergone a prostate-specific antigen test, or PSA test, which looks for levels of the protein PSA in the blood. Abnormally high levels of PSA in the blood can mean that a man has prostate cancer, but not always. In Stiller’s case, a follow-up MRI and biopsy showed he had prostate cancer.

“This thing saved my life,” Stiller said of the PSA test.

The PSA test is the main test used to screen for prostate cancer, but it is controversial. In 2012, the U.S. Preventive Services Task Force, or USPSTF (an expert panel that advises the federal government) recommended that men not undergo routine screening for prostate cancer with the PSA test, no matter their age.

The American Cancer Society recommends that men have a discussion with their doctor about whether to start PSA screening at age 50 if they are at average risk for prostate cancer, and at age 40 to 45 if they have a family history of prostate cancer.

The main issue with prostate cancer screening is that, although the PSA test can help detect prostate cancer early, it’s not clear if the test’s benefits outweigh its risks in the long run for most men.

One problem with the PSA test is that it often suggests that men have prostate cancer when they do not have cancer, according to the USPSTF. About 75 percent of men with abnormally high levels of PSA do not have cancer. These so-called false positive results can lead to anxiety and unnecessary follow-up tests, the USPSTF says.

The PSA test doesn’t always detect cancer, either — about 20 percent of men with prostate cancer have normal PSA levels, so the test may give these men a false sense of security, according to Harvard Medical School.

What’s more, even when true prostate cancer is detected, doctors cannot tell for sure whether the prostate cancer poses an actual threat to a man’s health.

In many cases, prostate cancer does not grow or cause symptoms, or it grows so slowly that it would never have caused problems in a patient’s lifetime, according to the USPSTF.

“Because of an elevated PSA level, some men may be diagnosed with a prostate cancer that they would have never even known about at all. It would never have led to their death, or even caused any symptoms,” the American Cancer Society says.

This means that some men with prostate cancer get treatment that they don’t need. And the treatments for prostate cancer, such as surgery and radiation, are not benign. They can lead to erectile dysfunction, urinary incontinence and problems with bowel control.

Man spent decades at parents

A 43-year-old man who lived in isolation at his parents’ home in Bavaria for three decades has been taken to a psychiatric hospital and German police are investigating whether his parents did anything wrong.

Police went to the home in Freienfels, in southeastern Germany near Bayreuth, on Sept. 21 after receiving a tip and found the man in a neglected condition, police spokesman Juergen Stadter said Wednesday.

“The man was unkempt, unwashed, but well nourished,” Stadter said. “But he wasn’t constrained and had several rooms to himself where he could move around freely.”

Police are now investigating whether the man stayed inside for all those years of his own will or if his parents forced him to stay at home.

The man’s parents, who are in their late 70s, are under investigation on suspicion of possible deprivation of freedom and causing bodily harm by neglect.

“We assume that he was suffering from some kind of handicap,” Stadter said, adding that as a boy the man went to elementary school, but then stopped attending school at 13 because he was declared unfit to attend.

Stadter would not give further details on what exactly kept the man from attending school, citing privacy concerns.

The man’s mother, who wasn’t named, was quoted as telling the local Nordbayerischer Kurier newspaper that the parents’ didn’t lock him up and “he didn’t want to go outside.”

She said she “always wanted to protect him,” and indicated that as a little boy, her son was treated badly by his schoolmates, the newspaper said.

Local authorities said the man didn’t initially want to leave the house and had to be convinced to go, news agency dpa reported.

What is shigellosis

The city of Flint, Michigan, is seeing a rise in cases of a bacterial illness called shigellosis, and the ongoing water crisis there may be in part to blame, according to news reports.

So far this year, there have been 85 cases of shigellosis in Genesee County, which includes Flint, according to The New York Times. That’s the highest number of shigellosis cases among all counties in Michigan this year.

A statement from Genesee County Health Department in September said that cases of the bacterial illness are up in both the county and the state. In the entire state of Michigan, there were 454 cases of shigellosis this year, and there were 515 cases in 2015. That compares to 175 cases in 2013 and 249 cases in 2012.

Shigellosis is a very contagious gastrointestinal disease caused by the bacteriaShigella. There are about 500,000 cases of the illness each year in the United States, according to the Centers for Disease Control and Prevention (CDC). Symptoms include diarrhea, fever and abdominal pain, and usually last a week, although it may take several months for people’s bowel habits to return to normal after infection, the CDC said.

The Shigella bacteria are spread through contact with fecal matter. People can become infected if they eat food or touch surfaces that have been contaminated with Shigella. Careful handwashing with soap and water can reduce the spread of the disease, the CDC said.

But residents of Flint may have changed their handwashing habits as a result of the city’s water crisis, CNNreported. In 2014, the city changed the source of its water supply, and that change resulted in an increase in the water’s levels of lead. Exposure to this lead may have caused health problems, including rashes, hair loss and neurological issues, The New York Times reported.

Distrust in the city’s water caused people to bathe and wash their hands less frequently, Jim Henry, the environmental health supervisor of Genesee County told CNN. “People have changed their behavior regarding personal hygiene. They’re scared,” Henry was quoted as saying.

Residents have been using baby wipes to wash their hands, but because these wipes aren’t chlorinated, they don’t kill bacteria, Henry said. “It doesn’t replace handwashing,” he said.

You should never be penalized for being a father

images-38As a practicing obstetrician, I always believe that it is fundamentally important to have partners involved with the birth of a child, and for them to participate in all aspects of the delivery— from prenatal care and becoming an advocate for the pregnant patient, to certainly taking part in the birthing experience. The bonding that this brings to the child is of monumental proportions because it provides that family unity and love from the moment of birth, which can translate itself to years of positive experiences for the child.

This is why I was outraged when I heard about a Utah father who says he was billed $39.35 to hold his newborn child during a common skin-to-skin ritual for the mother and child.

As the new dad’s viral Reddit post goes, Ryan Grassley, of Spanish Fork, was surprised to learn when he received his hospital bill that he was charged to hold his newborn on his wife’s neck and chest area. He wrote that the nurse borrowed his camera to take a few pictures of them.

“Everyone involved in the process was great, and we had a positive experience,” Grassley wrote in the post, where he shared a photo of the bill, and a picture of him, his wife and their infant. “We just got a chuckle out of seeing that on the bill.”

Although Grassley said he thought the whole thing was “funny and a bit ridiculous”— and even started a GoFundMe page to raise $39 and pay for the charge, which he met within days— I think this case shows just how absurd hospital bills have become in such crucial medical situations as childbirth and the immediate rituals following.

For mothers who undergo cesarean sections, as Grassley’s wife did, skin-to-skin contact after birth has several benefits for both women and their children. The action involves the baby lying on the mother’s chest, and is meant to help the baby hear his or her mother’s heartbeat and detect her nipple to aid in breastfeeding.

Now, the hospital responded to Grassley’s post, which other parents have met with disgust and outrage, by specifying that the charge wasn’t for the skin-to-skin contact itself, but rather for the additional nurse staff insisted was needed to ensure the baby’s safety during the action.

Regardless, I am sick and tired of patients getting billed to death by hospitals and caregivers, where in some cases, if you look at those crazy itemized bills, they would even charge you for the toilet paper you use when you’re staying in the hospital. Hospitals today charge in such a way that we look like the Pentagon, where we charge $800 for a hammer. And this has to stop.

This case where this father seems to have been billed to simply hold his newborn child is deplorable. There, I said it!

acupressure for morning sickness

For women with morning sickness, a range of remedies may be effective at alleviating mild to severe symptoms, but the evidence on how well they work is lacking, a new review from the United Kingdom finds.

Up to 85 percent of women experience morning sickness during pregnancy, and the symptoms can affect their day-to-day lives, according to the review, published Tuesday in the journal JAMA.

In the review, the researchers, led by Catherine McParlin, an associate researcher at Newcastle Upon Tyne Hospitals NHS Foundation Trust in the United Kingdom, looked at 78 studies on various treatments for nausea and vomiting during pregnancy.

Of the 78 studies, 67 were randomized clinical trials, meaning that the people in the study were randomly assigned to receive either the treatment or a placebo. Randomized clinical trials are considered the gold standard when it comes to determining if a certain treatment is effective.

However, after reviewing the studies, the researchers determined that many of them, including some of the randomized clinical trials, were “low-quality” studies, meaning that the research was imprecise, did not include a wide variety of patients, or didn’t offer enough information from which to draw conclusions, according to the study.

Overall, treatments for morning sickness fell into three main categories, according to the review. First-line treatments were those that included simple lifestyle changes, such as changes to diet, and over-the-counter remedies. Second-line treatments were medicines prescribed by a doctor, according to the review. And third-line treatments were reserved for the women with the most severe morning sickness, and are given in a hospital setting, the researchers wrote.

For women with mild morning sickness, the researchers found that consuming ginger, taking vitamin B6 supplements and using acupressure are all “appropriate initial” approaches. Acupressure is an ancient practice that involves applying pressure to certain points on the body. In the review, the researchers focused on studies that looked at applying pressure on a point on the inside of the wrist, about one-sixth of the way up the arm.

Other options, such as nerve stimulation, which involves applying a mild electrical current to certain parts of the body such as the wrist, may also be considered for mild cases, and although the procedure is safe, “the benefit is unclear,” the researchers wrote. In this case, the researchers looked at a study on nerve stimulation to the same pressure point used in acupressure.

For women with mild to moderate morning sickness, or in those who’ve tried the approaches for mild morning sickness and found they didn’t work, the researchers discovered that antihistamines were associated with improved symptoms. Women are sometimes recommended to take antihistamines in combination with vitamin B6, the researchers said in their review. In the U.S., this combination is available by prescription.

Other prescription drugs, such as promethazine and metoclopramide, which affect dopamine levels in the body, were found to be helpful for women with moderate morning sickness, according to the review.

One study included in the review evaluated psychotherapy as a treatment option for women with moderate to severe morning sickness. However, the researchers concluded that evidence that it worked was not strong enough to recommend it.

Anti-nausea drugs, such as ondansetron, appeared to be beneficial for women with all levels of morning-sickness severity, the researchers wrote. The drug appears to safe for pregnant women, but more research is needed to ensure that it is safe, the researchers wrote.