U.S. busts $108 million black market in Medicaid drugs

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Leaky bladder affects young women too

Reuters – 2 hrs 20 mins ago NEW YORK (Reuters Health) - Bladder control problems may be seen as a problem of older people, but a good percentage of college-age women have symptoms too, a study published Monday suggests.

In a survey of 1,000 young Australian women, researchers found that 13 percent said they'd had urinary incontinence in the past month. That meant problems like leaking urine when they exercised, or often having to rush to the bathroom to avert an accident.

"The traditional belief has been that incontinence really occurs as a consequence of pregnancy and aging," senior researcher Susan R. Davis, of Monash University in Melbourne, said in an email.

"What prompted us to undertake this study was the fact that nobody had actually looked at incontinence in younger women who had never been pregnant," said Davis, whose work was supported by Australian state and federal funds.

The study "contributes significantly to current knowledge about urinary incontinence in young women," said Mary K. Townsend, an epidemiologist at Brigham and Women's Hospital and Harvard Medical School in Boston.

Townsend, who was not involved in the research, has studied the prevalence of urinary incontinence and possible risk factors for it.

"Overall, a key message from this study is that urinary incontinence is a significant problem for women of all ages," Townsend said in an email.

But, she noted, the 13 percent figure could be either an underestimate or overestimate.

That's because the study participants, who were about 22 years old on average, were recruited from college campuses and health clinics. So they may not be representative of all young women.

"It will be important for future studies to confirm these results in a larger, population-based sample of young women," Townsend said.

LINK TO BIRTH CONTROL USE

The study, which appears in the Annals of Internal Medicine, also tried to weed out the possible risk factors for urinary incontinence in young, never-pregnant women.

It turned out that women were sexually active and not using birth control pills had the highest risk: about 22 percent had urinary problems in the past month.

That compared with rates of around 10 percent among women who had either never had sex or were sexually active and on the Pill.

The link to sexual activity might be related to urinary tract infections, Townsend speculated. Sexually active women have a higher rate of UTI, and those infections can trigger incontinence.

But the reasons for the birth control finding are not clear.

Townsend said past studies have come to conflicting conclusions on whether birth control pills are related to higher or lower risks of urinary incontinence -- or whether there's a relationship at all.

She and Davis both said more research is needed to see whether birth control pills, themselves, have any effect on bladder control problems.

There was no strong evidence that overweight young women had an increased risk of incontinence. And that's in contrast to what's been seen among older women.

But Davis said that may be because of numbers: only 15 percent of the study participants were overweight. And as a group, they were fairly healthy and physically active.

"This leaves open the possibility that the rate of incontinence we observed may in fact be an underestimate of the rate in a less healthy group of young women," Davis said.

Both she and Townsend said that young women who find their urinary symptoms troublesome should seek help. In this study, women with symptoms scored lower on a measure of mood and psychological well-being.

"I think the most important take-home message is that if young women experience urinary incontinence they should not feel embarrassed to seek help," Davis said.

There are different options for combating the symptoms, she noted.

Sometimes all you need are lifestyle changes -- like cutting back on caffeine and alcohol, and limiting how much fluid you drink at night.

Another option is "bladder training," which involves tactics like going to the bathroom at fixed times, even if you don't feel like you need to go. That often includes Kegel exercises to strengthen the pelvic muscles that control urination.

Depending on the type of incontinence, medications -- like oxybutynin (Ditropan), solifenacin (Vesicare), tolterodine (Detrol) -- may also help. But research shows that they work for only a minority of women, and they can have side effects like dry mouth, constipation and blurred vision.

SOURCE: http://bit.ly/PdxBlf Annals of Internal Medicine, July 17, 2012.

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Health Tip: Heed the Warning Signs of Heat Exhaustion

HealthDay – 2 hrs 2 mins ago (HealthDay News) -- Some people, including seniors, have a harder-than-average time adjusting to rapid changes in weather.

Chronic medical conditions can make it more difficult for their bodies to adjust to extreme cold or extreme heat. So the elderly should be closely monitored for potential symptoms of heat exhaustion.

The U.S. Centers for Disease Control and Prevention offers this list of possible warning signs:

Sweating heavily or appearing pale.Muscle cramps, headache, vomiting or nausea.Dizziness, weakness, fatigue or fainting.Moist skin that's quite cool to the touch.A weak and fast pulse, or fast and shallow breathing.

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Health Tip: Don't Neglect Oral Hygiene During Pregnancy

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Incontinence Affects Young Childless Women, Too

HealthDay – 2 hrs 2 mins ago TUESDAY, July 17 (HealthDay News) -- Urinary incontinence is often thought of as a problem that occurs after childbirth or in old age, but a new study finds that many young women who have never given birth have the bothersome condition, too.

Researchers in Australia surveyed more than 1,000 women aged 16 to 30 who had never been pregnant and found that one in eight, or nearly 13 percent, reported having urinary incontinence.

Urinary incontinence means leaking urine during certain activities such as running or sneezing, or being unable to hold urine with a full bladder.

Previous research has found the rates are higher among women who've had children. But this study shows that urinary incontinence can affect women of all ages, regardless of pregnancy history, and that the condition may be underdiagnosed and undertreated in younger women, experts said.

"Although incontinence is more prevalent as women age and with an increasing number of pregnancies, incontinence can affect women of all ages," said Dr. Jill Rabin, professor of obstetrics and gynecology at Hofstra North Shore-LIJ School of Medicine, who was not involved with the study.

The study, by Tessa O'Halloran and colleagues at Monash University, in Melbourne, is published in the July 17 issue of Annals of Internal Medicine.

The women who answered the survey came from eight medical clinics and three university campuses in Australia. They were asked to complete a questionnaire about an important issue in women's health, but were not told it was about urinary incontinence prior to filling it out. About 63 percent of those who took surveys returned them.

Commenting on the study, Dr. Elizabeth Kavaler, a urology specialist at Lenox Hill Hospital in New York City, pointed out that because people who have a problem may be more likely to answer a survey about it, that may mean the study overestimates the number of young women with incontinence.

On the other hand, Rabin noted, the women in the study were mostly normal weight, healthy and active, which may make the incontinence rate a conservative estimate.

There are two types of incontinence -- stress and urge incontinence, which have different causes, experts explained. In the study, about 6 percent of women reported stress incontinence, 4.5 percent reported urge incontinence, and about 2 percent reported both.

Stress incontinence is often caused by a weakening of the pelvic floor muscles that hold the bladder in place. Pregnancy and vaginal deliveries can weaken or damage pelvic floor muscles. But other factors, such as obesity or being overweight, are also associated with stress incontinence, although this study did not find an association between weight and incontinence.

Urge incontinence, or feeling the urge to go but not making it to the bathroom, usually has a neurological cause, in that the brain doesn't have sufficient control over the bladder. Neurological conditions such as multiple sclerosis, dementia or simply advancing age can contribute to urge incontinence, Kavaler noted.

It's well known that some younger women can experience what is essentially premature aging of that bladder control, and can experience urge incontinence earlier in life.

To alleviate stress incontinence, Kegel exercises, which strengthen the pelvic floor muscles, may help. Women should squeeze their pelvic muscles as if they are stopping the flow of urine for five seconds, then release for five seconds. Repeat that about five times, Rabin advised. Take a break, and then increase your Kegel set up to 10 times in a day.

"Over time, it thickens the muscle that supports the bladder, vagina and rectum and stabilizes it," Rabin said.

If Kegel exercises aren't helping, see your doctor. "There are young women who have urinary control issues, there are treatments, and they should seek help and talk to their doctor about it," Kavaler said.

Rabin pointed out that some women will resort to restricting fluid intake to alleviate incontinence, but that's a bad idea, she said. Dehydration can contribute to urinary tract infections and constipation, which can also stress the pelvic floor muscles during bowel movements.

The study did not receive university or outside funding.

More information

The U.S. National Kidney and Urologic Diseases Information Clearinghouse has more on urinary incontinence.

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Health Highlights: July 17, 2012

HealthDay – 2 hrs 1 min ago Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Annual Report Ranks Mass. General as Top Hospital in U.S.

Massachusetts General Hospital in Boston knocked off long-time champion Johns Hopkins in Baltimore to take this year's title as top hospital in the United States.

Hopkins was first for 21 consecutive years in the annual rankings by U.S. News and World Report, the Associated Press said.

The first-place ranking is a "tribute to the more than 23,000" staff at MGH, hospital president Dr. Peter Slavin said. The competition was not with other hospitals, but rather with "disease, health care costs, accessibility of services, and social issues," Dr. David Torchiana, chairman of the Massachusetts General Physicians Organization, said.

MGH is a 950-bed facility that admits about 48,000 patients a year and delivers about 3,600 babies annually. The hospital was founded in 1811, the AP reported.

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U.S. Produce Testing Program Faces Uncertain Future

A produce-safety testing program operated by the U.S. Department of Agriculture will continue for the rest of the year but then may shut down due to lack of funding.

The Microbiology Data Program screens thousands of produce samples a year and is the nation's largest produce-safety testing program. It has detected more than two dozen bacteria-contaminated samples that led to recalls of produce such as lettuce and tomatoes, the Associated Press reported.

Funding for the program -- which cost $4.3 million to run last year -- was slashed in President Barack Obama's proposed budget earlier this year and the House and Senate have not included money for it in their agriculture spending bills.

In order to keep the program operating until the end of the year, the USDA will use existing agreements with states.

Ending the program would leave the nation without a vital way to investigate outbreaks of foodborne illness, food safety advocated and public health officials say. The program could not easily be replaced by more modest federal sampling programs or by companies' internal tests, according to Dr. Robert Tauxe, the top food-germ investigator at the Centers for Disease Control and Prevention, the AP reported.

Last year, contaminated fruits and vegetables caused nearly one-third of major multistate foodborne illness outbreaks in the U.S., the CDC says.

"It is unacceptable for this crucial, cost-effective program to be eliminated," said Rep. Rosa DeLauro, D-Conn., a longtime food safety advocate, the AP reported. She said she would continue to push for the program to keep operating beyond December.

In recent years, produce industry leaders have urged the federal government to eliminate the USDA program and have said they want the private sector to do more testing.

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California Sues Companies Over High Lead Levels in Costume Jewelry

California is expected to file a lawsuit Tuesday against 16 companies accused of selling and distributing costume jewelry containing dangerous levels of lead.

State investigators found that some of the items from the retailers, wholesalers, suppliers and distributors had lead levels more than 1,000 times the legal state limit, the Associated Press reported.

Along with being accused of violating lead safety standards, the state alleges that the companies engaged in deceptive practices by falsely advertising contaminated jewelry as lead-free.

The three-year investigation involved spot checks at stores and factories in which inspectors used hand-held X-ray devices to check for lead in items such as earrings, necklaces, tiaras and hair clips. Items with a high lead content were then sent to a laboratory for detailed analysis, the APreported.

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Japan Nuke Disaster Will Kill Up to 1,300 People Worldwide, Study Estimates

HealthDay – 2 hrs 1 min ago TUESDAY, July 17 (HealthDay News) -- Radiation from last year's disaster at Japan's Fukushima Daiichi nuclear plant may eventually cause up to 1,300 deaths and 2,500 cases of cancer worldwide, according to U.S. researchers who calculated the global health effects of the incident.

Most of those deaths and cancer cases would occur in Japan, the Stanford University team said.

Although their estimates have a large range of uncertainty, the findings challenge previous claims that the radioactivity released by the damaged plant was not likely to cause any severe health effects.

The researchers' calculations are in addition to the approximately 600 deaths caused by the evacuation of the area around the nuclear plant after the March 2011 earthquake, tsunami and meltdown.

The study, published July 17 in the journal Energy and Environmental Science, is the first detailed analysis of how the disaster could affect health around the world.

For the study, the investigators used a global atmospheric model to predict the transport of radioactive material released by the plant and used another model to estimate the health effects of the radiation.

The health effects would overwhelmingly occur in Japan, with extremely small effects in mainland Asia and North America. For example, the United States was predicted to have between 0 and 12 deaths and 0 to 30 cancer cases related to radiation from the Fukushima plant.

The findings should "serve to manage the fear in other countries that the disaster had an extensive global reach," study author John Ten Hoeve, a recent Ph.D. graduate, said in a Stanford news release.

More information

The World Health Organization has more about health concerns associated with the Fukushima disaster.

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Weight-Loss Surgery May Not Cut Medical Costs: Study

HealthDay – 2 hrs 1 min ago TUESDAY, July 17 (HealthDay News) -- Although patients do indeed lose weight after bariatric surgery, health-care costs remain about the same as they were before the procedure, according to a new study.

Bariatric surgery reduces the size of the stomach, which results in significant weight loss. Most patients in the new study had undergone a procedure called Roux-en-Y gastric bypass.

Previous studies had shown that many obese people who have this procedure improve their health and reduce the cost of their care. In this group of patients, however, costs did not go down, the researchers said.

"These three-year findings suggest that the return on investment for bariatric surgery isn't seen," said lead researcher Matthew Maciejewski, from the Center for Health Services Research in Primary Care at the Durham VA Medical Center, in North Carolina.

"It is possible, however, that if we could follow these

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Sodium Buildup in Brain Linked to Disability in MS Patients

HealthDay – 2 hrs 1 min ago TUESDAY, July 17 (HealthDay News) -- Sodium buildup in the brain seems to be linked to disability in people with multiple sclerosis, researchers have found.

This accumulation of sodium could be an indicator of the degeneration of nerve cells that results from the disease, according to a team of European researchers. Although multiple sclerosis, or MS, symptoms vary from patient to patient, the study authors suggested that their findings may help predict the severity of disease progression and disability.

"A major challenge with multiple sclerosis is providing patients with a prognosis of disease progression. It's very hard to predict the course of the disease," Patrick Cozzone, director emeritus of the Center for Magnetic Resonance in Biology and Medicine, a joint unit of National Center for Scientific Research and Aix-Marseille University in Marseille, France, said in a news release from the Radiological Society of North America.

In conducting the study, the researchers used a specific type of imaging technology that provides information on the sodium content of cells in the body, known as 3 Tesla sodium MRI. The test was performed on 26 patients with relapsing-remitting MS, the most common form of the disease, in which flare-ups of symptoms are followed by periods of recovery.

Of the study's participants, 14 had early stage relapsing-remitting MS and 12 had advanced forms of the disease. The researchers also examined 15 healthy participants without MS that they matched for the patients' ages and genders.

"We collaborated for two years with chemists and physicists to develop techniques to perform

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Alzheimer's Treatment Shows Promise in Small, 3-Year Trial

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11 Countries Now Restrict Indoor Tanning Before Age 18

HealthDay – 2 hrs 1 min ago TUESDAY, July 17 (HealthDay News) -- Restrictions on young people's use of indoor tanning have been introduced by several countries in recent years, a new study reports.

Research suggests that indoor tanning is linked to skin cancer, the study authors pointed out.

Between 2003 and 2011, the number of countries with nationwide restrictions on the use of indoor tanning by people under 18 increased from two (Brazil and France) to 11 (Austria, Belgium, Brazil, England, France, Germany, Northern Ireland, Portugal, Scotland, Spain and Wales), according to the study released online in advance of print publication in the Archives of Dermatology.

"Since 2003, youth access to indoor tanning has become increasingly restricted throughout the world as accumulating evidence demonstrated an association between melanoma and indoor tanning. Additional countries and states are developing indoor tanning restrictions or making their existing legislation more restrictive," study author Dr. Mary Pawlak, of the Colorado School of Public Health, in Aurora, and colleagues said in a journal news release.

Experts at Memorial Sloan-Kettering Cancer Center, in New York City, voiced their opinion on the issue in an accompanying commentary. "Ideally, a ruling at the federal level to restrict tanning will have the most far-reaching impact. However, in the absence of a complete ban in the near future, other strategies to limit UV exposure to minors can be promoted," according to Lucy L. Chen and Dr. Steven Q. Wang.

"As dermatologists, we can play many unique roles in this ongoing health campaign. On a daily basis, dermatologists can educate and discourage patients, especially teenagers, from using tanning beds," the editorialists noted. "On a legislative level, we can provide testimony as health experts and serve as advocates for key legislation in our individual states."

More information

The U.S. Food and Drug Administration has more about the risks of indoor tanning.

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New Drug Approved for Colonoscopy Preparation

HealthDay – 2 hrs 1 min ago TUESDAY, July 17 (HealthDay News) -- Prepopik (sodium picosulfate, magnesium oxide and citric acid) has been approved by the U.S. Food and Drug Administration for adults preparing for a colonoscopy, a diagnostic procedure to inspect the colon's inner lining.

The cleansing regimen consists of two packets of powder, each dissolved in water, to be taken at different times before a colonoscopy, the FDA said in a news release. Additional fluid intake is needed to prevent dehydration and electrolyte imbalance, the agency warned.

In two clinical studies involving about 1,200 adults preparing for a colonoscopy, the most common side effects of Prepopik included nausea, headache and vomiting.

As a condition of approval, maker Ferring Pharmaceuticals must conduct additional studies to evaluate the product's safety and effectiveness among children, the FDA said.

Ferring is based in Parsippany, N.J.

More information

To learn more about colonoscopy, visit the National Digestive Diseases Information Clearinghouse.

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