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A Routine Skin Check Could Save Your Life

SATURDAY, Nov. 27, 2021 (HealthDay News) -- It may sound dramatic, but skin checks save lives.

While encouraging people to do routine self-exams, the American Academy of Dermatology (AAD) shares some case studies that led to important discoveries.

Richard Danzer, of West Palm Beach, Fla., found a large, painful cyst on his back during a skin self-exam. Dermatologist Dr. Brittany Smirnov examined him, and he was later diagnosed with lung cancer and given lifesaving treatment.

When John Ahearn, of Phoenix, had dark bruising that appeared on his legs, dermatologist Dr. Lindsay Ackerman suspected he might have a serious blood issue. She collaborated with a hematology-oncology specialist who diagnosed Ahearn with leukemia. He is now in remission after a bone marrow transplant.

After noticing changes to a mole on her toe, Yvonne Basil, of Plano, Texas, saw her dermatologist and was diagnosed with melanoma from an in-office biopsy. She is now cancer-free.

"Regular self-skin checks are crucial to identify skin cancer and other skin diseases early," AAD president Dr. Ken Tomecki said in an academy news release. "We encourage everyone to regularly perform skin self-exams to catch any changes early."

You can do your own skin checks at home, and then follow up with a dermatologist if you spot something concerning. The academy suggests using the initials A, B, C, D, E during your self-exam.

A is for Asymmetry, when one half of a spot is unlike the other. B is for border, when a spot has an irregular, scalloped or poorly defined border, C is for color, when the spots has color variation from one area to the next. D is for diameter. Melanomas are typically larger than 6 millimeters, which is about the size of a pencil eraser. E is for evolving. The spot looks different from the rest or is changing in size, shape or color.

To do a skin exam, look at your body in a full-length mirror. Look at your underarms, forearms and palms. Look at your legs, between toes and at the soles of your feet. Use a hand mirror to examine your neck and scalp, as well as to check your back and buttocks.

If you notice a spot that is different from others, or that changes, itches or bleeds, you should make an appointment to see a board-certified dermatologist.

Skin cancer is the most common cancer in the United States, with roughly 9,500 people diagnosed every day.

More information

The American Cancer Society offers more suggestions for a skin self-exam.

SOURCE: American Academy of Dermatology, news release, Nov. 11, 2021

As Holidays Return to Normal, Here's How to De-Stress

FRIDAY, Nov. 26, 2021 (HealthDay News) -- A return to a more normal holiday season may also mean higher stress levels, so an expert offers some coping tips.

Don't get too focused on buying the perfect presents, making the best dinner or planning the perfect party. Try to be mindful of pleasant things and moments, suggested Jennifer Wegmann, a health and wellness studies lecturer at Binghamton University, State University of New York.

"Being mindful requires you to be present and aware. It is impossible to be in the moment when you are focused on what is next or stuck in could have, would have, should have," Wegmann said in a university news release.

"Being mindful requires intentionality, so try an easy breathing exercise next time you find yourself mindlessly going through your day," she suggested. "Few things bring us into the moment like our breath. There are so many techniques out there, but something as simple as taking several deep breaths can be effective."

Try to adopt an attitude of gratitude, she advised.

"Gratitude is more than simply being thankful," Wegmann said. It requires intentionally seeking goodness in your life and understanding that goodness comes from both inside and outside of ourselves, she explained.

"Gratitude is a powerful positive emotion, and science shows when we practice gratitude, we experience numerous benefits. It improves sleep habits, cultivates happiness, reduces the stress hormone cortisol and improves mental health," Wegmann said. "A great exercise we can all do is to take a little time in the next few weeks to reflect upon what and who we are truly and genuinely thankful for. Being grateful will help us see the holidays through a different lens. I encourage everyone to find a way to let people in your life know you are grateful for them and why."

It's also important to set healthy boundaries by not saying yes to every party, dinner, present or other holiday request, she added.

"First, reflect on what your boundaries are. Surprisingly, many people can't tell you their boundaries because they have never given themselves time to think about them," Wegmann said.

"Once you acknowledge what your boundaries are, you need to communicate them assertively and directly. Remember, you can be assertive without forgoing compassion and kindness. If you do not communicate your boundaries, then you can't expect people to respect them," she explained.

"You can anticipate that some people may be taken aback by your boundaries, but remember that you are not responsible for others' actions," she said. "Do not fall into the trap of believing that setting a boundary is selfish. It's an act of self-love, as it acknowledges your self-worth."

More information

The U.S. Centers for Disease Control and Prevention offers holiday health tips.

SOURCE: Binghamton University, State University of New York, news release, Nov. 19, 2021

Could a Single Dose of the HPV Vaccine Be Enough?

FRIDAY, Nov. 26, 2021 (HealthDay News) -- Women getting vaccinated against the cancer-causing human papillomavirus (HPV) now need two or three shots, but an African clinical trial suggests a single dose is just as effective.

The finding could speed up the immunization process in developing countries with high levels of HPV-related cancers and protect many more women more quickly.

"These findings are a gamechanger that may substantially reduce the incidence of HPV-attributable cervical cancer and positions single-dose HPV vaccination as a high value and high impact public health intervention that is within reach for us," said Sam Kariuki, acting director general of the Kenya Medical Research Institute, in Nairobi.

The trial included 2,275 sexually active women in Kenya between 15 and 20 years of age. The women were randomly assigned a vaccine therapy and were followed from December 2018 to June 2021. To participate, they needed to have had no more than five lifetime sexual partners, be unvaccinated for HPV, and HIV-negative.

In all, 760 participants received a so-called bivalent vaccine that covered two strains of HPV (16/18). A similar number received a nonavalent vaccine that covered seven HPV strains (16/18/31/33/45/52/58). The rest received a vaccine that protects against meningococcal meningitis.

After 18 months, both HPV vaccines were 97.5% effective against HPV 16 and 18. (Seven in 10 HPV cases involve these two strains.)

The nonavalent vaccine was 89% effective against five other strains, as well. Even if women tested positive for one strain of HPV, the vaccine protected them from other strains of the virus.

"The single-dose vaccine was highly effective at 18 months for HPV vaccination," said study co-leader Ruanne Barnabas, a professor of global health at the University of Washington School of Medicine, in Seattle. "The single-dose efficacy was the same as multiple doses."

Her team said more studies need to be done to find out how long the protection lasts.

According to study co-leader Dr. Nelly Mugo, "This trial brings new energy to the elimination of cervical cancer. It brings great hope to the women living in countries like Kenya, who have a high burden of the disease." Mugo is an associate research professor at the University of Washington and a senior scientist at the Kenya Medical Research Institute.

Worldwide, cervical cancer kills a woman every two minutes, and Africa bears 80% of the burden.

Barnabas said the trial could help the World Health Organization reach its goal to have 90% of 15-year-old girls vaccinated against HPV by 2030. A single-dose vaccine would simplify logistics and lower costs, she noted, adding that women have been given multiple doses of the vaccine because of gaps in evidence for the effectiveness of a single-dose vaccine.

HPV is a common virus spread by intimate contact. Most sexually active men and women will be infected with HPV during their lives. For most, the infection clears on its own. But for others, the virus can lead to reproductive cancers, most commonly cervical cancer.

The U.S. Food and Drug Administration approved the first HPV vaccine 15 years ago and two others have since been introduced. The Gardasil-9 vaccine is recommended for boys and girls at 11 and 12 years of age, though it can be given through age 45.

But use has been low in areas like Kenya with high rates of cervical cancer.

The findings were presented recently at the International Papillomavirus Conference in Toronto. Research presented at meetings should be considered preliminary until published in a peer-reviewed journal.

More information

The U.S. Centers for Disease Control and Prevention has more on human papillomavirus.

SOURCE: University of Washington School of Medicine, news release, Nov. 17, 2021

Give Others Help, Get Back Health Benefits: Study

FRIDAY, Nov. 26, 2021 (HealthDay News) -- When it comes to helping others and your health, it might be better to give than to receive, a new study suggests.

Researchers surveyed more than 1,000 Americans between 34 and 84 about their social involvement and how much they thought they could rely on their family, friends or a spouse if they needed help.

On a key measure of health -- chronic inflammation -- positive social relationships were associated with lower inflammation only among respondents who said they were available to provide social support to family and friends.

"It may be that when people believe they can give more support to friends and family, these relationships are especially rewarding and stress-relieving, which reduces inflammation," study co-author Baldwin Way said in a news release from Ohio State University. He's an associate professor of psychology.

In other words, having people who support you may not help your health unless you're also there when they need you, according to the findings.

"Positive relationships may be associated with lower inflammation only for those who believe they can give more support in those relationships," said lead author Tao Jiang, a doctoral student in psychology at OSU.

Preliminary data suggest that the connection between offering social support and health is strongest in women, he said.

"This reflects the idea that social relationships are often seen as more important for women than for men," Jiang said. "But our sample size was not large enough to show that conclusively. We need to study that issue further."

While the study only examined what people said they were willing to do and not their actual actions, it does give "a more nuanced understanding" of the link between health and relationships, Jiang said.

"This work underscores the importance of incorporating the concept of giving support into future research in this area," he said.

The findings were recently published online in the journal Brain, Behavior and Immunity.

More information

University College London outlines the benefits of helping others.

SOURCE: Ohio State University, news release, Nov. 22, 2021

During the Holidays, Help Protect the Elderly from Falls

FRIDAY, Nov. 26, 2021 (HealthDay News) -- A holiday visit with older relatives might be a good chance to help them remove fall risks in their home, an expert suggests.

Older adults' risk of falling may have increased during the pandemic due to declines in physical activity and mobility, along with increased isolation, a University of Michigan poll shows. Many also became more fearful of falling, which, in turn, can increase the risk.

"Taking steps now to reduce fall risk in their homes could prevent catastrophic injury and hospitalization," said Geoffrey Hoffman, a fall researcher and assistant professor of nursing at the university.

Older people whose mobility declined during the first part of the pandemic were 70% more likely to say they'd had a fall in that time, and twice as likely to express a fear of falling, the poll revealed.

"Even if an older adult has gotten more active since getting vaccinated, their risk of falling could still be higher than it would have been if the pandemic hadn't increased their inactivity or isolation," Hoffman said in a university news release.

He offered some tips on fall-proofing older adults' homes:

Rugs and mats: Cut pieces of non-skid material to fit underneath small throw rugs and mats. If they already have non-skid material, check that it still grips the floor. Throw rugs/mats should only be used on bare floors, not on top of carpet. Make sure bath mats have rubber backing in good condition.

Furniture placement: Offer to help move furniture and other objects to create wider walking paths.

Bathrooms: A grab rail in the tub/shower is a good idea, along with a rubber mat with suction cups or a stool with non-skid feet. If possible, a walk-in shower is much better than a tub.

Lighting: Dark hallways, stairways, closets with high shelves and outdoor steps are fall risk areas. Install brighter light bulbs or new fixtures that take multiple bulbs. Add motion sensors so lights come on automatically when someone enters the area, and consider night lights that come on when it gets dark or have a motion sensor.

Safe reaching: Encourage use of a folding step stool that has multiple steps and a high hand rail instead of a small stool or chair when seniors want to reach things on high shelves or change a light bulb, clock or smoke/carbon monoxide detector batteries.

Sensible storage: Help them reorganize storage to place items on lower shelves, even if they're only used occasionally.

Railings and steps: Check railings on stairways and porch steps to make sure they're securely anchored. If steps can become slippery, add stick-on traction strips.

Seasonal decor: Offer to bring holiday decorations and lights from the attic, an upstairs room or basement, and to help put them up.

Ice problems: Make sure older adults have a good supply of de-icer or sand to use on steps, walkways and driveways. For those who can't easily lift a heavy jug, transfer the de-icer or sand to a container with a lid and add a scoop so they can scatter it more easily.

Snow removal: Make sure their snowblower is in good working order and that shovels, car scrapers and brushes are close at hand and in good shape. If an older person uses a shovel, it should have a back-saving handle to provide more stability when shoveling and prevent muscle strains.

More outdoor hazards: Make sure outdoor lights work and have automatic sensors. Check doormats to make sure they won't slip. Clean gutters above entrances so melting snow doesn't collect on steps and form ice.

More information

The U.S. National Institute on Aging has more about falls and fall prevention.

SOURCE: University of Michigan, news release, Nov. 22, 2021

COVID Protection Wanes After 2 Doses of Pfizer Vaccine: Study

THURSDAY, Nov. 25, 2021 (HealthDay News) -- Protection can gradually fade after a second dose of the COVID-19 vaccine by Pfizer-BioNTech, which suggests that a booster shot might be necessary, researchers report.

They analyzed data from more than 80,000 adults in Israel, average age 44, who had no previous evidence of infection and who had received a PCR test at least three weeks after their second shot of the two-dose Pfizer vaccine.

Across all age groups, 1.3% tested positive 21-89 days after a second dose, increasing to 2.4% after 90-119 days; 4.6% after 120-149 days; 10.3% after 150-179 days, and 15.5% after 180 days or more.

Compared with the first 90 days after a second dose, the risk of infection was 2.37-fold higher after 90-119 days; 2.66-fold higher after 120-149 days; 2.82-fold higher after 150-179 days, and 2.82-fold higher after 180 days or more.

The study, published Nov. 24 in the BMJ, was conducted at the Research Institute of Leumit Health Services in Israel. In December 2020, Israel became one of the first countries to introduce a large-scale COVID-19 vaccination campaign, but the country has seen a resurgence of infections since June 2021.

COVID-19 vaccination programs worldwide are helping control the spread of the coronavirus, but breakthrough infections still occur in countries with high vaccination rates, and scientists believe this is due to a gradual loss of vaccine-induced immunity over time.

While this study confirms that the Pfizer vaccine offers strong protection in the initial weeks after vaccination, it also suggests that protection declines over time for some people.

Because this was an observational study, the researchers said other factors such as household size, population density or virus strain may have had an effect on protection offered by the vaccine.

However, they feel the findings are solid because it was a large study of people who received the same vaccine and the investigators were able to conduct a detailed analysis of the data.

Because protection in people who received two doses of the Pfizer vaccine appeared to decrease and the risk of breakthrough infection increased over time, it might be a good idea to consider booster shots, they concluded.

More information

The U.S. Centers for Disease Control and Prevention has more on COVID-19 vaccines.

SOURCE: BMJ, news release, Nov. 24, 2021

Fetal Infection With COVID-19 Possible, But Unlikely

THURSDAY, Nov. 25, 2021 (HealthDay News) -- There is a very low risk that pregnant women with COVID-19 will pass the virus to their unborn babies, researchers say.

The study should reassure expectant parents, said the British investigators.

To find out if and how the virus could pass from an infected pregnant women to her fetus, the team examined various fetal organs and placenta tissue for two cell surface protein receptors (ACE2 and TMPRSS2) needed by the virus to infect cells and spread.

The only fetal organs with both of the receptors are the intestines and the kidney, but a fetus' kidney is anatomically protected from exposure to the virus and therefore at little risk of infection.

That means that the virus can only infect the fetus via the intestine through swallowing of amniotic fluid, which the unborn baby does naturally for nutrients, according to the researchers.

"The fetus is known to begin swallowing the amniotic fluid in the second half of pregnancy. To cause infection, the SARS-CoV-2 virus would need to be present in significant quantities in the amniotic fluid around the fetus," said study co-author Mattia Gerli of University College London and Royal Free Hospital.

"However, many studies in maternity care have found that the amniotic fluid around the fetus does not usually contain the SARS-CoV2 virus, even if the mother is infected with COVID-19. Our findings therefore explain that clinical infection of the fetus during pregnancy is possible but uncommon and that is reassuring for parents-to-be," Gerli said in a news release.

The findings were recently published in BJOG – An International Journal of Obstetrics & Gynaecology.

"We have shown that the fetal intestine, which is in contact with amniotic fluids swallowed by the baby, is susceptible to SARS-CoV-2 virus. However, the placenta acts as a natural barrier, and with the limited evidence of amniotic fluid containing the virus, our study should provide reassurance to mothers," added study co-author Dr. Paolo De Coppi, a professor at UCL Great Ormond Street Institute of Child Health.

The greatest risk to the fetus during pregnancy is if the mother becomes seriously ill with COVID, the authors note. The virus might then be present in high concentration in the amniotic fluid. This could also trigger preterm birth.

Vaccination against COVID-19 is the best way to protect the baby and mother, the researchers said.

More information

The U.S. Centers for Disease Control and Prevention has more on pregnancy and COVID-19.

SOURCE: University College London, Nov. 19, 2021

What You Need to Know About Stomach Cancer

THURSDAY, Nov. 25, 2021 (HealthDay News) -- New treatment options are giving hope to patients with stomach cancer.

Also known as gastric cancer, the disease is the world's sixth most common cancer with 1.09 million new cases in 2020, according to the World Health Organization.

It's an abnormal growth of cells that can affect any part of the stomach, but typically forms in the main part.

"I tell patients who have been recently diagnosed with gastric cancer that there is hope," said Dr. Mohamad Sonbol, a cancer specialist at the Mayo Clinic in Phoenix.

"We now have many more treatment options than before," he said in a clinic news release.

When the cancer hasn't spread, surgery is among them. It is the only curative approach for patients with localized or locally advanced stomach cancer. Other treatments, such as systemic therapy and radiation, increase the chances of a cure and lower the risk of the cancer returning.

Some immunotherapeutics are standard care for stomach cancer and some are in current studies.

Among the new options for treating stomach cancer that has spread to other parts of the body is a regimen that combines chemotherapy with nivolumab, an immunotherapeutic drug.

An option for patients with HER2-positive stomach cancer that has spread is fam-trastuzumab deruxtecan-nxki, which is administered by infusion.

Mayo Clinic describes chemotherapy as killing cells all over the body and immunotherapy as waking up the immune system to fight the cancer. While chemo works for a while and then stops, when immunotherapy works, it is usually for a longer time. Experts determine which regimen to choose based on different targets on the cancer cells.

Doctors typically diagnose the disease through endoscopy, in which the digestive tract is examined using a flexible tube with a light and camera attached to it. If it detects stomach cancer, they can use CT and PET scans to glean more information, according to Mayo Clinic specialists.

Unlike in East Asia, where stomach cancer is more common, screening for stomach cancer is not recommended for most Americans. It can, however, be used for those at higher risk. They include people who are obese, tobacco and alcohol users and those with a family history of cancer.

More information

The American Cancer Society has more on stomach cancer.

SOURCE: Mayo Clinic, news release, Nov. 17, 2021

Gout Drug Colchicine Won't Help Fight COVID-19

THURSDAY, Nov. 25, 2021 (HealthDay News) – Add an inexpensive gout drug to the growing list of medications touted as potential COVID-19 treatments -- only to offer no apparent benefit.

The anti-inflammatory drug colchicine doesn't lessen COVID severity, the risk of death or shorten hospital stays, a new study reports. Nor does it lower the need for admission to the intensive care unit or a ventilator.

"There is no additional benefit of adding colchicine to supportive care in the management of patients with COVID-19," said the study team, which was led by Dr. Kedar Gautambhai Mehta, an assistant professor of community medicine at GMERS Medical College Gotri in Vadodara, India.

The anti-inflammatory drug is also associated with a high risk of side effects, particularly diarrhea, researchers added.

They examined 69 studies published through July 2021 on the use of colchicine to treat SARS-CoV-2 infection. The studies included six randomized, controlled trials that included 16,148 patients who had COVID with varying degrees of severity.

Patients taking colchicine had 58% higher rates of side effects and almost double the risk of diarrhea compared to those given usual supportive care.

"Our findings on colchicine should be interpreted cautiously due to the inclusion of open-labeled, randomized clinical trials," the authors said in a news release. "The analysis of efficacy and safety outcomes are based on a small number of [randomized controlled trials] in control interventions."

The findings were recently published in the open access journal RMD Open.

More information

The U.S. Centers for Disease Control and Prevention has more on COVID-19.

SOURCE: BMJ, news release, Nov. 22, 2021

Many Kids Separated From Families at U.S. Border Suffer PTSD

WEDNESDAY, Nov. 24, 2021 (HealthDay News) -- Parents and children who were separated under the Trump administration's "zero tolerance" immigration policy have shown lasting psychological trauma -- even after being reunited, a new study finds.

Between 2017 and 2018, more than 5,000 children were separated from their parents at the U.S.-Mexico border under the policy, which aimed to deter asylum seekers.

The practice was denounced by human rights groups and medical experts as inhumane -- with the American Academy of Pediatrics calling it "government-sanctioned child abuse." It was ultimately overturned in the courts.

That was not the end of the story, however. As of August, more than 1,800 children remained separated from their parents, according to a task force established by the Biden administration. And the U.S. federal government is in negotiations on how to compensate families.

Now, the new study offers a snapshot of the policy's mental health fallout.

Researchers found that among 25 families separated at the border, nearly all parents and children met the criteria for a psychiatric diagnosis -- even though they'd been reunited.

Post-traumatic stress disorder, major depression and anxiety disorders (including separation anxiety in some children) were among the diagnoses delivered.

The families had experienced "compound trauma," said researcher Dr. Ranit Mishori, senior medical adviser to the nonprofit Physicians for Human Rights (PHR).

Many were victims of gang-based persecution in their home country, and fled due to violence and threats of violence. Once they made it to the U.S. border after a harrowing journey, they were confined to a detention center.

And when their children were taken away, parents were usually given no information on where they were going or whether and how they would be reunited.

It may sound unsurprising, then, that there would be psychological consequences. But there has been little hard data on these families. That, Mishori said, is because they are a difficult population for researchers to access.

The findings were published Nov. 24 in the journal PLOS One.

"This is a very important study," said Dr. Alan Shapiro, senior medical director of the community pediatrics program at Children's Hospital at Montefiore in New York City. "It's extremely important for policymakers to understand the consequences of these actions."

Shapiro, who was not involved in the research, is a co-founder of Terra Firma, a Montefiore-based program that provides health care and legal services to immigrant children and families.

As this study shows, Shapiro said, the trauma of separation does not disappear once families are reunited.

"The memory of the fear doesn't just go away," he said. And the reunion, itself, is not necessarily a smooth process, Shapiro noted: Children can be angry; parents can be guilt-ridden.

Mishori made the same point, noting that if children are quite young and the separation is long, they might not even remember their parents.

How long does recovery take? It varies and depends on many factors, Mishori said. But years of research on adverse childhood experiences shows the mental health effects can be long-lasting.

There were some signs of that in this study group.

"One 8-year-old boy was still having nightmares two years after being reunited with his parents," said co-researcher Kathryn Hampton, deputy director of PHR's Asylum Program.

She said the zero tolerance policy and its aftermath "should really cause us to look at how our immigration policies are implemented. How did we get to this, and how do we prevent it from happening again?"

Shapiro agreed. "These are families who are fleeing their home country for their lives. We should never have a policy like zero tolerance again."

The latest findings are based on records for 31 parents and children who'd been separated at the U.S.-Mexico border. All had been referred for a mental health evaluation related to a legal case -- including asylum claims, appeals or lawsuits for damages related to family separation.

Mishori, Hampton and their colleagues examined the detailed narratives written by the health care professionals who did the evaluations.

Overall, they found, 16 of 19 adults and all 12 children met the diagnostic criteria for PTSD, depression or an anxiety disorder. Many had more than one diagnosis.

According to Shapiro, families like these need access to "trauma-informed" mental health care. Finding and paying for that care, however, is a big challenge.

"Even for U.S. citizens, accessing mental health services is often difficult," Mishori noted.

The lasting mental health effects of separation, she said, should be taken into consideration in reaching a settlement with the affected families.

More information

The World Health Organization has more on refugee health.

SOURCES: Ranit Mishori, MD, senior medical advisor, Physicians for Human Rights, New York City; Kathryn Hampton, MSt, MA, deputy director, Asylum Program, Physicians for Human Rights; Alan J. Shapiro, MD, senior medical director, community pediatrics program, and co-founder, medical director, Terra Firma, Children's Hospital at Montefiore, assistant professor, pediatrics, Albert Einstein College of Medicine, New York City; PLOS One, Nov. 24, 2021, online

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