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ACEP NOW

APRIL 2015

 

A Deadly Case of MANOPAUSE A quest for the Fountain of Youth may cost more years than it gains.

The Case “I told him he never should have started that medication,” said the patient’s worried wife. Several hours earlier, her husband had presented to the emergency department for chest pain and shortness of breath. He first noticed it over the past week when doing routine chores such as cleaning and moving furniture. “It didn’t stop him, even though it was bothering him. He never had any serious health problems,” she said. Other than diabetes and sleep apnea, her 62-year-old husband was healthy. His primary doctor sent him to the ED for further evaluation after a concerning ECG was obtained in his office. He was tachycardic but seemed relatively stable. We proceeded with a chest pain and dyspnea work-up, which included cardiac enzymes, chest X-ray, and a d-dimer. He waited patiently, charming the staff with his small talk and affable personality. Enzymes were negative, and d-dimer was positive. I took him for his CT angiogram. As soon as it was done, the tech and I immediately noticed the large bilateral pulmonary emboli on the screen in front of us (see Figure 1). I was preparing to take him back to the ED when he asked, “Is there a bathroom over here? I’d rather use it here before going back to the ED. It’s pretty crowded over there.” He had a point. The ED could be a madhouse with just two bathrooms. His wife and I assisted him to the bathroom. It was only seconds before I heard her scream. I opened the door, and he was sitting on the toilet, a glazed look on his eyes. “I think he just passed out,” she exclaimed.

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SFGATE

 

 

With vivid burgundy seeds and a distinctive sweet flavor, the pomegranate is a nutrient-dense fruit that is fun to eat and steeped in history. Its medieval French name originates from the Latin roots for “apple” and “seedy,” according to the University of California. It was first cultivated in Iran, but spread to the Mediterranean area and later to the Americas. People during the Middle Ages thought pomegranates were good for liver inflammation, a common malady in men, but today, other male health benefits are being discovered.

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HealthDay

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HealthDay

Taking aspirin every day appears to reduce the odds of developing and dying from colon, stomach or esophageal cancer, a new study suggests.

Based on a review of available studies, researchers determined that the benefits of aspirin therapy for preventing cancer outweigh the risks. Millions of people already take this inexpensive drug to prevent or treat heart disease.

“We came to the conclusion that most people between the ages of 50 and 65 would benefit from a daily aspirin,” said lead researcher Jack Cuzick, head of the Center for Cancer Prevention at Queen Mary, University of London.

“It looks like if everyone took a daily aspirin, there would be less cancer, and that would far outweigh any side effects,” added Cuzick.

Gastrointestinal bleeding is the most serious side effect associated with aspirin.

Taking aspirin for 10 years could cut colon cancer risk by around 35 percent and deaths from colon cancer by 40 percent, the researchers reported Aug. 6 in the Annals of Oncology.

Daily aspirin also can reduce the risk of esophageal and stomach cancers by 30 percent and deaths from these cancers by 35 to 50 percent, the investigators reported.

Dr. Leonard Lichtenfeld, deputy chief medical officer at the American Cancer Society, said this study falls short of a recommendation that everyone take aspirin to prevent cancer. “But it rises to the level that people should have a discussion with their doctor,” he said.

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Men’s Fitness

The latest fad in homeopathy to hit the United States has roots in an un­likely place: the salt caves of Eastern Europe—a sort of primordial spa where people flocked for eons to treat ailments ranging from respiratory illnesses to skin infections. Dry salt therapy (or, as it’s officially known, “halotherapy”) involves basking in the sodium-rich air of small, custom-crafted “salt chambers.” Its lack of regulation and scientific backing hasn’t stopped its surge in popularity. According to Ulle Lutz, president of consultation service Salt Chambers Inc., about 150 halotherapy facilities have sprung up in the U.S. in the past two years. We gave one a test run.

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JAMA

April 14, 2015

The Health of Young African American Men

Deaths in Ferguson, Missouri; New York City; Sanford, Florida; and other areas have focused international attention on young African American men. In a recent campaign, young African American men draw attention to key overlooked facts that describe their demographic: 1 of 3 goes to college, 3 of 4 are drug free, 5 of 9 have jobs, 7 of 8 are not teenaged fathers, and 11 of 12 finish high school.1 How can clinicians help address existing health disparities and add to these positive outcomes?

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February 24, 2015

A Finnish study found daily saunas protect middle-aged men against heart attacks.

Men’s Fitness

MEN’S FITNESS

The Finnish are clearly onto something. Though the Angry Birds ship has sailed—we feel your deep-seeded jealousy toward Rovio’s genius, too—you can jump on Finland’s health bandwagon by stepping into a sauna.

Frequent sauna trips (baths? sits?) may help you live longer, a Finnish study published in JAMA Internal Medicine has found. Saunas are to Finland what Starbucks is to America. For a population of 5.3 million people, there are 3.3. million saunas in Finland, according to InterNations.org. And they have good reason to cherish their sweatboxes.


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Centers for Disease Control and Prevention

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FEB. 3, 2015

HEALTH

 Americans’ exposure to secondhand smoke has declined by half since 2000, federal health authorities reported Tuesday, as states and municipalities banned smoking in bars, restaurants and offices, and fewer Americans smoked inside their homes.The share of American nonsmokers exposed to secondhand smoke fell to 25 percent in 2012 from 53 percent in 2000, according to an analysis of federal health data by the Centers for Disease Control and Prevention.Exposure was determined by testing for cotinine, a marker of nicotine in the blood.

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Sugary Drinks Tied to Earlier Menstruation

BODY

 

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JANUARY 27, 2015 

Age of first menses has decreased substantially since the early 20th century, and studies have shown that younger age of menarche is associated with increased risk of breast and endometrial cancer in later life.Here is another mark against sugary drinks: A new study has found that drinking them is associated with lowered age of menarche.

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The study, published online in Human Reproduction, used data on 5,583 girls ages 9 to 14 who had not yet attained menarche at the start. They filled out diet questionnaires yearly from 1996 to 1998. By 2001, 159 still had not yet had their first period.

After controlling for birth weight, maternal age at menarche, physical activity, and many dietary and behavioral factors, they found that girls who drank one-and-a-half 12-ounce cans a day of nondiet soda or sugared iced tea had their first period an average of 2.7 months earlier than those who drank less than two cans a week.

The lead author, Karin B. Michels, an associate professor of epidemiology at Harvard, said that the contribution of sugary drinks to early menarche was independent of the well-known contribution of obesity.

“Our findings are robust,” she said, “and not dependent on body mass index. Sugared beverages are not healthy to begin with, and there should be heightened attention to avoiding them.”

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