Managing Frequent Nose Bleeds

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Submitted by the Baylor College of Medicine….

BaylorCollegeBloody noses, while incredibly common, are inconvenient and can often be alarming to whoever experiences one. While everyone has their own idea of how to remedy the occasional bloody nose, Baylor College of Medicine’s Dr. Eddie Liou breaks down what is really happening to cause the bleed and how to manage it.

“People of all ages experience nose bleeds, and most are caused by simple dryness due to weather or air conditioning, picking the nose or a trauma event, such as a fall or sports injury, or by predisposed conditions like septal deviation or inflammation due to allergies,” said Liou, assistant professor of otolaryngology-head and neck surgery at Baylor. “Though very rare, more serious causes can include growths, tumors or elevated blood pressure. Additionally, older individuals who are on blood thinners may experience more frequent nose bleeds.”

Liou explained that most bleeds happen in the anterior area of the nose, or the cartilaginous portion at the front of the septum.

“The interior lining of the nose can dry out and become brittle and break, much like a chapped lip can split, causing a bleed. Because the blood supply to the nose is so rich, it can take a little longer to subside,” Liou said.

When experiencing a nose bleed, Liou said the best thing to do is to pinch the nostrils together and apply pressure to the flexible, cartilaginous area of the septum, as opposed to the bony bridge of the nose, for about five minutes.

“A common misconception is to pinch the bridge of the nose, but that is not where most bleeds are originating from. People also often ask if they should tilt their head forward or back, which is another misconception. The angle of the head does not have an impact on stopping the bleed, and, conversely, swallowing blood can actually cause nausea,” Liou said.

After applying pressure to stop the bleed, Liou recommends using an over-the-counter decongestant spray, which causes the blood vessels in the lining of the nose to constrict. Moisturize the lining by applying nasal saline followed by petroleum jelly, which can be applied twice a day with a cotton swab.

“If you have a nose bleed lasting longer than an hour, or experience regular nose bleeds over the course of a couple of weeks, it is important to consult your physician, as there might be a bleed in the posterior area of the nose, near the throat, that needs to be cauterized by a doctor,” Liou said.

Sleepless Nights Linked To High Blood Pressure

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Submitted by the University of Arizona News Service…..

mansleepingatdeskA bad night’s sleep may result in a spike in blood pressure that night and the following day, according to new research led by the University of Arizona.

The study, to be published in the journal Psychosomatic Medicine, offers one possible explanation for why sleep problems have been shown to increase the risk of heart attack, stroke and even death from cardiovascular disease.

The link between poor sleep and cardiovascular health problems is increasingly well-established in scientific literature, but the reason for the relationship is less understood.

Researchers set out to learn more about the connection in a study of 300 men and women, ages 21 to 70, with no history of heart problems. Participants wore portable blood pressure cuffs for two consecutive days. The cuffs randomly took participants’ blood pressure during 45-minute intervals throughout each day and also overnight.

At night, participants wore actigraphy monitors – wristwatch-like devices that measure movement – to help determine their “sleep efficiency,” or the amount of time in bed spent sleeping soundly.

Overall, those who had lower sleep efficiency showed an increase in blood pressure during that restless night. They also had higher systolic blood pressure – the top number in a patient’s blood pressure reading – the next day.

More research is needed to understand why poor sleep raises blood pressure and what it could mean long-term for people with chronic sleep issues. Yet, these latest findings may be an important piece of the puzzle when it comes to understanding the pathway through which sleep impacts overall cardiovascular health.

“Blood pressure is one of the best predictors of cardiovascular health,” said lead study author Caroline Doyle, a graduate student in the UA Department of Psychology. “There is a lot of literature out there that shows sleep has some kind of impact on mortality and on cardiovascular disease, which is the No. 1 killer of people in the country. We wanted to see if we could try to get a piece of that story – how sleep might be impacting disease through blood pressure.”

The study reinforces just how important a good night’s sleep can be. It’s not just the amount of time you spend in bed, but the quality of sleep you’re getting, said study co-author John Ruiz, UA associate professor of psychology.

Improving sleep quality can start with making simple changes and being proactive, Ruiz said.

“Keep the phone in a different room,” he suggested. “If your bedroom window faces the east, pull the shades. For anything that’s going to cause you to waken, think ahead about what you can do to mitigate those effects.”

For those with chronic sleep troubles, Doyle advocates cognitive behavioral therapy for insomnia, or CBTI, which focuses on making behavioral changes to improve sleep health. CBTI is slowly gaining traction in the medical field and is recommended by both the American College of Physicians and the American Academy of Sleep Medicine as the first line of treatment for insomnia.

Doyle and Ruiz say they hope their findings – showing the impact even one fitful night’s rest can have on the body – will help illuminate just how critical sleep is for heart health.

“This study stands on the shoulders of a broad literature looking at sleep and cardiovascular health,” Doyle said. “This is one more study that shows something is going on with sleep and our heart health. Sleep is important, so whatever you can do to improve your sleep, it’s worth prioritizing.”

The Top Places You May Forget To Apply Sunscreen

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Submitted by the Baylor College of Medicine…..

sunYou may always wear sunscreen while spending time in the sun, but when it comes to protecting every part of your skin there are certain places that people commonly forget about. Baylor College of Medicine’s Dr. Carina Wasko, associate professor of dermatology, shares the top places people miss when putting on sunscreen and ways to prevent skin cancer and aging.

Tops of ears

When applying sunscreen to the face, people often overlook adding it to their ears as well. This is a common area on which to find precancerous abrasions as well as skin cancers during routine skin cancer screenings, Wasko said. 

“As far as places where people miss their sunscreen on a daily basis, the tops of the ears really come to mind,” Wasko said. “Women who have longer hair and cover them are a little less worrisome, but it is more worrisome for individuals with shorter hair who often forget the tops of their ears.”

Scalp

The scalp is another one of the most frequently missed places to apply sunscreen. While putting sunscreen on your scalp may not always be an option, Wasko recommends wearing a wide brimmed hat whenever you plan on being outside for an extended period of time or keeping your scalp away from direct sunlight.

“Maybe people will wear sunscreen when going out for a run, but on a daily basis it’s hard because people aren’t going to be spraying sunscreen in their hair and also don’t want to necessarily wear a hat,” she said. “You can get a lot of sun damage on the top of your head so that can be a little tricky.”

Hands

It is important to remember your hands when applying sunscreen to your arms or face. Wasko addresses that you should not only apply it while outside, but also when driving because the car windows do not fully block out the sun’s ultraviolet rays. She adds that this is one of the first places people begin to notice signs of aging.

“It’s important to apply it for skin cancer risks but also for photo aging and photo damage,” Wasko said. “A lot of people later on look at their hands and are very disappointed about how much freckling and wrinkling they have – much of that has to do with time spent driving in your car. The top of your hands are getting of sun exposure even if you’re not spending a lot of time outside.”

Forearms

It may be common knowledge to wear sunscreen on your forearms while at the pool or beach, but Wasko explains that this is an area where skin cancers often are found. Like the top of the hands, your forearms are also exposed to the sun while driving or during day-to-day activities. She recommends wearing sunscreen on your hands and forearms whenever you spend anytime outside or even simply driving to work.

“People think, ‘I’m at work and just in my office all day,’ but when you drive a lot of sun comes through the windows,” Wasko said. “Windows do not filter out all UV light, so we get a lot of sun damage, especially on the left side of the body where we drive”

Upper chest

twokidsunAlthough it is relatively common to apply sunscreen to the upper chest, Wasko explains how people tend to forget it on a daily basis. She said it is a frequent area where dermatologists find all types of skin cancers, including melanomas.

Wasko addresses that even when you are not spending time in the sun, it is important to apply sunscreen on those common places that could be exposed during the day, such as the chest, arms and legs.

“We try to really emphasize the importance of wearing sunscreen every day for exposed areas even if you’re just going to work, but if you’re going to be out it’s a different story – you must reapply,” Wasko said.

Since dermatologists check the entire body from head to toe during skin cancer screenings, Wasko stresses the importance of remembering to wear sunscreen every day and thinking about the areas that could be missed. She adds that it is also possible for melanomas and skin cancers to grow on areas of the skin that are not as exposed to the sun.

“Generally, skin cancer screening is from the top of your head to the bottom of your feet,” Wasko said. “People will often think if they don’t get sun exposure they can’t get skin cancer in that area, such as a part of their leg that’s usually covered up or the bottom of their feet, but skin cancers can occur anywhere, even in the areas that don’t get sun.”

Wasko recommends wearing a SPF 30 or above sunscreen even during cloudy or rainy days to prevent skin cancer and aging. If you are outside on a sunny day, it is essential to reapply about every two hours or when you towel off after swimming. For skin cancer screenings, she recommends the average adult visit their dermatologist at least once a year for a routine check.

What To Know About Osteoporosis

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Submitted by the Baylor College of Medicine….

seniorwoman2About 54 million Americans have low bone mass, putting them at risk of developing osteoporosis, which is characterized by bone fragility and discrepancies in both quality and quantity of bone mass in the body. During National Osteoporosis Awareness Month, Baylor College of Medicine’s Dr. Brendan Lee explains the causes and risk factors of osteoporosis.

There are many known genes that contribute to osteoporosis, but there are preventative measures both men and women can take to help protect themselves against the common bone disease, even if genetically predisposed.

“While we know that about 60 percent of bone mass traits are genetic, there are environmental factors, such as physical activity level, vitamin D intake, medications and sun exposure, that can contribute to bone deterioration over time as well,” said Lee, chair and Robert and Janice McNair Endowed Chair and Professor of Molecular and Human Genetics at Baylor.

Those at the highest risk for osteoporosis are post- and perimenopausal women, because estrogen is important for maintaining bone density. While more common in women, men also can develop osteoporosis, as well as younger people who have chronic or inflammatory diseases or take certain medications.

To help protect against bone density loss, Lee recommends exercising regularly, not smoking, getting adequate levels of calcium and vitamin D, as well as monitoring bone mass earlier in life, especially if there is a family history of osteoporosis or brittle bones.

“Osteoporosis is essentially a pediatric disease at first onset. Bone mass begins to decline in our 20s, so if it does not reach peak levels before that point, we are starting to decline from an already reduced bone mass level. Losing bone mass from an earlier age and from a lower baseline puts us at risk for osteoporosis later in life,” Lee said.

Warning signs of low bone density include bone pain, curvatures and easy breaks or fractures in adults, and children also may experience slightly stunted growth. Osteoporosis can be measured by a bone density test, which involves a scan, or it can be diagnosed by a physician if the patient experiences frequent fragility fractures.

How Stress Can Affect Your Sleep

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Submitted by the Baylor College of Medicine….

stressStress not only harms your well-being but it also can prevent you from getting a reasonable amount of sleep. A Baylor College of Medicine sleep expert explains how stress can interfere with your nighttime schedule and ways you can sleep more when life becomes busy.  

“Stress can affect sleep in different ways,” said Dr. Annise Wilson, assistant professor of neurology and of pulmonary, critical care and sleep medicine. “What we commonly see is insomnia.”  

Wilson explains that people who are stressed think excessively about responsibilities such as work, family and finances. For teens and young adults in school, this stress often focuses on exams and other important assignments. When one attempts to fall asleep, those thoughts continue and cause numerous disruptions in sleep patterns.  

“High levels of stress impair sleep by prolonging how long it takes to fall asleep and fragmenting sleep. Sleep loss triggers our body’s stress response system, leading to an elevation in stress hormones, namely cortisol, which further disrupts sleep,” Wilson explained. “Research has shown that sleep plays an important role in learning and memory. Chronic sleep deprivation also has been associated with decreased metabolism and endocrine dysfunction. ” 

It can be difficult to reach the recommended 7 to 9 hours of sleep when your mind is still active from daily responsibilities. Modifying your nighttime behaviors are the first step to feeling less stressed in the evenings and being able to fall asleep more efficiently, Wilson said. 

“Stimulus control therapy and improving sleep hygiene are well-validated methods to enhance sleep,” Wilson said. “If you find it difficult to turn your mind off, one technique we recommend is jotting down your thoughts before bed. Also, there are a lot of apps that can guide you through meditation and breathing exercises.” 

She also advises relaxing activities such as warm baths and yoga before bed to help you wind down after a long day. Other factors that can impact your sleep include screen time before bed, drinking caffeine late in the evening and excessive light exposure in the bedroom.  

“Creating an optimal sleep environment is crucial,” Wilson said. “One modern issue is the blue light emitted from smartphones, tablets and other electronics, because that particular wavelength is quite activating and can affect melatonin secretion. There are blue light filter apps available, and on the iPhone there is a pre-installed setting to eliminate it. But ideally, just limit screen time.” 

stresssleepingWilson also advises carving out a sufficient amount of time for sleep and finding ways to offload daytime responsibilities when possible, such as using delivery services and strategic planning. She also notes the importance of keeping a consistent sleep schedule throughout the week by sleeping the same hours on weekdays and weekends.   

While insomnia can be caused by excessive stress, Wilson notes that insomnia also can be related to other medical conditions, such as superimposed sleep apnea, mood disorders and chronic pain.

Not receiving an adequate amount of sleep throughout the night can cause daytime impairment, Wilson said, which can be dangerous when driving or operating heavy machinery. While many attempt over-the-counter remedies such as melatonin to address their sleeping troubles, Wilson advises visiting a professional when significant daytime impairment occurs or insomnia becomes a long-standing.

 

ACSM Publishes Science Behind The Updated Physical Activity Guidelines For Americans

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From The American College of Sports Medicine…..

joggersThe American College of Sports Medicine (ACSM) today published a collection of 14 new pronouncements that present the science behind the updated Physical Activity Guidelines released in November 2018. Authored primarily by ACSM subject matter experts, each pronouncement addresses a specific topic, sharing the scientific evidence and identifying key knowledge gaps for future research to address. The “Scientific Pronouncements: Physical Activity Guidelines for Americans, 2nd Edition” collection is published in ACSM’s flagship research journal, Medicine & Science in Sports & Exercise®.

“Publishing these papers aligns with ACSM’s mission to advance and integrate scientific research to improve education and the practical applications of exercise science and sports medicine. It also gives us an opportunity to highlight the innovative research and collaboration of our members,” said ACSM President-elect and Physical Activity Guidelines Advisory Committee member William E. Kraus, M.D., FACSM. “While the Physical Activity Guidelines rightfully receive a great deal of attention, the research evidence underlying them doesn’t. The translated research will help people worldwide be more active, combat chronic disease and ultimately live longer, healthier lives.”

Authors used best practice methodology to conduct the scientific reviews. This is a multistep process that includes identifying specific questions to answer, developing criteria, conducting systematic searches, reviewing evidence, assessing quality and composing a comprehensive summary. The steps mirror what ACSM uses to develop its own position stands and newer umbrella reviews. This methodology ensures the reviews accurately represent the science and reflect the current state of knowledge.

Topics addressed in the pronouncements range from the relationships between physical activity and health outcomes like cancer, cognition, hypertension, pregnancy and aging to specific physical activity metrics like daily step counts, activity bout duration and high intensity interval training (HIIT).

Health care and fitness professionals as well as basic and applied scientists can use the pronouncements to identify gaps in literature and plan future research projects. They can also cite the pronouncements as current evidence in research papers and grant applications. Additionally, the information can inform the development and delivery of effective interventions.

seniorjogger“ACSM is thrilled to bring these noteworthy papers together in one collection that is freely available for members and the public,” added Kraus. “Having all of the papers in one place provides health care and fitness professionals, as well as basic and applied scientists, with the information they need for day-to-day work with clients, teaching students or with patients in a clinical setting.”

In addition to the U.S. Physical Activity Guidelines Advisory Committee Report—Introduction, titles included in the ACSM Scientific Pronouncements: Physical Activity Guidelines for Americans collection are:

  • Daily Step Counts for Measuring Physical Activity Exposure and Its Relation to Health
  • Association between Bout Duration of Physical Activity and Health: Systematic Review
  • High-Intensity Interval Training (HIIT) for Cardiometabolic Disease Prevention
  • Sedentary Behavior and Health: Update from the 2018 Physical Activity Guidelines Advisory Committee
  • Physical Activity, Cognition and Brain Outcomes: A Review of the 2018 Physical Activity Guidelines
  • Physical Activity in Cancer Prevention and Survival: A Systematic Review
  • Physical Activity and the Prevention of Weight Gain in Adults: A Systematic Review
  • Physical Activity, All-Cause and Cardiovascular Mortality, and Cardiovascular Disease
  • Physical Activity and Health in Children under 6 Years of Age: A Systematic Review
  • The Benefits of Physical Activity during Pregnancy and Postpartum: An Umbrella Review
  • Physical Activity, Injurious Falls and Physical Function in Aging: An Umbrella Review
  • Physical Activity to Prevent and Treat Hypertension: A Systematic Review
  • Effects of Physical Activity in Knee and Hip Osteoarthritis: A Systematic Umbrella Review
  • Physical Activity Promotion: Highlights from the 2018 PAGAC Systematic Review

View and download the collection of scientific pronouncements at www.acsm.org/pagpros2019.

About the American College of Sports Medicine
The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. More than 50,000 international, national and regional members are dedicated to advancing and integrating scientific research to improve educational and practical applications of exercise science and sports medicine. More details can be found at www.acsm.org.

Arlington, Va. Is #1 ‘Fittest City’

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Submitted by The American College of Sports Medicine….

didyouknow?2019 American Fitness Index Ranks 100 Cities;
New Indicators Reveal Concerns About Pedestrian Safety and Air Quality

Indianapolis (May 14, 2019) – Arlington, Va. has earned the title of “America’s Fittest City” in the annual American Fitness Index® ranking published by the American College of Sports Medicine (ACSM) and the Anthem Foundation, the philanthropic arm of Anthem, Inc.

The ACSM/Anthem Fitness Index evaluated America’s 100 largest cities using 33 health behaviors, chronic diseases and community infrastructure indicators. Rounding out the top 10 cities were Seattle, Wash.; Minneapolis, Minn.; San Francisco, Calif.; Madison, Wis.; Washington, D.C.; St. Paul, Minn.; Irvine, Calif. (new to the top 10); Denver, Colo.; and Portland, Ore. You can access the full rankings and scores, summary report, city comparison tool and other insights on the American Fitness Index website.

Setting the standard for other cities, Arlington’s balance of healthy behaviors and community infrastructure earned it the #1 overall rank. Arlington ranked in the top 10 for 22 of the 33 indicators in the ACSM/Anthem Fitness Index, with six indicators ranked #1, including residents exercising in the last month; meeting aerobic and strength activity guidelines; reporting good or excellent health; and having low rates of smoking, poor physical health and pedestrian fatalities. You can compare your city to Arlington or others ranked in the Index by accessing the online City Comparison Tool.

“Our research-backed Fitness Index rankings reveal both personal health habits within a community and how well those communities encourage fitness among their residents. It’s one more way we are working to improve the lives of our communities in which we live and work every day,” said Stephen Friedhoff, M.D., chief clinical officer for Anthem. “For example, we added new social determinant of health indicators to this year’s report and learned that some cities have work to do in the areas of pedestrian safety and air quality, which are both critical to overall wellness. Four of the 10 worst cities for pedestrian fatalities are in Florida, and we know air pollution rivals car accidents and tobacco when it comes to causing deaths.”

At the community level, the ACSM/Anthem Fitness Index is used as an assessment and evaluation tool to educate community leaders on the importance of key indicators of physical activity. Leaders can then focus on policy, systems and environmental change strategies that are evidence-based and create sustainability for their community. ACSM and Anthem agree that the Fitness Index provides cities with the data and resources needed to drive healthy change.

familyfun“We challenge city leaders, regardless of where their community ranks on the ACSM/Anthem Fitness Index, to take bold and decisive action toward building and maintaining infrastructures that promote fitness,” said Barbara Ainsworth, Ph.D., chair of the American Fitness Index Board and a regents’ professor in the College of Health Solutions at Arizona State University.

“Chronic diseases, sedentary lifestyles and pedestrian fatalities are at critical levels in our country, and city leadership can effectively address each of these challenges by becoming a fit city,” Ainsworth added.

Additional findings from the 2019 Fitness Index rankings included:

  • 2.2 pedestrian deaths per 100,000 residents on average across all 100 cities with the worst city, St. Louis, reporting 5.8 pedestrian deaths per 100,000.
  • Nearly half of the 10 deadliest cities for pedestrians are located in Florida: Tampa, Orlando, Jacksonville and St. Petersburgh.
  • The 21 worst cities for air quality are in California, Arizona and Nevada.
  • Cities have poor air quality an average 38.3 percent of the year.
  • 75.2 percent of adults in all cities were physically active in the previous month on average, with only 51.2 percent meeting aerobic activity guidelines and 22 percent meeting both aerobic and strength guidelines.
  • 97 percent of residents in the top 10 cities are located within a 10-minute walk to a park, but only 66.4 percent are within a 10-minute walk of a park in all 100 cities.
  • An average of 30.3 percent of residents in all 100 cities were diagnosed with high blood pressure, 3.3 percent with heart disease and 2.9 percent were diagnosed with a stroke.
  • Only 4.5 percent of residents in all 100 cities walk or bike to work, and 7.1 percent use public transportation to and from work.

The 2019 ACSM American Fitness Index rankings are as follows:

Overall Rank City State Overall Score
1 Arlington VA 87.3
2 Seattle WA 77.9
3 Minneapolis MN 76.4
4 San Francisco CA 75.7
5 Madison WI 75.3
6 Washington D.C. 75.1
7 St. Paul MN 69.5
8 Irvine CA 69.4
9 Denver CO 68.4
10 Portland OR 67.8
11 Oakland CA 67.7
12 San Jose CA 67.4
13 Boise ID 66.7
14 San Diego CA 66.7
15 Chicago IL 66.2
16 Pittsburgh PA 66
17 Lincoln NE 63.2
18 Long Beach CA 62.5
19 Boston MA 62.5
20 Sacramento CA 61.9
21 St. Petersburg FL 61.6
22 Atlanta GA 61.2
23 Virginia Beach VA 60.4
24 Santa Ana CA 60
25 Milwaukee WI 59.7
26 Honolulu HI 59.5
27 Los Angeles CA 59
28 Durham NC 58.2
29 Chula Vista CA 58.2
30 Raleigh NC 57.7
31 Albuquerque NM 57.5
32 New York NY 57.3
33 Stockton CA 56.9
34 Fremont CA 56.8
35 Miami FL 56.6
36 Newark NJ 56.3
37 Anaheim CA 56.1
38 Richmond VA 55.7
39 Colorado Springs CO 55.7
40 Aurora CO 55.1
41.5 Orlando FL 54.5
41.5 Buffalo NY 54.5
43 Austin TX 54
44 Plano TX 53.2
45 Omaha NE 52.7
46 Tampa FL 52.3
47 Norfolk VA 52.2
48 Nashville TN 51.3
49 Reno NV 50.9
50 Jersey City NJ 50.9
51 St. Louis MO 50.5
52 Baltimore MD 50.4
53 Tucson AZ 49.7
54 New Orleans LA 49.3
55 Hialeah FL 49.1
56 Greensboro NC 48.2
57 Cincinnati OH 47.9
58 Riverside CA 47.6
59 Glendale AZ 47.5
60 Lubbock TX 47.4
61 Dallas TX 47.4
62 Anchorage AK 46.5
63 Philadelphia PA 46.5
64 Fresno CA 46.2
65 Cleveland OH 45.9
66 Mesa AZ 44.3
67 Kansas City MO 43.6
68 Chandler AZ 43.3
69 Scottsdale AZ 43
70 Columbus OH 42.6
71 Phoenix AZ 41.9
72 El Paso TX 41.8
73 Houston TX 41.5
74 Lexington KY 41.2
75 Charlotte NC 41.1
76 Garland TX 40
77 Jacksonville FL 39.4
78 Irving TX 39
79 Baton Rouge LA 38.5
80 Laredo TX 37.9
81 Winston-Salem NC 37.4
82 San Antonio TX 36.3
83 Gilbert AZ 36.3
84 Chesapeake VA 35.8
85 Las Vegas NV 34.3
86 Fort Wayne IN 34.3
87 Memphis TN 33.8
88 Fort Worth TX 33
89 Henderson NV 32.6
90 Wichita KS 31.6
91 Corpus Christi TX 31
92 Arlington TX 30.8
93 Detroit MI 30.5
94 Bakersfield CA 30.3
95 Louisville KY 28.8
96 Indianapolis IN 28.6
97 Toledo OH 27.8
98 Tulsa OK 27.8
99 North Las Vegas NV 27.2
100 Oklahoma City OK 20.8


About the American College of Sports Medicine
The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. More than 50,000 international, national and regional members are dedicated to advancing and integrating scientific research to improve educational and practical applications of exercise science and sports medicine. More details can be found at www.acsm.org.

ACSM is a global leader in promoting the benefits of physical activity and advocates for legislation that helps government and the health community make it a priority. ACSM encourages Congress to support continued funding of parks, trails and safe routes to school, to better enable all Americans to meet the prescribed physical activity recommendations included in the National Physical Activity Guidelines.

About Anthem Foundation
The Anthem Foundation is the philanthropic arm of Anthem, Inc. and through charitable contributions and programs, the Foundation promotes the inherent commitment of Anthem, Inc. to enhance the health and well-being of individuals and families in communities that Anthem, Inc. and its affiliated health plans serve. The Foundation focuses its funding on strategic initiatives that make up its Healthy Generations Program, a multi-generational initiative that targets: maternal health, diabetes prevention, cancer prevention, heart health and healthy, active lifestyles, behavioral health efforts and programs that benefit people with disabilities. The Foundation also coordinates the company’s year-round Dollars for Dollars program which provides a 100 percent match of associates’ donations, as well as its Volunteer Time Off and Dollars for Doers community service programs. To learn more about the Anthem Foundation, please visit http://www.anthem.foundation and its blog at https://medium.com/anthemfoundation.

Take A Deep Breath: How To Cope With Panic Attacks

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Submitted by The Baylor College of Medicine….

BaylorCollegeWith symptoms that often mimic heart attacks, panic attacks can be extremely scary for people who experience them. To help, Baylor College of Medicine’s Dr. Asim Shah gives his recommendations on recognizing the signs of a panic attack and relaxation strategies you can use if you are having one.

“Panic attacks are a mental health disorder that fall under the category of a panic disorder. Panic attacks can occur when a person becomes uncontrollably anxious, nervous or fearful,” said Shah, professor and executive vice chair in the Menninger Department of Psychiatry and Behavioral Sciences at Baylor.

There can be numerous causes of panic disorders, Shah said. They can have a genetic cause or a person may be more sensitive and react negatively to stress or anxiety. Common reasons why people have panic attacks include the death of a loved one, a divorce or loss of a job, but any stressful situation can cause panic attacks.

The symptoms of a panic attack can include:

  • Feeling impending doom
  • Feeling detached from reality
  • Feeling like your heart is sinking
  • Feeling like you are losing control or even dying
  • An increased heart rate
  • Shaking, trembling or having chills
  • Sweating or cramps
  • Tightness in your chest or throat

“In some ways, having a panic attack can resemble having a heart attack. Some people end up going to the emergency room thinking they are having a heart attack but come to find out they are having a panic attack,” Shah said.

yogaposeIf you realize that you are having a panic attack, there are few strategies that Shah recommends for you to use to help relax. The first step is to try to divert your thoughts to positive thinking. You also can do breathing and mindfulness exercises. For example, you can close your eyes, picture yourself somewhere you feel safe, and deeply and slowly breathe in and out. These exercises also can help with any muscle tension you might be experiencing because of the panic attack.

Shah added that is important to differentiate between panic and anxiety. Panic happens immediately. It can be unpredictable and unprovoked but the feeling lasts no more than 30 minutes. With anxiety, people can be fearful and have a feeling of doom, but it is less intense and can last for months.

“Panic attacks are easily treatable so please seek help if you are experiencing them,” Shah said. “Untreated panic attacks can cause complications with your medical and mental health and impact your social life. For example, you may avoid going to work or school or social engagements, which can lead to depression and then possibly to having suicidal thoughts. Some people may even develop alcohol and substance addictions. Given this, it is very important to be treated before any of these complications can arise.

SRC-1 Gene Variants Linked To Human Obesity

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From The Baylor College of Medicine…..

BaylorCollegeMaintaining a healthy body weight is no simple matter. A better understanding of how the body regulates appetite could help tip the scale toward the healthy side. Contributing toward this goal, a team led by researchers at Baylor College of Medicine and the University of Cambridge reports in the journal Nature Communications that the gene SRC-1 affects body weight control by regulating the function of neurons in the hypothalamus – the appetite center of the brain.

Mice lacking the SRC-1 gene eat more and become obese. SRC-1 also seems to be involved in regulating human body weight. The researchers identified in severely obese children 15 rare SRC-1 genetic variants that disrupt its function. When mice were genetically engineered to express one of these variants, the animals ate more and gained weight.

“The protein called steroid receptor coactivator-1 (SRC-1) is known to participate in the regulation of body weight, but its precise role is not clear,” said co-corresponding author Dr. Yong Xu, associate professor of pediatrics and of molecular and cellular biology and a researcher at the USDA/ARS Children’s Nutrition Research Center at Baylor College of Medicine and Texas Children’s Hospital. “Here we explored the role of SRC-1 in the hypothalamus, a brain area that regulates appetite.”

The researchers discovered that SRC-1 is highly expressed in the hypothalamus of mice, specifically in neurons that express the Pomc gene. Pomc neurons are known to regulate appetite and body weight.

Further experiments showed that SRC-1 is involved in regulating the expression of Pomc gene in these cells. When Xu and his colleagues deleted the SRC-1 gene in Pomc neurons, the cells expressed less Pomc and the mice ate more and became obese.

The researchers also explored whether SRC-1 also would play a role in regulating human body weight.

“We had identified a group of severely obese children carrying rare genetic variants in the SRC-1 gene,” said co-corresponding author Dr. I. Sadaf Farooqi, professor of metabolism and medicine in the Department of Clinical Biochemistry at the University of Cambridge and Wellcome Trust Principal Research Fellow.

Working together, Xu, Sadaf Farooqi and their colleagues found that many of the SRC-1 variants in the obese children produced dysfunctional proteins that disrupted the normal function of SRC-1. On the other hand, SRC-1 variants in healthy individuals did not disrupt SRC-1 function.

saladheartsmallFurthermore, mice genetically engineered to express one of the human SRC-1 genetic variants found in obese children ate more and gained weight. This is the first report of SRC-1 playing a role in the hypothalamus in the context of body weight control.

“By providing evidence that bridges basic and genetic animal studies and human genetic data, we have made the case that SRC-1 is an important regulator of body weight,” Xu said.

Other contributors to this work include Yongjie Yang, Agatha A. van der Klaauw, Liangru Zhu, Tessa M. Cacciottolo, Yanlin He, Lukas K.J. Stadler, Chunmei Wang, Pingwen Xu, Kenji Saito, Antentor Hinton Jr, Xiaofeng Yan, Julia M. Keogh, Elana Henning, Matthew C. Banton, Audrey E. Hendricks, Elena G. Bochukova, Vanisha Mistry, Katherine L. Lawler, Lan Liao, Jianming Xu, Stephen O’Rahilly, Qingchun Tong, UK10K consortium, Inês Barroso and Bert W. O’Malley. The authors are affiliated with one or more of the following institutions: Baylor College of Medicine; University of Cambridge Metabolic Research Laboratories; Wellcome Trust-MRC Institute of Metabolic Science; Huazhong University of Sciences & Technology, China; Wellcome Sanger Institute, Cambridge; University of Colorado – Denver and University of Texas Health Science Center at Houston.

For a complete list of the sources of financial support for this project, visit this link.

 

Study Reports Emerging Triggers Of Rare Food Allergy In Infants

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News from the Baylor College of Medicine…..

BaylorCollegeA study led by the section of immunology, allergy and rheumatology in the Department of Pediatrics at Baylor College of Medicine researches an uncommon food allergy known as ‘food protein-induced enterocolitis syndrome’ (FPIES) that occurs mostly in infants. The findings of the study determine the responsible foods triggers, as well as the characteristics and management of FPIES. 

“One of the main problems with FPIES is that it can be challenging to diagnose,” said Dr. Aikaterini Anagnostou, associate professor of pediatric allergy at Baylor, director of the food immunotherapy program at Texas Children’s Hospital and the lead researcher in the study. She stressed that FPIES symptoms can mimic other illnesses, such as viral gastroenteritis or sepsis in infants.

“I often find that this condition is misdiagnosed and that many people are not aware of it,” Anagnostou said. “There is also a significant delay in the diagnosis, and I have heard many stories from patients coming into my clinic and raising all of these concerns. The aim of our study is to further investigate FPIES, and to raise awareness of this uncommon food allergic disorder.”

The main symptoms of FPIES include vomiting, lethargy, pallor and diarrhea, which are triggered by typical weaning foods such as cow’s milk, soy, rice and oats. Anagnostou explains that weaning foods are introduced to infants when they are being weaned off breast milk or formula and onto solid foods. In contrast to other food allergies, FPIES presents with a delayed reaction two to four hours after ingesting the food.

The study took place over a three-year period from 2015 to 2017 and included 74 infant cases of FPIES in the area. The findings reveal that rice is the most common trigger amongst children affected by FPIES in Houston (cow milk is the most common cause in other U.S. geographic locations). Rarer triggers such as banana and avocado also were identified as more common for this population. Anagnostou also reported that a significant percentage of children had multiple food triggers, an unusual observation for FPIES-related studies.

“It is difficult to ascertain why we see different triggers in this area,” Anagnostou said. “We suspect that this observation is related to different dietary and weaning habits, with certain foods preferred as weaning foods in our area compared to other areas in the United States.”

Additionally, Anagnostou reported a six-month delay in the diagnosis of FPIES in the Houston population. “This finding highlights once more how challenging FPIES can be to recognize and diagnose,” she said. “For instance, we found that 22 percent of infants in our study received a sepsis work-up because it is often difficult to differentiate between FPIES and sepsis in young infants, especially at initial presentation.”

Due to the profuse vomiting caused by FPIES, infants can experience dehydration or in more severe cases, go into shock during the acute phase of the disease. In more chronic cases, Anagnostou said failure to thrive and malnutrition may occur if parents do not seek medical help.

“Another new finding of our study was the significant percentage of infants at risk for malnutrition because the parents become worried about introducing other foods,” Anagnostou said. “As a result of this, infants may suffer from a very limited and restricted diet.”

Anagnostou said that consulting a dietitian is one of the crucial parts of managing the disease so that families can receive education on proper food introduction. Also key to managing the condition is fluid resuscitation for severe dehydration and oral rehydration for mild cases. Anagnostou notes that giving epinephrine will not work for this type of allergy.

After a diagnosis of FPIES is made, Anagnostou recommends avoiding the triggering food. Subsequently, the food may be tried in the hospital setting under medical supervision, every 12 to 18 months to assess whether FPIES is outgrown.

“Different people outgrow FPIES at different time points,” Anagnostou said. “The food can be tried in a controlled environment and if there is a reaction, it will be treated appropriately. If the food is tolerated and there is no reaction during the observation period, then it can be reintroduced into the diet.”

mombabyAnagnostou advises parents who notice repeat reactions (usually profuse vomiting) after introducing a new food into their child’s diet to seek medical help and potentially consider this diagnosis. “I am not suggesting that for every child that vomits after a food introduction the diagnosis will be FPIES,” she said. “Of course, there are several factors at play here and many other diseases to consider, but this is something to keep in mind if the reaction is consistent with certain food triggers.”

One of the reassuring facts about FPIES is that most children outgrow the disease once they are older and that it rarely carries into adulthood. Anagnostou said there have been a few recorded cases of adult FPIES, with the main triggers being nuts and shellfish.

“There is a lot of information that is still missing,” Anagnostou said. “We don’t know much yet about the disease’s mechanism or any specific risk factors that could predispose an infant to having FPIES. What is clear is that we need to raise awareness about FPIES so that we minimize the delay in the diagnosis, which can be a significant source of anxiety for families.”

The full study was published this month in the Annals of Allergy, Asthma and Immunology journal.