Your Health: Bladder Control Problems Are Treatable

Rallie McAllister, M.D., M.P.H.
A few things haven't changed since kindergarten, like the rules and regulations regarding potty breaks. If you've ever lost control of your bladder as an adult, you may have felt just as embarrassed as you did when you were a preschooler. Although it may be unsettling, involuntary loss of urine isn't uncommon. Urinary incontinence, the official name for involuntary leakage of urine from the bladder, currently affects more than 12 million American adults. Urinary incontinence is more prevalent in older individuals, but young people aren't immune to the condition. Women are more likely to be affected than men for several reasons. Childbirth can weaken or injure the nerves and muscles of the pelvis, especially in women who deliver big babies or those who require forceps deliveries. Nearly a third of U.S. women experience long-term bladder leakage following childbirth. Among men, those with enlarged prostate glands are at increased risk for bladder control problems. Temporary urinary incontinence is relatively common following surgical procedures involving the bladder or prostate, and in some cases, the condition may be permanent. The involuntary loss of urine from the bladder may be due to one of several types of urinary incontinence -- each with different causes, symptoms and treatments. Stress incontinence is a condition in which involuntary loss of urine occurs during activities involving the muscles of the abdomen and pelvis, including sneezing, laughing or coughing. Stress incontinence may occur during running, jumping and other types of exercise, since these activities create physical forces that push down on the bladder and force urine out of the body. Urge incontinence, also known as overactive bladder, is caused by urinary muscle spasms that lead to the uncontrolled loss of urine. In many cases, individuals who suffer from an overactive bladder experience strong, unexpected urges to void, especially after drinking liquids or hearing the sound of running water. Overflow incontinence occurs when the bladder stays perpetually full. As additional urine is manufactured by the kidneys and delivered to the bladder, the excess liquid dribbles from the body. If you experience problems with bladder control, you may be a little embarrassed, but you shouldn't let it prevent you from seeking medical attention. In some cases, urinary incontinence is completely reversible, especially if the condition is the result of a medication side effect or caused by a smoldering urinary tract infection. Even if the condition isn't easily reversible, you're not doomed to a lifetime of dampness. Fortunately, a number of effective treatment options are available. Surgery can return a dropped bladder to its proper position, enlarge a small bladder or tighten weakened pelvic muscles. In many cases, a more conservative approach to treatment can correct the cause of urinary incontinence and put a stop to bladder-control problems. A cure might be as simple as treating an infection with antibiotics or taking a daily dose of medication that prevents problematic bladder contractions. If the condition doesn't respond to drug therapy, specific exercises may be helpful. Your doctor may instruct you to begin urinating at frequent, regular intervals, starting with once every hour and then progressively lengthening the interval. This practice, known as bladder training, significantly reduces symptoms in three-quarters of affected individuals and completely eliminates the problem in nearly 15 percent of those with urinary incontinence. If you have mild symptoms of urinary incontinence, you may be able to improve bladder control with pelvic floor exercises. Also known as Kegels, these exercises have been shown to improve bladder control in about 80 percent of incontinent adults. Kegels are easy to perform, and you can do them anywhere without anyone being the wiser. To execute the perfect Kegel, simply contract the muscles you would use to stop the flow of urination. It may require a little experimentation, but once you've mastered the maneuver, simply hold the contraction for three seconds and then relax for three seconds. Repeat this exercise 10 to 15 times per session, and try to squeeze in three sessions per day. Kegel exercises can be very effective, but only when they're done regularly. The more you exercise your pelvic floor muscles, the more likely you are to see significant improvements in bladder control. In addition to performing Kegels, losing excess weight can significantly improve symptoms of urinary incontinence. Avoiding alcohol and caffeine may also be helpful. If exercises and dietary changes don't seem to help, it's time to see your doctor. With proper treatment, there's an excellent chance you can overcome urinary incontinence for good.

Rallie McAllister is a board-certified family physician, speaker and the author of several books, including "Healthy Lunchbox: The Working Mom's Guide to Keeping You and Your Kids Trim." Her Website is http://www.rallieonhealth.com/. To find out more about Rallie McAllister, M.D., and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at http://www.creators.com/.
Copyright 2009 Creators Syndicate Inc.

Women more sensitive to looks rejection

BUFFALO, N.Y. (UPI) -- Women are more sensitive than men to appearance rejection, U.S. researchers say. Lora Park, assistant professor of psychology, graduate student Ann Marie DiRaddo of the University at Buffalo, and Rachel Calogero of the University of Kent in England said the study also finds men and women who had internalized media ideals of attractiveness had higher levels of appearance-based rejection sensitivity than did their peers. The study, published in the Psychology of Women Quarterly, says no relationship was found between parents' perceptions of attractiveness and study participants' increased sensitivity to appearance-based rejection. Therefore, peer and media influences, rather than parental influence, play a key role in appearance-based rejection sensitivity, the researchers say. "There is a lot of research to suggest that physically attractive people are less stigmatized by others in this society, and have significant advantages in many areas of life than those who are viewed as physically unattractive," Park says in a statement. The study observed 220 of U.S. college students ages 18-33 -- 106 women and 114 men. The subjects completed a series of questionnaires, including scales that assessed the perceived influence of peers and parents on sensitivity to appearance-based rejection, and an assessment of dimensions of media influence related to body image and appearance. Copyright 2009 by United Press International

ERs may not use lung blood clot guidelines

PROVIDENCE, R.I. (UPI) -- Emergency room physicians may not be following clinical guidelines for diagnosing patients with possible lung blood clots, U.S. researchers say. Researchers at the Warren Alpert Medical School of Brown University and Rhode Island Hospital in Providence, R.I., said current accepted clinical practice indicates patients with a low clinical suspicion for pulmonary emboli should undergo a blood test for D-dimer, a protein fragment present in the blood after a clot is degraded, then multi-detector row computed tomography, if positive. The study, involving 5,344 patients, found, however, that 42 percent of patients had a positive D-dimer exam but did not have a CT scan. "Current protocols suggest that those patients should have had a scan," Dr. Michael T. Corwin, the lead author, said in a statement. "Multi-detector row CT was performed in 7 percent of patients with negative D-dimer results, and the same protocols suggest that those patients should not have undergone a scan. "Anytime a patient gets a CT scan there is a radiation dose. The evaluation of patients with suspected PE should include D-dimer and CT testing in a more standardized fashion so that we can save patients from having unnecessary CT scans. " The D-dimer test should only be used in patients with a relatively low suspicion of having a pulmonary embolus, but if the D-dimer test is positive, then patients should have the CT. If the test is negative then no scanning is needed, Corwin explained. The finding is published in the American Journal of Roentgenology.
Copyright 2009 by United Press International

Toronto H1N1 flu-related death probed

TORONTO (UPI) -- A 44-year-old Toronto man with undisclosed pre-existing medical conditions who died tested positive for the H1N1 flu virus, medical officials said. Ontario Chief Medical Officer of Health, Dr. David Williams, told a news conference autopsy results would be needed to determine if the virus originally named swine flu played a role in the man's death, the Toronto Sun reported Tuesday. Williams said the east-end man's condition took a sudden bad turn at his home Saturday, and paramedics were unable to resuscitate him. His was the second H1N1-related death in Canada since April, when a northern Alberta woman, also with pre-existing medical problems, died. Her autopsy results couldn't conclude whether the flu virus killed her, the Sun said. The World Health Organization said after this death that Canada is second only to Mexico in reporting new cases of the flu. More than 11,000 people in 46 countries have contracted the virus.
Copyright 2009 by United Press International

Level of response to alcohol, risk factor

SAN DIEGO (UPI) -- A U.S. doctor says teens who report they "drink others under the table" may be at higher risk of alcoholism. Dr. Marc Schuckit of the Alcohol Research Center at the Veterans Affairs San Diego Healthcare System and the University of California, San Diego, says a low level of reaction to alcohol has been found to be a unique risk factor for alcohol use disorders across adulthood and not simply a reflection of a broader range of risk factors. Schuckit, the corresponding author of a study, looked at alcoholism risk factors such as family history in 297 men. The men -- participants in the San Diego Prospective Study -- were tested on their level of response when recruited between the ages of 18 to 25. They were also evaluated at 10-, 15-, 20- and 25-year follow-ups. "We showed that a low level of reaction at age 20 predicts later heavy drinking and alcoholism even if you control for all these other predictors of alcohol problems at age 20," Schuckit says in a statement. A person with low level of reaction may tend to drink more each time they imbibe, he says, but identifying the risk early in life may allow ways to decrease the risk. The study does not mean not having a low level of reaction means not developing alcoholism, Schuckit added. The findings are scheduled to be published in the September issue of Alcoholism: Clinical & Experimental Research. Copyright 2009 by United Press International

Race may have impact on teachers

ITHACA, N.Y. (UPI) -- A U.S. study found high-quality teachers may tend to leave schools that experience inflows of black students, researchers said. Study author C. Kirabo Jackson of Cornell University said the study suggests a school's racial makeup may have a direct impact on the quality of its teachers. "It's well established that schools with large minority populations tend to have lower quality teachers," Jackson said in a statement. "But it is unclear whether these schools are merely located in areas with a paucity of quality teachers, whether quality teachers avoid these schools because of the neighborhood or economic factors surrounding a school, or whether there is a direct relationship between student characteristics and teacher quality." Jackson said the findings suggest it's not neighborhoods keeping high-quality teachers away. "This is particularly sobering because it implies that, all else equal, black students will systematically receive lower quality instruction," Jackson said. The study of the Charlotte-Mecklenberg school district in North Carolina ended its race-based busing program in 2002 and some schools had a large and sudden inflow of black students -- but the racial makeup of the neighborhood and economic factors were the same. The study, published in the Journal of Labor Economics, found the black teachers were slightly more likely than white teachers to stay in the schools that experienced a black inflow. However, those black teachers who did leave black schools tended to be the highest qualified.
Copyright 2009 by United Press International

Sweden reports nationwide blood shortage

UPPSALA, Sweden (UPI) -- Sweden's hospitals are suffering a shortage of blood due to increasingly advanced healthcare techniques, a top hospital doctor said. The blood shortage forced Uppsala University Hospital to suspend operations until more blood is found, Johan Ronnelid, the hospital's chief physician, said Monday. "We have searched the country and will receive supplies by taxi during the day from some remote locations," he said. "There is a shortage of blood in the whole country." The shortage is most acute in blood groups O and B, Ronnelid said, explaining that increasingly sophisticated medical techniques require larger quantities of blood. Blood shortages in Sweden sometimes occur during the summer months, but rarely as early as May, the Swedish news agency TT reported Tuesday.
Copyright 2009 by United Press International

'Dex' ups high altitude exercise capacity

ZURICH, Switzerland (UPI) -- Taking dexamethasone, used in the treatment of high altitude cerebral edema, may improve exercise capacity in some mountaineers, Swiss researchers said. Lead authors Dr. Manuel Fischler of the University Hospital in Zurich, Switzerland, and Hans-Peter Brunner-La Rocca, of the University Hospital in Basel, Switzerland, recruited 23 mountaineers with a history of high altitude pulmonary edema and administered baseline cardiopulmonary exercise tests a low elevation at 1607 feet. All participants were randomized to take either dexamethasone, tadalifil -- used to treat erectile dysfunction and approved for the treatment of pulmonary arterial hypertension -- or placebo. Subjects were tested for oxygen uptake kinetics by pedaling a stationary bike at a constant rate for six minutes, and then for exercise capacity by pedaling at 50 percent of their predicted maximum workload for one minute, and then increasing output by 25 percent each additional minute until exhaustion, usually after 8 to 12 minutes. The study, published in the American Journal of Respiratory and Critical Care Medicine, found the climbers taking dexamethasone improved exercise capacity, oxygen uptake kinetics and decreased the anaerobic threshold. "Overall, this means that those climbers who took dex felt better, were able to do more, and probably experienced fewer altitude-related discomforts than both other groups," Fischler said in a statement.
Copyright 2009 by United Press International

More injuries during kickoff, punting

COLUMBUS, Ohio (UPI) -- A greater proportion of severe injuries in high school football occur during kickoffs and punt plays, U.S. researchers find. The study, published in Research in Sports Medicine, finds 33 percent of high school football injuries occurring during kickoffs and punts are severe -- and 20 percent are concussions. The study finds injuries sustained at the beginning or middle of a game are more severe compared to injuries sustained during the end or in overtime. "Not only does the time in competition affect injuries but also the phase of play," study author Dawn Comstock of the Center for Injury Research and Policy in The Research Institute at Nationwide Children's Hospital in Columbus, Ohio, says in a statement. "Overall, severe injuries accounted for 20 percent of all injuries, with 44 percent of severe injuries being fractures." Data for the study were collected from the 2005-2006 National High School Sports Injury Surveillance Study.
Copyright 2009 by United Press International

Binge drinking may affect working memory

GALICIA, Spain (UPI) -- Students desiring to excel at school or work may wish to forego binge drinking, research by Spanish scientists suggests. The study, published online ahead of print in the November issue of Alcoholism: Clinical & Experimental Research, finds binge drinkers expend more attentional effort to completing a given task, and have problems differentiating between relevant and irrelevant information. The study looked at 95 first-year male and female university students. Of these, 42 were binge drinkers -- defined as males who drink five or more standard alcohol drinks or females who drink four or more within a two-hour period. The researchers find binge drinkers showed anomalies during the execution of a task involving visual working memory not shown by the 53 non-binge drinkers. "One of the most relevant and worrying aspects of the high prevalence of intense consumption of alcohol in young people is the effect this drinking pattern probably has on the structure and function of the still developing brain, and that these consequences may persist in the long-term," study corresponding author Alberto Crego, a doctoral student at the University of Santiago de Compostela in Galicia, Spain, says in a statement. "Some neuromaturation processes continue until approximately 25 years of age; this means that late developing regions are probably even more vulnerable targets."
Copyright 2009 by United Press International

Canning not just for grandma anymore

SEATTLE (UPI) -- Home canning, fueled by movements to eat more fruits and vegetables, save money and eat locally is gaining favor among younger people, a Seattle Web site says. A survey of its community by Allrecipes.com, a food Web site that receives 300 million hits annually, indicates the demographic of canners is shifting from baby boomers to Generations X and Y -- and nearly half of canners are age 40 or younger. Moreover, almost half of canners live in suburban areas, signaling that canning is no longer reserved to rural communities -- or grandma, the Web site says. As the recession progresses and food prices continue to rise, 61 percent of canners say their greatest motivation is saving money. Canning has traditionally been a family tradition passed down by generations, but younger people are looking for canning advice on the Internet. Allrecipes.com says its canning page views increased by 109 percent since last year. Allrecipes.com is supporting the national "Canvolution" by partnering with Canning Across America, a grassroots canning movement started by food writers, bloggers, cooks, gardeners and food lovers to revitalize the popularity of canning as a way to make it easier to "strive for five," serving of fruits and vegetables. No survey details were provided.
Copyright 2009 by United Press International

Lifelong Health: Swine Flu Threat Continues in U.S., Throughout World

Though this once-terrifying virus has long since lost its media allure, the swine flu is still causing trouble throughout the country. With each passing day, more individuals are in a panic; do they have swine flu? While the swine flu is not often fatal, any stuffy nose, sore throat, fever, headache or gastrointestinal distress raises concerns. The initial panic over swine flu was likely overblown and the risks of death overstated. However, there is still cause for concern. Worldwide, the number of proven cases now exceeds 1 million. As of July 24, a total of 43,771 cases have been diagnosed in the U.S., leading to 302 deaths. Even after the public scare died down, the World Health Organization formally declared a swine flu pandemic. So, what is so new about this virus, how concerned should we be and what should we do about it? The virus was initially thought to have started in pigs in Mexico because the first reported cases in humans were centered in that area -- an analysis of viral cultures found that it had many similarities to strains commonly found in pigs. Further studies now show that this virus is very different from that found in North American pigs, but instead has features of influenza viruses that occur in pigs, birds and humans. Although the virus is new, there is no immunity to it and (as of now) no vaccine to protect against it. This virus appears to be no different from any of the other influenza viruses. It is transmitted from human to human by coughing, sneezing and blowing the virus in small airborne droplets. Once the virus is inhaled, it multiplies in the body and leads to an infection. Clinically, the features of the illness are very similar to that of any other influenza infection. After an incubation period of one to seven days (during which time the asymptomatic person can spread the virus to all around him), the patient becomes ill, typically complaining of a severe headache, a fever often greater than 101 degrees, cough, sore throat and runny nose. Occasionally, a patient may suffer from nausea, vomiting and diarrhea. Reports from the Centers for Disease Control and Prevention indicate that the severity of the infection can range from a mild respiratory infection to a severe illness with pneumonia, encephalitis, heart infection (myocarditis) and severe muscle pain (myopathy). Like all other influenza infections, swine flu is particularly serious in "at risk" individuals. These individuals include: infants and children less than 5 years old, those older than 65 but particularly the very old (over 85), nursing home residents and individuals with chronic illness and an impaired ability to fight infections. Here complications including pneumonia, dehydration, septicemia or viral infections of the heart and brain can prove fatal. Based on this information, the presence of any symptoms suggesting influenza should be taken very seriously, especially in those who are at high risk of developing complications. If symptoms are mild and the patient is healthy, it is adequate to stay in bed, drink plenty of liquids and take acetaminophen for headache and fever. Physicians can easily and rapidly diagnose the disease by taking a nasal swab of the patient. If present, therapy with an antiviral can decrease the severity of the symptoms and shorten the time to recovery. The two drugs commonly used are either Tamiflu or Relenza, although their effectiveness in swine flu is not proven and some evidence indicates that the virus may be resistant. The virus does not appear to be more virulent than any other influenza virus, but the lack of immunity or a vaccine raises the specter that multitudes worldwide could become infected. While deaths may be no greater than expected, the sheer number of those diagnosed raises concern that deaths could be in the millions. Because of the involvement of the WHO and global cooperation, a vaccine is on the fast track and expected to be available before the next flu season hits this winter. At-risk individuals, as well as those caring for them, should be vaccinated. Hopefully, vaccination will stave off a worldwide disaster. In this case, the old adage holds true: "An ounce of prevention is worth a pound of cure."

Dr. David Lipschitz is the author of the book "Breaking the Rules of Aging." To find out more about Dr. David Lipschitz and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com. More information is available at www.DrDavidHealth.com.
Copyright 2009 Creators Syndicate Inc.

Peste neumónica se cobra una tercera vida en China

Un tercer afectado murió por el brote de peste neumónica que afecta a la provincia noroccidental china de Qinghai, donde hay otros nueve enfermos por esta bacteria y las autoridades mantienen en cuarentena a miles de habitantes.
El último fallecido es un hombre llamado Danzhi, de 64 años y de la ciudad de Ziketan, en la prefectura tibetana de Hainan, cuyos 10.000 habitantes fueron puestos en cuarentena el fin de semana pasado, aunque se desconoce el número que permanece aislado.
Ziketan tiene una superficie de unos 3 mil kilómetros cuadrados habitados por pastores tibetanos.
"Se trata de una zona de pastores nómadas muy pobre y poco poblada. Los pastores viven muy distantes unos de otros" , explicó un portavoz de Sanidad de Qinghai apellidado Yang.
El actual brote no supone peligro para los viajeros estivales, ya que la zona cercana más turística, el lago Qinghai, se encuentra a 100 kilómetros de Ziketan, dijo Yang, aunque recomendó a todos aquellos que hayan estado en la zona desde el 16 de julio y que padezcan fiebre o tos que acudan de inmediato a un hospital.
Para prevenir el contagio, las autoridades están llevando a cabo tareas de desinfección y han bloqueado los accesos por carretera a la localidad, informó Yang, donde casi no hay actividad debido a la cuarentena, aunque tampoco pánico, ya que la peste no es nueva para sus pobladores.
Agregó que esta zona del altiplano tibetano registra cada verano brotes de peste, en concreto el área de Ziketan ha sufrido dos en la última década, aunque el actual es de una especial virulencia, por tratarse de un tipo de bacteria más letal.
"Tenemos experiencia en este tipo de brotes, por lo que hemos podido tomar medidas de forma inmediata" , aseguró el funcionario.
Las autoridades sanitarias indican que, hasta hoy, no han detectado ninguna nueva infección.El brote, que se inició el 20 de julio, ha acabado con la vida de otras dos personas desde el sábado, un pastor de 32 años y su vecino de 37, mientras que otras nueve personas están hospitalizadas en el Hospital Tibetano del distrito de Xinghai.
La bacteria neumónica, la "Yersinia pestis" , es la más peligrosa de las tres que producen la peste, una variable de la septicémica y la bubónica, esta última conocida en Europa por las plagas que mataron a millones en la Edad Media.
Según la Organización Mundial de la Salud (OMS) , la neumónica puede causar la muerte en 24 horas si no se trata a tiempo con antibióticos, y recomienda la cuarentena para aislar el contagio, que se produce a través del aire entre humanos o animales.
La bacteria está presente en roedores salvajes, como ratas, ratones y marmotas, y en sus parásitos, como pulgas o garrapatas.
"Generalmente, las medidas que se toman en este tipo de brotes consisten en identificar la amenaza y controlar su propagación. Una vez identificados los casos, hay que tratar a los pacientes con antibióticos a la mayor brevedad posible" , señaló Vivian Tan, portavoz de la OMS en Pekín.
Tan aclaró que la OMS ha recibido directamente del Ministerio de Sanidad datos actualizados de la epidemia desde el sábado pasado.
"La peste neumónica es la menos común de las tres pestes, pero puede matar a entre un 30 y un 60 por ciento de los contagiados" , agregó Tan.
De los nueve pacientes infectados en Ziketan -la mayoría familiares de la primera víctima-, uno se encuentra en condición grave, y otro ha desarrollado síntomas de tos y dolor torácico.
La peste neumónica ataca a los pulmones y se desarrolla en un máximo de tres días, por lo que, con el fin de reducir las posibilidades de fallecimiento, debe ser tratada en las primeras 24 horas de la aparición de síntomas como fiebre, dolor de cabeza, problemas respiratorios, debilidad y tos con sangre o esputo.