Study: Less restrictive reproductive rights reduce birth complications risk by 7%

Oct. 13 (UPI) — Women living in states with less restrictive reproductive rights policies are 7% less likely have low birth weight babies than those living in states with more stringent laws, according to an analysis published Tuesday by the American Journal of Preventive Medicine.

The risk was 8% lower for Black women living in less-restrictive states, the data showed.

“Our study provides evidence that reproductive rights policies play a critical role in advancing maternal and child health equity,” study co-author May Sudhinaraset, of the UCLA Fielding School of Public Health, said in a statement.

Since the Supreme Court’s decision in Roe v. Wade in 1973, which effectively legalized abortion, states have had “substantial discretion” in creating policies governing whether Medicaid covers the costs of contraception or reproductive health care.

Some states have taken steps that effectively limit access to abortion services and other reproductive care, Sudhinaraset and her colleagues said.

Black women are more likely to die in pregnancy and childbirth than any other race group, experience more maternal health complications than White women and generally have lower quality maternity care, they said.

In addition, women of color are more likely to experience adverse birth outcomes.

Compared to infants of normal weight, low-birth-weight babies face many potential health complications, including infections early in life and long-term problems, such as delayed motor and social development or learning disabilities.

Sudhinaraset and her colleagues analyzed birth record data for the nearly 4 million births that occurred in the 50 states and Washington, D.C., in 2016, comparing reproductive rights policies and adverse birth outcomes in each state.

They also evaluated if the associations were different for women of color and immigrants.

The findings indicate that expanding reproductive rights may reduce the risk of low-birth weight, particularly for U.S.-born Black women, the researchers said.

“Important policy levers can and should be implemented to improve women’s reproductive health overall, including increasing abortion access and mandatory sex education in schools,” Sudhinaraset said.

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Trump, downplaying risk, says he’s ready to ‘kiss everyone’ at his first campaign trail rally since COVID-19 diagnosis

President Trump in his return to the campaign trail in Florida on Monday evening boasted he has recovered from COVID-19 and is impervious to the disease that has killed more than 210,000 Americans.

The president, who tested positive on Oct. 1, also indicated he is unconcerned about being contagious and told the audience gathered at Orlando Sanford International Airport that he would be happy to engage in some close contact. 

“One thing with me, the nice part, I went through it, now they say I’m immune. … I feel so powerful,” Trump said. “I’ll walk in there, I’ll kiss everyone in that audience. I’ll kiss the guys, and the beautiful women, and the — everybody. I’ll just give you a big fat kiss.”

Trump spoke for about an hour. While his remarks were short by the standards of his past rallies, which are often about 80 minutes long, it was far longer than any of the brief videos he released while recovering from the virus or his first live speech, which took place at the White House on Saturday and lasted less than 2 minutes. 

The president’s return to the campaign trail came shortly after the White House medical team announced that he tested negative “on consecutive days.” Trump’s return to public events came exactly 10 days after the White House said his symptoms first appeared, which is the period of isolation recommended by the Centers for Disease Control.

Trump, who was treated with steroids and experimental drugs, became ill after his campaign and the White House hosted a series of events that ignored masks and social distancing measures designed to stop the spread of the virus. Over a dozen people linked to those gatherings also tested positive, including senior members of the president’s campaign team and White House staff.

The White House has declined to reveal precisely how many staffers have fallen ill. Trump’s team has also repeatedly refused to say when he last tested negative prior to his diagnosis, raising the possibility that the testing regimen supposedly in place at the White House was not followed and also making it impossible to say whether the president traveled to events while contagious. 

Even after the cluster of cases at the White House, Trump’s Florida rally still didn’t include standard measures designed to minimize risks of coronavirus spread. Guests were packed together and many did not wear masks. 

On stage, Trump, as he has for months, criticized lockdowns and quarantine measures as detrimental to the economy. He encouraged people to ignore them if they choose.

“The cure cannot be worse than the problem itself,” Trump said of the lockdowns.“If you want to stay, stay. Relax. Stay. But, if you want to get out there, get out.”



Donald Trump wearing a suit and tie: President Trump at a campaign rally in Orlando, Fla. (John Raoux/AP)


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President Trump at a campaign rally in Orlando, Fla. (John Raoux/AP)

The president also suggested keeping distance from others was never an option for him.   

Video: President Trump: White House doctors said I can’t spread the virus anymore

COVID-19 Risk Deemed Low in Intubation, Extubation

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

Tracheal intubation and extubation may not produce enough aerosols to warrant being designated as procedures associated with high risk for transmission of SARS-CoV-2, researchers say.

The researchers’ sampling of particle sizes in operating rooms calls into question the extreme infection protocols that have been mandated in many hospitals since the outbreak of COVID-19.

“Our findings are quite striking in that we don’t see aerosol generated to a significant level,” said Tony Pickering, MBChB, PhD, a professor of neuroscience and anestheisa at the University of Bristol in the United Kingdom.

The study was published in Anaesthesia.

Experts, however, are split on whether the data are sufficient to change safety protocols.

Aerosolized Droplets Monitored

Droplets greater than 20 µm in diameter appear to be the primary route by which SARS-CoV-2 is transmitted, but there is some evidence that smaller particles may also play a role. Aerosolized particles, which these authors say are “typically considered to be <20 µm in diameter and particularly those of < 5 µm,” might travel long distances, linger in the air, and potentially transit the length of the respiratory tract.

The World Health Organization and many national public health authorities have recommended that physicians who perform aerosol-generating procedures wear airborne-precaution personal protection equipment (PPE), including a fitted face piece (FFP3 or N95), a long-sleeved, fluid-resistant gown, gloves, and eye protection.

Many jurisdictions around the world, including in the United Kingdom and the United States, have designated tracheal intubation and extubation as aerosol-generating procedures.

Earlier retrospective and cohort studies of SARS-CoV-1 suggested that healthcare workers who perform intubation had an increased risk for infection from that virus. However, these data fall short of closing the case, Pickering and colleagues argue.

To investigate aerosolized particle generation during these procedures, the researchers used an optical particle sizer (TSI Inc) that could detect particles from 300 nm to 10 μm in diameter by laser optical scattering.

They sampled the air in an operating room with ultraclean, laminar flow ventilation, high-efficiency particular air filtration, and an air supply rate of 1200 m3/sec.

With this ventilation system, monitoring detected a background particle count of 0.4 particles per liter of air when the operating room was empty, and 3.4 particles per liter when the operating room was in use but no aerosol-generating procedure was underway.

The researchers then connected a sampling funnel through a tube to the optical particle sizer and positioned the funnel half a meter from the patients’ heads. They then carried out 19 intubations and 14 extubations. They found that a volitional cough in this setting sprayed an average of 732 (SD, 418) particles per liter of air.

Tracheal intubation, including face‐mask ventilation, produced almost no aerosolized particles (an average concentration of 1.4; SD, 1.4) per liter. The difference in concentration compared to a cough was highly significant (P < .0001).

Tracheal extubation produced an average detectable aerosol concentration of 21 particles per liter

New Cancer Risk With Textured Breast Implants?

Use of textured breast implants for postmastectomy reconstruction led to a small but significant increase in breast cancer recurrence as compared with smooth-surface implants, a retrospective study from South Korea showed.

Overall, 4% of 650 women had some form of disease recurrence during a median follow-up of 52 months after receiving breast implants. The 5-year locoregional recurrence-free survival (LRRFS) rate was 95.9% among women who received textured implants and 97.8% in those who had smooth implants, a nonsignificant difference, reported Sa Ik Bang, MD, PhD, of Sungkyunkwan University and Samsung Medical Center in Seoul, and colleagues.

As shown in their study online in JAMA Surgery, the 5-year disease-free survival (DFS) rate was significantly lower with textured implants: 93.3% vs 97.8%.

In a Kaplan-Meier survival analysis, LRRFS did not differ by implant surface type, but DFS remained significantly lower in the textured-implant group at 3, 4, and 5 years.

“Textured implant use could be associated with a lower DFS and high risk for recurrence than use of a smooth implant,” the researchers concluded. “This association may be valid regardless of other factors, including tumor stage and ER [estrogen receptor] status. Further investigation is required to verify these results.”

The results added to the well-documented risk of anaplastic large-cell lymphoma (ALCL) associated with breast implants, which have been blamed for 733 cases of ALCL and 36 deaths worldwide as of early 2020. The accumulation of adverse data makes a case for discontinuing use of textured implants, according to the authors of a commentary that accompanied the article by Bang and colleagues.

“Given the association of textured implants with ALCL, and now the suggestion that they are associated with increased risk for breast cancer recurrence, surgeons who choose textured implants should counsel their patients with breast cancer about their possible consequences,” wrote Michael R. Cassidy, MD, and Daniel S. Roh, MD, PhD, both of Boston University School of Medicine. “Many reconstructive surgeons across the world have already abandoned the use of textured implants altogether.”

The sudden emergence of the breast implant-associated (BIA) ALCL, and its possible relationship with implant-surface texture, focused more emphasis on implant safety, Bang and co-authors noted. Patients have raised concern about whether the implants might also be associated with breast cancer recurrence when used in reconstruction procedures after mastectomy, the team added.

No clinical studies had examined the association between breast implants and breast cancer recurrence. Chronic inflammation associated with an implant or the surgical procedure has been hypothesized as a potential trigger for BIA-ALCL.

Clinical and preclinical studies showed that surgery-induced inflammation could have implications for local residual or dormant tumor cells, including the potential to trigger tumor regrowth and metastasis, the authors continued.

To examine the issue, Bang and colleagues retrospectively analyzed data for patients whose breast cancer treatment included use of an implant during reconstruction procedures performed at Samsung Medical Center in Seoul from 2011 through 2016.

The researchers identified 650 patients who received a total of 687 implants, which had textured surfaces in 413

COVID-19 ICU Patients Have High Risk of Clots, Research Shows | Health News

By Alan Mozes
HealthDay Reporter

(HealthDay)

TUESDAY, Oct. 6, 2020 (HealthDay News) — Hospitalized COVID-19 patients face an increased risk of developing dangerous blood clots, a new review indicates.

The odds of a clot are highest for the most critically ill patients. Analysis of 66 studies found that 23% of COVID-19 patients in an intensive care unit (ICU) developed a blood clot in the leg, known as a deep vein thrombosis (DVT).

Overall prevalence of a DVT was 14% among ICU and non-ICU COVID-19 patients, and 8% among those with mild-to-moderate disease risk who were not admitted to the ICU.

The “numbers are surprisingly high when compared with other hospitalized patients,” said study author Dr. Cihan Ay.

Of great concern are blood clots in the legs that can break away and travel to the lungs. This is a life-threatening condition known as pulmonary embolism (PE).

Nearly 4% of patients not admitted to the ICU developed a pulmonary embolism. And “we found a very high PE risk of 14% in patients treated at an intensive care unit,” said Ay, an associate professor in hematology and hemostaseology at the Medical University of Vienna in Austria.

According to the American Heart Association, DVT and PE are each a form of venous thromboembolism, or VTE, as both refer to a blood clot that originates in a vein.

VTE is estimated to affect between 300,000 and 600,000 Americans every year, the AHA notes. It is most frequently triggered by surgery, cancer, hospitalization or long-term immobilization.

To examine VTE risk related to COVID-19, Ay and his colleagues analyzed the findings of 66 studies, involving roughly 28,000 COVID-19 patients.

On average, the COVID-19 patients were about 63 years old, and six in 10 were men. About one-fifth had been admitted to an ICU.

None of the studies looked at clotting risk among COVID-19 patients who had not received hospital treatment. So the findings do not speak to DVT or PE risk among such patients, said Ay, although “it seems that the risk of clots is low in patients with a mild clinical course of COVID-19.”

Early in the pandemic, it became clear that blood clot risk seemed elevated in patients with COVID-19 compared to other diseases. To prevent clotting, “physicians worldwide intensified dosing of blood thinners for COVID-19 patients,” Ay said.

This created another potential problem, however, since blood thinners increase the risk of bleeding.

The study authors hope their review will offer clinicians more insight into clotting risk profiles, offering guidance as to which patients truly need preventive clot treatment, Ay said.

As to why COVID-19 might drive up clotting risk in the first place, Ay said experts can only speculate based on available data.

“First, the clinical course in such patients is often severe, which by itself increases the thrombosis [clotting] risk,” he said. “Second, researchers found that COVID-19 interacts with the blood clotting system and the blood vessels, which might explain the increased risk in those patients.”

Dr. Gregg Fonarow is director of the

Marines may waive combat fitness tests for service members at risk for coronavirus – U.S.

Marines may waive combat fitness tests for service members at risk for coronavirus


Stars and Stripes is making stories on the coronavirus pandemic available free of charge. See other free reports here. Sign up for our daily coronavirus newsletter here. Please support our journalism with a subscription.


Marine Corps commanders may issue waivers for Marines, or even whole units, for semi-annual combat fitness tests if the testing sites cannot accommodate safety measures to protect against the coronavirus, a spokesman for III Marine Expeditionary Force on Okinawa said Monday.


The Corps is putting mitigating steps in place, such as screening Marines and taking their temperatures before the tests, disinfecting equipment and mandating face masks, said 1st Lt. Pawel Puczko by email to Stars and Stripes. He said Marines who are at a higher risk of contracting the coronavirus or share quarters with someone who is at a higher risk may apply for waivers.


In April, Marine Corps Commandant Gen. David Berger ordered a halt to all fitness testing due to the coronavirus. Last month, the Corps announced it will resume its physical fitness and combat fitness tests despite the ongoing pandemic.


Marines will have until the end of December to complete both tests, according to a Sept. 21 memo.


Individual waivers will be evaluated on a case-by-case basis, Puczko said.


“The health and safety of our Marines is always a top priority,” he said. “Commands across III MEF have demonstrated their dedication to keeping Marines and families safe from COVID-19 through diligent planning and implementation of safety protocols.”


The allowance for commanders to issue both combat fitness test and physical fitness test waivers will extend across the Marine Corps, according to a Marine administrative order.


COVID-19 is the respiratory disease caused by the coronavirus.


Social distancing may prove difficult during the combat fitness test, in which one event requires Marines to drag and carry each other to simulate maneuver under fire, according to the official Marine Corps website.


The Air Force in September postponed its physical fitness assessments until January 2021. Body composition measurements — waist, height and weight — are postponed until further notice, according to last month’s announcement.


All airmen will receive maximum points for the so-called “abdominal circumference” component as part of their official score, including those with exemptions to that waist measurement, the statement said.


“We know people are staying fit regardless, but we want to give our Airmen enough time to prepare,” Air Force Chief of Staff Gen. Charles Q. Brown Jr. said in the statement.


The Navy also postponed sailors’ physical fitness tests until further notice in an administrative message in July.


“Although the Navy PFA Cycle 2, 2020 has been excused, Sailors are reminded to make good choices for a healthy diet and are to continue a level of fitness to maintain Navy physical fitness standards,” the message said.


Thursday, the Army adopted its long-planned, six-event physical fitness

Marines may waive combat fitness tests for service members at risk for coronavirus – Pacific

Marines may waive combat fitness tests for service members at risk for coronavirus


Stars and Stripes is making stories on the coronavirus pandemic available free of charge. See other free reports here. Sign up for our daily coronavirus newsletter here. Please support our journalism with a subscription.


Marine Corps commanders may issue waivers for Marines, or even whole units, for semi-annual combat fitness tests if the testing sites cannot accommodate safety measures to protect against the coronavirus, a spokesman for III Marine Expeditionary Force on Okinawa said Monday.


The Corps is putting mitigating steps in place, such as screening Marines and taking their temperatures before the tests, disinfecting equipment and mandating face masks, said 1st Lt. Pawel Puczko by email to Stars and Stripes. He said Marines who are at a higher risk of contracting the coronavirus or share quarters with someone who is at a higher risk may apply for waivers.


In April, Marine Corps Commandant Gen. David Berger ordered a halt to all fitness testing due to the coronavirus. Last month, the Corps announced it will resume its physical fitness and combat fitness tests despite the ongoing pandemic.


Marines will have until the end of December to complete both tests, according to a Sept. 21 memo.


Individual waivers will be evaluated on a case-by-case basis, Puckzo said.


“The health and safety of our Marines is always a top priority,” he said. “Commands across III MEF have demonstrated their dedication to keeping Marines and families safe from COVID-19 through diligent planning and implementation of safety protocols.”


The allowance for commanders to issue both combat fitness test and physical fitness test waivers will extend across the Marine Corps, according to a Marine administrative order.


COVID-19 is the respiratory disease caused by the coronavirus.


Social distancing may prove difficult during the combat fitness test, in which one event requires Marines to drag and carry each other to simulate maneuver under fire, according to the official Marine Corps website.


The Air Force in September postponed its physical fitness assessments until January 2021. Body composition measurements — waist, height and weight — are postponed until further notice, according to last month’s announcement.


All airmen will receive maximum points for the so-called “abdominal circumference” component as part of their official score, including those with exemptions to that waist measurement, the statement said.


“We know people are staying fit regardless, but we want to give our Airmen enough time to prepare,” Air Force Chief of Staff Gen. Charles Q. Brown Jr. said in the statement.


The Navy also postponed sailors’ physical fitness tests until further notice in an administrative message in July.


“Although the Navy PFA Cycle 2, 2020 has been excused, Sailors are reminded to make good choices for a healthy diet and are to continue a level of fitness to maintain Navy physical fitness standards,” the message said.


Thursday, the Army adopted its long-planned, six-event physical fitness

Coffee may reduce risk for Parkinson’s disease, study says

Caffeine may reduce the risk of Parkinson’s disease in people who have a gene mutation associated with the movement disorder, researchers report.

“These results are promising and encourage future research exploring caffeine and caffeine-related therapies to lessen the chance that people with this gene develop Parkinson’s,” said study author Dr. Grace Crotty, of Massachusetts General Hospital.

“It’s also possible that caffeine levels in the blood could be used as a biomarker to help identify which people with this gene will develop the disease, assuming caffeine levels remain relatively stable,” Crotty added in a news release from the journal Neurology.

The study was published online in the journal.

Previous studies have shown that caffeine may protect against Parkinson’s in people with no genetic risk factors. This new study focused on a mutation in the LRRK2 gene that increases the risk of Parkinson’s.

Not all people with this gene mutation develop Parkinson’s disease, so scientists are trying to pinpoint other contributing genetic or environmental factors.

Could coffee — or its lack — be one of them?

This study compared 188 people with Parkinson’s disease to 180 people without the disease. Both groups had people with and without the LRRK2 gene mutation.

Among people with the gene mutation, those with Parkinson’s had a 76% lower concentration of caffeine in their blood than those without Parkinson’s. Among people without the mutation, those who had Parkinson’s had a 31% lower concentration of caffeine in their blood than those without Parkinson’s.

People with Parkinson’s who had the gene mutation consumed 41% less caffeine a day than the people with and without the gene mutation who didn’t have Parkinson’s.

The study assessed people at one point in time, so it doesn’t help researchers understand any long-term effect caffeine may have on Parkinson’s risk or how it may affect the disease’s progression, Crotty noted.

Also, the study doesn’t prove that caffeine consumption directly reduces the risk of Parkinson’s it only shows an association.

More information

The Parkinson’s Foundation has more on Parkinson’s disease.

Copyright 2020 HealthDay. All rights reserved.

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Incidence, risk factors, and prevalence

Urethral cancer affects the urethra, which is the tube that connects the bladder to the outside of the body. It serves to remove urine from the body.

Various treatments are available for urethral cancer, with the best option depending on the stage of the cancer and other factors, such as the person’s age. The side effects of these treatments and the outlook for people with this disease vary among individuals.

In this article, we provide more information about urethral cancer and what someone with this condition can expect.

Urethral cancer is a rare form of urological cancer that is responsible for less than 1% of all cases of cancer of the genital or urinary organs. Urological cancers include those that affect the urinary tracts of all sexes and the reproductive organs of males.

Urethral cancer affects males and females differently, though the research findings on this are conflicting. According to the National Cancer Institute, this type of cancer affected 4.3 of every million males and 1.5 of every million females between 1973 and 2002. The Urology Care Foundation also state that the cancer affects more males than females.

However, both Beaumont Health and UCLA Health state that the cancer affects more females than males.

According to a recent study, survival rates of urethral cancer are based largely on the age of the person and stage of the cancer at the time of diagnosis. As with most cancers, early detection plays an important part in treatment and survival.

A person may not notice symptoms in the early stages of the cancer. According to the Urology Care Foundation, a person may start to notice symptoms once the cancer has grown larger.

The symptoms may include:

  • a noticeable growth or lump on the urethra
  • pain during urination
  • blood in the urine
  • trouble emptying the bladder

Some people may experience additional symptoms, including:

  • urinary incontinence
  • enlarged lymph nodes in the groin
  • bleeding or discharge from the urethra
  • frequent urge to urinate or frequent urination
  • a growth on the penis or bulging along the underside of the penis

The Urology Care Foundation state that a female’s urethra is about 1.5 inches long. It sits near the outside of the front of the vagina, within the labia.

According to recent research, the treatment goal for females with urethral cancer is to remove the tumor while maintaining as much of the urethra as possible for urination.

As the female urethra is short, there is a high risk of urinary incontinence — the loss of bladder control — after the removal of any primary urethral tumor.

A male’s urethra is about 8 inches in length. It runs from the bladder, through the center of the prostate, and along the shaft of the penis.

Researchers note that the goals for treating males with urethral cancer include removing the tumor, as well as preserving the function of the penis.

UCLA Health state that urethral cancer is most common in people over the age of 60 years. Beaumont Health also indicate

Money Worries Raise Suicide Risk in People With ADHD: Study | Health News

By Robert Preidt, HealthDay Reporter

(HealthDay)

MONDAY, Oct. 5, 2020 (HealthDay News) — There’s a link between attention-deficit hyperactivity disorder (ADHD), financial stress and suicide risk, a new study suggests.

Researchers analyzed data on ADHD and suicide in Sweden from 2002 to 2015, as well as credit and default data from a random sample of more than 189,000 Swedish adults for the same period.

Before age 30, people with ADHD had only a slightly higher demand for credit than others. But demand among people with ADHD continued to grow with age, while demand for credit fell among others.

“Because they are in financial distress, those with ADHD keep asking for more credit and not getting it,” said study co-author Itzhak Ben-David, a professor of finance at Ohio State University.

“The result is that their financial problems just keep getting worse and worse through adulthood,” he said in a university news release.

Adults with ADHD were more than four times more likely than the general population to have bank overdrafts, impounded property and unpaid alimony, educational support or road taxes. By age 40, their default risk peaked at more than six times that of the general population.

As in previous research, this study found that people with ADHD were more likely than others to die by suicide.

But it also found that adults with ADHD who were at the highest risk of default were about four times more likely to die of suicide than those with ADHD who were at low risk of default and people without ADHD who had poor credit.

Among men with ADHD, the frequency of unpaid debts increased significantly in the three years prior to suicide, according to findings published Sept. 30 in the journal Science Advances.

“There is more financial chaos in the lives of men with ADHD in the years immediately preceding suicide,” said study co-author Marieke Bos, deputy director of the Swedish House of Finance at the Stockholm School of Economics.

The findings highlight the significant role that financial problems play in suicide risk among people with ADHD, according to the researchers.

“Our modern life is built on paying bills on time and making rent and mortgage payments. These tasks are more difficult for people with ADHD and it takes a toll,” Ben-David said.

Co-author Theodore Beauchine, a professor of psychology at Ohio State, said more attention should be given to financial difficulties facing people with ADHD.

“The impulsivity found in ADHD is predisposing to suicide. And if you have a lifetime of financial problems, that can lead to a sense of hopelessness,” he said in the release. “Hopelessness combined with impulsivity is a really bad combination and may increase the risk of suicide.”

The U.S. National Institute of Mental Health has more on ADHD.

Copyright © 2020 HealthDay. All rights reserved.

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