Methodist Healthcare Hospitals

Methodist Healthcare Hospitals
P 800.333.7333 (Toll Free)
www.sahealth.com

mhs

Methodist Healthcare Hospitals Overview

As the region’s most preferred health care provider, Methodist Healthcare has a dynamic team of over 8,000 professionals and support staff devoted to fulfilling our mission of Serving Humanity to Honor God and providing exceptional and cost-effective health care accessible to all. More than 2,700 physicians in every field of specialization maintain credentials to practice at Methodist Healthcare Hospitals. In 1963, Methodist Hospital was the first hospital to open in the now world-renowned South Texas Medical Center. Methodist Hospital includes these additional campuses in the Medical Center: Methodist Heart Hospital, Methodist Children’s Hospital and Methodist Specialty and Transplant Hospital. Specialized services are provided through departments including the Texas Transplant Institute, Texas Neurosciences Institute, Gamma Knife® Center and Methodist Women’s Pavilion.

 

Chartered in 1955, Methodist Hospital became the first hospital built in the South Texas Medical Center. A group of businessmen known as the Five Oaks donated 40 acres for the development of a world-class medical hub. A groundbreaking ceremony was held in 1960 featuring a mock nuclear blast to showcase the design plans of the hospital: the world’s first nuclear-age hospital with two floors built completely underground to ensure vital services were available in the event of a nuclear attack. The hospital opened in 1963 and welcomed the first baby born in the Medical Center. Methodist Hospital now delivers more than 5,000 babies annually. In addition to its outstanding obstetrics program, Methodist Hospital is also known for its outstanding neurology and neurosurgical care as well as orthopedics, bone marrow transplants, emergency services and an oncology program which includes South Texas’ only Gamma Knife® Center. Methodist Hospital is accredited by the Joint Commission in stroke care and is one of two Texas hospitals to receive the highest quality award from the Texas medical Foundation Health Quality Institute: The Texas Medical Foundation Gold Award for Health Care Improvement.

 

As an accredited chest pain center, Methodist Heart Hospital is the area’s leader in cardiac care and recognized for an outstanding heart transplant program. Methodist Heart Hospital pioneered many firsts in cardiac care including the first balloon angioplasty, the first heart valve transplant and, the first hospital in San Antonio to offer a cardio-hospitalist program in which two cardiologists work in the hospital on rotating shifts, 24 hours a day, seven days a week, prepared to care for patients with signs and symptoms of a heart attack. Methodist Heart Hospital recently opened a Hybrid Operating Room, offering cardiology specialists and surgeons the opportunity to provide a wider range of services in a single room. Methodist Heart Hospital is the only private hospital in the area performing Transcatheter Aortic Valve Replacement, or TAVR.

 

Methodist Children’s Hospital is dedicated to providing outstanding pediatric care from children from all over Texas and beyond. Colorful images and artwork enhance every window and wall, creating a warm, welcoming environment that is focused on the health and well being of each child. Methodist Children’s Hospital has a spacious emergency department dedicated to pediatric cases with 32 individual treatment rooms, each equipped with a television and an activity center. The newborn intensive care unit is a regional center of excellence with 78 licensed beds over 19,000 square feet, caring for the most fragile premature and special needs babies. Methodist Children’s Hospital is among the nation’s largest providers of blood and marrow stem cell and cord blood transplants for children having preformed over 500 transplants since program inception.

 

 

Methodist Specialty and Transplant Hospital is a full-service facility that is widely acclaimed for its outstanding kidney, liver and pancreas transplant programs. Home to the Texas Transplant Institute, the center made medical history by performing the world’s first 16-way kidney donor exchange in three consecutive days in a single center. The kidney transplant program is the largest living donor program in the nation due to the success of its paired exchange kidney program. Other specialty areas include emergency care, psychiatry, bariatric surgery, inpatient rehabilitation and the latest treatments for cancer and incontinence. The facility houses a program with a specially trained team that works with law enforcement officers to provide forensic exams and emergency care for survivors of sexual assault.

MHS Featured Video

Neuroscience Articles

  • Acupuncture may not be effective for knee pain: study

    By Kathryn Doyle

    NEW YORK (Reuters Health) - Acupuncture won't improve chronic knee pain in middle-aged people, researchers say.

    In their study, real acupuncture using needles and lasers was no more helpful than sham acupuncture for chronic knee pain among people 50 years old and older.

    "It is surprising that our study showed acupuncture was not effective compared to sham acupuncture, because many people with chronic knee pain report that treatment with acupuncture is beneficial for their symptoms," said Rana S. Hinman, the study's lead author from the University of Melbourne, Australia.

    Previous research showed acupuncture to be effective, although the benefits compared to mock acupuncture have been generally small and of questionable benefit, she told Reuters Health by email.

    The researchers write in JAMA - the Journal of the American Medical Association - that many people over age 50 are plagued with chronic knee pain. Many of them turn to alternative treatments, such as acupuncture.

    Acupuncturists may use a combination of traditional Chinese and Western techniques with needles or low-intensity lasers. However, the effectiveness of laser acupuncture had been uncertain, the researchers write.

    To test whether needle or laser acupuncture is superior to no acupuncture or sham acupuncture, the researchers divided 282 patients over age 50 with chronic knee pain and morning stiffness into four groups.

    The type of knee pain in the study is common with osteoarthritis, which is the result of normal joint wear and tear over the years.

    One group didn't receive acupuncture. Another group received needle acupuncture, another laser acupuncture and the last group received sham laser acupuncture. All of the treatments were delivered by family physicians who were trained in acupuncture.

    Patients received eight to 12 treatments over three months. Each treatment session lasted about 20 minutes.

    The laser and sham laser treatments looked the same to both patients and acupuncturists, but the laser was not turned on for the sham group.

    The patients rated their average knee pain and physical function on questionnaires at the beginning of the study, after three months of treatment and again at one year.

    There were "modest improvements" in pain at three months in the needle and laser acupuncture groups compared to the no-treatment group, but not compared to the sham group.

    And there were no differences between any of the groups on measures of knee pain and function after one year.

    This suggests that there were no "real" or "direct" effects of needle or laser acupuncture, Hinman said. The improvements patients felt were likely due to the placebo effect.

    "Acupuncture tends to be more effective for people who believe in the benefits of acupuncture," she said. "In our study, people did not know that were signing up for an acupuncture study, so our participants were less likely to be 'believers' in acupuncture, which probably explains why acupuncture was ineffective in our study."

    The new results are very similar to those of a review of individual patient data in 2012, said Andrew Vickers.

    Vickers, who led the previous review, is an attending research methodologist at Memorial Sloan Kettering Cancer Center in New York City and was not involved in the new study.

    The new review may have found a benefit from real acupuncture compared to sham acupuncture if the study included more people, he told Reuters Health by email.

    "About three million Americans try acupuncture per year, and chronic pain is the most common indication," he said.

    People with chronic pain should see a pain specialist, as there are many options for treatment, including acupuncture, he said.

    "As the authors suggest, the findings of this study are applicable to patients with moderate to severe persistent knee pain, and acupuncture may be effective in some people with neuropathic (nerve related) pain," said Dr. A. Abhishek, an arthritis researcher and associate professor at the University of Nottingham in the UK.

    The UK's National Institute for Clinical Excellence and Health does not recommend acupuncture for treating knee osteoarthritis, but does recommend it for persistent low back pain as it can be effective in that scenario, Abhishek, who was not part of the new study, told Reuters Health by email.

    As alternatives to acupuncture, Hinman said physical therapy, knee braces and exercise can all help alleviate chronic knee pain.

    SOURCE: http://bit.ly/WddS8K JAMA, online September 30, 2014.

  • Obama's BRAIN initiative awards $46 million in grants

    By Julie Steenhuysen

    CHICAGO (Reuters) - Wearable brain scanners and lasers that can turn hundreds of cells on and off were among 58 projects awarded $46 million in federal grants as part of President Obama's $100 million initiative to unlock the secrets of the human brain.

    Launched in 2013, the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative is designed to give scientists greater insight into how the healthy brain works and a better understanding of what systems go awry in diseases ranging from Alzheimer's to schizophrenia.

    "The human brain is the most complicated biological structure in the known universe. We've only just scratched the surface in understanding how it works - or, unfortunately, doesn't quite work when disorders and disease occur," said Dr. Francis Collins, director of the National Institutes of Health (NIH), the federal agency distributing the $46 million in grants.

    He likened the funding to his involvement in the early days of the Human Genome Project, the program that uncovered the precise sequence of 3 billion molecules common to the vast majority of humans' DNA.

    The grants represent the NIH's portion of the BRAIN Initiative. It is one of four federal agencies committing more than $110 million in fiscal 2014 spending. In addition to the NIH, the agencies include the National Science Foundation, the Food and Drug Administration and the Defense Advanced Research Projects Agency.

    Winners of the NIH grants were selected from a pool of more than 600 applicants. The grants will support the work of 100 investigators.

    Most of the projects focus on developing new tools to help answer basic questions about the brain, including classifying the myriad cell types in the brain and developing new methods to record brain activity and integrate that into fundamental theories of the brain.

    "There's a big gap between what we want to do in brain research and the technologies available to make exploration possible. These initial awards are part of a 12-year scientific plan focused on developing the tools and technologies needed to make the next leap in understanding the brain," Collins said.

    The White House is hosting a conference on the BRAIN Initiative later on Tuesday where new federal and private sector commitments will be unveiled.

  • After-school exercise may improve thinking skills, fitness

    By Kathryn Doyle

    NEW YORK (Reuters Health) - Children who participated in a physical activity program after school did better on thinking tasks than kids who didn't take part in the program, according to a new study.

    Participants in the nine-month program performed better on tasks that tested their abilities to block out distractions, focus and multitask, said Charles H. Hillman, the study's lead author from the Department of Kinesiology and Community Health at the University of Illinois at Urbana-Champaign.

    Those skills, he added, are needed by people throughout their lives.

    "Kids and adults do these things all the time," said Hillman.

    Additionally, the findings suggest that physical activity has a direct effect on brain health. If that's true, then cutting back on physically active times of the day like recess may have unintended consequences, the researchers write in the journal Pediatrics.

    Previous research has found that inactivity affects adults' brain health, but there have been few studies to test the connection between inactivity and brain health among children, the researchers write.

    The brain goes through extensive changes and development during childhood. An active lifestyle during those years may protect brain health throughout life, the researchers add.

    For the study, Hillman and his colleagues randomly assigned 221 kids in Illinois to a waitlist or an after-school program called FITKids, which was offered on 150 days of the school year. The children were all between seven and nine years old.

    The FITKids program includes two hours of physical activity per session, with at least 70 minutes of moderate to vigorous physical activity at "activity stations," followed by a snack and rest, and ending with another 45 minutes of organizational games centered on a skill, like soccer or tag.

    Current guidelines in the U.S. and Europe recommend at least 60 minutes of moderate to vigorous physical activity per day for kids and teens.

    Both the FITKids group and the waitlist group improved in fitness over the nine-month period, but the FITKids group improved more, with a 6 percent increase in aerobic ability, compared to 1 percent among the waitlist group.

    On cognitive tasks, the physical activity group improved in accuracy more than the waitlist group. They also improved more in multi-tasking than the waitlist group.

    Based on before-and-after studies of electrical activity in kids' brains, only the FITKids group increased the amount of attention they gave to tasks by the end of the study.

    Kids in the FITKids group attended an average of 80 percent of the sessions through the school year. Their performances tended to increase along with their attendance in the program, the researchers found.

    "We had some evidence that exercise programs could help children with their cognition, but now we have a result that it helps with cognitive flexibility too," said Catherine L. Davis.

    Davis, a professor of pediatrics, physiology and graduate studies at Georgia Regents University in Augusta, was not involved in the new study.

    While there are many theories about how physical activity may improve brain health, Davis said there is no one answer so far.

    The researchers can't say physical activity by itself led to the improved brain health, because the participants may have benefited from interacting with other children and general education from the program.

    Sports keep heart rates up and simultaneously test the brain in a unique way. In some sports, for example, the brain must predict where the ball is going and where teammates will be, Davis told Reuters Health.

    "Kids need to be physically active about an hour per day," Hillman said.

    Parents who don't have access to an after-school program like the one in the study could take their kids to a park or the YMCA, Hillman said, or some other safe environment where the kids can be physically active.

    SOURCE: http://bit.ly/1nAc36f Pediatrics, online September 29, 2014.

  • Colorado court hears appeal of worker fired for medical marijuana

    By Brendan Pierson

    (Reuters) - The Colorado Supreme court on Tuesday heard arguments over whether employees can be fired for using medical marijuana, which is legal in the state but illegal under federal law.

    The case was brought by Brandon Coats, a former customer service representative for Englewood, Colo.-based Dish Network who was fired in 2010 after testing positive for marijuana. Coats is quadriplegic as a result of a car accident and has a license to use marijuana to treat painful muscle spasms.

    Coats claims that his firing violated a state law that prohibits employers from firing employees for engaging in "lawful" activities outside of work.

    At Tuesday's argument, Colorado Supreme Court justices peppered attorneys for both Coats and Dish Network with skeptical questions, giving no hint of how they might resolve the contradiction between state and federal law.

    Coats' attorney, Michael Evans, said that Coats had used marijuana only outside of work, and that there was no evidence that he had ever been impaired at work. Marijuana, he noted, can show up in drug tests for more than a month after a single use.

    Evans argued that Colorado's constitutional amendment legalizing medical marijuana use, passed by voters in 2000, made Coats' use lawful.

    Justice Gregory Hobbs Jr. asked him why the definition of "lawful" under the state employment law should not include federal law.

    "When the Colorado legislature intends to include federal law, it does so expressly," Evans replied.

    "We must always remember that state sovereignty is a fundamental part of this country," he added near the end of his argument.

    Meghan Martinez, arguing for Dish Network, said the case "need not be an endorsement nor an indictment of medical marijuana."

    Rather, she said, it was about the right of employers to maintain "zero tolerance" policies on drug use.

    Martinez said it was impractical to ask employers to determine whether an employee who has used marijuana is impaired or not at work.

    "What do you do if the employer and the employee don't agree about the level of impairment?" she asked.

    Chief Justice Nancy Rice asked why Colorado's amendment explicitly making medical marijuana use legal would not make it "lawful" under the employment law, to which Martinez replied that the federal Controlled Substances Act trumped state law.

    Michael Francisco, an attorney for the state, spoke briefly at the end of the argument, agreeing with Dish's position.

    State supreme courts in California, Montana and Washington have ruled against medical marijuana patients in similar cases.

    Coats brought his suit in 2011 in Arapahoe County District Court. Judge Elizabeth Volz dismissed the case, finding the state's medical marijuana amendment created a defense against criminal prosecution but not a broader right to medical marijuana.

    In April 2013, a Colorado Court of Appeals panel voted 2-1 to uphold that ruling, though on different grounds, finding that Coats' conduct was unlawful because it violated federal law.

    The case is Coats v Dish Network LLC, Colorado Supreme Court, No. 2013SC000394.

  • Colorado, CDC probing 10 cases of virus-related paralysis in kids

    By Julie Steenhuysen

    CHICAGO (Reuters) - U.S. health officials are investigating at least 10 cases of children in Colorado who developed limb weakness or paralysis after testing positive for a respiratory virus, state health officials said on Monday.

    Of the 10, four children tested positive for enterovirus D68 (EV-D68), a virus that is causing severe respiratory infections in 40 U.S. states and the District of Columbia.

    From mid-August to September 26, 2014, the U.S. Centers for Disease Control and Prevention or state public health laboratories have confirmed a total of 277 people infected with the virus, according to the CDC website.

    Dr. Larry Wolk, chief medical officer of the Colorado Department of Public Health and Environment, said some of the children have been ruled out for enterovirus D68 infection and others are awaiting test results.

    All of those experiencing limb weakness have recently been diagnosed with either some form of enterovirus or rhinovirus, two large classes of common viruses that cause respiratory infections. The common cold, for example, is caused by a rhinovirus.

    "Just because it's not specific for D68 doesn't mean it's not another, similar virus," Wolk said.

    "There is a very high number of kids who have viral respiratory illness this time of year," he said, adding that limb paralysis is "a rare complication of all of these viruses."

    The CDC is investigating the cases and asking other states whether they are also are seeing higher than normal cases of limb weakness associated with a respiratory virus infections, according to its website.

    "It's obviously not just D68 in and of itself," Wolk said. "The question is, is there something else that ties these 10 cases together."

    All of the children in the Colorado cluster are under 21, and most live in the Denver area. Of those involved, six have been discharged from the hospital. Nine of the 10 were treated at Children's Hospital Colorado in Aurora.

    Magnetic resonance imaging (MRI) scans of all 10 cases show lesions in the spinal column. Symptoms range from weakness in arms or legs to total paralysis of a limb, Wolk said.

    The CDC said it is focusing its testing efforts on cases in which people develop severe respiratory illness, although it is likely that many more people with milder symptoms are infected with the virus.

    Enterovirus D68 is one of more than 100 non-polio enteroviruses, a group of viruses that cause 10 million to 15 million infections in the United States each year.

Oncology Articles

  • CORRECTED-Discuss risks of radiation imaging: cardiologists

    (Corrects name of academic journal in paragraph 5 to Circulation.)

    By Kathryn Doyle

    NEW YORK (Reuters Health) - Cardiologists should discuss with patients the risks and benefits of chest imaging using ionizing radiation before the procedure, according to a new statement endorsed by several medical organizations.

    Ionizing radiation, which can come from cardiac stress tests, CT scans and certain heart procedures, is tied to increased cancer risk.

    "There is continuing concern on the part of patients in the area of ionizing radiation," said Dr. Andrew J. Einstein, an associate professor of medicine in radiology at Columbia University in New York.

    In general, the risks of the radiation are small and the benefits of clinically appropriate imaging outweigh the risks, but many patients still have unanswered questions, said Einstein, a member of the writing committee for the new statement.

    The statement, published in the journal Circulation, is endorsed by the American Heart Association, the American College of Cardiology and several other medical organizations.

    "The purpose of this document is to address physicians in particular and provide recommendations in terms of methods that can enhance safety and methods that can enhance patient understanding," he told Reuters Health by phone.

    He and his coauthors recommend that providers explain to patients why radiation imaging is being used, the risks it involves and the benefits it offers.

    The decision to go ahead with ionizing radiation imaging should be shared between the doctor and the patient, they write.

    "Patient centered imaging is really tailored to the needs of the patient and their preferences," Einstein said. "The education responsibility falls squarely on the doctors."

    "As doctors, it is our obligation to make sure that we, our colleagues and our patients understand the potential benefits of a medical imaging study as well as potential risks," he said. "Patients shouldn't be scared off by a one in X chance of developing cancer, they should be reassured by the benefits of the imaging."

    For example, concerned patients should be reassured during certain heart procedures that the benefits are greater than the small risk posed by the radiation, Einstein said.

    Radiation imaging helps obtain useful, in many cases crucial information for decisions regarding the treatment, which often is life-saving, said Yehoshua Socol, a physicist and executive analyst at Falcon Analytics in Karnei Shomron, Israel.

    Socol was not involved in writing the new statement.

    Cancer risk only elevates slightly after multiple exposures to the radiation, he told Reuters Health by email.

    Past studies have found, however, that the small amount of radiation absorbed through medical tests may increase the risk of cancer over a lifetime (see Reuters Health stories of June 6, 2012 here: http://reut.rs/Ms8cWl and of July 13, 2009 here: http://reut.rs/1yylxne).

    For heart patients, there is no federal regulation of radiation dose for medical tests, leaving the appropriate use in the hands of doctors.

    "When it comes to ionizing radiation doses there is tremendous variability between facilities for the same tests," Einstein said.

    Some of that is because doses are tailored to the individual patient, but some is unnecessary, he said.

    The statement includes recommendations for making sure the right test is being done at the right time and that the lowest possible dose of radiation is used.

    "You should use enough radiation to answer the question but not more so than you need," he said.

    Doctors ordering imaging tests should understand when each type of test is appropriate, the typical average radiation dose, diagnostic accuracy, potential risks, availability, cost, and convenience, according to the statement.

    SOURCE: http://bit.ly/1orlP5v Circulation, online September 29, 2014

  • CORRECTED-Discuss risks of radiation imaging: cardiologists

    (Corrects name of academic journal in paragraph 5 to Circulation.)

    By Kathryn Doyle

    NEW YORK (Reuters Health) - Cardiologists should discuss with patients the risks and benefits of chest imaging using ionizing radiation before the procedure, according to a new statement endorsed by several medical organizations.

    Ionizing radiation, which can come from cardiac stress tests, CT scans and certain heart procedures, is tied to increased cancer risk.

    "There is continuing concern on the part of patients in the area of ionizing radiation," said Dr. Andrew J. Einstein, an associate professor of medicine in radiology at Columbia University in New York.

    In general, the risks of the radiation are small and the benefits of clinically appropriate imaging outweigh the risks, but many patients still have unanswered questions, said Einstein, a member of the writing committee for the new statement.

    The statement, published in the journal Circulation, is endorsed by the American Heart Association, the American College of Cardiology and several other medical organizations.

    "The purpose of this document is to address physicians in particular and provide recommendations in terms of methods that can enhance safety and methods that can enhance patient understanding," he told Reuters Health by phone.

    He and his coauthors recommend that providers explain to patients why radiation imaging is being used, the risks it involves and the benefits it offers.

    The decision to go ahead with ionizing radiation imaging should be shared between the doctor and the patient, they write.

    "Patient centered imaging is really tailored to the needs of the patient and their preferences," Einstein said. "The education responsibility falls squarely on the doctors."

    "As doctors, it is our obligation to make sure that we, our colleagues and our patients understand the potential benefits of a medical imaging study as well as potential risks," he said. "Patients shouldn't be scared off by a one in X chance of developing cancer, they should be reassured by the benefits of the imaging."

    For example, concerned patients should be reassured during certain heart procedures that the benefits are greater than the small risk posed by the radiation, Einstein said.

    Radiation imaging helps obtain useful, in many cases crucial information for decisions regarding the treatment, which often is life-saving, said Yehoshua Socol, a physicist and executive analyst at Falcon Analytics in Karnei Shomron, Israel.

    Socol was not involved in writing the new statement.

    Cancer risk only elevates slightly after multiple exposures to the radiation, he told Reuters Health by email.

    Past studies have found, however, that the small amount of radiation absorbed through medical tests may increase the risk of cancer over a lifetime (see Reuters Health stories of June 6, 2012 here: http://reut.rs/Ms8cWl and of July 13, 2009 here: http://reut.rs/1yylxne).

    For heart patients, there is no federal regulation of radiation dose for medical tests, leaving the appropriate use in the hands of doctors.

    "When it comes to ionizing radiation doses there is tremendous variability between facilities for the same tests," Einstein said.

    Some of that is because doses are tailored to the individual patient, but some is unnecessary, he said.

    The statement includes recommendations for making sure the right test is being done at the right time and that the lowest possible dose of radiation is used.

    "You should use enough radiation to answer the question but not more so than you need," he said.

    Doctors ordering imaging tests should understand when each type of test is appropriate, the typical average radiation dose, diagnostic accuracy, potential risks, availability, cost, and convenience, according to the statement.

    SOURCE: http://bit.ly/1orlP5v Circulation, online September 29, 2014

  • French pharmacies shuttered in protest against reform plans

    By Reuters Staff

    PARIS (Reuters) - All but a handful of France's pharmacies were closed on Tuesday to protest the Socialist government's plans to introduce more competition into the sector.

    Pharmacists were the latest profession to challenge President Francois Hollande's plans to deregulate their activities following a first-ever street protest earlier this month by notaries.

    Economy Minister Emmanuel Macron hopes to give the euro zone's second-biggest economy a boost by shaking up regulations that currently give 37 professions, ranging from court clerks to taxi drivers, a monopoly-like grip on their industry.

    Pharmacists are worried that the reform will allow supermarkets to sell over-the-counter drugs and pave the way to big outside investors buying up owner-run pharmacies.

    About 97 percent of the pharmacies not ordered by law to remain open remained shuttered on Tuesday, according to the national order of pharmacists.

    Big retailers like supermarket chain E.Leclerc are lobbying hard to win the right to sell non-prescription drugs, including by airing prime-time television spots.

    Macron, a 36-year-old former investment banker who was also previously Hollande's top economic adviser, said there were many false ideas circulating about the deregulation bill, which he aims to present at the end of the year.

    "The bill aims to modernise the country in order to create activity wherever it's possible and to lower prices for households and companies," Macron said in an interview with regional newspaper Paris-Normandie.

  • Roche breast cancer drug "unprecedented" in extending lives

    By Ben Hirschler

    MADRID (Reuters) - A new breast cancer drug from Roche has shown "unprecedented" benefits in extending lives in a clinical trial and experts urged its widespread use for women with an aggressive form of the disease.

    Patients with a type of breast cancer known as HER2 positive, which makes up about a quarter of all breast cancers, who were given Perjeta on top of older medicine Herceptin and chemotherapy lived 15.7 months longer than those on Herceptin and chemotherapy alone.

    That is the longest extension to survival ever seen for a drug studied in metastatic breast cancer and also an unusually good result for any type of metastatic cancer, where disease has spread to other parts of the body.

    The result is a vindication of combining medicines that fight tumour cells in a variety of ways.

    Both Herceptin and Perjeta are antibodies designed to block the function of HER2, a protein produced by a cancer-linked gene. Perjeta, also known as pertuzumab, binds to a different part of the same protein, which makes combining the two drugs extra effective.

    "The results, I think, are phenomenal," lead researcher Sandra Swain from the Washington Hospital Center told the European Society for Medical Oncology (ESMO) annual congress in Madrid on Sunday.

    "The survival improvement of nearly 16 months ... is unprecedented among studies of metastatic breast cancer."

    Perjeta, which was approved by regulators two years ago, was tested in the Roche-backed study involving more than 800 women.

    Researchers had previously reported the Perjeta drug regimen significantly extended progression-free survival, or the period of time patients live without their disease worsening, but the final overall survival data has taken longer to collect.

    The median overall survival time was 56.5 months for those given Perjeta against the already impressive 40.8 months for patients taking only the older drugs.

    Looking at the study results a different way, the risk of dying was reduced by 32 percent for women who received the Perjeta regimen compared to those who got Herceptin and chemotherapy.

    While both Perjeta and Herceptin have side effects, including rash, diarrhea and a potentially adverse impact on heart function, using the two drugs together did not make these issues any worse.

    "I think these data are really compelling," said Eric Van Cutsem of the University of Leuven, who was not involved in the research. "When you see in breast cancer such a big change in survival with not a lot of cardio-toxicities then that is really practice-changing."

    REMARKABLE RESULTS

    Swain and Javier Cortes, another researcher on the study from the Vall D'Hebron Institute of Oncology in Barcelona, said the results suggested using Perjeta should now be the standard of care for HER2 positive breast cancer patients.

    A favorable reaction from oncologists will underpin expectations of strong sales for Perjeta, which analysts currently expect to sell $3.1 billion a year by 2018, according to consensus forecasts compiled by Thomson Reuters Cortellis.

    But it poses a challenge for healthcare providers, since Perjeta and Herceptin are costly injectable drugs and the multiple-drug regimen promises to strain budgets.

    In the United States, the monthly price of Perjeta is approximately $5,900, while Herceptin costs around $5,300, a Roche spokeswoman said. Prices in Europe are lower.

    For Roche, Perjeta is an important new product that should help defend its position in breast cancer, following the success of Herceptin, which was first approved in 1998.

    The company said the latest data would be submitted to regulatory authorities around the world for inclusion in the prescribing information for Perjeta.

    The Swiss drugmaker also has another related drug called Kadcyla, which is also being tested in combination with Perjeta. Some analysts believe Kadcyla's prospects could be curbed if results from that combination are not better than the impressive findings reported this weekend.

  • Florida marijuana campaign heats up, could raise Nov. turnout

    By Bill Cotterell

    TALLAHASSEE (Reuters) - Opponents of a proposal to let doctors in Florida prescribe marijuana are poised to launch a $1.6 million advertising campaign on Monday, with potential side effects for the state's heated race for governor in November.

    Political consultants say a public battle over the proposed constitutional amendment to allow medical marijuana, included on this year's midterm election ballot, could boost turnout among young voters for Democrat Charlie Crist, who supports the measure. The extra support may be enough to help him defeat incumbent Republican Governor Rick Scott, who opposes it.

    But opponents of Amendment 2 got a major boost when Sheldon Adelson, Las Vegas casino magnate and a major Republican fundraiser, put up $2.5 million of the $3.2 million raised by Drug Free Florida.

    The ads will attack "loopholes," which law enforcement authorities say could lead to recreational use of the drug, said Sarah Bascom, whose Tallahassee consulting firm is handling the Drug Free Florida campaign.

    "Our message is, this is not about sick people," she said. Even if more young voters turn out for the marijuana referendum, Bascom said "a vote down-ticket doesn't mean they're going to vote up-ticket" in the governor's race.

    Some 23 U.S. states and the District of Columbia already have passed laws allowing medical marijuana in some form, beginning with California in 1996.

    The public petition campaign that put the amendment on the Florida ballot promised relief for suffers of diseases like cancer, AIDS and ALS, also known as Lou Gehrig's disease. But the measure would also allow doctors to prescribe marijuana whenever they determine benefits outweigh potential risks.

    The no campaign is being supported by wide-ranging "Don't Let Florida Go To Pot" coalition of medical and law-enforcement organizations arguing that the amendment does not provide any minimum age or residency requirements for obtaining marijuana.

    Orlando trial lawyer John Morgan, a Crist backer who figures on spending $6 million of his own money on the medical-marijuana initiative, believes the referendum will draw up to 4 percent more voters to the polls Nov. 4, including college students who believe marijuana is no big deal, elderly voters who have friends who covertly puff some pot to relieve nausea from chemotherapy and libertarians who believe it is none of the government's business.

    Morgan, who has been touring the state in a motorcoach, said the amendment might help Crist in what is expected to be a close race, but denied sponsoring the drive for that reason.

    "We're registering people who never registered before, so I think turnout is going to be 2, 3, maybe even 4 points higher than we might have seen, but for this," he said during a visit to the University of Florida last week.

    While supporting the amendment, Crist has distanced himself a little from the medical marijuana campaign.

    "It might get more younger voters to turn out," Crist, a former Republican who was governor 2007-11, said in an interview. "I really don't know is the honest answer," he added. "It may well increase turnout because if you're educating people about this being on the ballot, who otherwise might not have known it, then you're ginning it up."

    Supporters of the amendment say polling shows nearly 70 percent of likely voters back the measure with only 28 percent opposed.

    But a recent Public Policy Polling survey showed just 61 percent support and a poll by the Tampa Bay Times/Bay News 9 and the Bob Graham Center at the University of Florida showed only 57 percent backing. Florida constitutional amendments require 60 percent support to pass.

    Steve Schale, a member of the Crist campaign and a senior aide in President Barack Obama's two Florida campaigns, said amendment supporters might favor Crist more than Scott, but jobs, education and many other issues will be more decisive.

    David Johnson of Strategic Vision in Atlanta, a Republican campaign planner, said it was hard to see young voters turning out in large numbers over one issue.

    However, he cautioned, "Remember, even an uptick of 1 or 2 percent in a close race could make the difference."

Orthopedic Articles

  • Acupuncture may not be effective for knee pain: study

    By Kathryn Doyle

    NEW YORK (Reuters Health) - Acupuncture won't improve chronic knee pain in middle-aged people, researchers say.

    In their study, real acupuncture using needles and lasers was no more helpful than sham acupuncture for chronic knee pain among people 50 years old and older.

    "It is surprising that our study showed acupuncture was not effective compared to sham acupuncture, because many people with chronic knee pain report that treatment with acupuncture is beneficial for their symptoms," said Rana S. Hinman, the study's lead author from the University of Melbourne, Australia.

    Previous research showed acupuncture to be effective, although the benefits compared to mock acupuncture have been generally small and of questionable benefit, she told Reuters Health by email.

    The researchers write in JAMA - the Journal of the American Medical Association - that many people over age 50 are plagued with chronic knee pain. Many of them turn to alternative treatments, such as acupuncture.

    Acupuncturists may use a combination of traditional Chinese and Western techniques with needles or low-intensity lasers. However, the effectiveness of laser acupuncture had been uncertain, the researchers write.

    To test whether needle or laser acupuncture is superior to no acupuncture or sham acupuncture, the researchers divided 282 patients over age 50 with chronic knee pain and morning stiffness into four groups.

    The type of knee pain in the study is common with osteoarthritis, which is the result of normal joint wear and tear over the years.

    One group didn't receive acupuncture. Another group received needle acupuncture, another laser acupuncture and the last group received sham laser acupuncture. All of the treatments were delivered by family physicians who were trained in acupuncture.

    Patients received eight to 12 treatments over three months. Each treatment session lasted about 20 minutes.

    The laser and sham laser treatments looked the same to both patients and acupuncturists, but the laser was not turned on for the sham group.

    The patients rated their average knee pain and physical function on questionnaires at the beginning of the study, after three months of treatment and again at one year.

    There were "modest improvements" in pain at three months in the needle and laser acupuncture groups compared to the no-treatment group, but not compared to the sham group.

    And there were no differences between any of the groups on measures of knee pain and function after one year.

    This suggests that there were no "real" or "direct" effects of needle or laser acupuncture, Hinman said. The improvements patients felt were likely due to the placebo effect.

    "Acupuncture tends to be more effective for people who believe in the benefits of acupuncture," she said. "In our study, people did not know that were signing up for an acupuncture study, so our participants were less likely to be 'believers' in acupuncture, which probably explains why acupuncture was ineffective in our study."

    The new results are very similar to those of a review of individual patient data in 2012, said Andrew Vickers.

    Vickers, who led the previous review, is an attending research methodologist at Memorial Sloan Kettering Cancer Center in New York City and was not involved in the new study.

    The new review may have found a benefit from real acupuncture compared to sham acupuncture if the study included more people, he told Reuters Health by email.

    "About three million Americans try acupuncture per year, and chronic pain is the most common indication," he said.

    People with chronic pain should see a pain specialist, as there are many options for treatment, including acupuncture, he said.

    "As the authors suggest, the findings of this study are applicable to patients with moderate to severe persistent knee pain, and acupuncture may be effective in some people with neuropathic (nerve related) pain," said Dr. A. Abhishek, an arthritis researcher and associate professor at the University of Nottingham in the UK.

    The UK's National Institute for Clinical Excellence and Health does not recommend acupuncture for treating knee osteoarthritis, but does recommend it for persistent low back pain as it can be effective in that scenario, Abhishek, who was not part of the new study, told Reuters Health by email.

    As alternatives to acupuncture, Hinman said physical therapy, knee braces and exercise can all help alleviate chronic knee pain.

    SOURCE: http://bit.ly/WddS8K JAMA, online September 30, 2014.

  • Studies criticize U.S. medical device approval process

    By Andrew M. Seaman

    NEW YORK (Reuters Health) - Information on the safety and effectiveness of medical devices before and after they are cleared by U.S. health regulators can be improved, according to two new studies.

    One study found many U.S. Food and Drug Administration (FDA)-cleared medical devices meant to be implanted in the body were not backed by publicly available evidence that they are similar to a device already on the market.

    "Let the buyer beware before getting an implant in their body, because there may be no evidence the implant is going to benefit them and no study done in case it might harm them," said Diana Zuckerman, the study's lead author and president of the National Center for Health Research in Washington, D.C.

    The new report is not the first time researchers have criticized the process the FDA uses to evaluate many medical devices.

    In 2011, the Institute of Medicine issued a report that the medical device evaluation process known as 510(k) is fatally flawed and should be replaced. The FDA, which requested the report, disagreed. (See Reuters story of July 29, 2011 here: http://reut.rs/qAKdUv.)

    The 510(k) process allows medical devices to get to market faster if they are "substantially equivalent" to devices already being sold. Certain information that's submitted to the FDA about the devices must be made publicly available as a summary, Zuckerman and her colleagues write in JAMA Internal Medicine.

    For the new study, the researchers evaluated the publicly available information for implantable devices cleared by the FDA through the 510(k) process between 2008 and 2012. Because those devices are supposed to be similar to another device already on the market, the researchers also looked at the available information for those original devices.

    Overall, they were looking for information on 50 devices cleared between 2008 and 2012 and 1,105 previously cleared devices.

    They found enough evidence to support the claim that eight (or 16 percent) of the 50 new devices were substantially equivalent to previously cleared devices. Of those previously cleared devices, only 31 (or about 3 percent) were supported by publicly available evidence.

    "The study relied on publicly available information, and as noted by the authors, this information is generally limited because manufacturers are only required by law to provide either a safety summary or a safety statement for the public," the FDA said in a statement to Reuters Health.

    "However, the FDA reviews a significant amount of data - far more than what is publicly available - to determine whether or not to clear an implantable device under a 510(k). This approach has served the American public well by balancing the need for robust evidence to assure safety while expeditiously bringing new technologies to the patients who need them," the statement continued.

    Zuckerman said the companies are not providing sufficient summaries of its evidence, which are required by law.

    "I think this is a report card going forward," she said. "Clearly the FDA and companies are failing to provide information to doctors and patients so they can make reasonable judgments to affect their lives."

    In another study in the same journal, researchers led by Ian Reynolds at The Pew Charitable Trusts in Washington, D.C. found that barriers may decrease the usefulness of studies completed after medical devices are approved by the FDA.

    The researchers found the FDA ordered more than 223 studies for 158 medical devices between the start of 2005 and the end of 2011. Only one of the studies led to an action by the FDA other than a change of the devices label.

    "We encourage the agency to work together with all stakeholders to evaluate how these studies can more effectively be used to improve the public health," they write.

    In a commentary accompanying the new study, Elisabeth Dietrich from the University of California, San Francisco and Maryland's Secretary of Health and Mental Hygiene Dr. Joshua M. Sharfstein write that the FDA has already taken steps to address many of the issues pointed out in the new studies.

    "It is important to recognize and support this progress, even as the FDA's performance continues to be monitored through research and oversight," they write.

    SOURCES: http://bit.ly/1xusqo1, http://bit.ly/1u6xFYp, http://bit.ly/1wRBQqJ and http://bit.ly/Zl8KFp JAMA Internal Medicine, online September 29, 2014.

  • Too little research supports newer joint implants: study

    By Kathryn Doyle

    NEW YORK (Reuters Health) - There is not much hard evidence that new artificial joint devices, including ceramic-on-ceramic bearings for hip replacement and high flexion knee replacement, are better than older options - and in some cases they may be worse - according to a new review.

    Senior author Dr. Art Sedrakyan and his team reviewed clinical trials, comparative studies and registries for evidence that five new implantable device innovations were effective and safe.

    Similar research published in 2011 led to manufacturers withdrawing some metal-on-metal hip replacement options, which turned out to have higher failure rates than others because the metal parts rubbing together created debris that could lead to inflammation and tissue damage.

    "Back in 2011 when we published the first paper on metal-on-metal hips, hundreds of people contacted me and asked if they should be worried about hip replacement in general," said Sedrakyan, of the Patient Centered Comparative Effectiveness Program and U.S. Food and Drug Administration Medical Device Epidemiology Science and Infrastructure Center at Weill Cornell Medical College in New York.

    "The answer is 'no' because the procedure is generally very safe and outcomes are generally good," he told Reuters Health.

    However, new product designs tend to be based on engineering data more than on clinical data, he said. It seems, logically, like a new design may have an advantage over the old, but that often isn't supported by evidence with real patients, he said.

    Sedrakyan and his team looked for evidence supporting five recently introduced and well-known hip and knee devices, including ceramic-on-ceramic bearings, modular femoral necks and uncemented monoblock cups for total hip replacement, as well as high-flexion knee replacement and gender-specific knee replacement.

    All these technologies are already "implemented" in patients, the authors write in the journal BMJ.

    The 118 studies comparing outcomes with these devices versus older options were of varying quality and few were high-quality randomized trials, the study team found.

    None of the five devices appeared to improve functioning or survival more than the older versions. And some of them had up to twice the rate of needing replacement in a subsequent "revision" surgery compared to existing options.

    Registries showed modular femoral necks were revised 1.9 times as often as predecessor technologies, and ceramic-on-ceramic hip bearings and high-flexion knee bearings were also replaced more often, according to the results.

    None of the newer devices appeared to have poor enough outcomes that their use should necessarily be discontinued, Sedrakyan said, but there was generally a lack of evidence in their favor.

    "The technologies that are supposed to be better are not proving to be better and some which are widely used happen to be worse," Sedrakyan said.

    The data show that not all new orthopedic devices are being studied carefully, and when they are being studied, the studies themselves may be limited in quality, said Dr. Aaron S. Kesselheim of Brigham and Women's Hospital in Boston who co-authored an editorial on the topic in BMJ.

    Older implants may not always be safer, but since they have been around longer and used in more patients it's easier for safety issues to come to light, he said.

    "Of course, that issue would only emerge if someone's looking for it, and unfortunately, safety data on implants are not systematically collected all the time," Kesselheim told Reuters Health by email.

    Hospital administrators usually choose and purchase the devices that end up inside patients, he said. But patients can have a voice, and should ask their surgeons if the device slated for their surgery has been proven effective and safe, not just that it is widely used or popular with some patients, Sedrakyan said.

    Many patients do not know to ask this question, and the implant itself may be decided on at the time of surgery, Kesselheim said.

    "Stakeholders like surgeons, regulators and patients need to work together to demand a different and improved system of surveillance of these new products," Sedrakyan said.

    SOURCE: http://bit.ly/1xHna1p and http://bit.ly/1Dl6VY4 BMJ, online September 9, 2014.

Transplant Articles

There are currently no articles to display.

Women’s Health Articles

  • Spouse personality may affect career success

    By Shereen Lehman

    NEW YORK (Reuters Health) - The personalities of husbands and wives may affect their spouses' success at work, suggests a new study.

    Husbands and wives who were conscientious and helped create satisfying home lives for their spouses were linked to future job satisfaction, promotion and income, researchers found.

    "The person that you marry and spend a lot of time with . . . can influence you in a different domain," Joshua Jackson told Reuters Health in a phone call.

    Jackson, a researcher at Washington University in St. Louis, co-authored the paper with Brittany Solomon, a graduate student at Washington University.

    "Who they are within your relationship can influence who you are at your work - even though they're not there," he said.

    While past studies have found that home life can influence work life and spouses can influence job satisfaction, Jackson and Solomon say little is known about whether a spouse's personality is linked to success on the job.

    For the study, which is scheduled for publication in the journal Psychological Science, the researchers used information from the Household Income and Labour Dynamics in Australia survey from 2005 through 2009.

    Specifically, they looked at 4,544 heterosexual, married adults ranging in age from 19 to 89 years.

    The participants took a series of psychological tests in 2005 that assessed five broad measures of personality: openness, extraversion, agreeableness, neuroticism and conscientiousness.

    Over the following four years, the researchers tracked the on-the-job performance of working spouses using annual surveys designed to measure job success. The participants reported their opinions on job satisfaction, salary increases and the likelihood of being promoted.

    The researchers found that workers who scored highest on those measures of job success tended to have spouses with a high score for conscientiousness.

    The relationship was the same for both men and women. It was also true for single and dual income couples, although a partner's conscientiousness had a bigger impact on a spouse's income when they didn't work themselves.

    The researchers identified three ways by which conscientious spouses may help their mates at work.

    For example, Jackson said, conscientious spouses are hard working, efficient and able to complete several chores around the house and other responsibilities outside their mate's job.

    "And as a result you have more free time or more mental energy and you can use that to recover from a hard day at work," he said, adding that some people could use that time to work more.

    "But the idea is that you're able to not be bogged down by extra responsibilities outside of one's occupation," he said.

    Another possibility is that the workers pick up on their spouse's good behavior, Jackson said.

    The other possibility is that people who have conscientious partners tend to have better relationships throughout their lives, he added.

    Jackson said that more work is needed to know for sure what is behind the link.

    The results confirm the parental guidance that it's better to marry a person who is conscientious than beautiful, Dr. Emanuel Maidenberg told Reuters Health in a phone call.

    Maidenberg, who wasn't involved with the new study, is director of the Cognitive Behavior Therapy Clinic at the University of California, Los Angeles. He believes a person modeling their spouse's behaviors is likely the driving force behind the link.

    "We tend to model behaviors, so if I'm in a relationship with somebody and specifically more so if I respect that person, then I am likely to start doing things in a way that will simulate what they do," he said.

    Maidenberg added that it becomes a process of developing new habits that are functional, helpful and productive.

    "It seems like this is something that happens as a side effect of being in a relationship that is close and intimate," he said. "You start doing things either to compliment your partner or to repeat their behaviors and this is how we develop habits that seem then to slip into the working environment."

    SOURCE: http://bit.ly/YOMceM Psychological Science 2014.

  • Women who have been unemployed have fewer kids -US study

    By Reuters Staff

    BOSTON (Reuters) - Women who were unemployed in their youth tend to have fewer children into middle-age than women who worked, according to a U.S. study released on Monday.

    Janet Currie and Hannes Schwandt, two researchers at Princeton University in New Jersey, used more than 140 million U.S. birth records to track groups of women and found that those with higher unemployment rates in their early twenties had fewer babies.

    Previous studies have suggested unemployment has a short-term impact on women's fertility as they may not have the financial resources to support their children.

    "A one percentage point increase in the average unemployment rate experienced between the ages of 20 and 24 reduces the short-run fertility of women in this age range by six conceptions per 1,000 women," according to the study, published in the Proceedings of the National Academy of Sciences.

    It added that the long-run effect was even greater: when the same women reached age 40 the one percentage point increase in the unemployment rate experienced at ages 20-24 lead to an overall loss of 14.2 conceptions.

    "This larger long-term effect is driven largely by women who remain childless," it said.

    The study pointed out that previous research had discovered the short-term correlation between unemployment and fertility, but that none had yet tested the longer-run effects.

    "Scholars have been examining the relationship between fertility and unemployment for more than a century... but it is not known whether these negative effects persist, because women simply may postpone childbearing to better economic times," the study said.

    SOURCE: http://bit.ly/1rwPdL7 Proceedings of the National Academy of Sciences, September 29, 2014.

  • Long-acting reversible contraceptives best for teens: pediatricians

    By Will Boggs MD and Nancy Lapid

    NEW YORK (Reuters Health) - For adolescents who choose not to abstain from sex, the American Academy of Pediatrics (AAP) favors long-acting reversible contraceptives, such as contraceptive implants and intrauterine devices.

    All methods of hormonal birth control, including contraceptive pills, are safer than pregnancy, Dr. Mary A. Ott from the Indiana University School of Medicine in Indianapolis, Indiana told Reuters Health by email.

    But long acting reversible contraceptive (LARC) methods, including the contraceptive implant and the intrauterine device (IUD), should be the first-choice contraceptive methods for adolescents who choose not to be abstinent, she added.

    Today in the medical journal Pediatrics, Ott and colleagues on the AAP's Committee on Adolescence updated the organization's 2007 policy statement on prescribing contraception for adolescents.

    After reviewing such issues as confidentiality, discussing a teen's sexual history, and counseling about abstinence and contraception, the policy statement advises pediatricians to counsel teens about a broad range of contraceptive services, with a special focus on long-acting reversible contraceptives.

    The policy statement also urges pediatricians to ensure that adolescents have access to these methods. In order to do so, they must be familiar not only with national best practice recommendations for confidential care, but also with state and federal laws regarding consent to contraceptive care and information disclosure, the paper notes.

    Once an appropriate contraceptive method has been selected, the pediatrician should encourage its consistent use along with consistent and correct use of condoms with every act of sexual intercourse.

    These principles should also apply to the care of adolescents with chronic illnesses and disabilities, while recognizing that those illnesses may complicate the contraceptive choices.

    Finally, the AAP says, pediatricians must recognize that the contraceptives discussion is ongoing, and this requires time for their adolescent patients to have their needs addressed in a "developmentally appropriate" way.

    "The Bright Futures best practice guidelines from the American Academy of Pediatrics and the Maternal and Child Health Bureau recommend starting to speak to adolescents confidentially about puberty, relationships, and sexual behaviors starting in early adolescence," at ages 11 to 14, Ott explained.

    "Bright Futures recommends that counseling be developmentally tailored to the adolescent, with a stronger focus on abstinence in early adolescence gradually focusing more on healthy relationships and sexually transmitted infection prevention and contraception by late adolescence," or ages 18 to 21, she continued.

    "Adolescents are capable of understanding complex messages about sexual health," Ott said. "Adolescents trust pediatricians and understand that their pediatricians can simultaneously encourage abstinence and provide non-judgmental contraceptive information and care."

    Dr. Hatim Omar, Division of Adolescent Medicine chief at the University of Kentucky in Lexington, told Reuters Health, "Teens are less likely to be compliant and because of their development are not fully aware about consequences ('it won't happen to me'), so proper counseling and using long-acting reversible contraceptives are the most effective means of preventing unwanted pregnancy."

    "Counseling should always include abstinence, STIs, and condom use," Omar concluded.

    Not all parents will welcome the interventions, however.

    Eric Scheidler, executive director of the Chicago-based Pro-Life Action League, told Reuters Health that as a father of daughters he finds it "horrifying" that their pediatrician would promote contraception.

    "I'd prefer for this discussion about teen sexuality to be a discussion between parents and children and not a girl and her doctors," he said in a phone call. "It's not just a medical decision, it's a moral decision. It ties into a girl's aspirations, her personality, her state of mind" - things a parent knows better than the child's doctor, he added.

    "The recommendation from the APP can't replace the parental relationship," Scheidler said.

    SOURCES: http://bit.ly/1u6tgVw and http://bit.ly/1wRJnFM Pediatrics, online September 29, 2014.

  • Clintons say granddaughter Charlotte's life off to 'good start'

    By Reuters Staff

    (Reuters) - Chelsea Clinton has given birth to a girl, she said in a statement on social media, giving former President Bill Clinton and former Secretary of State Hillary Clinton their first grandchild.

    "Marc and I are full of love, awe and gratitude as we celebrate the birth of our daughter, Charlotte Clinton Mezvinsky," Clinton said in the post on her Twitter and Facebook profiles, referring to her investment banker husband Marc Mezvinsky.

    The messages came out after midnight on the U.S. East Coast. Details on the baby's height and weight have not been released.

    Later on Saturday, Charlotte's new grandparents shared their excitement about the birth in a joint statement.

    "We are thrilled to be with our daughter and her husband as they welcome their daughter into the world," the senior Clintons said.

    "Chelsea is well and glowing. Marc is bursting with pride. Charlotte's life is off to a good start," they said.

    Chelsea Clinton announced her pregnancy in April while sitting side-by-side with her mother in armchairs on a stage at a New York City event on empowering women.

    It remains unclear how the birth of the first Clinton grandchild will affect the political ambitions of Hillary Clinton, who is considering a run for the White House in 2016.

    In 2011, former President Clinton told reporters in Davos, Switzerland: "I would like to have a happy wife, and she won't be unless she's a grandmother ... It's something she wants more than she wanted to be president."

  • Walking is the superfood of fitness, experts say

    By Dorene Internicola

    NEW YORK (Reuters) - Walking may never become as trendy as CrossFit, as sexy as mud runs or as ego-boosting as Ironman races but for fitness experts who stress daily movement over workouts and an active lifestyle over weekends of warrior games, walking is a super star.

    For author and scientist Katy Bowman, walking is a biological imperative like eating. In her book, "Move Your DNA: Restore Your Health Through Natural Movement," she suggests there are movement nutrients, just like dietary nutrients, that the body needs.

    "Walking is a superfood. It's the defining movement of a human," said Bowman, a biomechanist based in Ventura, California. "It's a lot easier to get movement than it is to get exercise."

    Researchers say emerging evidence suggests that combined physical activity and inactivity may be more important for chronic disease risk than physical activity alone.

    "Actively sedentary is a new category of people who are fit for one hour but sitting around the rest of the day," Bowman said. "You can't offset 10 hours of stillness with one hour of exercise."

    Last year researchers at the University of Texas School of Public Health asked 218 marathoners and half marathoners to report their training and sitting times. Median training time was 6.5 hours per week. Median total sitting time was eight to 10.75 hours per day, suggesting that recreational distance runners are simultaneously highly sedentary and highly active.

    Leslie Sansone, creator of the "Walk at Home: Mix & Match Walk Blasters" DVD, said too many people believe that spending grueling hours at the gym is the only way to fitness.

    "There's this "Biggest Loser" idea out there that if you're not throwing up and crying you're not getting fit," she said, referring to the popular television weight-loss show.

    She added that a small study of non-obese men published in the journal Medicine & Science in Sports and Exercise by scientists at Indiana University suggests that three five-minute walks done throughout three hours of prolonged sitting reverses the harmful effects of prolonged sitting on arteries in the legs.

    Three miles (5 kilometers) per hour is a good beginning, gradually working to 4 miles per hour, she said about walking.

    Dr. Carol Ewing Garber, president of the American College of Sports Medicine (ACSM), notes that fitness-walking guidelines of 10,000 steps per day may be too much for many.

    "About 7,500 steps may be more accurate," she said, adding that current ACSM recommendations call for at least 150 minutes of activity each week.

    Garber, a professor of movement sciences at Columbia University in New York, said research suggests that even one bout of exercise causes beneficial physiological effects.

    But she concedes that walking does not do everything. It is less beneficial for bones than running, and for strength, it is better to lift weights.

    "Still," she said, "If you're going to pick one thing, research says it should be walking."