Traffic & Construction

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Traffic Updates

TRAFFIC CONGESTION AT STMC
We wanted to make you aware of a large transportation project around the STMC that will result in severe traffic problems:
  • The grade separation at Fred & Med will be a huge project lasting nearly two years. Please check the TxDot website for updates. Traffic will be impacted on both Medical and Fredericksburg roads.

For this reason, we are suggesting that you consider alternative routes through the STMC. We suggest you do this sooner rather than later.

Facility Construction

UNIVERSITY HEALTH SYSTEM
Hospital Construction

This project is in progress and should be complete by the end of the fourth quarter of 2013.


STMC Quarterly Construction Project Chart

(download pdf)


STMC Construction Projects through 2013

(download pdf)


The TXDOT Fredericksburg Road & Medical Drive Project

(view link)


To submit other construction project, please email Pam Leissener

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Neuroscience Articles

  • REFILE-Falls indoors may signal frailty, linked to shorter survival

    (corrects third paragraph to say study was led by Bailly)

    By Shereen Lehman

    NEW YORK (Reuters Health) - Women in their eighties who fell indoors, rather than outdoors or from a height like a ladder, died sooner than their peers, a new French study finds.

    Indoor falls could be an indicator of frailty and a sign that protective measures should be taken, say the authors.

    The study was led by Sebastien Bailly, a researcher with Hospices Civils de Lyon in France. He and his coauthors write in the journal Maturitas, "The mean survival time of women with inside falls was nearly 1.6 years shorter than that of women with other falling profiles."

    Bailly and his colleagues studied 4,574 women who were over the age of 74 when they joined the study, could walk by themselves and were not living in institutional settings.

    The researchers called the women every four months for the first four years of the study to find out if they had fallen at some time during the previous week and where.

    The study team distinguished among falls by their location, whether they were due to inattention or to an environmental obstacle, and how serious the resulting injuries were.

    Along these lines, they classified the falls as environmental falls, such as slipping or tripping on something outdoors, falls from a height like a ladder or stairs, and inside or outside falls in general.

    Looking at information on 329 women who had fallen the week before the phone call follow-ups, the researchers found that 26 percent were so-called environmental falls, 19 percent were outside falls, 43 percent were inside falls and 12 percent were falls from height.

    The study team followed up again after another 13 years and found that 269 women had died. And those who had fallen indoors had an average survival time of 7.6 years, compared with 9.2 years for women who had any other type of fall.

    Separate from the type of falls women had, the researchers also found that women with advanced age, signs of frailty, slow walking speeds and comorbidities - that is, other health conditions - also had shorter survival times.

    However, women with frailties, for example, "who experienced outside falls or falls from height had no increased mortality despite more serious injuries," the researchers note.

    "Among community-dwelling women, some fall more frequently than others," the study team concludes. "These women should draw the caregivers' attention because their falls may be indicators of frailty. Non-injurious falls are also of concern because women experiencing this type of fall may suffer from unfavourable underlying conditions and be at risk of short survival."

    "The study is very well done," Dr. Kathleen Walsh told Reuters Health. "It has been shown in prior studies that for indoor falls the mortality tends to be worse, and longevity is diminished," said Walsh, who was not involved in the French research.

    Walsh, a geriatric and emergency medicine specialist at the University of Wisconsin Hospital in Madison, said there are different reasons that people fall inside and one of the questions that would be have been interesting to ask was how much time the patients were spending indoors or outdoors.

    "In general, people who fall inside have to stay inside for a reason and that's because of comorbidities - they're not super active and may not be active for different reasons," she said.

    But, Walsh said, family members shouldn't panic and tell their elderly loved ones that they need to move into assisted living after they've had a fall.

    "Because if you panic without having things evaluated by the physician that person will probably not tell you again when they have fallen," she said. "Staying calm is the number one thing."

    Walsh also said that physicians should ask their elderly patients if they have fallen within the previous year. If they have fallen, the doctors should find out what the patient remembers about the fall and if it was caused by certain movements, or if the patient could get up after the fall.

    "The red flags are, did they pass out before they fell," she said. "It's all in the history, if you take a good history you can usually figure things out."

    Walsh said that family members help to prevent falls by doing things like removing rugs and putting bars in bathrooms. In addition, she suggests elderly patients take classes to improve their balance and strength, such as the Stepping On class (http://www.steppingon.com).

    "Stepping is usually held at a local hospital or senior center and it's all about things that you can do while you're washing dishes or doing odds and ends around the house so you don't have to go to the physical therapist," she said.

    SOURCE: http://bit.ly/1oHXLKv Maturitas, online August 4, 2014.

  • REFILE-Falls indoors may signal frailty, linked to shorter survival

    (corrects third paragraph to say study was led by Bailly)

    By Shereen Lehman

    NEW YORK (Reuters Health) - Women in their eighties who fell indoors, rather than outdoors or from a height like a ladder, died sooner than their peers, a new French study finds.

    Indoor falls could be an indicator of frailty and a sign that protective measures should be taken, say the authors.

    The study was led by Sebastien Bailly, a researcher with Hospices Civils de Lyon in France. He and his coauthors write in the journal Maturitas, "The mean survival time of women with inside falls was nearly 1.6 years shorter than that of women with other falling profiles."

    Bailly and his colleagues studied 4,574 women who were over the age of 74 when they joined the study, could walk by themselves and were not living in institutional settings.

    The researchers called the women every four months for the first four years of the study to find out if they had fallen at some time during the previous week and where.

    The study team distinguished among falls by their location, whether they were due to inattention or to an environmental obstacle, and how serious the resulting injuries were.

    Along these lines, they classified the falls as environmental falls, such as slipping or tripping on something outdoors, falls from a height like a ladder or stairs, and inside or outside falls in general.

    Looking at information on 329 women who had fallen the week before the phone call follow-ups, the researchers found that 26 percent were so-called environmental falls, 19 percent were outside falls, 43 percent were inside falls and 12 percent were falls from height.

    The study team followed up again after another 13 years and found that 269 women had died. And those who had fallen indoors had an average survival time of 7.6 years, compared with 9.2 years for women who had any other type of fall.

    Separate from the type of falls women had, the researchers also found that women with advanced age, signs of frailty, slow walking speeds and comorbidities - that is, other health conditions - also had shorter survival times.

    However, women with frailties, for example, "who experienced outside falls or falls from height had no increased mortality despite more serious injuries," the researchers note.

    "Among community-dwelling women, some fall more frequently than others," the study team concludes. "These women should draw the caregivers' attention because their falls may be indicators of frailty. Non-injurious falls are also of concern because women experiencing this type of fall may suffer from unfavourable underlying conditions and be at risk of short survival."

    "The study is very well done," Dr. Kathleen Walsh told Reuters Health. "It has been shown in prior studies that for indoor falls the mortality tends to be worse, and longevity is diminished," said Walsh, who was not involved in the French research.

    Walsh, a geriatric and emergency medicine specialist at the University of Wisconsin Hospital in Madison, said there are different reasons that people fall inside and one of the questions that would be have been interesting to ask was how much time the patients were spending indoors or outdoors.

    "In general, people who fall inside have to stay inside for a reason and that's because of comorbidities - they're not super active and may not be active for different reasons," she said.

    But, Walsh said, family members shouldn't panic and tell their elderly loved ones that they need to move into assisted living after they've had a fall.

    "Because if you panic without having things evaluated by the physician that person will probably not tell you again when they have fallen," she said. "Staying calm is the number one thing."

    Walsh also said that physicians should ask their elderly patients if they have fallen within the previous year. If they have fallen, the doctors should find out what the patient remembers about the fall and if it was caused by certain movements, or if the patient could get up after the fall.

    "The red flags are, did they pass out before they fell," she said. "It's all in the history, if you take a good history you can usually figure things out."

    Walsh said that family members help to prevent falls by doing things like removing rugs and putting bars in bathrooms. In addition, she suggests elderly patients take classes to improve their balance and strength, such as the Stepping On class (http://www.steppingon.com).

    "Stepping is usually held at a local hospital or senior center and it's all about things that you can do while you're washing dishes or doing odds and ends around the house so you don't have to go to the physical therapist," she said.

    SOURCE: http://bit.ly/1oHXLKv Maturitas, online August 4, 2014.

  • Secure Italian military lab to grow medical marijuana

    By Steve Scherer

    ROME (Reuters) - Italy said on Thursday it would grow medical marijuana at a secure military lab outside Florence and distribute it through pharmacies to slash costs and make it more easily available to the sick.

    The use of medical marijuana or cannabis derivatives to treat patients has been legal in Italy since 2007, but only a few dozen people took it through the national healthcare system in 2013 because of its prohibitive cost.

    The military lab produces so-called "orphan" drugs no longer made by large pharmaceutical companies that are needed to treat rare diseases, Defense Minister Roberta Pinotti said after signing an agreement with Health Minister Beatrice Lorenzin.

    "The institute already produces some medicines," Pinotti said, explaining the unusual case of tasking the military to grow pot. "And we can guarantee security conditions."

    Lorenzin said she wanted to "debunk all the cultural or ideological myths" about using certain drugs in healthcare.

    "We already allow the use of drugs in medical treatment that are opiate or cocaine derivatives, and now we'll use cannabis," she told reporters.

    "Recreational drug use is harmful. But cannabis can be used to help treat certain pathologies or alleviate pain," she said.

    Possessing, selling and growing marijuana are illegal in Italy, which now imports all of its medical supplies of the drug, mostly from the Netherlands.

    Tax and transportation more than double the cost, with the retail price reaching almost 38 euros ($49) per gram, Dr. Francesco Crestani, an anesthesiologist and president of Italy's Association for Therapeutic Cannabis, told Reuters.

    PILOT PROJECT

    While several Italian regions have drafted laws aimed at cutting the cost of medical marijuana for people suffering from pathologies like cancer or multiple sclerosis, they have run into fierce opposition.

    Many argue that allowing the use of marijuana, even by the sick, sends the wrong message to teenagers, whose use of the drug is growing. One in four between the age of 15 and 19 has smoked it last year, a parliamentary report said this week.

    Italy's choice to keep tight control of the production of marijuana contrasts with developments in the United States, where almost half the 50 states allow sick people to grow their own, or in some states to buy it from dispensaries.

    The agreement, which the ministers described as a "pilot project", should result in the medicines being delivered to pharmacies by the end of 2015, Lorenzin said.

    Private pharmaceutical companies will not be able to produce medical marijuana "given the delicacy of this issue," she said.

    Each of Italy's 20 regional governments will establish the exact cost of the medicine to patients, Lorenzin added, but the retail cost of medical marijuana in Italy should be "more than halved."

    "This is a positive step," said therapeutic cannabis proponent Crestani, adding he hopes production is not delayed by bureaucratic snags.

    Due to the costs, most sick people who want marijuana have been buying it from the local drug dealer, Crestani said.

    "It's not safe to buy it on the street because there is no control over how it is produced. And the more you can cut the cost of the medicine, the better it is for the patient."

  • Stoners get high on love with marijuana dating sites

    By Mary Papenfuss

    SAN FRANCISCO (Reuters) - Dinner and a movie make for a typical date night but dinner followed by a joint could raise some eyebrows or be a turn-off despite increasing acceptance of marijuana use across the United States.

    So now, tuned-in stoners and users of medical pot are turning on to dating websites that cater exclusively to tokers or, at the very least, the "cannabis friendly" to avoid experiencing what they describe as all-too-frequent shock and rejection on the dating circuit.

    That has worked out well for a Vietnam War veteran from Michigan who works in the automotive industry and smokes to deal with the pain caused by chemotherapy treatment for hepatitis C.

    Larry, who asked to be identified only by his given name because of the legal issues surrounding marijuana use, says he is "very much enjoying" dating a woman he met on the dating website 420singles.net. The site name corresponds to a numerical code widely recognized within the cannabis subculture as a symbol for all things marijuana.

    "She lives near me but we wouldn't know about our shared medical marijuana use if we hadn't connected on the site because no one discusses pot smoking in my circles," he said.

    Larry's go-to website, with nearly 23,000 members, was the brainchild of 28-year-old California entrepreneur and self-described stoner Ryan Moxon of Marin County. About three years ago he dreamed up the idea for the site while yearning for the girl of his dreams: one who smokes pot.

    Membership is concentrated on the U.S. West Coast but also includes international smokers and has ballooned since voters in Washington state and Colorado opted to legalize recreational marijuana use in 2012.

    Voters in Oregon, Alaska and the District of Columbia will vote in November on the issue, and the New York Times in July called for the repeal of the federal ban on marijuana for those over the age of 21.

    "It's suddenly much cooler to come out as a toker," Moxon said of his site, which he says eliminates awkwardness about smoking.

    A newer website launched several months ago "aims to connect those with a passion for cannabis," said Miguel Lozano of Los Angeles, founder of My420mate.com with some 6,200 members.

    POTENTIAL INVESTORS

    Lozano, a medical marijuana user who enjoys pot to ease sports injury pain, is eager to counter the image that cannabis lovers are "merely hippies," he says.

    "There's a stereotype that pot smokers are lazy, isolated and lonely. They're not," he said. "They're the life of the party, they're often professionals and ambitious business people, and they make good partners."

    Lozano and Moxon are hoping their sites will become ad magnets for the burgeoning number of legal marijuana dispensaries and related products. Both sites already have drawn interest from potential investors, they say.

    Legal pot sales alone are expected to reach $10 billion by 2018, according to The ArcView Group, a marijuana industry investment company in San Francisco. Sales of pot-related products, from dope-infused health bars to cannabis-laced sexual lubricant, are among products expected to skyrocket.

    Another man, from Missouri, is dating a woman he met on Lozano's site. He classifies himself as a "recreational to daily" pot smoker. His new love interest smokes less but "she's totally cool with that," said the man, who asked that he be identified only by his given name, Corey, because marijuana use is illegal in his state.

    Although it's important to Corey that a date shares or is tolerant of his pot use, he believes would-be partners also have the personality he relates to.

    "Smokers come from all walks of life but they tend to chill back," he says. "When I go out with buddies who get wasted on alcohol, it can be embarrassing. With my cannabis-smoking pals, we relax and let the creativity unroll."

  • Mid-life migraine sufferers more likely to develop Parkinson's: study

    By Kathryn Doyle

    NEW YORK (Reuters Health) - People who experience migraines with aura during middle age are more than twice as likely as those without headaches to be diagnosed with Parkinson's disease later in life, according to a new study.

    Whether or not you've had headaches, Parkinson's disease is still rare, lead author Ann I. Scher told Reuters Health.

    "This definitely should not alarm people," said Scher, of the Uniformed Services University and the National Institute on Aging in Bethesda, Maryland.

    "Even though the risk was doubled, it was still uncommon, so people should not be unduly concerned," she said.

    Nonetheless, the results are novel and should be interesting to scientists and researchers, she said.

    Past studies have linked migraine with movement disorders like Parkinson's and restless legs syndrome, in part based on shared features such as dysfunction in the brain's responses to the neurotransmitter dopamine, Scher and her colleagues note in the journal Neurology.

    But those studies were limited to groups with specific disorders, so she and her team wanted to look at a broader population sample over time to see if migraine was linked to later Parkinson's.

    The researchers used data from an existing study started by the Icelandic Heart Association in 1967, which included people born between 1907 and 1935.

    The men and women randomly selected to be part of the study group answered questions about headache symptoms at an average age of 51. If they reported at least one headache per month, they answered follow-up questions to categorize the type of headache based on migraine symptoms like nausea, pain on one side of the head, sensitivity to light, visual disturbance before or during the headache and numbness.

    Nonmigraine headaches include none, or at most one, of those symptoms. Someone who has migraine without aura might experience nausea, one-sided pain or sensitivity to light. Migraines with aura include visual disturbance or numbness in addition to any of the other symptoms.

    Of the 5,620 people included in the study, almost 4,000 had no headaches, 1,028 reported non-migraine headaches, 430 had migraines with aura and 238 had migraines without aura.

    Typically, Scher said, about a third of migraine sufferers have migraines with aura.

    In an interview at around age 77, participants answered questions about movement disorder symptoms like hand tremor, weak voice, stiff gait, arm rigidity, slowed arm movement or smaller handwriting.

    Almost nine percent of the group reported four or more movement disorder symptoms.

    All movement symptoms were more common for people who reported migraine with aura earlier in life, especially hand tremor and arm rigidity.

    Most symptoms were also more common for people with migraine without aura, but the connection was stronger for those with aura, according to study results.

    Only 1.2 percent of the group as a whole reported being diagnosed with Parkinson's disease. Those who had reported migraine with aura were two and a half times more likely to be diagnosed with Parkinson's than those with no headaches.

    While Parkinson's disease was strongly related to certain types of headaches, restless leg syndrome was more common for people with all types of headaches. The same connection has been found before, Scher said.

    "You wonder, because it's a population based study and done some time ago, whether some of those labeled as migraine without aura did have aura," said Dr. Peter J. Goadsby, a headache diagnosis and treatment specialist at the University of California, San Francisco, who was not part of the new study.

    He has almost never encountered a patient with headaches and Parkinson's disease, but it is interesting to consider headaches earlier in life and Parkinsonism later, he told Reuters Health by phone.

    People with migraines with aura tend to be at increased risk of stroke, and some types of Parkinsonism are also related to stroke or stroke risk, but based on these results, stroke doesn't explain the connection, Scher said.

    "We don't think it's the medications they're taking either," she said.

    It could be that people with migraines and Parkinson's may share a genetic trait that explains the connection, or it may be that those with migraines tend to have experienced more head injuries, which may then increase Parkinson's risk, she said.

    "This is all speculation," Scher said. "It could be more than one thing and they could work together - genes and environment."

    It would be too speculative to suggest what people with headaches could do to reduce their risk of Parkinson's disease later in life, she said.

    Although the study does not have immediate clinical applications, it may have implications for developing new therapies to treat migraine, Goadsby said.

    "I'm really hopeful that this will someday lead to better understanding of what migraine is," Scher said.

    SOURCE: http://bit.ly/NwhhyY Neurology, online September 17, 2014.

Oncology Articles

  • Many think of dermatology as superficial: survey

    By Madeline Kennedy

    NEW YORK (Reuters Health) - The public has some misconceptions about what dermatologists actually do, according to a recent U.S. survey.

    "Overall, 46 percent of the participants thought that we spend the majority of our time managing skin cancer and 27 percent thought that we spend the majority of our time doing cosmetic procedures," said Dr. April Armstrong of the University of California-Davis, the study's senior author.

    The results show a lack of understanding of the day-to-day realities of dermatology, the researchers say, and that misperception could affect whether people get needed care for skin diseases or if adequate funding goes to dermatology research.

    According to a 2007 workforce survey, only 10 percent of a dermatologist's work involves cosmetic procedures and the remaining 90 percent is made up of surgery and managing medical conditions, Armstrong and her team point out in the Journal of the American Academy of Dermatology.

    For their own study, Armstrong and her colleagues asked a sample of more than 800 people across the United States what they think dermatologists spend most of their time doing.

    They also asked participants how important they consider dermatology to be, how much dermatologists earn and how many hours they work, as compared to other types of doctors.

    The respondents felt that cardiologists and primary care physicians have "more critical" professions than dermatologists and that plastic surgery is less important. Most people chose the same hierarchy when asked how difficult the job of a dermatologist was, with only plastic surgery rated as easier.

    The respondents were correct in certain of their perceptions, including the number of hours worked per week by different types of doctors and the average incomes in the various fields.

    Dermatologists tend to work fewer hours than the other specialties, though they report seeing a larger number of patients, according to the study team. Dermatologists also earn less than cardiologists and plastic surgeons but more than primary care physicians, the researchers say.

    Dr. Karen Edison, a dermatologist at the University of Missouri Hospital in St. Louis agreed that there are some misconceptions about her field. She told Reuters Health in a phone call that, "While we certainly have expertise and in fact pioneered many of the most popular cosmetic procedures, most of what we do is medical and surgical dermatology."

    According to the American Academy of Dermatology, dermatologists diagnose and treat over 3,000 diseases, ranging from skin cancer to eczema to bacterial infections.

    "In addition to the common dermatological conditions which are acne, rosacea, and psoriasis, dermatologists also manage a number of very complex medical dermatological conditions such as blistering diseases, pemphigus or pemphigoids, and a number of cutaneous infections that I think the public is not quite aware of," Armstrong said.

    "Misconceptions about dermatology may discourage patients with severe skin disease who need our expertise to seek care in settings that are not prepared to deliver high quality dermatology care and services," she added.

    "We also do quite a bit of primary care in dermatology," Edison said. "We talk to patients not only about the need for sun protection, but we talk to them about their smoking, about their diet and exercise, many of us look at a patient as an entire person because the general health of a patient really affects the health of their skin."

    Armstrong and her colleagues write that media emphasis on cosmetic innovations likely contributes to the public's confusion about what dermatologists really do.

    Edison places some of the responsibility with dermatologists as well. "We have also played a part, by in some areas not participating as fully as we perhaps should with the greater house of medicine or the wider medical community," she said.

    Armstrong emphasized that it's important for dermatologists to find ways to speak to the public about their profession.

    "The key message," Armstrong said, "is that there are gaps in the public understanding of the profession, of dermatologists' expertise and what we spend the majority of our time doing, and I think there can be educational efforts there to close the gap."

    SOURCE: http://bit.ly/1o6rpdq Journal of the American Academy of Dermatology, online August 28, 2014.

  • Secure Italian military lab to grow medical marijuana

    By Steve Scherer

    ROME (Reuters) - Italy said on Thursday it would grow medical marijuana at a secure military lab outside Florence and distribute it through pharmacies to slash costs and make it more easily available to the sick.

    The use of medical marijuana or cannabis derivatives to treat patients has been legal in Italy since 2007, but only a few dozen people took it through the national healthcare system in 2013 because of its prohibitive cost.

    The military lab produces so-called "orphan" drugs no longer made by large pharmaceutical companies that are needed to treat rare diseases, Defense Minister Roberta Pinotti said after signing an agreement with Health Minister Beatrice Lorenzin.

    "The institute already produces some medicines," Pinotti said, explaining the unusual case of tasking the military to grow pot. "And we can guarantee security conditions."

    Lorenzin said she wanted to "debunk all the cultural or ideological myths" about using certain drugs in healthcare.

    "We already allow the use of drugs in medical treatment that are opiate or cocaine derivatives, and now we'll use cannabis," she told reporters.

    "Recreational drug use is harmful. But cannabis can be used to help treat certain pathologies or alleviate pain," she said.

    Possessing, selling and growing marijuana are illegal in Italy, which now imports all of its medical supplies of the drug, mostly from the Netherlands.

    Tax and transportation more than double the cost, with the retail price reaching almost 38 euros ($49) per gram, Dr. Francesco Crestani, an anesthesiologist and president of Italy's Association for Therapeutic Cannabis, told Reuters.

    PILOT PROJECT

    While several Italian regions have drafted laws aimed at cutting the cost of medical marijuana for people suffering from pathologies like cancer or multiple sclerosis, they have run into fierce opposition.

    Many argue that allowing the use of marijuana, even by the sick, sends the wrong message to teenagers, whose use of the drug is growing. One in four between the age of 15 and 19 has smoked it last year, a parliamentary report said this week.

    Italy's choice to keep tight control of the production of marijuana contrasts with developments in the United States, where almost half the 50 states allow sick people to grow their own, or in some states to buy it from dispensaries.

    The agreement, which the ministers described as a "pilot project", should result in the medicines being delivered to pharmacies by the end of 2015, Lorenzin said.

    Private pharmaceutical companies will not be able to produce medical marijuana "given the delicacy of this issue," she said.

    Each of Italy's 20 regional governments will establish the exact cost of the medicine to patients, Lorenzin added, but the retail cost of medical marijuana in Italy should be "more than halved."

    "This is a positive step," said therapeutic cannabis proponent Crestani, adding he hopes production is not delayed by bureaucratic snags.

    Due to the costs, most sick people who want marijuana have been buying it from the local drug dealer, Crestani said.

    "It's not safe to buy it on the street because there is no control over how it is produced. And the more you can cut the cost of the medicine, the better it is for the patient."

  • Stoners get high on love with marijuana dating sites

    By Mary Papenfuss

    SAN FRANCISCO (Reuters) - Dinner and a movie make for a typical date night but dinner followed by a joint could raise some eyebrows or be a turn-off despite increasing acceptance of marijuana use across the United States.

    So now, tuned-in stoners and users of medical pot are turning on to dating websites that cater exclusively to tokers or, at the very least, the "cannabis friendly" to avoid experiencing what they describe as all-too-frequent shock and rejection on the dating circuit.

    That has worked out well for a Vietnam War veteran from Michigan who works in the automotive industry and smokes to deal with the pain caused by chemotherapy treatment for hepatitis C.

    Larry, who asked to be identified only by his given name because of the legal issues surrounding marijuana use, says he is "very much enjoying" dating a woman he met on the dating website 420singles.net. The site name corresponds to a numerical code widely recognized within the cannabis subculture as a symbol for all things marijuana.

    "She lives near me but we wouldn't know about our shared medical marijuana use if we hadn't connected on the site because no one discusses pot smoking in my circles," he said.

    Larry's go-to website, with nearly 23,000 members, was the brainchild of 28-year-old California entrepreneur and self-described stoner Ryan Moxon of Marin County. About three years ago he dreamed up the idea for the site while yearning for the girl of his dreams: one who smokes pot.

    Membership is concentrated on the U.S. West Coast but also includes international smokers and has ballooned since voters in Washington state and Colorado opted to legalize recreational marijuana use in 2012.

    Voters in Oregon, Alaska and the District of Columbia will vote in November on the issue, and the New York Times in July called for the repeal of the federal ban on marijuana for those over the age of 21.

    "It's suddenly much cooler to come out as a toker," Moxon said of his site, which he says eliminates awkwardness about smoking.

    A newer website launched several months ago "aims to connect those with a passion for cannabis," said Miguel Lozano of Los Angeles, founder of My420mate.com with some 6,200 members.

    POTENTIAL INVESTORS

    Lozano, a medical marijuana user who enjoys pot to ease sports injury pain, is eager to counter the image that cannabis lovers are "merely hippies," he says.

    "There's a stereotype that pot smokers are lazy, isolated and lonely. They're not," he said. "They're the life of the party, they're often professionals and ambitious business people, and they make good partners."

    Lozano and Moxon are hoping their sites will become ad magnets for the burgeoning number of legal marijuana dispensaries and related products. Both sites already have drawn interest from potential investors, they say.

    Legal pot sales alone are expected to reach $10 billion by 2018, according to The ArcView Group, a marijuana industry investment company in San Francisco. Sales of pot-related products, from dope-infused health bars to cannabis-laced sexual lubricant, are among products expected to skyrocket.

    Another man, from Missouri, is dating a woman he met on Lozano's site. He classifies himself as a "recreational to daily" pot smoker. His new love interest smokes less but "she's totally cool with that," said the man, who asked that he be identified only by his given name, Corey, because marijuana use is illegal in his state.

    Although it's important to Corey that a date shares or is tolerant of his pot use, he believes would-be partners also have the personality he relates to.

    "Smokers come from all walks of life but they tend to chill back," he says. "When I go out with buddies who get wasted on alcohol, it can be embarrassing. With my cannabis-smoking pals, we relax and let the creativity unroll."

  • Venezuelan cartoonist says fired for health satire

    By Andrew Cawthorne

    CARACAS (Reuters) - A Venezuelan cartoonist said she was fired from her newspaper for a caricature that used the late socialist leader Hugo Chavez's signature to satirize the state of healthcare.

    "I was informed of my sacking from El Universal over this caricature and my awkward attitude over graphic satire," veteran cartoonist Rayma Suprani said via Twitter late on Wednesday.

    There was no confirmation from the newspaper.

    The cartoon, which ran on El Universal's editorial page on Wednesday, showed a normal-looking electrocardiogram under the heading "health" with another one merging Chavez's signature into a flat-lining heartbeat line under a title "health in Venezuela."

    The cartoon touched on two hugely sensitive subjects in Venezuela: the legacy of Chavez, the former president who ruled for 14 years before his death from cancer in 2013, and the socialist government's management of the health system.

    Supporters say Chavez transformed healthcare for the poor via popular programs like 'Barrio Adentro' (Inside the Neighborhood) which set up a network of small health clinics staffed by Cuban medics that offered free treatment.

    Opposition supporters often acknowledge welfare advances under Chavez, but say they were patchy, and are highly critical of shortages of medicine and equipment due to Venezuela's economic crisis.

    One opposition leader, Henrique Capriles, paid public tribute to Rayma after the caricature affair and used it to take a jab at Chavez's successor President Nicolas Maduro.

    "You have masses of talent and the admiration of thousands - just what those in power lack," he said on Twitter.

    El Universal's traditionally virulent anti-government line has softened under new ownership this year, though critical stories and opinions still appear.

    El Universal representatives were unavailable for comment on Thursday. One newspaper employee, speaking on condition of anonymity, said the cartoonist was fired because her work had increasingly annoyed her bosses.

  • Toronto Mayor Rob Ford diagnosed with rare cancer

    By Reuters Staff

    (Reuters) - Toronto Mayor Rob Ford has a very rare and aggressive type of cancerous tumor in his abdomen, his doctor said on Wednesday, and the controversial municipal leader will start chemotherapy treatment within days.

    Ford, who made international headlines with his admission that he smoked crack cocaine while in office, was hospitalized last week after having unbearable abdominal pains. He dropped out of the city's hotly contested mayoral race last week.

    In a briefing on Wednesday, Toronto doctor Zane Cohen said the mayor had malignant liposarcoma, a type of cancerous tumor that arises in fat cells in deep soft tissue.

    Cohen, a colorectal surgeon Toronto's Mount Sinai Hospital, called it a "very rare" and "very difficult" type of tumor, noting that malignant liposarcoma makes up just 1 percent of all cancers. However, he was also optimistic about Ford's treatment prospects.

    "The plan will be, initially, chemotherapy," said Cohen. "There may or may not be radiation involved, there may or there may not be surgery involved, it will all depend on the response to the initial treatment, and subsequent treaments as well."

    Cohen said the mayor would start in on the first of two rounds of chemotherapy within 48 hours, followed by further testing in roughly 40 days to assess the tumor's response to the treatment.

    The doctor said the tumor, which measures about 4-3/4 inches by 4-3/4 inches (12 cm by 12 cm), was "very aggressive" and had likely been present for two or three years.

    After being admitted to the hospital last week, Ford dropped his bid for re-election as mayor and was replaced by his brother and campaign manager Doug Ford. The mayor will instead run for a safe city council seat.

    Doug Ford called the cancer diagnosis "devastating" in a statement on Wednesday, but said his brother remained "upbeat and determined to fight."

    'NOT GOOD'

    Mayor Ford has had his own health struggles, having had part of his colon removed and kidney stones in separate incidents in the past. He also sought to lose weight but struggled to get below 310 pounds (141 kg).

    In May and June, the mayor underwent rehab for drug and alcohol abuse. He emerged noticeably thinner though still obese.

    Ford's doctor would not comment on the prognosis on Wednesday, saying only that the specific type of sarcoma the mayor has is "sensitive" to chemotherapy.

    Dr Mitchell Posner, chief of general surgery and surgical oncology at the University of Chicago Medicine, who is not treating Ford, said the prognosis of this type of cancer is generally determined by the size and grade of the tumor.

    In general, he said, such tumors are best treated by removing them surgically. "Some of them can be removed and never come back," Posner said.

    While doctors found the tumor last week, they did not reveal it was cancer until Wednesday.

    Ford, who came to power in 2010 pledging to cut waste at city hall and keep a lid on taxes, said in an interview in the Toronto Sun newspaper on Saturday that he was "shocked" and "devastated," and had to quit the race to focus on his health.

    "It's not good," Ford was quoted as saying about his preliminary diagnosis. "I guess the good Lord wants me somewhere else."

Orthopedic Articles

  • REFILE-Falls indoors may signal frailty, linked to shorter survival

    (corrects third paragraph to say study was led by Bailly)

    By Shereen Lehman

    NEW YORK (Reuters Health) - Women in their eighties who fell indoors, rather than outdoors or from a height like a ladder, died sooner than their peers, a new French study finds.

    Indoor falls could be an indicator of frailty and a sign that protective measures should be taken, say the authors.

    The study was led by Sebastien Bailly, a researcher with Hospices Civils de Lyon in France. He and his coauthors write in the journal Maturitas, "The mean survival time of women with inside falls was nearly 1.6 years shorter than that of women with other falling profiles."

    Bailly and his colleagues studied 4,574 women who were over the age of 74 when they joined the study, could walk by themselves and were not living in institutional settings.

    The researchers called the women every four months for the first four years of the study to find out if they had fallen at some time during the previous week and where.

    The study team distinguished among falls by their location, whether they were due to inattention or to an environmental obstacle, and how serious the resulting injuries were.

    Along these lines, they classified the falls as environmental falls, such as slipping or tripping on something outdoors, falls from a height like a ladder or stairs, and inside or outside falls in general.

    Looking at information on 329 women who had fallen the week before the phone call follow-ups, the researchers found that 26 percent were so-called environmental falls, 19 percent were outside falls, 43 percent were inside falls and 12 percent were falls from height.

    The study team followed up again after another 13 years and found that 269 women had died. And those who had fallen indoors had an average survival time of 7.6 years, compared with 9.2 years for women who had any other type of fall.

    Separate from the type of falls women had, the researchers also found that women with advanced age, signs of frailty, slow walking speeds and comorbidities - that is, other health conditions - also had shorter survival times.

    However, women with frailties, for example, "who experienced outside falls or falls from height had no increased mortality despite more serious injuries," the researchers note.

    "Among community-dwelling women, some fall more frequently than others," the study team concludes. "These women should draw the caregivers' attention because their falls may be indicators of frailty. Non-injurious falls are also of concern because women experiencing this type of fall may suffer from unfavourable underlying conditions and be at risk of short survival."

    "The study is very well done," Dr. Kathleen Walsh told Reuters Health. "It has been shown in prior studies that for indoor falls the mortality tends to be worse, and longevity is diminished," said Walsh, who was not involved in the French research.

    Walsh, a geriatric and emergency medicine specialist at the University of Wisconsin Hospital in Madison, said there are different reasons that people fall inside and one of the questions that would be have been interesting to ask was how much time the patients were spending indoors or outdoors.

    "In general, people who fall inside have to stay inside for a reason and that's because of comorbidities - they're not super active and may not be active for different reasons," she said.

    But, Walsh said, family members shouldn't panic and tell their elderly loved ones that they need to move into assisted living after they've had a fall.

    "Because if you panic without having things evaluated by the physician that person will probably not tell you again when they have fallen," she said. "Staying calm is the number one thing."

    Walsh also said that physicians should ask their elderly patients if they have fallen within the previous year. If they have fallen, the doctors should find out what the patient remembers about the fall and if it was caused by certain movements, or if the patient could get up after the fall.

    "The red flags are, did they pass out before they fell," she said. "It's all in the history, if you take a good history you can usually figure things out."

    Walsh said that family members help to prevent falls by doing things like removing rugs and putting bars in bathrooms. In addition, she suggests elderly patients take classes to improve their balance and strength, such as the Stepping On class (http://www.steppingon.com).

    "Stepping is usually held at a local hospital or senior center and it's all about things that you can do while you're washing dishes or doing odds and ends around the house so you don't have to go to the physical therapist," she said.

    SOURCE: http://bit.ly/1oHXLKv Maturitas, online August 4, 2014.

  • REFILE-Falls indoors may signal frailty, linked to shorter survival

    (corrects third paragraph to say study was led by Bailly)

    By Shereen Lehman

    NEW YORK (Reuters Health) - Women in their eighties who fell indoors, rather than outdoors or from a height like a ladder, died sooner than their peers, a new French study finds.

    Indoor falls could be an indicator of frailty and a sign that protective measures should be taken, say the authors.

    The study was led by Sebastien Bailly, a researcher with Hospices Civils de Lyon in France. He and his coauthors write in the journal Maturitas, "The mean survival time of women with inside falls was nearly 1.6 years shorter than that of women with other falling profiles."

    Bailly and his colleagues studied 4,574 women who were over the age of 74 when they joined the study, could walk by themselves and were not living in institutional settings.

    The researchers called the women every four months for the first four years of the study to find out if they had fallen at some time during the previous week and where.

    The study team distinguished among falls by their location, whether they were due to inattention or to an environmental obstacle, and how serious the resulting injuries were.

    Along these lines, they classified the falls as environmental falls, such as slipping or tripping on something outdoors, falls from a height like a ladder or stairs, and inside or outside falls in general.

    Looking at information on 329 women who had fallen the week before the phone call follow-ups, the researchers found that 26 percent were so-called environmental falls, 19 percent were outside falls, 43 percent were inside falls and 12 percent were falls from height.

    The study team followed up again after another 13 years and found that 269 women had died. And those who had fallen indoors had an average survival time of 7.6 years, compared with 9.2 years for women who had any other type of fall.

    Separate from the type of falls women had, the researchers also found that women with advanced age, signs of frailty, slow walking speeds and comorbidities - that is, other health conditions - also had shorter survival times.

    However, women with frailties, for example, "who experienced outside falls or falls from height had no increased mortality despite more serious injuries," the researchers note.

    "Among community-dwelling women, some fall more frequently than others," the study team concludes. "These women should draw the caregivers' attention because their falls may be indicators of frailty. Non-injurious falls are also of concern because women experiencing this type of fall may suffer from unfavourable underlying conditions and be at risk of short survival."

    "The study is very well done," Dr. Kathleen Walsh told Reuters Health. "It has been shown in prior studies that for indoor falls the mortality tends to be worse, and longevity is diminished," said Walsh, who was not involved in the French research.

    Walsh, a geriatric and emergency medicine specialist at the University of Wisconsin Hospital in Madison, said there are different reasons that people fall inside and one of the questions that would be have been interesting to ask was how much time the patients were spending indoors or outdoors.

    "In general, people who fall inside have to stay inside for a reason and that's because of comorbidities - they're not super active and may not be active for different reasons," she said.

    But, Walsh said, family members shouldn't panic and tell their elderly loved ones that they need to move into assisted living after they've had a fall.

    "Because if you panic without having things evaluated by the physician that person will probably not tell you again when they have fallen," she said. "Staying calm is the number one thing."

    Walsh also said that physicians should ask their elderly patients if they have fallen within the previous year. If they have fallen, the doctors should find out what the patient remembers about the fall and if it was caused by certain movements, or if the patient could get up after the fall.

    "The red flags are, did they pass out before they fell," she said. "It's all in the history, if you take a good history you can usually figure things out."

    Walsh said that family members help to prevent falls by doing things like removing rugs and putting bars in bathrooms. In addition, she suggests elderly patients take classes to improve their balance and strength, such as the Stepping On class (http://www.steppingon.com).

    "Stepping is usually held at a local hospital or senior center and it's all about things that you can do while you're washing dishes or doing odds and ends around the house so you don't have to go to the physical therapist," she said.

    SOURCE: http://bit.ly/1oHXLKv Maturitas, online August 4, 2014.

  • Salt and smoking may interact to raise RA risk

    By Shereen Lehman

    NEW YORK (Reuters Health) - Eating a diet high in salt may increase the risk of rheumatoid arthritis among smokers, according to a large study from Sweden.

    Researchers set out to see if a salty diet might be linked to the onset of RA, but found a connection only among smokers - who were more than twice as likely as anyone with a low-salt diet to develop the condition.

    "Although we could not confirm our original hypothesis, we were surprised by the large influence of sodium intake on smoking as a risk factor," Björn Sundström told Reuters Health in an email.

    "Smoking is a strong risk factor for developing rheumatoid arthritis, and this risk is further amplified by less than ideal food habits with high sodium intake," said Sundström, a researcher in the departments of public health and clinical medicine at Umea University who led the new study.

    Rheumatoid arthritis is a chronic disease that causes pain and swelling in the joints. About 1.5 million Americans, three-quarters of them women, have been diagnosed with the condition, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

    The cause of rheumatoid arthritis isn't known, but it results from a person's own immune system attacking joint tissues. Genetics and lifestyle factors, such as smoking, hormone and cholesterol levels and obesity, have all been identified as risk factors.

    Previous laboratory research on animals and human cells also suggests sodium may provoke inflammatory molecules that are often elevated in people several years before RA appears, the authors write in the journal Rheumatology.

    To see if there is a link between sodium in the diet and risk for developing RA, Sundström and colleagues looked at health records and lifestyle information for almost 100,000 participants in a screening and intervention program that began in 1991 in Vasterbotton County in northern Sweden.

    The study team identified 386 cases of people who developed rheumatoid arthritis by 2011. Then for each case, they identified five participants who were similar in age and sex, but did not develop disease, for comparison.

    The researchers accounted for dietary habits, education, cholesterol and triglyceride levels, weight and other factors for all the participants and found no significant associations between sodium in the diet and who went on to develop RA.

    But when they looked just at smokers, they found those who consumed the most sodium were 2.26 times as likely as smokers who consumed the least sodium to develop RA.

    Smokers who consumed the least sodium had similar risk to nonsmokers in the study, leading the researchers to conclude that smoking and heavy sodium intake interact somehow to promote RA.

    "Ideally, these results needs to be repeated in an independent population," Sundström, said.

    More research is also needed to identify the biological pathways through which sodium intake can affect smoking as a risk factor, he said.

    "The study provides the first evidence in rheumatoid arthritis that sodium intake may influence risk for onset of the disease," Dr. Lars Klareskog told Reuters Health in an email.

    Klareskog, a rheumatologist and researcher at the Karolinska Institute and Karolinska University Hospital in Stockholm, was not involved in the study.

    "In addition, the study demonstrates that the impact of high salt diet is restricted to individuals who smoke," he said.

    Klareskog noted that smoking is an important risk factor for rheumatoid arthritis.

    "The contribution of smoking to risk for rheumatoid arthritis overall is such that 25 percent of all rheumatoid arthritis in our country, Sweden, would not have happened without smoking," he said. One third of all cases with the more severe form of rheumatoid arthritis would not have happened without smoking, he added.

    The present study suggests that reducing salt intake may be added to this list of lifestyle advice for avoiding rheumatoid arthritis, Klareskog said.

    "Confirmatory studies are, however, needed before recommendations on salt intake can be made to the public as ways to protect against getting rheumatoid arthritis," he said.

    SOURCE: http://bit.ly/1piaEeE Rheumatology, online September 10, 2014.

  • Chiropractic care may ease back-related leg pain

    By Shereen Lehman

    NEW YORK (Reuters Health) - People with leg pain related to back problems had more short-term relief if they received chiropractic care along with exercise and advice, rather than exercise and advice alone, a new study has found.

    Patients with back-related leg pain, such as sciatica, are usually treated with prescription medications, injections and surgery.

    Increasingly, spinal manipulative therapy by chiropractors, exercise and self-management are being recommended as low-risk strategies for back-related leg pain, but good research studies have been lacking, experts say.

    "Spinal manipulation combined with home exercise may be worth trying for those with back-related leg pain that has lasted more than four weeks," Gert Bronfort told Reuters Health in an email.

    Bronfort, who led the study, is a researcher with the Integrative Health and Wellbeing Research Program at the University of Minnesota in Minneapolis.

    "This combination resulted in advantages in pain reduction, disability, global improvement, satisfaction, medication use and general physical health status after 12 weeks," he said.

    Nine months after the treatment ended, patients who received chiropractic therapy were still doing better than the other group in terms of global improvement, medication use and satisfaction, he added.

    Bronfort said that about four out of five people will develop low back pain during their lifetime, and up to 40 percent of them will develop back-related leg pain.

    As reported in Annals of Internal Medicine, Bronfort and colleagues enrolled 192 adults with back pain that had been radiating into the leg for at least four weeks. Patients were recruited through newspaper advertisements, direct mail, and community posters.

    Half the patients received instructions for specific exercises to do at home plus simple pain management techniques. In addition, during the first 12 weeks, they visited a chiropractor up to 20 times for 10 to 20 minutes of spinal manipulation at each visit.

    Patients in the other group also received the instructions for exercises and pain management techniques. They too met with a chiropractor, exercise therapist, or personal trainer during the first 12 weeks, but for four one-hour sessions without spinal manipulation.

    The patients were asked to rate their pain at the beginning of the study, after the 12 weeks of treatments and again at the end of the year.

    At 12 weeks, 37 percent of the spinal manipulation group felt their pain was reduced by at least three-quarters, compared to 19 percent of those who received exercise and advice only.

    In addition, the patients who had spinal manipulation had higher scores for overall improvement and satisfaction.

    By the one-year follow-up, the no-manipulation group had caught up, and there was no longer a significant difference in pain relief. But the scores for overall improvement and satisfaction remained higher for the patients who received spinal manipulative therapy.

    "We actually find the outcomes of the home exercise alone group to be very interesting," Bronfort said.

    Almost half of these patients experienced a 50 percent reduction in leg pain symptoms in both the short (at 12 weeks) and long term (at 52 weeks), Bronfort said.

    "That's an important improvement and warrants future research," he said, "We look forward to investigating how home exercise alone may compare to usual medical treatment and/or no treatment at all."

    "This is a well-conducted study by a group of well-respected chiropractic researchers," Sidney Rubinstein told Reuters Health in an email.

    Rubinstein is a researcher with the Department of Health Sciences at the University of Amsterdam in The Netherlands. He wasn't involved in the study, but has recently published a paper analyzing previous studies on spinal manipulative therapy.

    "It is perhaps the only study of good methodological quality using a robust sample of patients which examines the additional benefit of spinal manipulative therapy in those with sub-acute or chronic back-related leg pain," Rubinstein said.

    Rubinstein said it would be necessary to conduct an economic evaluation to determine if the use of spinal manipulative therapy in addition to home exercises is worth the cost.

    "This of course, must be considered in light of alternatives for this condition, such as epidural steroid injections or surgery, which are not only much more costly but also associated with important (and serious) adverse events," he said.

    Bronfort said his team feels that as long as there are no serious medical complications, patients can focus on self-management strategies.

    "Try and keep moving . . . simple activities like taking short walks and changing positions frequently (both advised in the home exercise program) may be helpful," he said.

    But, he added, for people who have pain that is too severe for to deal with on their own, seeing a chiropractor, physical therapist, or osteopath who can use spinal manipulation might help relieve their pain - possibly without the use of medications.

    SOURCE: http://bit.ly/1s3PM2z Annals of Internal Medicine, online September 15, 2014.

  • About half of ACL surgeries end with a return to competitive play

    By Kathryn Doyle

    NEW YORK (Reuters Health) - Most athletes who undergo ACL reconstruction surgery do return to some form of sport, but only 55 percent will return to competitive level sports, an updated review suggests.

    About 200,000 anterior cruciate ligament (ACL) knee injuries happen each year in the United States, and half of those injuries are surgically repaired, according to the American Academy of Orthopaedic Surgeons. Surgeons usually replace the torn ligament with a grafted replacement.

    The authors reviewed the topic in 2010 and found that less than half of patients returned to competitive level sport, but since then, reporting on whether or not athletes return to play after surgery has increased, they write in the British Journal of Sports Medicine.

    "I think we used to presume that everyone returned to their sport after surgery, especially since one of the main reasons why people have surgery is because they want to return to sport," said lead author Clare L. Ardern. "But clearly these results show that this is not the case."

    "I think this is lower than what we previously assumed was the case, but having said that, this doesn't mean that people stopped playing sport altogether," said Ardern, of the School of Allied Health in the Faculty of Health Sciences at La Trobe University in Bundoora, Australia.

    "Some people may have changed the sport they played, but we were not able to measure this in our study," she told Reuters Health by email.

    Ardern and her team reviewed 69 new articles on ACL surgery and return to play published between April 2010 and November 2013.

    Of the 7,556 patients in total, 81 percent returned to some level of sport after surgery, while 65 percent returned to pre-injury level and 55 percent returned to competitive level sports.

    This is an area where sports medicine specialists strive to improve," said Gregory D. Myer, director of the Human Performance Laboratory at Cincinnati Children's Hospital Medical Center in Ohio.

    "Our mission in sports medicine is to get everyone back to their pre-injury activity levels regardless of the injury," said Myer, who was not involved in the review. "A 55 percent success rate is certainly below the standards we aim to achieve."

    Younger players and men were more likely to return to sport than older players or women, the researchers found.

    Elite athletes were about six times more likely to return to competitive sport than non-elite athletes.

    Not surprisingly, better physical function after surgery increased the chances of returning to sports. Patients who were able to hop the same distance on each leg after surgery were more likely to play competitively again.

    "These results are only generalizable if you were an athlete prior to sustaining the injury," Myer said.

    Psychological function seemed to make a difference too.

    Patients who had more fear of injuring themselves again and less psychological readiness to play were less likely to return to pre-injury level sport.

    Psychological factors may be modifiable, unlike gender or age, which makes mental readiness to play an important factor for doctors to consider, the authors write.

    "More and more we are recognizing that physical and mental recovery is important to maximize the chances of returning to sport after surgery," Ardern said. "This means that patients and their physical therapists need to make sure they also address both aspects."

    Patients should make sure they really understand what surgery and rehabilitation involves, and work with their physical therapist to set realistic goals, she said.

    "Sometimes it can be useful to talk to teammates or friends who have had an ACL injury and made a successful return to sport about what it took and what to expect," Ardern said. "In a team environment, if there are teammates with ACL injuries, it can be helpful for them to be paired together for rehabilitation to motivate each other."

    SOURCE: http://bit.ly/1BpJV8s British Journal of Sports Medicine, online August 25, 2014.

Transplant Articles

  • British Ebola survivor flies to United States for blood donation

    By Reuters Staff

    (Reuters) - A British man who survived Ebola after being treated in London has flown to the United States to try to help another patient suffering from the virus, the Foreign Office in the United Kingdom said on Thursday.

    Media reports said William Pooley planned to donate his blood, which likely contains protective antibodies that could help fight the disease, for an emergency transfusion to an Ebola patient in Atlanta.

    An American doctor who worked for the World Health Organization is being treated at Emory University Hospital in Atlanta after he became infected with Ebola in Sierra Leone.

    A spokesman for the Emory hospital would not confirm on Thursday whether the doctor, who has not been named, will be getting blood donated from the British man, citing patient privacy laws.

    There are two Ebola patients being treated in the United States. A spokesman for the Nebraska hospital where another American is receiving care for the virus said the British man was not headed to that facility.

    Pooley, 29, contracted the disease while working as a volunteer nurse in Sierra Leone. He was discharged earlier this month from a special isolation unit at the Royal Free Hospital in London after 10 days of treatment with the experimental ZMapp drug.

    London's Evening Standard newspaper said Pooley and the doctor he is hoping to help were reported to be close friends after working together at the Ebola treatment center in Kenema, Sierra Leone.

    The pair has the same blood type, which made Pooley the perfect donor, the newspaper said.

    There is no proven cure for Ebola, a deadly virus that was discovered nearly 40 years ago in the forests of central Africa. The worst-ever outbreak on record of the virus, which has killed at least 2,630 people in West Africa, has triggered a scramble to develop the first drug or vaccine to treat it.

    Earlier this month at the University of Nebraska Medical Center in Omaha, Dr. Rick Sacra received a plasma infusion from another American Ebola survivor, Dr. Kent Brantly. Brantly's blood likely contained protective antibodies that doctors said could help buy Sacra some time while his body worked to fight off the infection.

    Brantly's blood type also turned out to be a match for his friend and fellow missionary Sacra.

  • British Ebola survivor flies to United States for blood donation

    By Reuters Staff

    (Reuters) - A British man who survived Ebola after being treated in London has flown to the United States to try to help another patient suffering from the virus, the Foreign Office in the United Kingdom said on Thursday.

    Media reports said William Pooley planned to donate his blood, which likely contains protective antibodies that could help fight the disease, for an emergency transfusion to an Ebola patient in Atlanta.

    An American doctor who worked for the World Health Organization is being treated at Emory University Hospital in Atlanta after he became infected with Ebola in Sierra Leone.

    A spokesman for the Emory hospital would not confirm on Thursday whether the doctor, who has not been named, will be getting blood donated from the British man, citing patient privacy laws.

    There are two Ebola patients being treated in the United States. A spokesman for the Nebraska hospital where another American is receiving care for the virus said the British man was not headed to that facility.

    Pooley, 29, contracted the disease while working as a volunteer nurse in Sierra Leone. He was discharged earlier this month from a special isolation unit at the Royal Free Hospital in London after 10 days of treatment with the experimental ZMapp drug.

    London's Evening Standard newspaper said Pooley and the doctor he is hoping to help were reported to be close friends after working together at the Ebola treatment center in Kenema, Sierra Leone.

    The pair has the same blood type, which made Pooley the perfect donor, the newspaper said.

    There is no proven cure for Ebola, a deadly virus that was discovered nearly 40 years ago in the forests of central Africa. The worst-ever outbreak on record of the virus, which has killed at least 2,630 people in West Africa, has triggered a scramble to develop the first drug or vaccine to treat it.

    Earlier this month at the University of Nebraska Medical Center in Omaha, Dr. Rick Sacra received a plasma infusion from another American Ebola survivor, Dr. Kent Brantly. Brantly's blood likely contained protective antibodies that doctors said could help buy Sacra some time while his body worked to fight off the infection.

    Brantly's blood type also turned out to be a match for his friend and fellow missionary Sacra.

  • British Ebola survivor flies to United States for blood donation

    By Reuters Staff

    (Reuters) - A British man who survived Ebola after being treated in London has flown to the United States to try to help another patient suffering from the virus, the Foreign Office in the United Kingdom said on Thursday.

    Media reports said William Pooley planned to donate his blood, which likely contains protective antibodies that could help fight the disease, for an emergency transfusion to an Ebola patient in Atlanta.

    An American doctor who worked for the World Health Organization is being treated at Emory University Hospital in Atlanta after he became infected with Ebola in Sierra Leone.

    A spokesman for the Emory hospital would not confirm on Thursday whether the doctor, who has not been named, will be getting blood donated from the British man, citing patient privacy laws.

    There are two Ebola patients being treated in the United States. A spokesman for the Nebraska hospital where another American is receiving care for the virus said the British man was not headed to that facility.

    Pooley, 29, contracted the disease while working as a volunteer nurse in Sierra Leone. He was discharged earlier this month from a special isolation unit at the Royal Free Hospital in London after 10 days of treatment with the experimental ZMapp drug.

    London's Evening Standard newspaper said Pooley and the doctor he is hoping to help were reported to be close friends after working together at the Ebola treatment center in Kenema, Sierra Leone.

    The pair has the same blood type, which made Pooley the perfect donor, the newspaper said.

    There is no proven cure for Ebola, a deadly virus that was discovered nearly 40 years ago in the forests of central Africa. The worst-ever outbreak on record of the virus, which has killed at least 2,630 people in West Africa, has triggered a scramble to develop the first drug or vaccine to treat it.

    Earlier this month at the University of Nebraska Medical Center in Omaha, Dr. Rick Sacra received a plasma infusion from another American Ebola survivor, Dr. Kent Brantly. Brantly's blood likely contained protective antibodies that doctors said could help buy Sacra some time while his body worked to fight off the infection.

    Brantly's blood type also turned out to be a match for his friend and fellow missionary Sacra.

Women’s Health Articles

  • It's not a small world after all: world population will soar

    By Will Dunham

    WASHINGTON (Reuters) - Contrary to some earlier projections, the world's population will soar through the end of the 21st century thanks largely to sub-Saharan Africa's higher-than-expected birth rates, United Nations and other population experts said on Thursday.

    There is an 80 percent likelihood that the number of people on the planet, currently 7.2 billion, will increase to between 9.6 billion and 12.3 billion by 2100, the researchers said. They also saw an 80 percent probability that Africa's population will rise to between 3.5 billion and 5.1 billion by 2100 from about 1 billion today.

    The study, led by U.N. demographer Patrick Gerland and University of Washington statistician and sociologist Adrian Raftery and published online by the journal Science, foresees only a 30 percent chance that earth's population will stop rising this century.

    "Previous forecasts did indeed forecast a leveling off of the world population around 2050, and in some cases a decline," Raftery said.

    Raftery said the new projections arise from data that clearly establishes that birth rates in sub-Saharan Africa have not been decreasing as quickly as some experts had expected, a trend that was "not as clear when previous forecasts were made."

    Raftery said the researchers used data on population, fertility, mortality and migration from every country and then predicted future rates using new statistical models. Some of the figures, such as the median projection of the population hitting 10.9 billion by 2100, mirror a U.N. report published in 2013.

    U.N. demographer Gerland said sub-Saharan Africa countries already with big populations and high fertility levels are expected to drive population growth, including Nigeria, Tanzania, Democratic Republic of the Congo, Niger, Uganda, Ethiopia, Kenya, Zambia, Mozambique and Mali.

    The world's population reached 1 billion in the early 19th century, doubled to 2 billion in the 1920s and doubled again to 6 billion in the 1990s. It hit 7 billion in 2011.

    The findings underscore worries expressed for decades by some experts about a planet growing more crowded and humankind exhausting natural resources, struggling to produce enough food or cope with poverty and infectious diseases.

    Raftery said African nations could benefit by intensifying policies to lower fertility rates, with studies showing that greater access to contraceptives and more education for girls and women can be effective.

    The researchers projected that Asia's population, now 4.4 billion, will peak at around 5 billion people in 2050, then begin to decline. They forecast that the populations of North America, Europe and Latin America will stay below 1 billion each by 2100.

    Among the experts who had predicted the global population rise would peter out was a 2010 report by Austrian demographer Wolfgang Lutz. He forecast it likely would reach 8 billion to 10 billion by 2050 but "population stabilization and the onset of a decline are likely" in the second half of the century.

    SOURCE: http://bit.ly/Xq6URw Science, online September 18, 2014.

  • REFILE-Falls indoors may signal frailty, linked to shorter survival

    (corrects third paragraph to say study was led by Bailly)

    By Shereen Lehman

    NEW YORK (Reuters Health) - Women in their eighties who fell indoors, rather than outdoors or from a height like a ladder, died sooner than their peers, a new French study finds.

    Indoor falls could be an indicator of frailty and a sign that protective measures should be taken, say the authors.

    The study was led by Sebastien Bailly, a researcher with Hospices Civils de Lyon in France. He and his coauthors write in the journal Maturitas, "The mean survival time of women with inside falls was nearly 1.6 years shorter than that of women with other falling profiles."

    Bailly and his colleagues studied 4,574 women who were over the age of 74 when they joined the study, could walk by themselves and were not living in institutional settings.

    The researchers called the women every four months for the first four years of the study to find out if they had fallen at some time during the previous week and where.

    The study team distinguished among falls by their location, whether they were due to inattention or to an environmental obstacle, and how serious the resulting injuries were.

    Along these lines, they classified the falls as environmental falls, such as slipping or tripping on something outdoors, falls from a height like a ladder or stairs, and inside or outside falls in general.

    Looking at information on 329 women who had fallen the week before the phone call follow-ups, the researchers found that 26 percent were so-called environmental falls, 19 percent were outside falls, 43 percent were inside falls and 12 percent were falls from height.

    The study team followed up again after another 13 years and found that 269 women had died. And those who had fallen indoors had an average survival time of 7.6 years, compared with 9.2 years for women who had any other type of fall.

    Separate from the type of falls women had, the researchers also found that women with advanced age, signs of frailty, slow walking speeds and comorbidities - that is, other health conditions - also had shorter survival times.

    However, women with frailties, for example, "who experienced outside falls or falls from height had no increased mortality despite more serious injuries," the researchers note.

    "Among community-dwelling women, some fall more frequently than others," the study team concludes. "These women should draw the caregivers' attention because their falls may be indicators of frailty. Non-injurious falls are also of concern because women experiencing this type of fall may suffer from unfavourable underlying conditions and be at risk of short survival."

    "The study is very well done," Dr. Kathleen Walsh told Reuters Health. "It has been shown in prior studies that for indoor falls the mortality tends to be worse, and longevity is diminished," said Walsh, who was not involved in the French research.

    Walsh, a geriatric and emergency medicine specialist at the University of Wisconsin Hospital in Madison, said there are different reasons that people fall inside and one of the questions that would be have been interesting to ask was how much time the patients were spending indoors or outdoors.

    "In general, people who fall inside have to stay inside for a reason and that's because of comorbidities - they're not super active and may not be active for different reasons," she said.

    But, Walsh said, family members shouldn't panic and tell their elderly loved ones that they need to move into assisted living after they've had a fall.

    "Because if you panic without having things evaluated by the physician that person will probably not tell you again when they have fallen," she said. "Staying calm is the number one thing."

    Walsh also said that physicians should ask their elderly patients if they have fallen within the previous year. If they have fallen, the doctors should find out what the patient remembers about the fall and if it was caused by certain movements, or if the patient could get up after the fall.

    "The red flags are, did they pass out before they fell," she said. "It's all in the history, if you take a good history you can usually figure things out."

    Walsh said that family members help to prevent falls by doing things like removing rugs and putting bars in bathrooms. In addition, she suggests elderly patients take classes to improve their balance and strength, such as the Stepping On class (http://www.steppingon.com).

    "Stepping is usually held at a local hospital or senior center and it's all about things that you can do while you're washing dishes or doing odds and ends around the house so you don't have to go to the physical therapist," she said.

    SOURCE: http://bit.ly/1oHXLKv Maturitas, online August 4, 2014.

  • REFILE-Falls indoors may signal frailty, linked to shorter survival

    (corrects third paragraph to say study was led by Bailly)

    By Shereen Lehman

    NEW YORK (Reuters Health) - Women in their eighties who fell indoors, rather than outdoors or from a height like a ladder, died sooner than their peers, a new French study finds.

    Indoor falls could be an indicator of frailty and a sign that protective measures should be taken, say the authors.

    The study was led by Sebastien Bailly, a researcher with Hospices Civils de Lyon in France. He and his coauthors write in the journal Maturitas, "The mean survival time of women with inside falls was nearly 1.6 years shorter than that of women with other falling profiles."

    Bailly and his colleagues studied 4,574 women who were over the age of 74 when they joined the study, could walk by themselves and were not living in institutional settings.

    The researchers called the women every four months for the first four years of the study to find out if they had fallen at some time during the previous week and where.

    The study team distinguished among falls by their location, whether they were due to inattention or to an environmental obstacle, and how serious the resulting injuries were.

    Along these lines, they classified the falls as environmental falls, such as slipping or tripping on something outdoors, falls from a height like a ladder or stairs, and inside or outside falls in general.

    Looking at information on 329 women who had fallen the week before the phone call follow-ups, the researchers found that 26 percent were so-called environmental falls, 19 percent were outside falls, 43 percent were inside falls and 12 percent were falls from height.

    The study team followed up again after another 13 years and found that 269 women had died. And those who had fallen indoors had an average survival time of 7.6 years, compared with 9.2 years for women who had any other type of fall.

    Separate from the type of falls women had, the researchers also found that women with advanced age, signs of frailty, slow walking speeds and comorbidities - that is, other health conditions - also had shorter survival times.

    However, women with frailties, for example, "who experienced outside falls or falls from height had no increased mortality despite more serious injuries," the researchers note.

    "Among community-dwelling women, some fall more frequently than others," the study team concludes. "These women should draw the caregivers' attention because their falls may be indicators of frailty. Non-injurious falls are also of concern because women experiencing this type of fall may suffer from unfavourable underlying conditions and be at risk of short survival."

    "The study is very well done," Dr. Kathleen Walsh told Reuters Health. "It has been shown in prior studies that for indoor falls the mortality tends to be worse, and longevity is diminished," said Walsh, who was not involved in the French research.

    Walsh, a geriatric and emergency medicine specialist at the University of Wisconsin Hospital in Madison, said there are different reasons that people fall inside and one of the questions that would be have been interesting to ask was how much time the patients were spending indoors or outdoors.

    "In general, people who fall inside have to stay inside for a reason and that's because of comorbidities - they're not super active and may not be active for different reasons," she said.

    But, Walsh said, family members shouldn't panic and tell their elderly loved ones that they need to move into assisted living after they've had a fall.

    "Because if you panic without having things evaluated by the physician that person will probably not tell you again when they have fallen," she said. "Staying calm is the number one thing."

    Walsh also said that physicians should ask their elderly patients if they have fallen within the previous year. If they have fallen, the doctors should find out what the patient remembers about the fall and if it was caused by certain movements, or if the patient could get up after the fall.

    "The red flags are, did they pass out before they fell," she said. "It's all in the history, if you take a good history you can usually figure things out."

    Walsh said that family members help to prevent falls by doing things like removing rugs and putting bars in bathrooms. In addition, she suggests elderly patients take classes to improve their balance and strength, such as the Stepping On class (http://www.steppingon.com).

    "Stepping is usually held at a local hospital or senior center and it's all about things that you can do while you're washing dishes or doing odds and ends around the house so you don't have to go to the physical therapist," she said.

    SOURCE: http://bit.ly/1oHXLKv Maturitas, online August 4, 2014.

  • Stoners get high on love with marijuana dating sites

    By Mary Papenfuss

    SAN FRANCISCO (Reuters) - Dinner and a movie make for a typical date night but dinner followed by a joint could raise some eyebrows or be a turn-off despite increasing acceptance of marijuana use across the United States.

    So now, tuned-in stoners and users of medical pot are turning on to dating websites that cater exclusively to tokers or, at the very least, the "cannabis friendly" to avoid experiencing what they describe as all-too-frequent shock and rejection on the dating circuit.

    That has worked out well for a Vietnam War veteran from Michigan who works in the automotive industry and smokes to deal with the pain caused by chemotherapy treatment for hepatitis C.

    Larry, who asked to be identified only by his given name because of the legal issues surrounding marijuana use, says he is "very much enjoying" dating a woman he met on the dating website 420singles.net. The site name corresponds to a numerical code widely recognized within the cannabis subculture as a symbol for all things marijuana.

    "She lives near me but we wouldn't know about our shared medical marijuana use if we hadn't connected on the site because no one discusses pot smoking in my circles," he said.

    Larry's go-to website, with nearly 23,000 members, was the brainchild of 28-year-old California entrepreneur and self-described stoner Ryan Moxon of Marin County. About three years ago he dreamed up the idea for the site while yearning for the girl of his dreams: one who smokes pot.

    Membership is concentrated on the U.S. West Coast but also includes international smokers and has ballooned since voters in Washington state and Colorado opted to legalize recreational marijuana use in 2012.

    Voters in Oregon, Alaska and the District of Columbia will vote in November on the issue, and the New York Times in July called for the repeal of the federal ban on marijuana for those over the age of 21.

    "It's suddenly much cooler to come out as a toker," Moxon said of his site, which he says eliminates awkwardness about smoking.

    A newer website launched several months ago "aims to connect those with a passion for cannabis," said Miguel Lozano of Los Angeles, founder of My420mate.com with some 6,200 members.

    POTENTIAL INVESTORS

    Lozano, a medical marijuana user who enjoys pot to ease sports injury pain, is eager to counter the image that cannabis lovers are "merely hippies," he says.

    "There's a stereotype that pot smokers are lazy, isolated and lonely. They're not," he said. "They're the life of the party, they're often professionals and ambitious business people, and they make good partners."

    Lozano and Moxon are hoping their sites will become ad magnets for the burgeoning number of legal marijuana dispensaries and related products. Both sites already have drawn interest from potential investors, they say.

    Legal pot sales alone are expected to reach $10 billion by 2018, according to The ArcView Group, a marijuana industry investment company in San Francisco. Sales of pot-related products, from dope-infused health bars to cannabis-laced sexual lubricant, are among products expected to skyrocket.

    Another man, from Missouri, is dating a woman he met on Lozano's site. He classifies himself as a "recreational to daily" pot smoker. His new love interest smokes less but "she's totally cool with that," said the man, who asked that he be identified only by his given name, Corey, because marijuana use is illegal in his state.

    Although it's important to Corey that a date shares or is tolerant of his pot use, he believes would-be partners also have the personality he relates to.

    "Smokers come from all walks of life but they tend to chill back," he says. "When I go out with buddies who get wasted on alcohol, it can be embarrassing. With my cannabis-smoking pals, we relax and let the creativity unroll."

  • International surrogacy traps babies in stateless limbo

    By Emma Batha

    THE HAGUE (Thomson Reuters Foundation) - The lack of regulation around international commercial surrogacy has left many babies in stateless limbo, with no country granting them citizenship because of complex conflicts over who the legal parents are.

    Experts said the problem could affect thousands of babies as more and more couples seek surrogates in countries like India, Mexico and Thailand, turning it into a multimillion dollar business.

    Problems arise when the country of the intended parents and the country of the surrogate mother both refuse to grant the baby nationality, or when the parents who ordered the baby decide to abandon it.

    "International commercial surrogacy can and does lead to child statelessness," said Claire Achmad, a New Zealand lawyer told experts told the first international forum on statelessness.

    Stateless people have no nationality and are not accepted as citizens by any country. Without citizenship, stateless children are deprived of basic rights most people take for granted and cannot access healthcare and education.

    Achmad cited the case of a Norwegian woman, Kari Ann Volden, who had used an Indian surrogate to carry a baby created from a donated egg and sperm.

    The surrogate gave birth to twin boys in early 2010, but Norway refused to give Volden passports to take the twins home, saying the Indian surrogate was the legal parent. India also refused to recognize the babies, saying that Volden was the legal parent.

    "For the first two years of their life, these twins (were) stateless," Achmad said. Volden and the twins were stranded in India until she was able to go back to Norway and legally adopt them.

    The statelessness forum, which ended on Wednesday, focused on large-scale stateless situations. The United Nations is launching a major drive to end statelessness, which affects 10 million people around the world.

    Achmad said the rise in surrogacy was creating "a new generation of children born lost, at a time when we are trying to eliminate statelessness."

    She cited another case in which a gay couple from Belgium arranged for a baby to be born in Ukraine, but Belgian authorities refused to accept the men as the boy's legal parents.

    Neither Belgium nor Ukraine recognized the baby as a citizen, and he ended up spending the first 16 months of his life with foster parents and another year in an orphanage before he was allowed into Belgium.

    REJECTED BABIES

    Lawyers said cases were currently sorted out in an ad hoc way, and there is a need for international regulation that takes into account the child's best interests.

    Sanoj Rajan, a professor at the School of Law at ITM University in India, said surrogacy was big business and the issue of potential statelessness was not as marginal as might appear. He said there were at least 10,000 surrogacy clinics in India, and most are not registered.

    "No one knows how many surrogate children are being born in India," he said.

    Would-be parents come to India from other parts of Asia and the Middle East Gulf, as well as Europe and the United States.

    Rajan said most citizenship problems arise when the parents are from a country that bans commercial surrogacy, like France, Italy, Germany and Spain, and the baby is created in a country where surrogacy is allowed like India, Ukraine, Russia and Thailand.

    Babies born to surrogates may also end up stateless if the "commissioning parents" reject it, Rajan said. This can happen if there is a fertility mix-up whereby the wrong sperm or egg was used, if the child is born with a disability, or if the parents divorce before the baby is born.

    He suggested countries that ban surrogacy could find alternative ways to penalize parents who break the law without penalizing the baby by denying it a nationality.