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Why are more black women dying of breast cancer compared to white women?

Published: Friday, October 20, 2017 @ 12:58 PM

What You Need to Know: Breast Cancer

According to the Centers for Disease Control and Prevention, black women under 60 years old are more likely to die from breast cancer than white women in the same age group. In fact, data from 2015 showed black women had a 39 percent higher breast cancer death rate.

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New research from Emory University, the American Cancer Society (ACS) and the Dana-Farber Cancer Institute points to differences in health insurance as the culprit.

The findings, published in the Journal of Clinical Oncology, included data from the National Cancer Data Base on 563,497 black and white women between the ages of 18 and 64 who had been diagnosed with stage I to stage III breast cancer between 2004 and 2013.

The researchers examined five factors for the study:

  • Demographics (age, stage, state, year of diagnosis, etc.)
  • Comorbidities (other health conditions)
  • Insurance (lack of insurance, private insurance, Medicare/Medicaid, etc.)
  • Tumor characteristics (size, type, stage, etc.)
  • Treatment (chemotherapy, hormonal therapy, surgery, etc.)

The findings

They found that insurance explained one-third of the additional risk of death among the black women compared to white women diagnosed with early-stage breast cancer.

Additionally, almost three times as many black women (22.7 percent) were either uninsured or had Medicaid insurance compared to white women (8.4 percent).

“Lack of insurance is a barrier to receipt of timely and high-quality treatment and screening services,” study authors wrote.

Other major factors that explained the differences: tumor characteristics (23.2 percent), comorbidities (11.3 percent) and treatment (4.8 percent).

Nearly 80 percent of the women in the study had the most common type of breast cancer (hormone receptor-positive breast cancer) and according to the researchers, when matched for factors such as insurance, comorbidity and others, those factors accounted for a combined 76.3 percent of the total excess risk of death in black patients.

The authors noted that when it came to treatment differences, black and white women contrasted most for hormone therapy, which, according to ACS, is typically used after surgery to help reduce the chance of recurrence.

“Several studies reported that black women are less likely to complete chemotherapy and hormone therapy,” study author Ahmedin Jemal told the ACS. “This could be for many reasons, including problems with transportation or the inability to pay for medicine.”

Additionally, previous research has shown that black women get lower quality mammograms and are less likely to have a follow-up appointment after receiving abnormal mammograms.

(Scott Barbour/Getty Images)

And insurance is vital for both high-quality cancer care and for early detection.

“We know so much about cancer prevention and control,” Jemal, who is also vice president of the ACS surveillance and health services research program, said. “But we’re not applying it to the whole population equally. We have to make the standard of care available to everyone, including people with low income. And blacks are disproportionately represented in that group.”

Read the full study at ascopubs.org

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Aimovig: New migraine prevention drug approved by FDA

Published: Monday, May 21, 2018 @ 6:23 AM

Migraines Could Be Triggered By Gut Bacteria

If you suffer from chronic migraines, relief is here.

According to The Associated Press, the Food and Drug Administration last week approved Aimovig, a monthly shot that aims to reduce migraines. The drug, developed by Amgen Inc. and Novartis AG, is "injected monthly just under the skin using a pen-like device," the AP reported. Its price tag: $6,900 annually before insurance.

>> On ActionNewsJax.com: New drug could reduce migraines

But how does Aimovig work? The FDA said it blocks "the activity of calcitonin gene-related peptide, a molecule that is involved in migraine attacks." Amgen researchers said participants in one study saw their migraines reduced by half and experienced "minor side effects" like colds, the AP reported.

>> Read more trending news 

If Aimovig doesn't sound right for you, you're still in luck: Three similar shots and various pills to combat migraines are in the works.

Read more here.

– The Associated Press contributed to this report.

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New autism research could predict whether children as young as 3 months old are at risk

Published: Thursday, May 17, 2018 @ 6:05 AM

New Autism Research Could Determine Which Children Are At Risk

A groundbreaking study is being done at Boston Children's Hospital that researchers say could potentially predict whether a child as young as 3 months old is at-risk for developing autism.

>> Watch the news report here

Right now, most children can't receive a reliable diagnosis until they are at least 1 year old. 

Chase Minicucci and his mother, Hillary Steele Minicucci, regularly go to Boston Children’s to track his development. Chase seems to be a typically developing toddler, and he’s learning to point and use words to express his needs.

>> Could blood and urine test be used to diagnose autism?

However, Chase has been identified as at risk because his older brother, who is 7, has autism.

“We did the testing, and one day after his 4th birthday … the doctor said, ‘so your son has autism,’” said Hillary Steele Minicucci. 

Hillary and her husband also have a 6-year-old daughter who does not have autism, but autism is more prevalent in boys. 

Research shows one in five children whose siblings have autism will also be on the spectrum. Hillary spent the first year of Chase's life watching his behavior closely and worrying.

“I was literally making myself crazy over it,” she said. 

Hillary was able to find a spot for Chase in a study at Boston Children's Cognitive Neuroscience Lab, involving 99 siblings of children with autism.

Infants as young as 3 months old and toddlers up to 36 months old spend only a few minutes wearing a cap with more than 100 sensors. While wearing it, they watch a T.V. showing cartoons, which is also an eye tracker.

Boston Children's Cognitive Neuroscience Lab Director Dr. Charles Nelson said by studying their EEG signals, the electrical activity in the brain, they can predict which infants are likely to develop autism.

“What we've seen is at 3 months of age, we've seen patterns of brain activity that basically predict who, three years later, will develop autism,” said Nelson. 

>> Read more trending news 

One of the big unknowns is when does autism develop, and Nelson said the study is shining light on whether it happens before or after birth. 

“It's very unlikely that brain development was perfectly normal until birth and then something happened. The fact that we see it so early, just at 3 months, makes me think that it started before birth. But what derailed brain development, we don't know,” he said. 

Dr. Nelson stressed the medical community is not at the point yet where a 3-month-old could receive a diagnosis, but the child could be flagged. The next step is developing early intervention strategies for that age group.

As for Chase, his mother said that right now, he doesn't seem to be exhibiting some of the warning signs, which has given her some much-needed reassurance.

“I can start to enjoy my baby now,” she said. 

The study is ongoing and open to three groups of children: 

  • Babies with older siblings with ASD
  • Babies with no family history of autism who failed an autism screening
  • Typically developing babies
Because the EEG caps are relatively inexpensive, Nelson hopes someday soon every local pediatrician's office could have one and all infants could be identified within a critical window of time.

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Major depression diagnoses on the rise in the U.S., study finds

Published: Monday, May 14, 2018 @ 6:59 AM

10 Signs of Depression

Over the past five years, diagnoses of major depression in the United States have risen by at least 33 percent.

>> On AJC.com: People with depression are more likely to use certain words — here’s how they express themselves

That’s according to a new report from the Blue Cross Blue Shield Association, for which analysts assessed the BCBS Health Index built from billions of claims for more than 41 million commercially insured Americans annually.

>> Read more trending news 

The index, which quantifies how more than 200 diseases and conditions affect quality of life, showed that major depression is the second most significant condition on overall health in America. The first is hypertension, or high blood pressure.

According to the report, those diagnosed with major depression are nearly 30 percent less healthy on average than those without the condition. Such a decrease in overall health may mean a loss of nearly 10 years of healthy life for both men and women.

>> On AJC.com: Why are Americans so lonely? Massive study finds nearly half of US feels alone, young adults most of all

More than 9 million commercially insured Americans in the index are affected by major depression. The rate of diagnosis in the country is 4.4 percent. But while diagnoses are up 33 percent since 2013 overall, the rate is even higher among teens and young adults − 47 percent. For teen girls, specifically, the rate has risen by 65 percent.

"The high rates for adolescents and millennials could have a substantial health impact for decades to come," Trent Haywood, senior vice president and chief medical officer for BCBSA, said in a statement. "Further education and research is needed to identify methods for both physicians and patients to effectively treat major depression and begin a path to recovery and better overall health." 

Analysts also found that overall, women are more than twice as likely as men to be diagnosed with major depression (6 percent compared to 2.8 percent, respectively).

>> On AJC.com: Depressed? Reduce your symptoms with this type of exercise

Geographically, 49 of the 50 states saw rising diagnosis rates between 2013 and 2016. Hawaii was the only state that experienced a slight decline (a rate of less than 2 percent). Communities in New England, the Pacific Northwest and areas throughout the South and Midwest had higher rates of major depression compared to the rest of the country.

Rhode Island had the highest diagnosis rate with 6 percent. However, the authors noted that differences in efforts to screen for major depression can result in varying diagnoses rates across states.

“While major depression is the second most impactful health condition for the nation, it is complicated by an increased likelihood of overlapping diagnoses of other chronic, behavioral health and pain-related conditions,” authors of the report wrote.

In fact, of the 9 million Americans diagnosed with major depression in 2016, only 15 percent were diagnosed with depression alone. Eighty-five percent, according to the analysis, were diagnosed with an additional health condition.

>> On AJC.com: 5 signs you should ask your doctor about depression

In addition to a lower quality of life, those diagnosed with major depression are more likely to use more healthcare services, resulting in more than twice the spending.

It’s important to note that the report’s findings, based on people with BCBS commercial health insurance, are likely an underestimate. Most Americans are covered by a commercial health plan, but many who report symptoms of depression say they have not been diagnosed or received treatment for the condition.

According to the World Health Organization, more than 300 million people of all ages suffer from depression, and it’s the leading cause of disability worldwide.

>> On AJC.com: The suicide rate for teen girls is the highest it’s been in 40 years — Is social media to blame? 

Additionally, approximately 800,000 people die of suicide each year; that’s one person every 40 seconds. In the U.S., between 1999 and 2014, the suicide rate rose by 24 percent. And, according to recent data released from the Atlanta-based Centers for Disease Control and Prevention, suicide rates among 15- to 19-year-old girls doubled between 2007 and 2015, reaching a 40-year high.

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Drowning doesn't look like what you think. How to recognize the signs

Published: Thursday, May 10, 2018 @ 3:43 PM

Dad Recognizes 'Dry Drowning' Symptoms In Son After Reading Viral Story

No yelling, no waving. Just a silent gasping for air and 20 to 60 seconds later, submersion. And someone has drowned, maybe in plain site.

»RELATED: This is how preventable drownings occur. What parents need to know about 'dry' and 'secondary' drowning

"Drowning is not the violent, splashing call for help that most people expect," noted Coast Guard retiree and trained rescue swimmer Mario Vittone in an article that appeared on the Army blog. "To get an idea of just how quiet and undramatic from the surface drowning can be, consider this: It is the No. 2 cause of accidental death in children ages 15 and under, just behind vehicle accidents."

According to the Center for Disease Control and Prevention, about 10 people die from unintentional drowning each day, making it the fifth leading cause of death by unintentional injury in the U.S.

Of the drowning victims who survive, 50 percent of those treated in ERs require further hospitalization or transfer for further care. Nonfatal drowning injuries can cause severe brain damage that leads to long-term disability such as memory problems, learning disabilities and even a permanent vegetative state, the CDC warned.

Some drownings occur simply because people don't realize what they're seeing, according to Vittone. Dramatic, loud drowning is part of our cultural expectation. It's what we've seen on television and in movies, from adventure flicks to “Matlock” episodes − or just insert any sweltering near drowning plot twist here.

5 myths about drowning

In contrast, real life drowning involves what psychologist Francesco A. Pia dubbed the Instinctive Drowning Response. Here are five ways that response differs from myths about drowning:

 Myth 1: Drowning people will yell for you. "Except in rare circumstances, drowning people are physiologically unable to call out for help," Pia noted. "The respiratory system was designed for breathing. Breathing must be fulfilled before speech occurs. The mouths of drowning people are not above the surface of the water long enough for them to exhale, inhale and call out for help."

Contrary to movies and myths, people who are drowning rarely have the capacity to wave or yell and they won't be face down in the water. Instead, look for glassy eyes, hyperventilating or a head low in the water with mouth at water level.(Contributed by MarioVittone.com/For the AJC)

Myth 2: Drowning people will wave wildly. They can't, Vittone said. "Nature instinctively forces them to extend their arms laterally and press down on the water's surface. Pressing down on the surface of the water permits drowning people to leverage their bodies so they can lift their mouths out of the water to breathe."

Myth 3: Someone drowning might be able to assist in the rescue. "Physiologically, drowning people who are struggling on the surface of the water cannot stop drowning and perform voluntary movements such as waving for help, moving toward a rescuer or reaching out for a piece of rescue equipment," Vittone warned. He added an important distinction: "This doesn't mean that a person that is yelling for help and thrashing isn't in real trouble, [only that] they are experiencing aquatic distress," he said. "Aquatic distress doesn't last long, but unlike true drowning these victims can still assist in their own rescue. They can grab lifelines, throw rings, etc."

Myth 4: Drowning takes a while. Unless someone who's drowning in the water is rescued by a trained lifeguard, they'll only be able to struggle on the surface of the water for 20 to 60 seconds before submersion occurs.

Myth 5: Kids who are drowning will make noise. Bystanders and parents should actually be more alert to the kids who seem to be playing quietly, Vittone advised. "Children playing in the water make noise," he reminded. "When they get quiet, you get to them and find out why."

12 real-life signs of drowning

Since you can't expect someone who's drowning to get your attention, here are the things to look for to make sure someone's not quietly drowning in plain sight, according to Vittone and other experts:

  • Head low in the water with their mouth at water level
  • Head tilted back with mouth open
  • Eyes glassy and empty, unable to focus
  • Eyes entirely closed
  • Hair that's flopped over the person's forehead or eyes
  • Not using their legs but vertical in the water
  • Hyperventilating or gasping
  • Trying to swim in a particular direction but not making headway
  • Trying to roll over on their back without success
  • Appearing to be climbing an invisible ladder
As Vittone summed up, sometimes the most common indication that someone is drowning is that they don't look like they're drowning. "They may just look like they are treading water and looking up," he said. "One way to be sure? Ask them, 'Are you all right?' If they can answer at all, they probably are. If they return a blank stare, you may have less than 30 seconds to get to them."

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